The key to stopping breast cancer returning: Scientists identify 'Achilles heel' of condition in landmark discovery

The 'Achilles heel' of breast cancer cells has been identified, according to scientists.

A study has shed light on why the disease can return years after women appear to be free of it.

Many invasive forms of breast cancer have too much of the protein HER2 on the surface of the cancerous cells, which leads to uncontrolled growth.

HER2 is present in all human cells, but unusually high levels are found in about one in five breast and stomach cancers, known as HER2-positive types.

The cancer drugs Herceptin and Perjeta – the brand names for trastuzumab and pertuzumab, respectively – recognise HER2 but they do not kill off the cancerous cells. Instead, they only render the cells dormant, which means they can become active again at any time.

This means many women can appear to be 'cured', only for their cancer to re-awaken years later.

In a study published in Nature Communications, researchers from Zurich University aimed to find out why these drugs merely slow the growth of tumours, rather than destroy them.

HER2 uses several signalling pathways at the same time to inform a cell that it should grow and divide. Currently available drugs block only one of those signalling pathways, while others remain active.

But now scientists believe they have developed a method to switch off all the signals, using a protein compound that binds to HER2 and changes its structure.

This prevents any growth signals being transmitted to the cell's interior, causing the cancer cell to die.

Crucially, the technique targets only cancer cells, leaving healthy ones unharmed.

Professor Dr Andreas Pluckthun, of Zurich University, said: 'Now that we have identified the Achilles heel of HER2-positive cancer cells, new opportunities are opening up for treating invasive tumour types like breast cancer more effectively in the future.'

Meanwhile, separate research has shown that up to 1,200 patients with one of the deadliest types of cancer could survive for at least five years using a different method of treatment.

It reveals that offering a combination of two chemotherapy drugs for pancreatic cancer is far more effective than one on its own.

Scientists from Liverpool University studied 732 patients who underwent surgery followed by chemotherapy at hospitals in the UK, Germany, Sweden and France.

About half were offered the standard chemotherapy of gemcitabine alone and half were offered a combination of gemcitabine and capecitabine.

The study – which will be presented at the American Society for Clinical Oncology cancer conference – shows 29 per cent of patients given the combined drugs lived at least five years, compared with only 16 per cent of patients given just gemcitabine. It suggests about 1,200 patients a year could benefit from the technique.

The findings were so compelling they have prompted experts to change the treatment guidelines for pancreatic cancer. From now on, doctors will be told to offer both chemotherapy drugs.

Pancreatic cancer is one of the deadliest forms and there are 9,400 new cases and 8,800 deaths in the UK each year.

Professor John Neoptolemos of Liverpool University said: 'This important trial shows that this drug combination could give pancreatic patients valuable extra months and even years and so will become the new treatment for patients with this disease.

'The difference in short-term survival may seem modest, but improvement in long-term survival is substantial for this cancer.

'Although pancreatic cancer is difficult to treat, finding drugs that will shrink the tumour enough to make it suitable for surgery will help in the fight against this disease.

'We've learnt a lot about pancreatic cancer from our clinical trials and now this drug combination will become the new standard of care for patients with the disease.
'
Cancer Research UK's Professor Peter Johnson said: 'Nearly 10,000 people are diagnosed with pancreatic cancer each year in the UK and it remains a very difficult disease to find and treat. Despite this we are making steady progress through trials like this one, where the use of better chemotherapy after surgery was able to increase the number of people surviving the disease.'

Smoking during pregnancy raises the risk of the baby developing schizophrenia in later life

Mothers-to-be who smoke during pregnancy increase the risk of their children developing schizophrenia, a study has revealed.

Researchers found that the more women were exposed to nicotine the greater chance they had of having a child affected by the severe mental illness.

Signs of heavy nicotine exposure in a mother's blood were associated with a 38 per cent increased likelihood of the condition.

Scientists analysed data on 1,000 schizophrenia patients and matched their birth and health records with those of non-affected 'control' individuals.

They assessed their smoking habits by looking at levels of a nicotine marker, cotinine, in their blood.

Based on this measurement, 20 per cent of mothers of schizophrenia patients were found to have smoked heavily while pregnant, compared with 14.7 per cent of mothers of controls.

Smoking when expecting is known to contribute to significant problems in the womb and following birth, including low birth weight and attentional difficulties.

Nicotine is known to cross the placenta easily and enter the foetal bloodstream, leading to neurodevelopmental abnormalities.

Senior researcher Professor Alan Brown, from the University of Columbia, New York, said: 'To our knowledge, this is the first biomarker-based study to show a relationship between foetal nicotine exposure and schizophrenia.'

Women participating in the study had been recruited into the Finnish Prenatal Study of Schizophrenia.

Blood tests were carried out during the first and early second trimesters (three month periods) of pregnancy.

Professor Brown said: 'These findings underscore the value of ongoing public health education on the potentially debilitating, and largely preventable, consequences that smoking may have on children over time.'

Further studies could shed light on exactly how nicotine affects a foetus' brain, he added.

'Finally, it is of interest to examine maternal cotinine in relation to bipolar disorder, autism, and other psychiatric disorders. '

In a previous study, Professor Brown and his colleagues showed that offspring of mothers who smoked while pregnant have an increased risk of bipolar disorder.

The research was published in the American Journal of Psychiatry.

Fear that Malaria Parasite is Mutating

Currently-effective treatment programs could be endangered across the world

By Asia Sentinel

As was probably inevitable, the parasites carried by mosquitos in Southeast Asia are mutating genetically to become resistant to the most popular drug used to combat malaria, according to a study in the New England Journal of Medicine, causing deep concern that heretofore-effective malaria treatment programs could be endangered, both in Asia and Africa.

The World Health Organization reported in 2010 that 219 million documented cases of malaria were recorded across the world, killing 660,000 to 1.2 million people, many of them children in Africa. The actual number is not known given that many cases in rural areas are undocumented.

Resistance to artemisinin, the main drug used to treat malaria, is now widespread throughout Southeast Asia, particularly in areas of Cambodia, Myanmar, Thailand and Vietnam, according to the study, conducted by an international team of scientists including those from the National Institute of Allergy and Infectious Diseases in the United States. It now takes a six-day course to combat malaria instead of the standard three-day course, according to the study,

Although that is likely to be a temporary solution. The history of mutation of parasites is grim. Poor drug compliance during treatment can lead to failure to fully clear a malaria attack, allowing the remaining parasites, which were less susceptible to the drug, to survive and reproduce. As the infected persons are bitten by new generations of mosquitoes, the hardier disease spreads. As parasites’ life cycles are short, with successive generations natural selection leads to the evolution of strains of new, resistant parasites. Mass drug administration programs in areas where malaria is endemic may also give people doses of the drug that are too low to kill the parasite. If treatment of ill patients fails for some reason, they retain parasites in their blood which can carry on reproducing.

Quinine was the first effective western treatment for malaria, remaining the drug of choice and leading to the famed gin and tonic highball. It was introduced by the army of the British East India Company after it was discovered in the 1700s that quinine could be used to prevent and treat the disease, although the bitter taste was unpleasant. British officers in India took to adding a mixture of water, sugar, lime and gin to the quinine. In the 1940s other drugs such as chloroquine, with fewer unpleasant side effects, replaced it.

Chloroquine was replaced by sulphadoxine-pyrimethamine (SP), but resistance to SP also emerged in Western Cambodia and spread to Africa. SP was replaced by ACTs, and now there are concerns that history will repeat itself for a third time.

According to a report by the National Institutes of Health, artemisinin was regarded as something of a wonder drug. It was used by Chinese herbalists for the treatment of skin diseases as well as malaria going back to 200 BC. In the 1960s, the People’s Liberation Army established a screening research program to attempt to find a malaria treatment program that would rid its soldiers of the debilitating disease, Of a list of nearly 5,000 traditional Chinese medicines, scientists discovered that artemisinin, found in the leaves of wormwood trees, could be extracted and subjected to purification. A number of other products were found by Chinese scientists to be used in combination with artemisinin.

The drug was widely distributed and was considered to be an effective treatment. However, the parasite, Plasmodium falciparum, appears to have mutated genetically, according to the New England Journal of Medicine study, threatening treatment programs. The study, which analyzed blood samples from more than 1,000 malaria patients in 10 countries across Asia and Africa, found that artemisinin resistance in P.falciparum - the most deadly form of malaria-causing parasites – is now firmly established in western and northern Cambodia, Thailand, Vietnam and eastern Myanmar. There are also signs of emerging resistance in central Myanmar, southern Laos and northeastern Cambodia, the study said.

“It may still be possible to prevent the spread of artemisinin-resistant malaria parasites across Asia and then to Africa by eliminating them, but that window of opportunity is closing fast,” Nicholas White, senior author of the study and Chairman of Mahidol Oxford Tropical Medicine Research Unit (MORU), told reporters. “Conventional malaria control approaches won’t be enough – we will need to take more radical action and make this a global public health priority, without delay."

“Frontline ACTs are still very effective at curing the majority of patients. But we need to be vigilant as cure rates have fallen in areas where artemisinin resistance is established,” said Elizabeth Ashley, lead scientist of the TRAC study and a clinical researcher at MORU. “Action is needed to prevent the spread of resistance from Myanmar into neighboring Bangladesh and India.”

“If resistance spreads out of Asia and into Africa much of the great progress in reducing deaths from malaria will be reversed,” said Jeremy Farrar, Director of the Wellcome Trust in a prepared news release. “Our ability to respond to these rapidly emerging health problems depends on swift gathering of evidence, which can be quickly translated into public health and clinical interventions that are then implemented. Antimicrobial resistance is happening now. This is not just a threat for the future, it is today's reality.”

While new antimalarial medicines are in development, and another paper published in the New England Journal of Medicine has shown some promising trial results for a potential new antimalarial drug in development at Novartis, they are unlikely to be available for widespread distribution for several years, according to the group. “The artemisinin drugs are arguably the best antimalarials we have ever had. We need to conserve them in areas where they are still working well,” Ashley concluded.

Subra: Medical fee cap to protect public

Health Minister Dr S Subramaniam says competition among private healthcare providers will reduce costs.
UPDATED

PUTRAJAYA: The fee hike for private healthcare costs is done in order to protect public interest, Health Minister Dr S Subramaniam said today.

He said the fee amendments under the 13th Schedule of the Private Healthcare Facilities and Services (Privates Hospitals and Other Private Health Facilities) Regulations 2006 would make private healthcare providers compete among themselves to provide better services.

“Under the revised fee, action can be taken against doctors who charge more than what is proposed in the schedule,” he said, adding the ministry was instructed to review the prices in 2010.

Subramaniam added that the 14% rate hike for private medical and dental practitioners was done after studying the consumer price index (CPI) for healthcare between 2002 and 2010.

“In my experience, the public will avoid any clinics which charge high fees. Thus, I believe the private hospital would not impose the maximum charges,” he said.

The revision included a spike in consultation charges from between RM10 and RM35 to RM30 and RM125 for general practitioners, and from between RM30 and RM125 to RM80 and RM235 for specialist doctors.

Fees for medical procedures have soared between 14% and 18%.

Dr Subramaniam said the Health Ministry reviewed the 13th schedule on Sept 22, 2010.

Fees for consultation and medical procedures have not been revised since 2002 and is considered low compared to other nations.

“Consultations and meetings were held. We established two committees and a working group. We then forwarded the proposal to the cabinet which approved the amendment to the 13th schedule on Oct 12, 2012,” he added.

The amended schedule fee structure, was presented to the Attorney-General’s chambers on April 29, 2013 and gazetted on Dec 16 after the cabinet’s approval.

The minister also assured Malaysians that the fee structure would not be amended again, at least for another three to four years.

“It was just gazetted last year. The people need not to worry about the increase of the fees after this,” he added.

Warga asing kena bayar kos sebenar perubatan, kata Subramaniam

Dengan pelaksanaan langkah tersebut, kerajaan mampu menjimatkan sehingga RM100 juta setahun

PUTRAJAYA: Warga asing bakal dikenakan bayaran kos perubatan sebenar di klinik dan hospital kerajaan tidak lama lagi, kata Menteri Kesihatan Datuk Seri Dr S.Subramaniam.

Beliau berkata pada masa ini warga asing termasuk pekerja dan pelajar yang mendapatkan rawatan di klinik dan hospital kerajaan menikmati subsidi perubatan antara 30 hingga 40 peratus.

“Dengan pelaksanaan langkah tersebut, kerajaan mampu menjimatkan sehingga RM100 juta setahun yang wang itu boleh digunakan untuk meningkatkan lagi mutu perkhidmatan kesihatan dan perubatan di negara ini,” katanya pada sidang media selepas menghadiri perhimpuan bulanan kementerian itu di sini hari ini.

Beliau berkata kementerian sedang memuktamadkan kos tersebut sebelum dikuatkuasakan.

Beliau turut melancarkan logo rasmi kementerian dengan moto ‘Kami Sedia Membantu’ yang akan diguna pakai bagi jabatan, institusi, unit dan agensi kesihatan selain urusan surat menyurat dan portal kementerian.

Dr Subramaniam berkata di beberapa negara Eropah seperti United Kingdom, warga asing perlu memiliki polisi perubatan sendiri yang jika tidak mereka terpaksa menanggung segala kos perubatannya.

Beliau berkata oleh itu rakyat perlu menghargai perkhidmatan kesihatan kerajaan yang memberikan subsidi kepada mereka sehingga 98 peratus.

Sementara itu beliau berkata kerajaan memperuntukkan RM1.9 bilion tahun ini bagi pembangunan hospital dan klinik di seluruh negara merangkumi kos pembinaan blok tambahan baharu dan kerja-kerja menaik taraf.

“Kita cuba menyelesaikan seberapa banyak masalah yang dihadapi oleh hospital. Kita menerima hakikat bahawa kebanyakan hospital perlu di naik taraf dan ia tidak boleh dilakukan sekali gus tetapi secara berperingkat,” katanya.

- Bernama

RM38,000 wasted in Health Ministry's 'stupid' campaign

Organ Donation Among Malaysians Still Low, Says Health Minister

PUTRAJAYA, Sept 17 (Bernama) -- The Health Ministry Tuesday launched the www.dermaorgan.gov.my website to create greater awareness among Malaysians on the importance of pledging their organs for donation upon their death.

Its minister, Datuk Seri Dr S. Subramaniam said that up to Aug 31, 2013, the recorded number of those who pledged their organs was still low as only 233,573 people or 0.81 per cent of the country's population did so.

He said public awareness on organ donation was vital as the number of Malaysian patients still waiting for organ transplantation stood at 16,945 as at Aug 31, this year and most of them had kidney problems.

"During the same period, the number of cadaveric tissue donors (deceased) was also small at only 432. Overall, patients requiring donated organs far outnumber the donors.

"Therefore, the ministry has drawn up the Organ Donation Strategic Awareness Plan," he said after launching the website at the ministry's headquarters, in Putrajaya.

Also present were his deputy Datuk Seri Dr Hilmi Yahya, the ministry's secretary-general Datuk Farida Mohd Ali and the director-general of Health Datuk Dr Noor Hisham Abdullah.

Dr Subramaniam said the awareness campaign through the new media, using the website launched on Tuesday was among the actions taken by the ministry under the strategic plan. It would serve as a one-stop centre to gather all information on organ donation.

"The ministry has obtained approval from the secretary-general of the Treasury, Finance Ministry, for exemption from any treatment charges at the government hospitals for deceased organ donors.

"This means the organ donors' family members need not pay for the hospital charges after the donation had been done," he said.

Dr Subramaniam said the Finance Ministry had also approved life-long free First Class treatment for organ donors, including those who donated their bone marrow or blood for hematopoeitic stem cell transplantation.

New Study: Eggs as Harmful as Cigarettes

New research has found that egg consumption is nearly as harmful to heart health as smoking tobacco. The study found a correlation between the number of egg yolks consumed and thickened arteries; the correlation was nearly as high as the correlation between the amount of tobacco smoked and thickened arteries.

Researchers measured the carotid wall thickness (an indicator of heart health) and measured the smoking, diet, and exercise habits of over 1,200 participants. "We believe our study makes it imperative to reassess the role of egg yolks, and dietary cholesterol in general, as a risk factor for coronary heart disease," the study authors concluded. 

 

 

 

 As scientific research continues to show the harmful effects of egg consumption on human health, undercover investigations continue to expose the horrific abuses hens and other farmed animals endure. Fortunately, preventing cruelty, heart disease, and cancer is easy with a plant-based diet.

WHO: Cell phone use may heighten cancer risk

I can’t say this was unexpected. The World Health Organisation has classified long-time use of cell phones as ’2B’, meaning “possibly carcinogenic to humans”.
WHO adds there could be a significantly higher risk of brain cancer for long-time users.
Read the full WHO statement.
This is especially true if the phones are held close to the ear, and the risk increases with accumulated exposure over time.
Consider ourselves warned.

India's farmers profit from organic boom

Bathinda, India (CNN) -- The northwest state of Punjab is popularly known as the breadbasket of India.

But many local farmers say that decades of using chemicals and pesticides, encouraged by the government, has caused health problems including cancer.

It's a point of view borne out by research.

A 2008 study by the International Journal of Environmental Research and Public Health found that the incidence of cancer in the area was nearly double that of a similar sized town 200 kilometers away, citing "involvement in cultivation, pesticide use, alcohol consumption and smoking"

It's not clear what's causing the cancer, but the study also noted that the drinking water contained several heavy metals.

India is one of the largest producers of pesticides in the world, much of it for local consumption. But now there's a new awareness.

There's a big change sweeping across the fields of rural India. Tens of thousands of farmers are giving up on chemical farming and going back to a traditional ancient way of farming which is organic.

Environmentalists estimate that India has around 300,000 organic farms. Farmers are learning different skills and adjusting their mindset, says Upendra Dutt, who organizes training sessions in organic agriculture.

Farming isn't just about chasing profits anymore.

"Eating an organic 

apple is not only 

good for you, it's 

good for the 

environment.
--Anuj Katyal

Farmer Nirmal Singh has stopped using synthetic fertilizers and pesticides on his fields in favor of organic ones made from cow dung.

"My input costs are lower. I don't have to spend money on buying chemicals," Singh says, "plus, it's healthier."

At harvest time, his yield is lower, but the selling price is higher. Organic wheat goes for three times as much money as wheat grown using chemicals.

With the growing demand both is India and abroad for organic products, it makes business sense as well.

Test your knowledge of organic food

Anuj Katyal's company exports organic basmati rice to 15 countries where customers don't mind paying a premium for the organic label.

India's organic farming sector accounts for only a sliver of the global $50 billion market for organic products but the potential is huge.

"We tell people eating an organic apple is not only good for you, it's good for the environment and will help the farmer grow another organic one," Katyal said.