New research has revealed exactly why ovarian cancer spreads to the peritoneal cavity and this means that we could edit existing drugs to stop this from happening.
- There was around 7270 cases of ovarian cancer in the UK in 2015
- In 2016 there was 4227 deaths resulting from ovarian cancer in the UK
- It is estimated that only 35% of people survive ovarian cancer for 10 or more years, 2010-11 in England and Wales
- It is also estimated that 21% of cases of ovarian cancer are preventable
Ovarian cancer is the deadliest form of cancer of the reproductive system, but treatment is currently effective if the cancer is caught early. However this does not happen very often. Unfortunately only 15% of patients present themselves with this form of cancer at an early stage, while 75% of cases are found when the tumour has already spread or metastasized to the peritoneal cavity.
Previous studies of ovarian cancer have demonstrated that in this form of cancer, having a high number of immune cells called macrophages is linked with a worse outcome. However Prof. Kreeger and team looked at whether or not these immune cells enable cancer cells to spread and attach to the peritoneal cavity. They later found that there is a complex system of interactions between healthy cells and cancer cells which helps facilitate the spread of cancer. Normally, the peritoneal cavity is lined cells which form the mesothelium — a slippery, non-sticky surface layer that lines the body’s cavities and internal organs, protecting them. However they found that in ovarian cancer macrophages transform these mesothelial cells into sticky cells that help cancer cells to attach.
This research is likely to cause a significant improvement in treatment of ovarian cancer and although there are already existing drugs, these could be repurposed to inhibit the key aspects of the metastatic process which has been discovered by this study.
“We’re interested in pursuing multiple avenues, because it’s possible one will work better than another,” says Prof. Kreeger. “It’s also possible one will have more tolerable side effects than another.”
There is a newly developed ‘pill on a string’, developed at the University of Cambridge which can help doctors detect oesophageal cancer. This pill is swallowed, and once it has dissolved and travelled down the oesophagus, it forms a ‘cytosponge’ that scrapes off over half a million cells when withdrawn up the gullet, that can be tested for oesophageal cancer. Through scraping off the cells the entirety of the passage of the gullet, it allows doctors to collect cells from all along the gullet, whereas standard biopsies take individual point samples.
This development is potentially a revolutionary investigation and can make a huge difference in terms of investigating patients with potential malignancy or premalignant conditions in the oesophagus, and because this can now be done more simply, more cost effective and now patients are able to be potentially monitored much more easily. Most oesophageal cancers occur in the lower third of the oesophagus. Incidence rates for oesophageal cancer are projected to fall by 3% in the UK between 2014 and 2035, to 18 cases per 100,000 people by 2034. 1 in 55 men and 1 in 115 women will be diagnosed with oesophageal cancer during their lifetime. This discovery is likely to save many lives ultimately and prevent advanced cancer of the oesophagus.
E- cigarettes have always been said to be healthier than normal cigarettes, but is that actually the case? A study has found that these popular devices leak harmful metals, some of them highly toxic.
E- cigarettes work by heating up flavoured liquids which sometimes contain nicotine and rather than releasing smoke, they release aerosols. It has been found that people who use E-cigarettes may have a higher risk of cancer and cardiovascular problems, as well as certain E-cigarette flavours being particularly toxic. Some of the metal comes from the heating of the coils inside the E-cigarette leaking toxic metals which then get into the aerosols that people inhale, however it is not confirmed yet where the other metal comes from.
The metals found which cause for concern are manganese, lead, nickel and chromium, all of which have been linked with important health risks, including cancer, brain damage, and disorders of the respiratory system.
“We’ve established with this study that there are exposures to these metals, which is the first step,” says Rule, adding that there is a “need also to determine the actual health effects.”
For coronary heart disease, men who smoked one cigarette a day had 46% of the excess relative risk for smoking 20 cigarettes a day (53% using only the relative risks adjusted for multiple cofounders). For stroke, men who smoked had 41% of the excess risk for smoking 20 cigarettes a day (64% using multiple factor adjusted relative risks).
For coronary heart disease, women who smoked one cigarette a day had 31% of the excess risk (38% using multiple factor adjusted relative risks). For stroke, women who smoked had 34% of the excess risk for smoking 20 cigarettes a day (36% using multiple factor adjusted relative risks).
As you can see from these statistics, there is not a very large difference at in comparison to how likely someone is to develop either coronary heart disease or stroke who smokes one cigarettes a day to someone who smokes 20 cigarettes a day, which I found very shocking.
As I have touched on in a previous article about over-diagnosis there has been a huge rise in drug resistance, and so as a result we need to develop new antibiotics or improve current antibiotics. Drug resistance is the ability of microbes (e.g. bacteria, viruses, parasites, fungi) to grow in the presence of a drug that would normally kill it or limit its growth. A new study has shown that onions may be able to help us treat drug-resistant tuberculosis.
Tuberculosis is a bacterial infection which is spread through inhaling droplets from the coughs or sneezes of an infected person. It mainly affects the lungs however it can affect any part of the body, including the glands, bones and nervous system. Internationally, tuberculosis which is resistant to the two strongest anti-tuberculosis drugs, affects more than 480,000 people annually.
Dr. Sanjib Bhakta — of the Institute of Structural and Molecular Biology at Birkbeck— and colleagues have identified a number of onion-derived compounds that can kill tuberculosis bacteria. The compounds come from a type of onion ( Allium Stipitatum), known for its antibacterial properties. They then tested the effects of these compounds on various drug-resistant bacteria, including Mycobacterium tuberculosis, which is the bacterial species that causes tuberculosis. They found that the compounds from the onions showed inhibitory effects against several bacteria, and was found to inhibit the growth of Mycobacterium tuberculosis by 99.9%!
This study has the potential to make a big contribution in finding other similar compounds which could be used to inhibit the growth of these drug resistance microbes and ultimately help in largely reducing the effects of these serious diseases.
Should organ donations be in the ‘opt out’ system rather than the ‘opt in’ system?
The way that the ‘opt out’ system works is that rather than people saying that they would like to donate their organs and signing up to it as our current system now says, people will be presumed to want to donate their organs unless they have otherwise expressed a wish not to.
There are many reasons why some people don’t want to donate their organs for example religious reasons and some people many believe that it will affect you in an after life. Others, however, may have a particular desire to be cremated.
On the other hand there are many reasons why people do want to donate their organs. You will be able to save lives. Around 90,000 people are waiting for organ donations every month, and roughly 20 people a month die who could otherwise have been saved by available organs. Through being an organ donor you can help you to save several lives and a single donor can touch the lives of up to 50 people.
So why should we have the ‘opt out’ system? The number of people whose lives could be saved by a transplant is rising more rapidly than the number of willing donors and so this will help provide the much needed organs. As well as this doctors and surgeons can be trusted not to abuse the licence which a change of the law would grant them. Ultimately, we will saving a much greater proportion of lives.
However there are also problems with the ‘opt out’ system. Organ removal without the expressed wish of the deceased could be distressing for his or her family. As well as this the proposed change in the law is open to abuse, with the possibility of death being hastened to secure an organ needed by some other patient. This system leads us to question whether this person is really giving their consent for this happen. The definition of consent is where someone has permission for something to happen or agreement to do something.
Although the opt out system is not explicit consent, are we right to just assume consent?
If you wish to donate your organ, please register to be an organ donor with this link- https://www.organdonation.nhs.uk
The headlines predicted for 2018 by the BBC’s global health correspondent Tulip Mazumdar are-
- Malaria – it is hoped that for 2018, global leaders will see the urgent need to tackle this problem and invest in a drive for malaria elimination.
- Famine- with newer technology and a larger number of resources, we are now able to assist more people in more hard to reach places than ever before, however we are not able to help everyone and with a growing population and global warming affecting crops, a large concern for 2018 is how to minimise the effects of famine.
- Antibiotic resistance – it is becoming increasingly harder to treat people due to the cause developing resistance to the treatment so there will be a much larger drive in order to overcome this. Check out my post on overdiagnosis for some more information on this!
Some medical advances we can hopefully expect for 2018 are-
- Drones distributing medicine to isolated areas
- Diseases to be cured through gene editing– CRISPR
- Artificial pancreas for diabetes
- Amyotrophic lateral sclerosis (ALS) patients will be able to communicate with their thoughts
- Enhanced post surgery recovery – hospitals are looking into post-operative nutrition plans and alternative methods to pain medication to speed up the recovery time
- The first human head transplant
- Next generation vaccines- freeze drying vaccinations so they can be transported to remote areas more effectively and investigation into faster ways to manufacture vaccinations to make them more readily available
- More targeted, precise breast cancer therapies
Wishing you all the best for 2018
With a recent boom of photoshopped images of 6 ft perfect models spiralling the internet, it is likely to influence the way that we think about ourselves and our own appearance, but from how young are people experiencing this body dysmorphia and how early on is this affecting their eating?
Eating disorders include a range of conditions that can affect someone physically, psychologically and socially, and are noticeably affecting much younger people in particular female, with social media playing a large role in this. The most common eating disorders are: anorexia nervosa, bulimia and binge eating disorder. An eating disorders accompany behaviours such as restricted eating, binge eating, excessive exercise, vomiting and laxative use, which in turn often lead to other health problems. Although there are many physical problems which can occur with an eating disorder, the psychological effect is not often considered as much. It can cause substantial psychological consequences for example a low mood, low self esteem, suicidal ideation and behaviour, social withdrawal, irritability, increased anxiety and rigidity of thinking.
Treatment for eating disorders is available but it is important to make sure that the person affected wants to get better, and the support of family and friends is invaluable.
- self-help manuals and books,
- cognitive behavioural therapy (changing how a person thinks about a situation which will change how they act)
- interpersonal psychotherapy (focuses on relationship-based issues)
- dietary counselling
- psychodynamic therapy or cognitive analytic therapy (focuses on how a person’s personality and life experiences influence their current thoughts, feelings, relationships and behaviour)
- family therapy
- medication, for example a type of antidepressant called selective serotonin reuptake inhibitors may be used to treat bulimia nervosa or binge eating
Eating disorders are becoming much more common in this time and it is important of us not to turn a blind eye to this issue and to not underestimate the seriousness of it, and to seek a professionalshelp when needed.
With the aim to diagnose, treat and help people, there is evidence to show that ‘overdiagnosis’ plays a much larger role in this than it should. Overdiagnosis is when a person is labelled or treated for a disease however the disease would not actually cause them significant harm and can lead to the overuse of further tests and treatment.
For example over 500 000 people are estimated to have received overdiagnosis for thyroid cancer across 12 countries in the last 20 years. This leads them to often having surgery and lifelong medication which is not actually needed in the first place.
Some of the key points to do with over diagnosis include:
- Interest is growing in tackling the problems of overdiagnosis and over treatment
- Possible drivers and potential solutions arise across five inter- related domains: culture, the health system, industry and technology, healthcare professionals, and patients and the public
- More work is needed to develop and evaluate interventions aimed at preventing overdiagnosis
- Raising public awareness of overdiagnosis is a priority
-BMJ 23rd September 2017, 358:421-462 No 8122 / CR ISSN 0959-8138
A main reason for this overdiagnosis is that there are many fears of uncertainty, ageing, death and disease, and in many cultures people believe that in healthcare ‘more is better’, when this is not necessarily always the case.
Possible solutions for this include public awareness and education campaigns to challenge this common belief in healthcare that ‘more is better’. Another possible solution for this is through bringing in incentives for medical professionals to be rewarded based on the quality of their care rather than the quantity of their care.
I understand that the intentions of medical proffessionals are to do what is best for us and that we are brought up in a culture which believes that doing ‘something’ in healthcare is better than doing ‘nothing’, and in the majority of cases this is true. However I also think that it is important that this issue of overdiagnosis is addressed and people are made aware of it so that they can be cautious of the medical treatment that they do received and are fully informed on the extent to which their conditions need to be treated.
5 Reasons why coffee is good for you
- It boosts your mood– a study found that woman who drank four or more cups of coffee every day were 20 percent less likely to suffer from depression, coffee drinkers were half as likely to attempt suicide
- Helps ward off diabetes– people who drink a lot of coffee are less likely to develop type 2 diabetes than people who drink smaller amounts, or no coffee at all, according to some studies due to it containing ingredients that lower blood sugar
- Protects Your Heart- Two or more cups of coffee each day could protect against heart failure, according to one Harvard Study
- Good for Parkinson’s– studies have shown that the caffeine in coffee could help people who have Parkinson’s disease manage their uncontrollable movements. Others have shown that having a higher intake of coffee is associated with a lower risk of Parkinson’s altogether
- Lends You a Longer Life– a study that accounted for poor lifestyle habits (eating red meat and skipping exercise, for instance), found that those who drank at least one cup of coffee each day lowered their risk of dying from lifestyle-related health problems over the period of a decade
5 Reasons why coffee is bad for you
- The acidity of coffee is associated with digestive discomfort, indigestion and heart burn
- The caffeine in coffee increases your stress hormones. The stress response elicits cortisol and increases insulin. Insulin increases inflammation and this makes you feel lousy
- Addiction is often an issue with coffee drinkers and makes it really difficult to rely on the body’s natural source of energy
- It reduces fertility – according to some research it can prevent the full development of eggs
- It may cause cancer– emerging research has found that coffee contains acrylamide- a known carcinogen
There are more research and resources that are available to us that suggest coffee has more benefits rather than negative consequences, and so like most things in life, it is probably best to just drink it in moderation!