Category: Private cancer specialist nottingham

Futile antibiotic treatments

Infections are normally highly treatable with antibiotics.

But when someone is dying , the body’s immune system gets weaker. Hence infections quite often occur as part of the dying process.

Treating these infections are often futile. But human nature is inclined to “fight and survive” by all means. So quite often powerful antibiotics are used to treat these infections in dying patients.

There is an ethical argument against futile treatments.

There is also the risk of antibiotic resistance in general population if antibiotics are used inappropriately.

Submit your views at BMJ journal website (rapid response section).

References

Access the article at: http://bmj.com/cgi/content/full/bmj.l6706

Toll-free link:

http://bmj.com/cgi/content/full/bmj.l6706?ijkey=ZXN1zz6QXpPz8np&keytype=ref

Can long working hours kill you?

Yes, it can.

It has been well established by systemic review that working long hours can lead to excessive heart attacks. ( ref 1).

A recent French study indicates that working long hours can lead to increased risk of stroke ( Long hours defined as more than 10 hours on at least 50 days per year in this study) (ref 2).

So look after yourself and don’t push yourself too hard !

References

1. Long Working Hours and Coronary Heart Disease: A Systematic Review and Meta-Analysis .

2. Long working hours ‘linked to stroke risk’ BBC News.

Can complementary therapies do harm ?

Yes,

Very interesting program on BBC “Vitamins and Green Tea” broadcast by BBC . ( BBC iPlayer).

Another Good article on BBC website: Complementary cancer therapies ‘do more harm than good’

So everything in moderation if necessary and take only that’s appropriate for your individual circumstances!!!

 

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Are some people fat because of their “gut bacteria mix” is of the wrong sort?

Some people are able to eat everything they like and do not gain much weight (as long as they don’t go over the top).

But others have to just smell a chocolate or a cake and they put on weight (even though this comment is made jokingly some people are so exasperated with their weight gain in-spite of all diets !!!).

Could this discrepancy be related to the having “wrong cocktail of Bacteria in their gut”.

Some scientists seem to think so. An intriguing proof of concept study has been published in Nature Medicine which is a very esteemed science journal.

Read this thoroughly interesting and balanced article on The Atlantic website.

References

The Fundamental Link Between Body Weight and the Immune System

JAMES HAMBLIN

AUG 2, 2019

Inflammation plays a critical role in determining how we digest food, and it’s only now starting to reveal itself.

Can stress cause infection?

Yes, stress can increase risk of serious infections.

Based on personal experience, anecdotally many people would vouch for the fact that stressful events makes them more prone to illness. But strong scientific evidence has been spare.

A recent Swedish study published in British Medical Journal confirms that stress related disorders significantly increase risk of life threatening infections later in life.

Reference

Stress related disorders and subsequent risk of life threatening infections: population based sibling controlled cohort study

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l5784 (Published 23 October 2019)

Cite this as: BMJ 2019;367:l5784

Can weather affect joint pain?

Yes, weather can affect joint pain.

A study involving 2500 people conducted by University of Manchester study showed that “people with arthritis feel more pain on humid days”

The study reports that “Damp and windy days with low pressure can increase risk of experiencing more pain than normal”

“Cold, damp days also made pain worse but interestingly pain was not made by temperature alone”.

Other studies in the past have also found a “significant correlation between humidity and pain“.

References

BBC News. People ‘more likely to feel pain on humid days’.

Does rheumatoid arthritis disease activity correlate with weather conditions?

The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis.

“Think Positive “ and live longer !

People with sunny disposition seems to live longer.

Having a positive outlook on life seems to protect heart.

Is it a case of “chicken vs egg” in that what came first. Do healthy people have a optimistic outlook and pessimistic people have lot of social, personal and health problems. Do life problems make people pessimistic or being optimistic makes one do better?

Researchers have adjusted the data for confounding factors. Evidence so far is very intriguing.

And the next question is – can one learn to be optimistic, change personality and have beneficial health effects. We don’t know at present.

References

1. Guardian. Optimists have lower risk of heart problems and early death.

2. Guardian. Optimism may hold secret to longer life, study suggests.

3. The association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA)

4. JAMA. Association of Optimism With Cardiovascular Events and All-Cause Mortality

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Crowdfunding expensive stem cell therapies

Crowd fund metaphor

If you have come across a desperate request to crowdfund an expensive stem cell therapy, read this well researched BBC article before you contribute.

Hope is a powerful driver particularly when someone is facing immense difficulties in life. Human beings have a natural inclination to fight against all odds and it seems to be inbuilt in our DNA and psyche.

But not all promising treatments do help desperate people searching for a cure.

Reference.

BBC news. The unwarranted hype of stem cell therapies. By Jules Montague. 21 August 2019

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Dietary advice: take it with a pinch of salt

Official dietary advice as well as various “Diets” promoted by various celebrities tend to be very prescriptive. They often give the impression that the evidence behind everything they promote is very clear cut.

But truth is far more murkier ( I might say more “mish mash “).

A new study analysis of old data comes to a different conclusion about “red meat”. This is in fact not surprising as the evidence for various Dietary guidelines and “Diets” are not usually robust and watertight and involves lot of assumptions.

What is the take home message:

Eat “everything you like” in moderation and try to make it as balanced as possible with substitutes for things you avoid !!

Avoid processed food as much as possible and eat fresh.

Don’t be surprised if the next two studies on this topic reach three different conclusions.

References

1. BBC news. Is red meat back on the menu?

2. New York Times. Eat Less Red Meat, Scientists Said. Now Some Believe That Was Bad Advice.

3. The original study article from Annals of Internal Medicine. Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium.

4. Daily Mail. You DON’T need to cut out red meat: Scientists say official advice on eating less beef, pork and lamb is based on bad evidence and having it four times a week poses ‘NO cancer risk’ 

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Olaparib: exciting results in treatment of prostate cancer harbouring certain genetic alterations

https://www.esmo.org/Oncology-News/Olaparib-Outperforms-Enzalutamide-or-Abiraterone-Acetate-in-Men-with-mCRPC-and-HRR-Alterations

Olaparib is set to become a standard treatment option for advanced prostate cancer patients whose tumours harbour certain genetic alterations.

Study results presented at ESMO congress in Barcelona shows good response to olaparib compared to other hormonal agents in this sub-group of patients.

References

1. ESMO European Society of Medical Oncology Annual Conference 2019. Barcelona. Olaparib Outperforms Enzalutamide or Abiraterone Acetate in Men with mCRPC and HRR Alterations.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Acknowledgement: Copyright of Slides: Authors and ESMO

Prostate Bed Radiation can be avoided or delayed in many prostate patients following surgery

A large UK trial shows that lot of men undergoing surgery for prostate do not need Immediate follow-on radiation straightaway.

Trial data was presented at ESMO conference in Barcelona.

Radiation can be entirely avoided in many patients at high risk of relapse and it can be safely delayed until there is definite evidence of relapse in selected patients for months and years.

Waiting and watching is certainly prudent in some patients rather than rushing in with radiation so as to avoid side effects.

Combined data analysis using study data from France as well as Australian and New Zealand trials confirm these findings.

References

1. ESMO 2019 Barcelona. Men with Prostate Cancer can be Spared Radiotherapy after Surgery [ESMO 2019 Press Release].

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Veliparib : Another new drug for treatment of Ovarian Cancer

Veliparib trial data has certainly brought more options to the table in treatment of advanced Ovarian cancer.

Trial data presented at ESMO congress at Barcelona shows that first line therapy with Veliparib is beneficial.

Acknowledgement: Copyright of Slides: Authors and ESMO

References

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

New drug combination for Ovarian Cancer (Olaparib and Bevacizumab)

New trial data presented at the ESMO cancer Congress 2019 in Barcelona, Spain, show excellent results for the combination of Olaparib and Bevacizumab. The combination looks likely to become standard of care in at-least a subgroup of patients.

The expert discussing the trial data did raise the possibility that most benefit seems to come from Olaparib in patients with BRCA mutations and whether Olaparib alone instead combination is enough for this group. More data is awaited.

References

1. ESMO 2019 congress press release. Ovarian Cancer: More Women Benefit from Maintenance Combined Targeted Therapy [ESMO 2019 Press Release]

Acknowledgement: Copyright of Slides: Authors and ESMO

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Niraparib : New treatment for new diagnosed Ovarian Cancer

A landmark study presented at ESMO congress at Barcelona shows significant benefits for maintenance treatment with the drug Niraparib.

Niraparib is likely to become a standard treatment in a much more widely group of advanced ovarian cancer patients.

Many clinicians will be weighing up Niraparib Vs Olaparib in Some patients and Niraparib vs Bevacizumab in other groups of patients.

Reference

1. Niraparib Prolongs PFS in Patients with Newly Diagnosed Advanced Ovarian Cancer. ESMO press release.

Acknowledgement: Copyright of Slides: Authors and ESMO

Melanoma Skin cancers: significant improvement in life expectancy with immunotherapy

Advanced melanoma skin cancers used to carry a dismal prognosis.

Data presented at Barcelona European Cancer Congress ( ESMO) shows the prognosis has improved remarkably in the recent years.

Fifty percent of patients are now alive for at-least five years. It is quite a remarkable achievement for immunotherapy.

References

1. ESMO press release. One in Two Patients with Metastatic Melanoma Alive after Five Years with Combination Immunotherapy [ESMO 2019 Press Release].

2.BBC News. Skin cancer: Half of people surviving advanced melanoma. By James Gallagher. Health and science correspondent, BBC News

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Exercise: Anything is better than nothing

Many people put off exercise thinking it needs to be a planned activity with time allocated for it.

A paper published in British Medical Journal ( BMJ) reports that any exercise is good and contributes to good health compared to no exercise

The recent UK guidelines also advises to “clock up few minutes at a time” whenever and wherever you can. (UK Chief Medical Officer).

You don’t need to run a marathon or join a running group. Just taking the stairs rather the lift would be good.

References

1. Guardian. Even a few minutes’ exercise is good for you, new guidelines state.

2. BMJ. British Medical Journal. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4570 (Published 21 August 2019)

Cite this as: BMJ 2019;366:l4570

3. Daily Telegraph. No such thing as too little exercise, says Chief Medical Officer, as ten minute minimum is scrapped.

4. BBC news. Strengthen muscles as well as heart to stay fit and healthy, say top doctors

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Celery Juice: Super Juice ?

Why Celery Juice is popular now?

Every year some type of food or fruit trends on the social media after being hyped by celebrities and Influencers.

Unfortunately, it seems Celery Juice is trending now.

Just because something is endorsed with good intentions by well meaning people doesn’t mean you have to blindly believe them.

Read the BBC news article for a balanced account .

Reference

1. Celery Juice: The big problem with a viral Instagram ‘cure. BBC news.

Is Vegan diet the most healthy ? Are there any risks from Vegetarian diet?

Life would be very simple if we can have clear cut answers with regards to the best diet for everyone’s health.

A recent study published in BMJ indicates that while Vegan diet reduces risk of heart problems it can increase the risk of strokes.

The results might seem confusing and scientists would be certainly seeking more answers. But don’t be surprised if another study from some other research group comes up with a contradictory result. That’s normal in science.

What’s most important is to realise that there are no easy scientific answers to most scientific questions. Research quite often shows unexpected results. What is a logical scientific question quite often throws up unexpected answers.

Overall, the message is “have a well balanced diet” without omitting essential nutrients.

References

1. BBC news. Plant-based diets ‘linked to higher stroke risk‘ Vegan and vegetarian diets ‘link to higher stroke risk’ Sept 2019.

2. BMJ. British Medical Journal.

Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4897 (Published 04 September 2019)

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

What news can you trust as a cancer patient?

A Cancer diagnosis is terrifying and upsets all the carefully crafted life’s plans.

Many cancer patients would like to have in-depth information about cancer. It is quite natural and logical to expect “black and white” information cancers. But cancer is always associated with uncertainty.

Well meaning but ill informed people sometimes inadvertently bombard cancer patients with fake news. Even worse, there are charlatans who would try to sell unproven treatments to vulnerable cancer patients.

There is a good article in Observer about this “cancer fake news”.

If you are not sure about information you have read on the net, ask your doctor to clarify.

If you prefer a independent person , ring the helpline of independent charities such as Cancer Research UK or Macmillan.

Reference

1. How to survive the fake news about cancer. Observer.

Can fruit juices increase risk of cancer?

Instinctively, many people would think of fruit juices as healthy. Many would not associate fruit juices with cancer.

A recent study in British Medical Journal says that “the consumption of 100% fruit juice was significantly associated with the risk of overall cancer”.

The conclusion – sugar is bad from cancer point of view.

References

Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l2408 (Published 10 July 2019)

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.

Taking up Exercise in middle age: is it worthwhile?

You could have been a ‘couch potato‘ all your life.

Is it worthwhile starting exercise now?

Yes, says the paper published in British Medical Journal.

The study involving nearly 15,000 people found that irrespective of your past, taking up physical activity in middle and old age is beneficial.

The study concludes “Middle aged and older adults, including those with cardiovascular disease and cancer, can gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors.”

So get going !!!!!

Reference

Physical activity trajectories and mortality: population based cohort study. BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2323 (Published 26 June 2019)

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only. See your own doctor to discuss concerns and options relevant for you.