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Rare form of skin cancer cured at Cytecare Hospital Bangalore

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Amina, who was suffering from skin cancer, was misdiagnosed in Nigeria

Thirty seven-year old Amina Abubakar was not sure that she will survive after being diagnosed with breast cancer. Amina, who hails from Nigeria is a final year medical student, who was wrongly diagnosed with breast cancer in 2014 in Nigeria while she was actually suffering from skin cancer. After struggling for more than three years, Amina can now breathe easy. Thanks to the treatment that cured her at a city hospital.

She was bed-ridden for more than three years under heavy antibiotics and other cancer treatments. But the last 20 days made her recover miraculously. That is after the doctors removed a 5 kg tumour from her breast. Talking about her condition, Amina said, “I found a lump on the left breast in November 2014 and then was diagnosed as chronic mastitis in local hospital in Nigeria. I have suffered wongdiagnosis and lack of treatment for years. I was physically and mentally broken and was unable to deal with the pain and the foul smell that comes with cancer.”

Unable to find any cure in Nigeria, Amina, whose father was also once treated in a city hospital, decided to travel to Bengaluru.

She adds, “My family and I got very anxious about this situation and on the recommendation of a local doctor decided to visit Dr Anthony Pais at Cytecare for treatment.

” But it wasn’t easy for the city doctors to cure her as the disease was rare. “Skin cancer on the breast and infiltrating it is the rarest of the rare cancers in the world. This was the first treatment for a rare form of skin cancer – Syringocystadeno carcinoma paplliferum, which was diagnosed and treated in the world. It is one such case where the right diagnosis was the game-changer in the treatment of the disease,”claimed Dr Anthony Pais.

He said, “There are two types of skin cancer – melanoma and non-melanoma, most of them being non-melanoma. Among all the non-melanoma skin cancers, 75% of them are basal cell cancers; 20% of them are squamous cell cancers and about 2% of them being adnexal skin tumours. Most of these adnexal tumours are benign. The rarity of this adnexal skin cancer involving the breast is the rarest of the rare cancer. In this case, the problem started with the wart and with a birthmark close by, which is technically called a nevus. This grew over a period of time.”

Amina, who got a new lease of life, will head for Nigeria this Saturday. She will continue a follow-up at a local hospital for a couple of months more.

Curious case of cancer

According to Dr Pais, it is very difficult to know about the disease or diagnose it at an early stage. So, there is no precaution and can’t be prevented. Moreover, it is not genetic. Excessive exposure to sunlight can be one of the reasons. People living near the Equator are more prone this type of cancer as they are exposed to direct ultraviolet rays. One might diagnose this case to be that of a breast cancer which can be followed by unnecessary chemotherapy. The treatment is for the skin cancer arising on the breast infiltrating into it. So, proper surgery and radiotherapy is the answer. People should consider screening if they have any ulcer for more than three months. They should do that in case of moles or itching that appears for a months.

Source: http://bangaloremirror.indiatimes.com/bangalore/others/nigerian-woman-cured-of-rare-cancer-in-city-hospital/articleshow/59276487.cms

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First-line immunotherapy treatment can improve survival for subset of lung cancer patients

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Results of phase III global clinical trial show that 75 percent of stage IV lung cancer patients with both complex tumor mutations and PDL-1 positive status respond to nivolumab.

Findings from a phase III clinical trial for advanced lung cancer patients could help oncologists better predict which patients are likely to receive the most benefit from immunotherapy as a first-line treatment based on the unique molecular characteristics of their tumor, according to a new study reported by a global team led by David Carbone, MD, PhD, of The Ohio State University Comprehensive Cancer — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC — James).

In this study, researchers compared the effectiveness of the immunotherapy drug nivolumab (pronounced “nye VOL ue mab,” marketed at Opdivo), with standard-of-care chemotherapy in 541 patients with previously untreated or recurrent non-small cell lung cancer (NSCLC) that expressed PDL-1 antibodies.

Nivolumab is part of a class of immunotherapy drugs known as PD-1 blocking antibodies. These drugs work by targeting the PDL-1 receptor — a known immunotherapy biomarker for lung and other cancers — to boost immune responses to the cancer.

Patients were randomized to receive either immunotherapy or standard-of-care chemotherapy. About 60 percent of patients treated on the trial ultimately crossed over to the immunotherapy treatment arm due to disease progression.

Results from this new study showed that nivolumab did not result in longer progression-free survival compared with chemotherapy in the overall population. The response rate for patients receiving nivolumab was 26.1 percent, with a 12.1 month median duration of response before disease progression. The response rate for patients treated on the chemotherapy arm was 33.5 percent, but median duration of response was just 5.7 months before disease progression.

“The good news is that we discovered that a subset of patients who had both high tumor mutation burden and high PDL-1 positive status did experience a significant benefit from immunotherapy,” says Carbone.

Patients with both high tumor mutation burden and high PDL-1 positive status had a 75 percent response rate compared with a 16 percent response rate to immunotherapy among patients with low mutation burden and low PDL-1. These same two groups had 25 percent and 23 percent response rates, respectively, when treated with chemotherapy, showing that these markers were selective for immunotherapy.

Understanding a patient’s overall tumor burden through genomic testing, says Carbone, could help identify patients most likely to benefit from immunotherapy before therapy ever begins.

“This study is an important step toward understanding the impact of tumor mutation burden and PDL-1 in immunotherapy response. This data shows we should evaluate these two factors independently to most accurately define who will benefit from immunotherapy,” says Carbone.

The findings are reported in the June 22, 2017, issue of the New England Journal of Medicine.

Source: https://www.sciencedaily.com/releases/2017/06/170621190037.htm

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New discovery may ‘impact treatment of autoimmune diseases’

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Scientists have found a way of “dictating” cell fate to ensure controlled production of helper and regulatory T cells.

A new study has found a way of manipulating the differentiation of T cells in the immune system so as to strike a balance between pro-inflammatory and anti-inflammatory cells. This discovery may have implications for treating autoimmune diseases and some types of cancer.

Autoimmune diseases are triggered when our immune system misidentifies healthy cells as foreign bodies and decides to attack them. In this process, certain cells called “T cells,” which are found in the immune system, are involved.

T cells are of different types and have distinct functions, but their main role is to mediate immune reactions in the body. Some T cells are pro-inflammatory, promoting an immune response, while others are immunosuppressive, regulating the “aggressiveness” of this response.

Autoimmune diseases, as well as some types of cancer such as colorectal cancer and lung cancer, are mediated by certain T cell imbalances in the immune system. These imbalances lead either to anomalous inflammations, or to a lack of reaction, wherein the body is unable to identify pathogens.

Recently, much research has been conducted into a particular type of T cells called “T helper 17” (Th17) cells. Studies have found that Th17 cells can be unstable, thus sustaining autoimmune diseases and mediating some cancers.

A new study led by Dr. Sheng Ding, from the Gladstone Institutes in San Francisco, CA, discovered a way of changing cell fate to determine differentiation either into Th17 cells, which are pro-inflammatory, or into regulatory T cells, which are immunosuppressive.

The researchers published their findings in the journal Nature.

“Our findings could have a significant impact on the treatment of autoimmune diseases, as well as on stem cell and immuno-oncology therapies,” says Dr. Ding.

Chemical compound key to cell manipulation
In this study, experiments were conducted both in vitro (using cell cultures) and in vivo (using mice) to test the effect of a chemical compound called “(aminooxy)acetic acid” (AOA).

The researchers found that AOA is key in “telling” a progenitor cell to specialize into either Th17 or regulatory T cells. This allows for the formation of strategies to help promote cellular balance within the immune system.

Dr. Ding and his colleagues explain that this discovery can have wider implications for cancer and autoimmune disease treatments.

Determining differentiation into regulatory T cells rather than Th17 in the case of autoimmune diseases, for instance, could inhibit the exacerbated inflammatory effect caused by the helper cells.

The researchers are also eager to investigate any potential benefits this strategy might bring to stem cell-driven therapy; regulatory T cells can sometimes be used to prevent the system from rejecting organ transplants.

Dr. Ding and his colleagues now suggest that production of regulatory T cells might also be used to promote immune tolerance of cell transplants. They have also expressed their hope that the same strategy might prove effective – albeit indirectly – in cancer therapy.

“Our work could also contribute to ongoing efforts in immuno-oncology and the treatment of cancer. This type of therapy doesn’t target the cancer directly, but rather works on activating the immune system so it can recognize cancer cells and attack them.” – First author Dr. Tao Xu, Gladstone Institutes

While there is still some way to go in understanding how AOA might best be utilized to make treatments more effective, the researchers suggest that this is the first step in regaining control of faulty immune system mechanisms.


Source: http://www.medicalnewstoday.com/articles/318824.php

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Breast cancer ‘can return 15 years after treatment ends’

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Breast cancer can resurface after remaining dormant for 15 years following successful treatment, a study has found.
Women with large tumours and cancer that had spread to the lymph nodes had the highest 40% risk of it coming back.
Researchers writing in the New England Journal of Medicine said extending treatment with hormone therapy could reduce the risk of it recurring.
Scientists analysed the progress of 63,000 women for 20 years.
All had the most common form of breast cancer.
This is a type fuelled by the hormone oestrogen which can stimulate cancer cells to grow and divide.
Every patient received treatments such as tamoxifen or aromatase inhibitors which block the effects of oestrogen or shut off the hormone’s supply.
Although after five years of treatment their cancers had gone, over the next 15 years a steady number of women found that their cancer spread throughout their body – some up to 20 years after diagnosis.
Women who originally had large tumours and cancer that had spread to four or more lymph nodes were at highest risk of the cancer returning the next 15 years, the study said.
Women with small, low-grade cancers and no spread to the lymph nodes had a much lower 10% risk of cancer spread over that time.

‘Remarkable’

Lead researcher Dr Hongchao Pan, from University of Oxford, said: “It is remarkable that breast cancer can remain dormant for so long and then spread many years later, with this risk remaining the same year after year and still strongly related to the size of the original cancer and whether it had spread to the (lymph) nodes.”
Doctors have long known that five years of tamoxifen reduces the risk of recurrence by about a third in the five years after stopping treatment.
Recent research has suggested that extending hormone therapy to 10 years may be more effective at preventing breast cancer recurrence and death.
Aromatase inhibitors, which only work for post-menopausal women, are believed to be even more effective.
But there are side effects with hormone treatments which can affect patients’ quality of life and cause them to stop taking the pills.
These include menopausal symptoms, osteporosis, joint pain and carpal tunnel syndrome.
Prof Arnie Purushotham, senior clinical adviser at Cancer Research UK, which funded the study, said that since the research began, new drugs had been used to treat breast cancer and those worked in different ways to tamoxifen.
He said: “It’s vital that work continues to better predict which cancers might return.
“We also need to know what the difference for women might be in taking hormone therapies for 10 years instead of five, the side effects and how this affects patients’ quality of life.”
Sally Greenbook, from charity Breast Cancer Now, said it was essential that women discussed any changes in treatment with their doctor.
“We would urge all women who have had treatment for breast cancer not to be alarmed, but to ensure they are aware of the signs of recurrence and of metastatic breast cancer, and to speak to their GP or breast care team if they have any concerns.”

Source: http://www.bbc.com/news/health-41928647

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People who are diagnosed with Hepatitis C would undergo treatment free of cost

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The health ministry has drafted a national action plan for Hepatitis C for ensuring that there is no discrimination on the basis of a patient suffering from Hepatitis and to reduce morbidity and mortality due to the viral disease.
People who underwent surgery or blood transfusion for any reason before 2002 will be screened for Hepatitis C in a new drive by the government.

The step has been initiated, as before 2002, blood samples at the blood banks were not examined thoroughly, a senior health ministry official said.

The screening programme is expected to start from March, the official said.

The number of such people who have undergone surgery or blood transfusion before 2002, ranges between 60 lakh to 1.2 crore.

People who are diagnosed with Hepatitis C would undergo treatment free of cost, he said.

“The population that would be focused include those who received blood transfusion or underwent surgery before 2002, injection drug users, people receiving repeated blood transfusions (thalassemics and hemophiliacs), those living with HIV and attendees of STI clinics, among others,” the official said.

The test facilities are available from primary health centres to district hospitals and the government plans to open 100 more centres for carrying out such tests, he informed.

The ministry has also drafted a national action plan for Hepatitis C for ensuring that there is no discrimination on the basis of a patient suffering from Hepatitis and to reduce morbidity and mortality due to the viral disease.

The action plan is expected to be rolled out this year.

“The objective is to increase awareness and take promotive prevention measures through various stakeholders and to capacitate the health sector response to viral Hepatitis, including early diagnosis, management and surveillance,” the official said.

Viral Hepatitis are mainly of four types — water and foodborne A and E, and bloodborne B and C, and like HIV/AIDS, bloodborne viral hepatitis has stigma attached to it.

According to rough estimates, 6-12 million suffer from Hepatitis C in India, and close to 35,000 people succumb to the infection each year.

Hepatitis C symptoms sometime may take 10 to 12 years to come to the forefront.

Source: http://www.hindustantimes.com/health/those-who-underwent-surgery-transfusion-before-2002-to-be-screened-for-hepatitis-c/story-ZTq0AHYtKGrb3mp6uGk42K.html

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New robotic implant in infants can help treat rare birth defect of food pipe

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Scientists have created a robot which can be implanted into a baby’s body to treat a rare birth defect that affects the food pipe.

The prototype robotic implant, developed by the researchers at Harvard Medical School and Boston Children’s Hospital in the US, encourages tissue growth in babies.

The robot is a small device which is attached to the oesophagus by two rings. An incorporated motor then stimulates the cells by gently pulling the tissue.

Using two types of sensors – one to measure the tension in the tissue and another to measure tissue displacement – the robot monitors and applies tissue traction depending on the tissue properties.

The robot’s function is inspired by the Foker technique of correcting the oesophageal atresia which involves manually pulling the tissue slowly using sutures over a period of time.
“Doctors have been performing the Foker procedure as they realised that tissue lengthening can be achieved by pulling on the tissue,” said Dana Damian, from University of Sheffield.

However, it is unknown how much force should be applied to produce tissue lengthening.

Although the technique is one of the best standards, sometimes the sutures surgeons attach to the oesophagus can tear which can result in repetitive surgeries or scar tissue can form that can cause problems for the patient in the future.

“The robot we developed addresses this issue because it measures the force being applied and can be adapted at anytime throughout the treatment,” said Damian.

“With it being implanted in the patient, it means they have – in effect – a doctor by their side all the time, monitoring them and changing their treatment when needed,” she said.

Oesophageal atresia is a rare genetic disease which affects about one in 4,000 babies born in the US and Europe.

It occurs when the upper and lower parts of the oesophagus do not connect, which means food can not reach the stomach.

Some of these cases are characterised by a gap between three and 10 cm between the oesophageal stubs, called long gap oesophageal atresia.

The treatment of these cases using Foker technique can start as early as three months old and can take months.

Usually, the patient is sedated during the treatment to ensure the sutures in place do not tear.

The study suggests that with this robot, babies would be free to move around and be allowed to interact with their parents while undergoing treatment, taking away some of the stress from both parties.

The implant is powered by a control unit which remains outside of the body, attached to a vest. This means that doctors can monitor the patient without impacting on the baby’s routine.

Source: http://www.dnaindia.com/health/report-new-robotic-implant-in-infants-can-help-treat-rare-birth-defect-of-food-pipe-2576510

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Treatment against blindness to sell for $850,000 in US

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There are currently about 1,000 cases of people who suffer from hereditary degeneration of the retina, and 10 to 20 new cases are expected to be added each year.

Luxturna, a medication against hereditary degeneration of the retina that can lead to total blindness, will be sold for $850,000 in the United States, making it one of the world’s most expensive medical treatments.

It is administered in a single dose, according to its manufacturer, Philadelphia-based Spark Therapeutics.

It will retail for $425,000 per eye, which is less than the $1 million price tag that had been expected before the company received FDA approval in mid-December.

The announcement comes amid a growing debate in the United States over the high cost of medicine, particularly for supposedly innovative treatments.

Anticipating criticism, Spark promised to reimburse patients if the treatment proves not to be effective, and said it expects US health authorities to authorize payment in stages.

In doing so, the company is following the lead of Novartis, which sells Kymriah, a treatment for a very aggressive form of leukemia in children and young adults. The Swiss drug maker has pledged to reimburse insurers and patients if the $475,000 drug doesn’t work.

Luxturna is considered the first American medication to emerge from gene therapy, which consists of repairing a defective gene.

There are currently about 1,000 cases of people who suffer from hereditary degeneration of the retina, and 10 to 20 new cases are expected to be added each year.

Besides Luxturna, several other medications are near the million-dollar price mark, although they are often administered in several doses.

Such is the case with Spinraza (known as Nusinersen in Europe), developed by Biogen and Ionis against muscular dystrophy, and Soliris, made by Alexion Pharmaceuticals to treat a rare form of kidney disease. Both cost around $750,000.

The prize for the world’s most expensive medication goes to Glybera, which its Dutch developer UniQure sells for $1 million as a treatment for several genetic maladies.

Source: https://www.hindustantimes.com/world-news/treatment-against-blindness-to-sell-for-850-000-in-us/story-lqQEuoEE1txBeUPYB3b9KO.html

New hope for patients with hard-to-treat triple negative breast cancer

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A team of researchers has identified a method for treating particularly aggressive forms of breast cancer that could potentially save thousands of lives each year.

According to results from a SWOG clinical trial, those with tough-to-treat triple negative breast cancer, whose tumors also don’t allow for double-strand DNA repair, fare better when treated with a common adjuvant breast cancer chemotherapy combination.

The trial results showed that a well-established drug combination – adjuvant doxorubicin and cyclophosphamide (AC) chemotherapy – works well in this patient population.

The results also showed the value of collecting and preserving cancer tumor tissue. University of Kansas Cancer Center’s Priyanka Sharma and her team used nearly 20-year-old tumour samples stored in SWOG’s biospecimen bank to conduct their analysis.

“We learned three interesting things from this trial,” Sharma said. “First, we showed that assays tested in our study worked well in very old tissue samples. We also learned that 25 % of triple negative breast cancer patients harbored BRCA 1 or BRCA2 mutations and tumors in these patients were HRD positive.”

“However, presence of HRD was not restricted to just patients with BRCA mutations, as among patients without BRCA mutations, 55 % also demonstrated tumor HRD. Finally, and most importantly, we learned that 67 % of triple negative breast cancer patients – a solid majority – respond well to a standard, backbone chemotherapy combination. So, while, AC chemo is an old treatment, for many, it’s still a good one. HRD status is a biomarker that, when identified, can potentially help a physician best tailor a chemotherapy treatment for that particular triple negative breast cancer patient.”

The study is published in Annals of Oncology.

Source: https://www.hindustantimes.com/health/new-hope-for-patients-with-hard-to-treat-triple-negative-breast-cancer/story-Jf5IFZA7Uqpru8d0j3Yu1I.html

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Suffering from cavities? This new technique can treat and rebuild teeth

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Are dental treatments burning a hole in your pocket? Researchers have now designed a convenient and natural product that uses proteins to rebuild tooth enamel and treat dental cavities. “Remineralisation guided by peptides is a healthy alternative to current dental health care,” said lead author Mehmet Sarikaya at the University of Washington.

The new biogenic dental products can — in theory — rebuild teeth and cure cavities without today’s costly and uncomfortable treatments. “Peptide-enabled formulations will be simple and would be implemented in over-the-counter or clinical products,” Sarikaya said.

Cavities are more than just a nuisance. According to the World Health Organization, dental cavities affect nearly every age group and are accompanied by serious health concerns. Additionally, direct and indirect costs of treating dental cavities and related diseases have been a huge economic burden for individuals and health care systems.

“Bacteria metabolise sugar and other fermentable carbohydrates in oral environments and acid, as a by-product, will demineralise the dental enamel,” said co-author Sami Dogan. Although tooth decay is relatively harmless in its earliest stages, once the cavity progresses through the tooth’s enamel, serious health concerns arise. If left untreated, tooth decay can lead to tooth loss.

This can present adverse consequences on the remaining teeth and supporting tissues and on the patient’s general health, including life-threating conditions. Taking inspiration from the body’s own natural tooth-forming proteins, the UW team has come up with a way to repair the tooth enamel. The researchers accomplished this by capturing the essence of amelogenin — a protein crucial to forming the hard crown enamel — to design amelogenin-derived peptides that biomineralize and are the key active ingredient in the new technology. The bioinspired repair process restores the mineral structure found in native tooth enamel.

“These peptides are proven to bind onto tooth surfaces and recruit calcium and phosphate ions,” said Deniz Yucesoy, a co-author. The peptide-enabled technology allows the deposition of 10 to 50 micrometers of new enamel on the teeth after each use. Once fully developed, the technology can be used in both private and public health settings, in biomimetic toothpaste, gels, solutions and composites as a safe alternative to existing dental procedures and treatments.

The technology enables people to rebuild and strengthen tooth enamel on a daily basis as part of a preventive dental care routine. It is expected to be safe for use by adults and children. The research findings have been published in ACS Biomaterials Science and Engineering.

Source: https://www.hindustantimes.com/health/suffering-from-cavities-this-technology-can-help-treat-and-rebuild-teeth/story-KUwPxI92tCm3FRPunV35tJ.html

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Painful bone biopsies will soon be replaced with small credit card-sized chips to treat plasma cancer

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Scientists have developed a low-cost, reliable blood test for multiple myeloma that uses a small plastic chip about the size of a credit card, which could make painful bone biopsies a relic of the past.

The diagnosis and treatment of multiple myeloma, a cancer affecting plasma cells, traditionally forces patients to suffer through a painful bone biopsy, said researchers from University of Kansas in the US.

During that procedure, doctors insert a bone-biopsy needle through an incision to get a bone marrow sample – or make a larger incision and remove a section of bone via surgery.

The blood test, described in the journal Integrative Biology, uses a small plastic chip about the size of a credit card that can deliver the same diagnostic information as a bone biopsy – but using a simple blood draw instead.

“For the last 10 years, we have been developing a blood-based test for a variety of cancer diseases – one of them is multiple myeloma,” said Steven Soper, a professor at the University of Kansas.

“We will be able to eliminate the need for bone-marrow biopsies and allow the clinician to determine the best way to treat the disease using a blood draw,” said Soper.

“From this test, the clinician will be able to determine the stage of the disease, what type of drug will best treat the disease and monitor for signs of recurrence if the disease goes into remission,” he said.

High levels of circulating multiple myeloma cells are linked with more aggressive disease and worse outcomes, so a sensitive test is vital for assessing the state of the disease in a patient and devising the most effective therapy.

“The chip we are using, because it is made from a plastic, can be injection molded, the same method that is used to produce CDs, DVDs and Blu-ray Discs,” Soper said.

“What is really nice is we can produce these chips for a couple of dollars per chip, which makes it really appropriate for testing in a clinical setting,” he said.

The technology could have applications across many cancers, making diagnostics easier for patients and clinicians, and helping usher in more tailored therapies that could improve patient outcomes, researchers said.

Source: http://www.dnaindia.com/health/report-painful-bone-biopsies-will-soon-be-replaced-with-small-credit-card-sized-chips-to-treat-plasma-cancer-2606965

Image source: https://www.m3india.in/contents/news/72767/chip-based-blood-test-could-replace-painful-bone

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