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Indian Express
4 days ago
- Health
- Indian Express
Hope for stomach, brain cancer? Cancer-fighting immune therapy works on solid tumours in early trials
Despite a failed bone marrow transplant, Delhi's Dr (Col) VK Gupta beat his blood cancer after receiving CAR T-cell therapy at Tata Memorial Hospital. Not only did he recover, he was able to go back to work in his outpatient clinic. He is among those with blood cancer who has benefitted from this cutting edge cancer treatment that re-engineers the body's own immune cells, enabling them to fight the cancerous ones. Can this therapy now work for solid and hard-to-treat tumours as well? Earlier this month, there was good news on this front with two studies indicating increase in life span. Positive results from the first ever phase II trial of CAR T-cell therapy for solid cancers — those in the form of gastrointestinal tumours — were published from China. Another early study on the impact of a double target CAR T-cell therapy on a very difficult-to-treat brain cancer was also published in the US. 'With so many people working on the problem, it is possible that we could soon see CAR T-cell therapy for solid cancers. While the results are unlikely to be as dramatic as we have seen with blood cancers, any hope is good when survival otherwise is just a couple of months,' says Dr Hasmukh Jain, a specialist of blood cancers from Tata Memorial Hospital. He collaborated with the IIT Bombay team that developed the country's first CAR T-cell therapy. CAR T-cell therapy essentially uses a cancer patient's own immune T-cells and engineers them in a laboratory to add receptors that can bind specifically with the cancer cells only. These engineered cells are then multiplied and infused in the patient. Usually, the cancerous cells have the ability to hide from the unmodified T-cells. However, with the new receptors on the T-cells, they cannot. The body's immune system then kills the cancer cells. This, experts say, is because it is much more difficult to target solid cancers than blood cancers. 'One of the biggest problems with CAR T-cell therapy for solid cancers is that there aren't enough good targets. Several of the solid cancer markers are also found on normal, healthy cells, so they cannot be used. There have been cases of pulmonary toxicity with therapies whose target was expressed in small quantities in the lungs. Or, take for example, the BRCA gene mutations in breast cancers; these are expressed by other healthy cells as well,' says Dr Mayank Singh, associate professor of medical oncology at AIIMS-New Delhi. Another challenge is that the same type of cancer may be molecularly very different in different patients — or even within the same patient — making it extremely difficult to find a suitable target for CAR T. Besides, solid tumours are a more complex disease, says Dr Jain. 'Unlike blood cancers, other cancers are not in the blood where the T-cells are. So, they have to find the tumour and enter it. This is difficult as the T- cells are not able to effectively penetrate the tumour microenvironment or the immediate area round the tumour,' he explains. This is hostile towards immune cells and can deactivate them, including the modified T-cells given to patients. The phase II study from China showed that the outcome was better with the new CAR T therapy as compared to the therapy generally prescribed by the physician. Patients with gastrointestinal cancers carrying a specific mutation called CLDN18.2 — having received two unsuccessful treatments previously — were given either the new therapy or existing treatments. The study found that 35 per cent of the patients given the new treatment responded as compared to 4 per cent of those on existing treatments. Those on the new therapy also lived 2.4 months longer on average as compared to the control group. Another new CAR T-cell therapy, which used two targets instead for a very difficult to treat brain tumour called glioblastoma, showed promise in a trial conducted at University of Pennsylvania. The tumours became smaller in nearly two-thirds of the patients with recurrent glioblastoma who received the novel therapy. And, several of the patients have already lived 12 months or longer, which is significant considering that people with this type of cancer typically survive only for six to ten months. Importantly, the researchers also found evidence to suggest that the modified T-cells remained in the patients' immune system and continued to prevent tumour growth over time. Experts say that studies on brain and spinal cancers called gliomas and those targeting CLDN18.2 are probably at the most advanced stages of development and may be approved within a few years. 'Now, researchers are using AI to identify suitable targets for CAR T therapies. This is the reason for the recent increase in trials,' says Dr Singh. The IIT Bombay-incubated start-up ImmunoACT is also working on a therapy that can work on brain and nerve cell cancers called glioblastoma and neuroblastoma. Another therapy that it is pursuing will work on the gastric and gastroesophageal junction cancers — the same cancers as the Chinese trial looked at. Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government's management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country's space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University's Dart Centre. Dutt has a Bachelor's Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More
Times
7 days ago
- Health
- Times
Kara Tointon: Why I had a double mastectomy at 39
Last year I made one of the biggest decisions of my life. I chose to have a double mastectomy and have my fallopian tubes removed. I didn't have cancer, but my decision was driven by it. Six years ago, my mother, Carol, underwent chemotherapy for ovarian cancer. During that time, she was tested for the BRCA1 and 2 gene alterations, which put you at greater risk of breast and ovarian cancers, because we know they run in our family. It was suggested that my sister, Hannah, and I also take a test. We did so in our own time, when we felt ready. My result came back positive. Hannah's, thankfully, came back negative. She had convinced herself that we would enter the process together and so it took a moment for her to be able to talk about it, but she has been a rock for me and has been with me every step of the way. Finding out about the gene alteration gave us all a clarity and an explanation of the generations of women we'd lost in my family, all too early, to cancer. My mum had lost her mother to cancer at the age of 13. In 2002, my Auntie June died lost a ten-year battle to both ovarian and breast cancer and in 2019, two and a half years after her initial diagnosis and three months after my first son, Frey, was born, cancer claimed Mum's life too. For the next five years after my test I was put under 'surveillance' — I had mammograms and MRIs once per year. Doctors had told me about the option of having a mastectomy when I first took the BRCA alteration test in 2018, but I was hoping to have a second child before I went through any major surgery. The first scan showed a benign lump. When tested, this wasn't cancerous, but the risk suddenly felt a lot more real. When these lumps showed up again in a few more scans, it was enough to convince me that I wanted the double mastectomy. The process was surprisingly straightforward. After attending various meetings where everything was explained to me, I waited for the date of surgery. In April last year, I went into the Royal Marsden hospital for one night and returned home the next day with drainage tubes, two mesh layers under my skin where my breasts used to be, and implants underneath. The procedure usually takes up to three hours. My surgeon told me that, although some patients' are able to use fat from their abdomen and buttocks to reconstruct, this wasn't an option for me at this time, hence us choosing implants. Within a few weeks I was up and about; within two months I was able to lift things. The operation did take a mental toll — I found myself surprisingly tired for about three months, but to a certain extent that was overridden by the overwhelming sense of relief. I still have some procedures to complete but I'm very happy with the results and the decision I've made. Five months later, when I had just turned 40, I had a second surgery to remove my fallopian tubes, which reduced my risk of ovarian cancer without me needing to go into an early menopause. When I am closer to a natural menopause, I will have my ovaries removed to further reduce my risk. The procedure and my recovery was relatively quick, and again I only spent one night in hospital. One of the biggest fears people have around this type of surgery is the physical scars it leaves and, while I do have those, I don't worry about them. How you look becomes far less of a concern when you've seen your body heal from two potentially life-saving operations. I now live a peaceful life in Sogne, southern Norway, with my partner, Marius, and our two sons, but I hope I can use my experience to spread awareness of the tests and operations that can help defend against breast and ovarian cancer. Many people are afraid to speak about cancer; Mum certainly was. My childhood growing up in the picturesque Westcliff-on-Sea in Essex was joyful and I'm lucky to have such a close family, but there was one thing Mum would never speak about: her health. For me, speaking about my procedures with other women and hearing their stories makes me feel less alone. That's why I decided to share my experience on Instagram last month. I'd seen a video on my feed of somebody else sharing theirs and it gave me such comfort. At first I felt nervous posting something so personal, but the kind messages I received from other women, many of them going through the same thing, really moved me. Having the BRCA alteration test and preventive surgery is a personal decision and one with many different considerations, but it was the right one for me. I was able to take back some autonomy — cancer once dominated my family but I feel like I am no longer controlled by it. I will always grieve that more treatment options were not available to my mum, but I know that she would want me to give other women a message: don't ignore your body; confronting your health head-on could save your life. Kara is an ambassador for The Eve Appeal — the leading gynaecological cancers charity, which funds research and raises awareness for the prevention and earlier diagnosis of all gynae cancers. You can find information on BRCA gene alterations, genetic testing and preventive options at
Business Insider
14-06-2025
- Health
- Business Insider
I got breast cancer at 30. My treatment means I'll need to delay having kids for 5 to 10 years.
Shortly after my 30th birthday, I was diagnosed with hormone-positive breast cancer. I froze my eggs ahead of my partial mastectomy; treatment means I can't get pregnant for five years. I resent that I have to wait to build a family, but grateful for the chance at survival. When I turned 30, it felt like I was stepping into a new chapter. My partner and I had spent most of our 20s together and were finally in a place where planning for the future felt tangible. After a few difficult years, including the sudden loss of my father and several career missteps, I found myself longing for something joyful and grounding. I wanted purpose, direction, and maybe even a little stability. For the first time, I began picturing myself as a mom. Then I was diagnosed with breast cancer. I was shocked when I got my diagnosis I was diagnosed by accident. I had gone years without seeing a gynecologist. During a routine check-up, I casually mentioned this to my primary care physician, who offered to do a quick breast exam"just in case." That's when she felt a lump. I mentioned that I'd recently been laid off and was in between jobs, without insurance. She told me to reach out once I had coverage and she'd write a prescription for a mammogram. On the drive home, I felt a quiet but urgent instinct not to wait. As soon as I got home, I called her back and asked for the prescription. After a mammogram, ultrasound, and biopsy, I received my diagnosis: stage 1 estrogen receptor-positive, progesterone receptor-positive invasive ductal carcinoma. I couldn't make sense of what I was hearing. Nothing about me fit the narrative I'd grown up believing about who gets breast cancer. I have no family history, don't carry the BRCA gene mutation or any other genetic markers linked to increased risk. What was once seen as a medical anomaly is becoming increasingly common among women my age. My treatment plan included a partial mastectomy, four weeks of daily radiation treatments, and a daily hormone therapy regimen of Tamoxifen, prescribed for five to 10 years, depending on how my system responds. Tamoxifen, often prescribed to treat hormone-positive breast cancer, suppresses estrogen and simulates menopause. It comes with a parade of side effects, including hot flashes, weight gain, and unpredictable mood swings. I learned I can't get pregnant during my treatment Then came a very different kind of blow. Pregnancy while on the medication is strongly discouraged due to the risk of serious complications, including birth defects, miscarriage, and stillbirth. Beyond that, the hormonal surge associated with pregnancy before completing treatment could increase the likelihood of a cancer recurrence. I was scheduled for surgery just one month after my diagnosis. And two weeks before the procedure, my oncologist urged me to freeze my eggs. She explained that pregnancy wouldn't be advised until I was at least 35 due to the complications that could be caused by Tamoxifen — an age that, however dated or insulting it sounds, qualifies as a "geriatric pregnancy" by medical standards. I dissociated my way through a blur of hormone injections, blood draws, and invasive procedures that I barely had time to process. Thankfully, I was spared the financial burden, an immense relief amid the mental, emotional, and physical toll. In 2018, my home state of Connecticut became the first in the nation to require insurance coverage for fertility preservation in cancer patients. Delaying motherhood isn't my choice Though my treatment plan gives me the best chance at survival, it comes at a cost. I'm losing the ability to choose when I want to have kids, and now, I won't be able to have them before 35 at the earliest — possibly as late as 40. I resent that, like it or not, I'll have to be an "old mom" before I ever had the chance to be a "young" one. So far, my partner has been supportive. But I know he always pictured himself becoming a dad sooner rather than later. And when I see him play with our friends' kids, I feel a pang of guilt I can't always ignore. Now we're stuck in limbo while our friends move forward — throwing baby showers, assembling cribs, and posting first-day-of-school photos. I picture myself at preschool, the silver-haired mom whose knees crack at circle time. And I hate that I care. But I do. Then, there's navigating the dissonance between medical necessity and personal expectation. By my 30s, I expected to have it all figured out — career, family, identity. But my timeline was taken from me, redrawn by scans and blood tests, follow-ups, and daily pills. There's also no villain here, no one to blame. It's just a sterile, clinical equation guiding huge decisions about my future. I don't know what's next, but I'm still grateful I'm grateful to be here. I know many people diagnosed with breast cancer never get to consider family planning at all. But I also want to be honest about the loss, the uncertainty, and the weird in-between space where you're healthy but still healing, coping but still grieving the version of your life that never got to happen. I don't know what comes next. Maybe the family I envisioned is still on the way, just a little later than I thought. This isn't the path I planned, but it's the one I'm on. And for now, that has to be enough.
Medscape
13-06-2025
- Health
- Medscape
Fast Five Quiz: Ovarian Cancer Overview
Ovarian cancer poses a significant threat to women's health, often developing quietly and without early symptoms. It is commonly discovered after progression. This late detection, along with resistance to treatment and frequent relapse, contributes to poor outcomes. Although medical and surgical interventions have evolved, survival rates remain low. These challenges highlight the critical importance of early detection methods, precise diagnostic technologies, and individualized care coordinated across medical specialties. How much do you know about ovarian cancer? Test your knowledge with this quick quiz. High-grade serous carcinoma is by far the most prevalent, representing approximately 70%-80% of epithelial ovarian cancer cases. In contrast, the low-grade form of serous carcinoma is much less common (< 5%). Endometrioid and clear cell subtypes are each responsible for about 10% of cases and have known associations with endometriosis. Mucinous carcinomas are uncommon, comprising a small fraction (around 3%) of epithelial ovarian cancers. Learn more about ovarian cancer. According to the National Institute for Health and Care Excellence guidelines, for patients with inherited mutations linked to a higher chance of developing ovarian cancer (eg, alterations in BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, PALB2 ), the most effective preventive surgical procedure is the bilateral salpingo-oophorectomy (which is the removal of both fallopian tubes and ovaries). This intervention has been proven to greatly reduce ovarian cancer risk and enhance long-term survival among these high-risk groups. However, when performed in premenopausal women, it induces menopause. Removing one ovary (unilateral oophorectomy) or the uterus (total hysterectomy) does not offer adequate protection against ovarian cancer. Procedures like cervical conization are unrelated to ovarian cancer and are used to manage cervical abnormalities. Learn more about salpingo-oophorectomy. HRT is typically recommended for women who undergo bilateral salpingo-oophorectomy before reaching the natural age of menopause and have not had breast cancer. This type of surgery causes a sudden and early drop in estrogen levels, which can result in bothersome symptoms and increase the risk for long-term health issues such as bone loss or cardiovascular problems. HRT helps ease these effects and maintain health until the typical menopausal age. In contrast, women older than age 50 years are often already in or near menopause, and HRT is not routinely needed unless specific symptoms arise. Patients who have a history of breast cancer must be assessed on a case-by-case basis because HRT might not be safe. Women with a uterus should be offered combined HRT, whereas women without a uterus should be offered estrogen-only HRT. Additionally, women who have not had their ovaries removed do not experience the abrupt hormonal shift that warrants preventive HRT. Learn more about HRT. Individuals who carry a BRCA1 mutation face a significantly elevated risk of developing ovarian cancer, often at a younger age than those with other hereditary mutations. If a woman with a BRCA1 mutation decides not to undergo surgery to remove her ovaries and fallopian tubes, monitoring for early signs of cancer should begin after age 35 years. This timing aligns with evidence suggesting that BRCA1 -related ovarian cancers tend to occur earlier than those linked to BRCA2 or other genetic variants. Initiating surveillance at age 30 years is generally premature and not part of standard recommendations. For BRCA2 carriers, screening is usually deferred until after age 40 years, whereas those with alterations in genes like RAD51C, RAD51D, BRIP1 , or PALB2 typically begin surveillance after age 45 years. Individuals with Lynch syndrome-related mutations (eg, MLH1, MSH2, MSH6 ) are also advised to start at age 35 years if surgery is postponed. Learn more about breast cancer risk factors. Although mucinous tumors can arise directly from the ovary, many are actually secondary cancers that have spread from other organs, most notably the gastrointestinal system, including the colon and appendix. Distinguishing between primary and metastatic mucinous tumors is crucial for proper diagnosis and management. High-grade serous cancers more commonly begin in the epithelium of the fallopian tubes rather than the ovaries. On the other hand, low-grade serous carcinomas are thought to originate in the ovary and are typically diagnosed in younger females, with outcomes generally more favorable than their high-grade counterparts. Germ cell tumors and sex cord-stromal tumors are far more frequent in adolescents and young adults, with most cases occurring before age 30 years and not in women older than 45. Learn more about endometrioid carcinoma.
Daily Mail
13-06-2025
- Health
- Daily Mail
The shocking cancer link behind a common cosmetic procedure that puts millions at risk
Some women who get breast implants could be up to 16 times more likely to develop a deadly blood cancer, a government-funded study suggests. Around one in 500 women — the equivalent of 34million in the US — have a genetic mutation that appears to raise the risk of tumors forming in scar tissue around breast implants. Known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), the cancer develops when the rough surface of textured breast implants triggers inflammation that damages DNA and causes cells to mutate into cancer cells. Most patients survive if the implants are removed, but if left undetected it can spread elsewhere in the body and become deadly. Dr Paula Ghione, lead researcher and lymphoma specialist at the Memorial Sloan Kettering Cancer Center in New York City, said: 'If we look at the absolute numbers [seen in this study], it's still fairly rare. 'But the important thing to note is that when we look at women with this genetic predisposition, there is a big jump in the percentage with this lymphoma.' Of the 300,000 US women who get breast implants every year, nine in 10 have smooth implants, which have not been associated with an increased cancer risk. The women at risk of BIA-ALCL are those with mutations to their BRCA genes — sometimes dubbed the 'Angelina Jolie gene' — which significantly increases a woman's risk of developing breast and ovarian cancer. In 2023, the latest data available, the FDA reported 1,264 cases of BIA-ALCL and 63 deaths in the US. For their study, published in the journal Blood Advances, researchers followed 3,000 breast cancer survivors at MSKCC who had breast implants after a double mastectomy. Double mastectomies are meant to stop breast cancer from spreading to other parts of the body. Of those, 520 were tested for BRCA mutations. About eight percent of patients, 43, who were tested for BRCA mutations ended up being carriers. After following the women for 12 years on average, the researchers found those with BRCA1 or BRCA2 mutations had a 16-fold increased risk of BIA-ALCL. They also found women with BIA-ALCL were 'significantly' more likely to have BRCA mutations. Dr Gione said: 'Our findings show that BRCA1 and BRCA2 mutations are a significant risk factor for developing this type of lymphoma, confirming earlier suggestions of a possible role. 'It's possible that implant-associated lymphoma is yet another cancer that can arise because of these genetic mutations.' Breast implants with textured surfaces, which can feel like sandpaper, are thought to create space where bacteria can accumulate and form biofilms, or collections of micro-organisms. These harmful biofilms can trigger an inflammatory response, which damages DNA and causes cells to mutate into cancer cells. Silicone in some implants may also lead to inflammation. Because the risk of BIA-ALCL is so low, the FDA doesn't recommend having textured implants removed unless women experience symptoms, which include pain, lumps, swelling or unexpected changes in breast shape. Dr Ghione said: 'The implants that are put in place now are theoretically safe; however, there are still a lot of women who are living with textured breast implants, so it's important that women know what implants they have and talk with their doctor and remember to report this surgery as part of their medical history.'
