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New ‘Trojan horse’ drug kills cancer from inside

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A novel cancer drug which acts as a ‘Trojan horse’ to destroy tumours from the inside has shown promising results across six different forms of the deadly disease, scientists say. In patients with advanced, drug-resistant cancers, over a quarter with cervical and bladder tumours, and nearly 15 per cent with ovarian and lung tumours, responded to the new treatment, said researchers from the Institute of Cancer Research in the UK.

The innovative new drug, called tisotumab vedotin (TV), releases a toxic substance to kill cancer cells from within.

The results, published in The Lancet Oncology, are so positive the drug has now moved forward to phase II trials in cervical cancer and will be tested in a range of additional solid tumour cancers. The researchers led a global clinical trial of nearly 150 patients with a variety of cancer types who had stopped responding to standard treatments. They found that a significant minority of cancer patients responded to the drug, with their tumours either shrinking or stopping growing.

 

The researchers saw responses in 27 per cent of patients with bladder cancer, 26.5 per cent with cervical cancer, 14 per cent ovarian cancer, 13 per cent with oesophageal, 13 per cent with non-small cell lung and seven per cent with endometrial cancer.

Responses lasted an average of 5.7 months, and up to 9.5 months in some patients, researchers said. TV is made up of a toxic drug attached to the tail end of an antibody. It is designed to seek out a receptor called ’tissue factor’ — present at high levels on the surface of many cancer cells and linked with worse survival. Binding to tissue factor draws the drug inside cancer cells, where it can kill them from within.

The trial initially recruited 27 patients to assess safety and establish the right dose, before expanding to a further 120 patients primarily to look at whether the drug was hitting the right target but also at what effect it had on tumours.

The majority of patients in the early trial had advanced stage cancer (spread locally or around the body) that had already been treated with, and became resistant to, an average of three different types of treatment. TV is now being trialled in other cancer types including bowel, pancreatic, squamous cell lung and head and neck, as well as in a phase II trial as a second-line treatment for cervical cancer.

“What is so exciting about this treatment is that its mechanism of action is completely novel — it acts like a Trojan horse to sneak into cancer cells and kill them from the inside,” said Professor Johann de Bono, a professor at the Institute of Cancer Research. “Our early study shows that it has the potential to treat a large number of different types of cancer, and particularly some of those with very poor survival rates,” de Bono said.

“TV has manageable side effects, and we saw some good responses in the patients in our trial, all of whom had late-stage cancer that had been heavily pre-treated with other drugs and who had run out of other options,” he said.

The researchers have already begun additional trials of the drug in different tumour types and as a second-line treatment for cervical cancer, where response rates were particularly high. They are also developing a test to pick out the patients most likely to respond.


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Health

Hepatitis A Causes and Symptoms

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Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:

 

Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.

Symptoms

Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Headaches
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Health

Busting myths around blood donation

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As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.

 

The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Health

Erectile dysfunction’s connection with lifestyle

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By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.

 

DIAGNOSIS OF ED

We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.

SHORT-TERM SOLUTION, LONG-TERM CURE

Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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