Nutritional supplements are often tried to prevent cancer. But well- designed rigorously conducted clinical trials have NOT shown any benefit in prevention of many cancers.
Selenium was suggested as a preventative supplement for skin cancer.
A clinical trial compared Selenium against placebo in United States. The results were disappointing.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The study presented at the ASCO ( American Society of Clinical Oncology) virtual scientific symposium in 2020,
“The VITamin D and OmegA-3 TriaL (VITAL) was a high quality study. The study randomly assigned patients to Vitamin D3 supplements and/or omega-3 fatty acid supplements and/or both or placebo in 25,871 men and women.
The study found that “vitamin D supplementation decreased risk of developing advanced cancers by 17% compared with placebo ”
“Omega-3 supplementation did not reduce the incidence of advanced cancer.”
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
It might seem foolish to ask the question “Anything good from this COVID-19 pandemic?” when so many people across the world has been so badly affected by the coronavirus pandemic.
There is some truth in the proverb that “every dark cloud has a silver lining” and no matter how bad the current pandemic is now, human spirit and endeavour would get something positive out of it.
One possible good thing that has come out of the pandemic is the “mRNA technology”.
The successful use of RNA technology for Coronavirus Vaccines would hopefully enable the versatile RNA technology to be further developed and successfully used a cancer treatment in near future.
Further clinical trials in cancer patients would be done to provide proof of their potential.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.
You might have read information about the COVID vaccines on various news outlets and social media messages.
If you want complete summary information about vaccines approved by the regulatory authorities, click on the links below.
Two types of information leaflets accompany all licensed medicines. – One is meant for health professionals and has lot of clinical information. (called SPC) – The other is meant for patients and public and provides a summary of facts using lay terms.(called PIL).
The leaflets provide information about all common side effects observed in the trials.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.
Now the regulatory authorities have approved a third vaccine. The third vaccine from Moderna along with two other vaccines should help to bring the pandemic to an end.
The Moderna vaccine is a new technology like the Pfizer Vaccine. (based on mRNA technology).
Like the two vaccines, the short term data for Moderna vaccine is very encouraging.
Over long term, one hopes that the protective effect of all the three vaccines is long lasting and that they remain effective against any new variants of coronavirus that might emerge in the coming months.
Overall, there is certainly ‘light at end of the tunnel’ and the world can emerge out of this horrific pandemic in a short period.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.
Lot of diets promoted by Magazines, Social Media Influencers and Celebrities do not have strong scientific evidence in favour of them.
A scientifically sound trial published by the medical journal JAMA ( Journal of American Medical Association) recently, found the Vegan Diet helped weight loss and promoted Good metabolism.
The trial involving 244 participants found that over 16 weeks, body weight decreased on average by 5.9 kg in those having a Vegan Diet. That’s very impressive!
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The new mutant is more dangerous because it is more easily transmissible from person to person. The new variant is now spreading very rapidly in London and South East of England.
Emergence of this new mutant (called variant VUI-202012/01 fall) is a certainly a worrying development in this pandemic.
The mutations has made the new strain 70 per cent more transmissible but scientists do not expect these mutations to reduce the effectiveness of vaccines.
Tests are being carried out to confirm that the existing vaccines would still have a high degree of protective affect.
It is an evolving area and we have to hope that the new variant doesn’t make things worse than they are now !
Covid-19: New coronavirus variant is identified in UK. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4857 (Published 16 December 2020) Cite this as: BMJ 2020;371:m4857
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
If you are going to have an emergency surgery, it may be worthwhile asking your surgeon whether it is their birthday on that day.
If you accept the findings of a recent study at face value, one should weigh up the pros and cons of seeking a different surgeon if one is available or request your surgeon to be extra careful.
An intriguing paper published in BMJ recently suggests so. The study looked at the outcome of Medicare patients who underwent emergency surgery in USA. It is a very large study in which 980876 procedures performed by 47489 surgeons were analyzed. Hence the study findings do need to be taken very seriously.
The study found that patients operated by surgeons on the surgeons’ birthday had a higher risk of death.
The study provocatively suggests, without any direct proof, that surgeons were possibly distracted on their birthdays and in their rush to go to their birthday celebration, they might have done “botched emergency surgeries” by not concentrating properly during surgery and by not providing good post-operative care.
The findings are entirely plausible from behavioural psychology point of view and the study authors seem to have done a thorough statistical analysis of various factors that could have spuriously affected the death rates.
Nevertheless, there remains a distinct possibility that the study findings are spurious. For instance, the scientific community is aware of the fact that if “any data is tortured enough”, the dataset will cough up spurious and unexpected results.
Genuine Surgical errors can sometimes lead to death but much more commonly surgical errors can often lead to increase in rate of surgical complications. It is a bit of stretch for the study to suggest that surgeons all over the country are doing “ technically poor surgeries” everyday if that day happens to be their birthday and they are doing it in such a way to cause deaths without causing any surgical complications.
We don’t know whether the study inadvertently looked at male surgeons working on weekends at rural non-teaching hospitals as these factors could have a bearing on death rates.
Sad life events can adversely affect the work performance of any human being. But happy people are more productive at work. So the conclusion by the study that a happy event, such as a birthday, can adversely affect a surgeon’s performance deserves more scrutiny in a well designed study.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
In contrast , plant proteins such as nuts and lentils reduced the risk of developing heart disease.
References: Red meat intake and risk of coronary heart disease among US men: prospective cohort study. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4141 (Published 02 December 2020) Cite this as: BMJ 2020;371:m4141
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The superstitious might say “don’t jinx it by calling the end early”……..
So the answer is “may be”.
The good news from two Vaccine trials indicates that this might be “beginning of the end” for COVID-19.
Two recent press reports give rise to lot of optimism to the population that is getting weary with the lockdown. It is good to have a ray of hope among all the doom and gloom.
The covid-19 vaccine (mRNA-1273) from US biotech company Moderna was found to be 94.5% effective.
Another mRNA vaccine developed by Pfizer and BioNTech was reported to be 90% effective.
Now the caveats…. these are interim trial results and the trial results have not been subject to scrutiny by the wider scientific community as the full results are yet to be published.
Clinical Trials usually recruit motivated people without too many other medical problems. So one has to hope that these interim trial results can be replicated in the wider elderly population with lot of medical problems.
Let’s hope that all the vaccines are very safe and highly effective when used in the real world population.
References: (1). Covid-19: Vaccine candidate may be more than 90% effective, interim results indicate. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4347 (Published 09 November 2020). Cite this as: BMJ 2020;371:m4347.
(2). Covid-19: Moderna vaccine is nearly 95% effective, trial involving high risk and elderly people shows. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4471 (Published 17 November 2020). Cite this as: BMJ 2020;371:m4471
(3). Covid-19: Oxford vaccine is up to 90% effective, interim analysis indicates BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4564 (Published 23 November 2020) Cite this as: BMJ 2020;371:m4564
Covid-19: What do we know about the late stage vaccine candidates?. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4576 (Published 24 November 2020) Cite this as: BMJ 2020;371:m4576
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The Staff at National Health Service in UK are doing an admirable job during the pandemic. In the particular, the frontline staff (“patient-facing”) are showing great courage in face of great difficulties and are primarily driven by altruism.
But the pressures of pandemic means many routine scans and hospital clinic appointments have been cancelled particularly during the first wave. There is a great worry about delayed diagnosis of cancer and delayed treatment of cancer.
A paper in BMJ reports that cancer patients survival can be significantly compromised.
But, as with everything else in life, things are not always what they look like at first impression. Even things that are logical and common sense at first glance do not turn out to be simple and clear.
Firstly, delays and cancellations of scans paradoxically could have psychologically benefited some cancer patients . This might seem counterintuitive or even an outrageous statement.
But there are some cancers which are being over diagnosed. A Cancer diagnosis does not always mean a death sentence. Some cancers do not cause problems for a long time or never in the life time of a person. These cancers do not need to be diagnosed promptly. Not being diagnosed with these cancers prevents the psychological burden of a cancer diagnosis. This “over diagnosis” would be expectedly less during pandemic.
Secondly, treatment delays could be caused by a cancer that is advanced and the need for time consuming additional investigations and procedures. Sometimes delays are caused by patients needing to see many medical specialists for the treatment. So it’s the aggressive cancer and the complex patient care that would cause the delay and is responsible for poor outcome rather than the delay by itself.
A study from Norway found that the combination can be harmful in certain people.
They report that “Treatment with folic acid plus vitamin B(12) was associated with increased cancer outcomes and deaths in patients with ischemic heart disease in Norway,”.
So avoid Vitamin supplementation if you have a well balanced healthy diet and no deficiency..
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
After someone has recovered from a Coronavirus infection, the body remembers how to fight the virus in future. This is called immunity and it is not known how long this immunity will last.
If the immunity is not long lasting, people can get coronavirus infection again during the second and even third wave.
The body’s immunity is made up of two types of cells: B cells and T cells. T cells and B cells are central to the human immune system.
B cells produce antibodies and previously in various studies , they were found to decline rapidly give rise to fear that people would get Coronavirus infection again and again.
Now a study has reported that T cell immunity can last more than 6 months in patients who have recovered from an infection.
This news is also good from a vaccine point of view. It gives us hope that sooner or later an effective vaccine would become available.
BMJ News. Covid-19: T cell response lasts for at least six months after infection, study shows BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4257 (Published 02 November 2020) Cite this as: BMJ 2020;371:m4257
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
“Patient Facing” healthcare workers do admirably put them at harms way during this Coronavirus pandemic .
So health workers are at increased risk of getting admitted to hospital due to COVID-19.
But a recent Paper in BMJ says that families of healthcare workers are also at increased risk of hospital admission. In very few other lines of work, does the occupational hazard affect the families of workers as well.
The authors report “ …. patient facing healthcare workers and members of their households were, respectively, threefold and twofold more likely to be admitted to hospital. Healthcare workers and their households accounted for one in six of all admissions with covid-19 in the working age population (18-65 years).”
The paper says “Among admitted healthcare workers, one in eight were admitted into critical care and six (2.5%) died; in admitted household members, one in five were admitted to critical care and 18 (12.9%) died.”
Routine testing of healthcare workers and early testing of families as well as better access to effective PPE is urgently needed.
References : 1. Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3582 (Published 28 October 2020)Cite this as: BMJ 2020;371:m3582
2. Covid-19: risks to healthcare workers and their families. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3944 (Published 28 October 2020)Cite this as: BMJ 2020;371:m3944
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
1. One study found that Vitamin C and carotenoids have a protective effect against diabetes ( eg diet rich in citrus fruits, tomatoes , root vegetables such as carrots )
A word of caution to those rushing to buy vitamin supplements from the authors : “fruit and vegetable intake, rather than vitamin supplements, is potentially beneficial for the prevention of type 2 diabetes”.
2. Another study found that “whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, significantly reduced the risk of developing diabetes.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Many Viral infections give some sort of immunity to the person infected. For example, if a child has chicken pox, then the child develops immunity to further chicken pox. This immunity can even be life long for many children.
But some viral infections don’t result in significant immunity to further infection. For example, Flu and Common Cold viruses infections do not result in effective long immunity. That’s why flu vaccines are given yearly to vulnerable people.
It was hoped that a Coronavirus infection could result in at least some sort of long immunity to further infections.
A recent report of man who developed Coronavirus/ COVID-19 for the second time is worrying. If this is a widespread phenomenon and not an isolated case, then it has significant implications for the current pandemic.
Herd immunity, whereby many people are immune to further Coronavirus infection either through previous infection or Vaccination, was suggested as the way of ending the current pandemic.
This report, if confirmed to be true across significant sections of population, would indicate a much more longer duration of COVID-19 pandemic.
6. To KK-W et al. COVID-19 re-infection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole genome sequencing.Clin Infect Dis. 2020; (published online Aug 25.)https://doi.org/10.1093/cid/ciaa1275View in Article
8. Prado-Vivar B et al.COVID-19 re-infection by a phylogenetically distinct SARS-CoV-2 variant, first confirmed event in South America.SSRN. 2020; (published online Sept 8.) (preprint)https://doi.org/10.2139/ssrn.3686174View in Article
9. Dearlove B et al. A SARS-CoV-2 vaccine candidate would likely match all currently circulating variants.Proc Natl Acad Sci USA. 2020; 117: 23652-23662View in Article
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Coronavirus was previously known to survive for about 3 days at room temperatures. (On certain surfaces made of plastic and stainless steel).
Now an Australian team has found that Coronavirus can survive upto 28 days in Cold conditions. The results need to be interpreted with great caution as it tested virus under unusual artificial conditions and hence might not be relevant for real life situations
On the other hand , if the study is right, then it might indicate that the Pandemic can get worse during cold Winter before it gets better in Spring and Summer.
What can we do? In addition to Social distancing measures and Mask wearing, Frequent hand washing would stop the Virus from Spreading.
Every Week , we are learning more about the Virus. Let’s hope it comes to an end soon.
3. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 April 16, 2020 N Engl J Med 2020; 382:1564-1567 DOI: 10.1056/NEJMc2004973
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The old adage “prevention is better than cure” is mostly true with regards to cancer if you can do it.
If you can’t prevent it , at least catch it early, has been the prime motive behind screening tests for breast, cervical, bowel, lung and prostate cancers. (“early is better”). Cancers that are detected at an early stage can offer a better chance of curative treatment.
So one might logically expect that intensive monitoring and early diagnosis of a cancer relapse or a secondary cancer after initial treatment can be immensely helpful.
But the evidence for intensive hospital follow-up visits and investigations is weak for most cancers except for some cancers such as Testicular Cancers which are highly curable.
Intensive monitoring after bowel cancer treatment can detect treatable cancers. To confirm the benefit of early detection of relapse by intensive monitoring , a trial was conducted comparing intensive follow up versus routine follow up ( in France and Belgium).
Data presented at ESMO ( European Society of Medical Oncology) shows that the intensive follow with scans can detect cancer recurrences which can be treated by further surgery. But unfortunately the intensive follow up did NOT lead to longer life expectancy.
The results might be counterintuitive but after an average follow up more than six years, this trial demonstrates that intensive follow is NOT always best. Scans might be done for psychological reassurance but they could end up causing significant anxiety.
When there are resource constraints (e.g low economic countries) , one has to be careful about frequents routine scans for those without symptoms.
During COVID-19, even in rich countries such as UK where there might be huge waiting lists, one has to consider prioritising scans for those who need most.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Advanced ovarian cancer is treated by chemotherapy. A pre ious study of Japanese ovarian cancer patients RT showed significantly increased survival in those treated with dose-dense weekly paclitaxel compared to the standard three-weekly schedule.
Data from an international trial called ICON8 was presented at the ESMO Virtual Congress 2020, this week.
The final analysis of ICON8 “provides conclusive evidence that although weekly dose-dense chemotherapy can be successfully administered as first-line treatment for ovarian cancer, it has no survival advantage over the standard chemotherapy given once every 3 weeks.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
3. Visualizing droplet dispersal for face shields and masks with exhalation valves. Physics of Fluids 32, 091701 (2020); https://doi.org/10.1063/5.0022968
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
References 1. Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority, randomised trial. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30825-X/fulltext
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The treatment of kidney cancer has dramatically changed in the last decade. More treatments are in pipeline and there was more exciting news this week.
Upfront immunotherapy in combination with other agents is very promising in 1st line treatment of advanced kidney cancers.
“Nivolumab and Cabozantinib” combo joins the other combos “Nivolumab and Ipililumab” and “Pembrolizumab and Axitinib “ as 1st line options
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Elderly cancer patients on the whole did very badly but surprisingly cancer patients under age of 50 did far worse than their peers without cancer.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Immunotherapy has revolutionised the treatment of many advanced cancers such Skin cancer Melanoma and Kidney cancers.
Immunotherapy is a standard treatment for 2nd line treatment of bladder cancer.
Two recent trials presented at ESMO virtual meeting explored the use of immunotherapy in 1st line setting. (Pembrolizumab and Durvalumab).
Immunotherapy alone, or in combination with Chemotherapy was not superior even in patients selected by markers thought to favour immunotherapy alone.
For most bladder cancer patients immunotherapy remains a excellent 2nd line option or as a maintenance treatment option.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
If large trials confirm this finding, the combination would be standard treatment in future.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The National Health Service had recently embarked on a Risk assessment exercise of its staff to assess the Vulnerability of individual members to Coronavirus infection ( COVID-19).
The exercise is being done with good intentions. Given the unprecedented situation of the pandemic and lack of concrete data , the exercise seemed to have steered away from firm “one size fits all” type of recommendations.
Given the uncertainties with the currently available data on various forms of protection ( from simple surgical masks to shielding) , the exercise could have been a starting point for an nationwide intervention study .
An opportunity seems to have been missed and if there is a second wave, NHS might regret not learning from the first wave.
Permanent hair dyes are widely used. A recent study published in BMJ suggests that use of Hair dyes might be risky.
This large study from United States enrolled 117 200 women in the Nurses’ Health Study. The women reported on personal use of permanent hair dyes, and were followed for 36 years. So overall it is a high quality observational study.
Read the full paper and Caveats at the BMJ website.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Last month, we had studies reporting that the immunity to Coronavirus fades quickly after recovering from an infection. The scientists have warned that re-infection is a risk.
Now, we have a case in Hong Kong where a patient seem to have been unlucky to get the infection again. It is a worrying report and suggests that coronavirus is going to be with us for a long time.
The only reassuring fact is that patient was free of symptoms during second infection. One has to hope that all re-infections are mild !
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Normally many flu-like viruses spread by direct or close contact.
Because Virus containing droplets are heavier than air, scientifically it is thought that when someone coughs or sneezes, virus particles quickly fall to ground or surrounding objects.(“like a brick or stone falling to ground“).
But a group of scientists and WHO have raised the possibility that coronavirus can stay in air for longer periods, float around and cause more infections. (“float like a balloon“). This is called air-borne transmission.
What does it mean?
If confirmed– this means “closed spaces” are high risk even if you maintain 2 metre distance from an infected person. AVOID CLOSED SPACES.
As many people in UK do not wear masks in public places, there is a high chance of second wave of infections in the coming weeks as lock down is eased. WEAR A MASK.
It also means avoiding non-essential visitors to hospitals so that visitors cannot catch the infection or pass the infection to vulnerable patients. AVOID NON-ESSENTIAL VISITORS AT HOSPITALS.
If air borne transmission is confirmed, it is also bad news for the coming winter.
If Coronavirus is still in community and not eliminated by winter, air-borne transmission is likely to result in further wave of infections.
This is because Winter means more closed spaces and more chance of infection !!!!!!
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
In Western countries, upto two thirds of people take vitamin and mineral supplements regularly.
Many people think it’s common sense to take supplements. Many people don’t realise mega doses of vitamins can cause harm. Paradoxically the people who don’t have a healthy diet are less likely to supplements than those who have a well balanced diet.
A recent article in BMJ reviews the evidence regarding “Health effects of vitamin and mineral supplements” and concludes that “Randomised trial evidence does not support use of vitamin, mineral, and fish oil supplements to reduce the risk of non-communicable diseases”.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
The hormone injections reduce the Testosterone in men.
Now a new medication, called Relugolix, has been successfully tested in clinical trials. Relugolix, unlike other first line hormone injections , can be taken by mouth instead.
Relugolix also has the advantage of not only working rapidly but also has the advantage of stopping to work quickly when it is withdrawn. This is unlike the injections which take a while to work but also do not stop working quickly when injections are stopped.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Possible but like every other observational study, take it with pinch of salt.
Further evidence from well conducted trials are needed before it can be recommended as a COVID treatment.
In mean time, it’s better to stick to natural sources of vitamin such as those mentioned in the newspaper article ( spinach, broccoli, green vegetables, blueberries, all types of fruit and vegetables).
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
So stay safe and consider shielding if your cancer is not under control .
Furthermore, there is lot of interest in use of Chloroquine, an anti-malaria drug for treatment of COVID-19. The study reports that “Treatment with the drug combination hydroxychloroquine and azithromycin was also strongly associated with greater risk of death”. So best to avoid unproven treatments outside a trial setting.
Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.
Should Public wear face masks because of Corona Virus pandemic ?
Yes.
In some of the Asian Countries there has been universal acceptance of face masks even before Corona Virus pandemic. Hence, it is not surprising that there is wide spread use of face masks during this pandemic .
In USA, after initial hesitation, CDC now recommends use of cloth face masks by public.
In Germany, many states have made face masks compulsory.
In UK, there has been no official recommendation about widespread use of face masks.
4. BMJ paper. Analysis. Face masks for the public during the covid-19 crisis. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1435 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1435
5. BMJ editorial. Editorial. Covid-19: should the public wear face masks?. Editorials. Covid-19: should the public wear face masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1442 (Published 09 April 2020). Cite this as: BMJ 2020;369:m1442
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Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of publication and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views expressed are not substitute for professional advice.
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.
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.
Cancer patients are quite often aware of own body and pre-existing aches and pains.
The best thing is to act promptly if there are “any new and persistent symptoms” . For vast majority of cancer patients, there is no need to do a frequent check list of possible symptoms, on a daily or weekly interval.
Do NOT be on constant vigilance for all possible cancer symptoms unless you have been specifically advised to do so by your oncology team.
Eternal Vigilance for months and years can wreck your quality of life.
Think Positive. Nothing is lost when you maintain hope.
‘Unacceptable’ delays in diagnosing secondary breast cancer
The standard disclaimer is very relevant to this blog.
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.
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.
Personalising complex medical terminology in a letter dictated over a few minutes is NOT an inherent skill possessed by many doctors including those who are native English speakers.
Dictating Plain English medical letters would take considerable time and effort – particularly if letters are going to succinctly summarise everything from a medical consultation.
Cancer Patients in UK also have the support of Cancer Nurse Specialists ( CNS ) who do a fantastic job of guiding patients through their cancer journey and clarify all medical jargon to patients.
Other specialities might not have the resources that are available to cancer patients. But, on the whole, Clinic Time slots are precious. Many UK specialists have long waiting lists.
So if further time and effort is to be expended in busy clinics for dictating plain English Letters – in addition to the usual Medical letters to GP – good clinical evidence is needed to demonstrate that separate plain English letters do benefit patients in a meaningful way.
Please do read the BMJ article and put forward your views in the rapid response section.
New year. January. First month of a New year – it’s the time of year many people take a look at their lifestyle and vow to eat better, exercise better and live better.
Many people consider Gym or Health Club membership.
But Exercise doesn’t need to cost a lot. Being active, doesn’t need to be regimented.
Simply walking anywhere is good compared to no exercise at all. Walking in the Park or Quiet streets has lot of benefits.
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.
It is still early days. The principle has been proven in lab. But to be a useful treatment that can be used in cancer patients, it is still far off.
This particular novel form of immunotherapy using T cells is still in early stages and so many hurdles have to be overcome before this discovery could be employed in cancer treatment.
Nevertheless, it has certainly excited many researchers in the field of cancer and the paper has been published by a premier scientific journal.
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.
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).
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 !
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.
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.
