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Radiotherapy may cut lymphoedema risk

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Radiotherapy to the armpit instead of surgery may cut lymphoedema risk in some breast cancer patients, early trial results suggest.

Lymphoedema is swelling of the arm or armpit that can happen after surgery to remove lymph nodes.

New findings suggest axillary radiotherapy may be as effective at killing any remaining cancer cells while being less likely to trigger this complication.

The results come from the pilot phase of a phase III randomised international clinical trial looking at whether axillary radiotherapy has a lower risk of lymphoedema than axillary lymph node dissection in breast cancer patients who have had chemotherapy or hormone therapy before surgery, and whose cancer has spread to only one or two lymph nodes.

The trial will also assess overall survival and disease-free survival.

The researchers stressed that these are preliminary results from two years of follow-up in the pilot study, and that clinicians should wait for results from the ongoing phase III trial before considering changes to clinical practice.

Amparo Garcia-Tejedor, from the Functional Breast Unit at Bellvitge University Hospital in Spain and the Institut Català d’Oncologia, is leading the trial.

She said studies had already shown that axillary radiotherapy was a good alternative to axillary lymph node dissection in patients whose first line of treatment was surgery.

She said: “In situations where patients have received chemotherapy or hormone therapy before surgery, it is expected that results could be similar. However, robust prospective data are not yet fully established or published.

“Many patients treated with neoadjuvant therapy experience a significant reduction in axillary disease burden and ultimately present with only one or two lymph nodes that are positive for cancer metastases, which often correspond to the sentinel lymph node, while the remaining axillary nodes are negative.

“This observation strongly suggested that further axillary surgery might be unnecessary in a substantial proportion of patients and that a strategy of de-escalation should be explored.”

From June 2021 to April 2023, the ADARNAT trial recruited 272 breast cancer patients whose disease might have spread to one or more lymph nodes.

The patients had received neoadjuvant therapy and, at the time of surgery, had metastatic cancer in one or two sentinel lymph nodes, the lymph nodes where cancer typically spreads first.

Patients were randomised to receive either axillary radiotherapy or axillary lymph node dissection, and patients in both groups also received radiotherapy to areas of the breast and chest. Results were available for 46 patients in the radiotherapy group and 56 in the surgery group, with a median follow-up of two years.

No cancer recurred in the axillary area in the radiotherapy group, compared with one recurrence in the surgery group, or 1.8 per cent.

Cancer spread to other parts of the body in 4.4 per cent of radiotherapy patients and 5.5 per cent of surgery patients, and there were two deaths in the surgery group, or 4.3 per cent.

Lymphoedema was more common after surgery, at 26.7 per cent, than after radiotherapy, at 18.9 per cent, although the researchers said this difference was not statistically significant. Disease-free and overall survival rates were similar after two years.

Garcia-Tejedor said: “These results indicate that ART instead of ALND is feasible and has good cancer outcomes at two years.

“While some specialists have already begun to substitute axillary lymph node dissection with axillary radiotherapy without waiting for definitive results, the only way to determine with certainty whether this strategy is truly safe and effective is through participation in a well-designed clinical trial such as the one we are now conducting.

“This is particularly important given that the study population includes patients with residual axillary disease and, therefore, a potentially worse prognosis.

“In this context, treatment decisions should not be made without robust evidence.

“Our trial is designed to provide the necessary data to definitively answer this question and to ensure that any future change in standard practice is safe in terms of cancer outcomes and is also beneficial for patients.”

Maria Laplana-Torres, a radiation oncologist at the Hospital Clínic de Barcelona, presented pilot-phase results showing that although axillary radiotherapy was linked to more skin damage from radiation, this was usually temporary and easily treated.

Acute skin damage of grade 2 or above occurred in 27.8 per cent of radiotherapy patients compared with 13.3 per cent after surgery.

It mainly involved skin redness, pigment changes or, in some cases, skin peeling. There were no significant differences in later skin damage between the two groups.

She said: “Some patients experienced mild, temporary difficulty raising the arm above the shoulder or lifting it to the side. These limitations were usually short-lived and did not affect everyday activities.

“We found that treating the axilla with radiotherapy instead of extensive surgery can avoid a more aggressive operation without compromising treatment safety in patients with sentinel lymph node involvement.

“One and two years after treatment, there were no meaningful differences in arm mobility or quality of life between the two groups, although there was a more favourable trend in the ART patients.

“These results show that axillary radiotherapy may be a safe and less invasive option for some women treated with chemotherapy or hormone therapy before surgery.’

“This kind of research is essential to continue improving patient outcomes and to define safer, equally effective therapeutic approaches.”

More than 500 patients have now joined the main phase III trial. The researchers estimate that about three more years will be needed to complete recruitment, followed by five years of follow-up to fully assess cancer outcomes.

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Why the UK’s fertility rate keeps falling – and what it means if you’re trying now

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Article produced in association with Spital Clinic

The UK’s fertility rate has fallen for a third consecutive year to the lowest level ever recorded. That headline gets written every year, and it is easy to read it as a purely demographic story.

For anyone currently trying for a baby, the figure is something more practical: the conditions that produced the statistic are the same conditions shaping your own chances.

The decline has a clear pattern, and it is mostly not about couples being unable to conceive.

The change sits in when people start trying, and in what happens to fertility during the years by which most are now ready to have children.

What the numbers actually show

Figures from the ONS put the total fertility rate in England and Wales at 1.41 children per woman in 2024, down from 1.42 in 2023. The rate has been in overall decline since 2010 and has now recorded its lowest value three years running.

The figure sounds abstract until you compare it with the replacement level of 2.1 – the rate required for a population to sustain itself without net migration.

The UK has been below that line since the early 1970s, but the gap is now wider than at any point on record.

The data also shows where the decline is happening. Age-specific fertility rates for women in their twenties are the lowest of any generation since 1920. Rates for women in their thirties are holding up, and in some parts of the country rising.

Mothers are having babies later, not necessarily in smaller numbers. The average age of a first-time mother in England and Wales is now 31.0, up from 30.9 the year before. Regional variation matters too: London sits at 1.35, the West Midlands at 1.59.

Why the rate is falling

None of this is new. Every decade since the 1970s has seen the same trend, and it has accelerated in recent years. What has changed is the pace.

The shift is primarily social: delayed partnership formation, high housing costs, expensive childcare, and careers structured around full-time work through the exact years fertility is easiest.

The same pattern shows up across the EU, where the total fertility rate sat at 1.5 in 2022.

These forces compound. People meet later, partner later, feel financially ready later, and start trying later.

For many couples, first attempts happen in the early thirties, by which point fertility has begun its slow and uneven decline. A low national TFR is the population-level consequence of millions of individual timing decisions made under real-world constraints.

What this means for individuals trying now

Around one in seven couples in the UK will struggle to conceive naturally.

That figure has been stable for decades; the population of people seeking help, however, has grown – not because fertility itself has worsened, but because more people are trying during the window where it becomes harder.

UK fertility treatment data from the HFEA shows around 52,400 patients had over 77,500 IVF cycles in 2023, making 1 in every 32 UK births IVF-conceived.

The average age of a first-time IVF patient in the UK is now just over 35 – nearly six years older than the average first-time mother in the population overall.

NHS-funded IVF cycles have fallen from 40 per cent of the total in 2012 to 27 per cent in 2022, and to 24 per cent in England in 2023. The private sector has absorbed the rest.

When to get checked – and what it involves

Current NHS advice is to see a GP after a year of regular unprotected sex without a pregnancy, or sooner if you are 36 or older.

That threshold reflects the fact that every additional six months of trying is more clinically informative in the years when fertility is starting to shift.

The first set of investigations is usually straightforward.

For women, this typically covers hormone testing (AMH, FSH, LH, TSH and prolactin), rubella immunity, chlamydia screening, a mid-luteal progesterone and a transvaginal ultrasound.

For men, a semen analysis is the first step.

A private trying-to-conceive screening covers the same ground without the NHS waiting list, with the advantage that results can be reviewed in a single consultation.

The purpose of early screening is not to diagnose infertility – most couples conceive naturally within a year or two – but to identify specific, treatable issues before more time passes.

The fertility window is narrower than most people think

The uncomfortable truth behind the falling TFR is that the biological fertility window has not changed. The subtle decline begins around age 32, and accelerates from the late thirties.

The chance of natural conception in any given month is substantially lower at 40 than at 30, and falls sharply through the early forties.

IVF success rates track the same curve.

For patients aged 18 to 34, the average birth rate per embryo transferred was around 35 per cent in 2022; for those aged 40 to 42, around 10 per cent using their own eggs.

This is why the growth areas in UK fertility care are now pre-conception screening and elective egg freezing – HFEA data shows egg storage cycles rose from 4,700 in 2022 to 6,900 in 2023, one of the fastest-growing treatments in the sector.

A focused fertility consultation earlier in the timeline – in the late twenties or very early thirties, before there is a known problem – tends to produce better decisions than a consultation triggered by a year of trying without success.

The wider picture

The UK’s falling fertility rate is the product of a society that has reorganised when people have children, not one in which couples have become less capable of conceiving.

There is no need for alarm in that finding. The practical takeaway is that the old default of ‘wait and see’ assumes a timeline no longer matching the one most people now live.

For anyone currently trying, or planning to try soon, the single most useful move is to understand your own numbers earlier than previous generations did.

The national trend is not going to reverse quickly.

A clear picture of your own fertility window – and the information to use it well – is within reach in a way the headline statistics are not.

If you are trying to conceive or thinking about starting, a structured pre-conception review is a reasonable first step.

Disclaimer: This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published NHS, ONS and HFEA data as at April 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article. This piece was produced in association with Spital Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

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Condé Nast to close women’s health magazine after 47 years

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Condé Nast will close its women’s health publication Self after 47 years, with unprofitable editions of Glamour and Wired also set to shut.

In a memo published on the magazine giant’s website on Thursday, the media company’s chief executive, Roger Lynch, said: “As audience behaviours shift, we have not seen a path for Self to continue in its current form as a digital publication.”

“Going forward, health and wellness content will be integrated into our other brands, including Allure and Glamour,” Lynch said, referring to Condé Nast’s other beauty and wellness titles.

Self, which moved to an online-only format in 2017, still reaches more than 20m people each month.

The publication has also earned significant recognition over the years, including a National Magazine award and a Webby’s People’s Voice award.

The closure is part of a wider set of operational changes across the company. Lynch also announced the end of Wired’s Italy edition, noting that while the brand “remains a strong global brand, the Italian edition has not kept pace with growth in our other markets”.

Condé Nast will also wind down Glamour’s publishing operations in Germany, Spain and Mexico.

Lynch said: “Taken together, Wired in Italy, Self and the affected Glamour markets represent a little over 1 per cent of our overall revenue.

“They also remain unprofitable, and continuing to operate them in their current form limits our ability to invest in the ideas and areas that will drive future growth.”

Beyond editorial changes, the company is also restructuring internally to adapt to technological shifts.

Lynch said Condé Nast would make “changes within our technology organisation, reflecting the rapid advancement of AI and its impact on our ability to innovate and build products faster”, adding: “Teams will be restructured to be more agile and to work more closely with our brands and customers, reducing barriers to execution.”

The latest moves follow a series of transformations at Condé Nast in recent years.

Glamour ended its print edition in 2018, followed by Allure moving to a digital-only format in 2022.

In 2024, music publication Pitchfork was folded into GQ, the company’s men’s style magazine.

More recently, last November, Vogue, one of Condé Nast’s key revenue drivers, announced it would absorb Teen Vogue to create a more “unified reader experience across titles”.

The media industry has been shrinking steadily over the years.

From 2010 to 2017, the industry lost an average of 7,305 jobs annually, according to data from Challenger, Gray & Christmas published in December 2025.

Since 2018, the average number of job cuts in the industry has risen to 14,298 a year.

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GSK ovarian and womb cancer drug shows promise in early trial

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GSK said its ovarian cancer drug shrank or cleared tumours in more than 60 per cent of patients in an early trial as CCO Luke Miels pushes faster development.

The company said that in an early-stage trial, Mocertatug Rezetecan, known as Mo-Rez, shrank or eliminated tumours in 62 per cent of patients with ovarian cancer after chemotherapy had failed, and in 67 per cent of those with endometrial cancer.

Hesham Abdullah, GSK’s global head of cancer research and development, said: “Treatment of gynaecological cancers remains a major challenge, with a pressing need for new therapies that offer improved response rates.

“With Mo-Rez we now have compelling evidence of a promising clinical profile.”

GSK acquired the Mo-Rez treatment, an antibody-drug conjugate, from China’s Hansoh Pharma in late 2023 and has trialled it in 224 patients around the world, including the UK, over the past year.

Only a few patients needed to stop treatment because of side effects, the most common being nausea.

It is given every three weeks by intravenous infusion, meaning directly into a vein.

Combined with data from a separate intermediate trial in China, the results have given the British drugmaker the confidence to go straight to late-stage trials, with five clinical studies planned globally in the next few months, including on patients in the UK.

Speaking to journalists before the conference, Abdullah described Mo-Rez as a “key asset” in the company’s growing cancer portfolio.

It is expected to be a blockbuster drug, with peak annual sales of more than £2bn, which GSK hopes will help it achieve its 2031 sales target of £40bn.

A few years ago GSK did not have any cancer drugs on the market, but it now has four approved medicines and 13 in clinical development.

Last year, oncology generated nearly £2bn in sales, up 43 per cent from 2024, with sales of its endometrial cancer drug Jemperli rising 89 per cent.

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