Octopus Invasion in English Channel Flags Marine Heat Wave Risks
Some English fisherman have hit the jackpot this season, hauling in tons of octopus, but the invasion of eight-legged molluscs also highlights the threat from marine heat waves.
Persistent high-pressure weather patterns this spring accelerated the heating of an already unusually warm north Atlantic, blocking cooling westerly winds and smothering currents that stir up colder water layers deep in the ocean, said Paul Moore, a climatologist with Ireland's Met Éireann.
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Medscape
35 minutes ago
- Medscape
The Genetic Counselor: Your Clinic's Missing Link
'Prioritizing Counseling in Genetic Counseling' was a thought-provoking workshop title at the 2025 European Society of Human Genetics Conference, held May 24-27 in Milan, Italy. While it may seem obvious that counseling should be prioritized at a meeting dedicated specifically to counseling patients and their families, this is not always the case in practice. Advances in technology and increasingly complex data could shift the focus toward technical details, often sidelining core counseling principles. These include the emotional burden of living with a genetic disorder or anxiety associated with an increased risk of developing one. 'This focus on issues beyond 'simple' genetics is what defines the role of a genetic counselor. The role is distinct from that of a medical geneticist and is trained in psychological aspects.' Christophe Cordier, PhD, Head of the Genetic Counselling Unit and Genetic Counsellor at Sonic Suisse, Switzerland, told Univadis Italy . Cordier also teaches in the Master's program in genetic counseling at the University of Siena, Siena, Italy, currently the only institution in Italy offering such a course. Theory and Practice Who, then, is the genetic counselor, and what is their role? Jehannine Austin, PhD, is professor and head in both the Departments of Psychiatry and Medical Genetics, and Graduate Advisor in the Genetic Counselling Training Program at the University of British Columbia, Vancouver, British Columbia, Canada, addressed this in her presentation. Since the 1940s, when the term 'genetic counseling' first appeared, the profession has evolved dramatically. It shifted from a service delivered by physicians and researchers, who, despite an official definition free of eugenic intent, focused largely on preventing families from conceiving children with birth defects, to a process designed to help individuals understand and adapt to genetic contributions to the disease. Yet even the most recent definitions fall short, Austin argued: 'It seems to me that it describes the process and not what we should do with patients.' She offered an updated definition: Genetic counseling is a true 'therapeutic interaction' that helps patients make sense of genetic information and apply it in line with their values, needs, and desires. This expansive theory has outpaced practice, often limiting counselors to those with positive genetic test results. In this situation, counselors can encounter burnout problems linked to dissatisfaction or a marked difference between theory and practice. Numbers Matter When faced with genetic data, practitioners can adopt two possible approaches to counseling: One based on what can be defined as 'teaching' and one based on counseling. Both aim for behavioral change; however, teaching drives change from the outside, whereas counseling fosters change from within. Counseling is not only about conveying numbers and ensuring patient comprehension; it is also about helping patients understand why their questions and answers matter, often for deep psychological reasons that can be addressed in a session. 'If we truly want to change someone's behavior, we cannot assume that communicating genetic data,' Austin said. She stressed the importance of integrating genetic data into a coherent narrative that instills responsibility and awareness of how actions matter. It is equally important to address emotions that may block behavioral changes. Counselor Role 'For me, prioritizing counseling is the rule, I could not do otherwise,' Cordier told Univadis Italy . He insisted that direct face-to-face interaction with those participating in the counseling session, whether they are patients or not, is fundamental. 'I do even believe telemedicine or virtual consultations — which can be useful in some particular cases but cannot and must not be the norm, since the psychological implications of a genetic interview are extremely varied and often heavy,' he added. Genetic counseling is a standalone profession that complements other professions. Cordier stated, 'The medical geneticist makes the diagnosis; the counselor takes care of other things, for instance, supporting the geneticist in communicating the result and taking care of emotional and psychological aspects of the diagnosis or referral for testing,' highlighting the pivotal role of the primary care physician as the first point of contact. 'The counselor often serves as a filter between the patient and the geneticist,' said Irene Feroce, a certified genetic counselor at the Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy, who shared the insight with Univadis Italy . This significantly helps physicians to deal only with patients who need to undergo the test. 'All this also translates into a significant economic saving for the health system,' said Feroce. 'Let's not forget, if we want to talk about savings, that a counselor 'costs less' than a doctor,' Cordier said. Professional Challenge In summary, genetic counselors offer multiple benefits. 'In every context in which I have asked at conferences, working groups, commissions, etc. I have always been told that the counselor is a necessary figure,' Cordier said. However, only a few countries, such as France and Iceland, have officially recognized the profession, leading to frustration and burnout among counselors. Barriers often include funding constraints or misunderstandings about the role of these professionals, and sometimes physicians' fear about being replaced by counselors and losing part of their jobs and positions. Genetics now touches every medical specialty, but not everyone needs genetic testing, and not all healthcare professionals can provide counseling. 'We need a change of mentality that gives the right importance to the specificities of different professionals, and we need projects to expand the knowledge among patients and physicians on these issues,' said Cordier and Feroce in unison. 'Keep going. Do not give up!' Cordier advised the aspiring genetic counselors.
Yahoo
an hour ago
- Yahoo
Oceans feel the heat from human climate pollution
Oceans have absorbed the vast majority of the warming caused by burning fossil fuels and shielded societies from the full impact of greenhouse gas emissions. But this crucial ally has developed alarming symptoms of stress -- heatwaves, loss of marine life, rising sea levels, falling oxygen levels and acidification caused by the uptake of excess carbon dioxide. These effects risk not just the health of the ocean but the entire planet. - Heating up - By absorbing more than 90 percent of the excess heat trapped in the atmosphere by greenhouse gases, "oceans are warming faster and faster", said Angelique Melet, an oceanographer at the European Mercator Ocean monitor. The UN's IPCC climate expert panel has said the rate of ocean warming -- and therefore its heat uptake -- has more than doubled since 1993. Average sea surface temperatures reached new records in 2023 and 2024. Despite a respite at the start of 2025, temperatures remain at historic highs, according to data from the Europe Union's Copernicus climate monitor. The Mediterranean has set a new temperature record in each of the past three years and is one of the basins most affected, along with the North Atlantic and Arctic oceans, said Thibault Guinaldo, of France's CEMS research centre. Marine heatwaves have doubled in frequency, become longer lasting and more intense, and affect a wider area, the IPCC said in its special oceans report. Warmer seas can make storms more violent, feeding them with heat and evaporated water. The heating water can also be devastating for species, especially corals and seagrass beds, which are unable to migrate. For corals, between 70 percent and 90 percent are expected to be lost this century if the world reaches 1.5 degrees Celsius (2.7 degrees Fahrenheit) of warming compared to pre-industrial levels. Scientists expect that threshold -- the more ambitious goal of the Paris climate deal -- to be breached in the early 2030s or even before. - Relentless rise - When a liquid or gas warms up, it expands and takes up more space. In the case of the oceans, this thermal expansion combines with the slow but irreversible melting of the world's ice caps and mountain glaciers to lift the world's seas. The pace at which global oceans are rising has doubled in three decades and if current trends continue it will double again by 2100 to about one centimetre per year, according to recent research. Around 230 million people worldwide live less than a metre above sea level, vulnerable to increasing threats from floods and storms. "Ocean warming, like sea-level rise, has become an inescapable process on the scale of our lives, but also over several centuries," said Melet. "But if we reduce greenhouse gas emissions, we will reduce the rate and magnitude of the damage, and gain time for adaptation". - More acidity, less oxygen - The ocean not only stores heat, it has also taken up 20 to 30 percent of all humans' carbon dioxide emissions since the 1980s, according to the IPCC, causing the waters to become more acidic. Acidification weakens corals and makes it harder for shellfish and the skeletons of crustaceans and certain plankton to calcify. "Another key indicator is oxygen concentration, which is obviously important for marine life," said Melet. Oxygen loss is due to a complex set of causes including those linked to warming waters. - Reduced sea ice - Combined Arctic and Antarctic sea ice cover -- frozen ocean water that floats on the surface -- plunged to a record low in mid-February, more than a million square miles below the pre-2010 average. This becomes a vicious circle, with less sea ice allowing more solar energy to reach and warm the water, leading to more ice melting. This feeds the phenomenon of "polar amplification" that makes global warming faster and more intense at the poles, said Guinaldo. bl/klm/mh/phz
Medscape
7 hours ago
- Medscape
Tumor Treating Fields Boost Pancreatic Cancer Survival
The addition of low-intensity electric tumor treating fields (TTFields) therapy to first-line standard chemotherapy was associated with significantly improved overall survival in a phase 3 trial for patients with unresectable, locally advanced, pancreatic adenocarcinoma (LA-PAC). The PANOVA-3 trial 'establishes tumor treating fields with gemcitabine/nab-paclitaxel as a potential new standard treatment paradigm for unresectable, locally advanced pancreatic cancer,' reported Vincent J. Picozzi, MD, first author of the new research, at the American Society of Clinical Oncology (ASCO) 2025 Annual Meeting. The new study, which was simultaneously published in the Journal of Clinical Oncology , is the first phase 3 trial to show an overall survival (OS) benefit for any treatment added to standard chemotherapy in this patient population, where the current 5-year OS rate is less than 8%, said Picozzi in his presentation. TTFields is a non-invasive therapy that delivers electricity to the tumor site via a wearable device and transducer arrays placed on the skin. The electric fields 'disrupt processes critical for cancer cell division and may do a variety of other things, such as trigger an enhanced anti-tumor response,' he explained. The therapy has already been approved in the United States and Europe for use in various cancers, including glioblastomas, metastatic pleural mesothelioma, and metastatic non-small cell lung cancer (NSCLC). Study Methods The open-label study, conducted across 20 countries and 196 sites, included 571 patients with unresectable, locally advanced, biopsy-confirmed, and previously untreated pancreatic adenocarcinoma. Participants had a life expectancy of at least 3 months and Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-2. The patients (median age 67 years, 47.6% male) were randomly assigned to receive only gemcitabine 1000 mg/m2 and nab-paclitaxel 125 mg/m2 by intravenous infusion once a day on days 1, 8, and 15 of a 28-day cycle (n = 286), or the same chemotherapy plus TTFields (n = 285). Patients wore the devices about 15 hours per day for about 28 weeks on average. Notably, almost 30% of the patients were non-White, almost 4% were ECOG PS 2, 'and perhaps most importantly, almost 30% had CA 19-9 levels greater than 1000, suggesting a high incidence of occult, unrecognized metastatic disease,' said Picozzi, a hematologist-oncologist and director of the Pancreaticobiliary Program at Virginia Mason Medical Center, Seattle, Washington. Follow-up visits were every 4 weeks, with chest, abdomen, and brain CT or MRI performed every 8 weeks to assess disease progression. Study Results After a median follow-up of about 13 months, the primary endpoint of OS was statistically improved in the TTFields arm compared with controls (16.2 vs 14.2 months, hazard ratio [HR] 0.82, P = .039), and the 1-year survival rate was similarly better (68.1% vs 60.2%; P = .029). There was no significant difference between groups in median progression-free survival (PFS), at 10.6 vs 9.3 months, respectively. However, the 1-year PFS rate was higher in the TTFields arm (43.9% vs 34.1%, P = .026). 'Perhaps somewhat surprisingly,' a post-hoc analysis showed a statistically significant benefit to TTFields in distant PFS, Picozzi said. Importantly, TTFields showed benefit in quality of life. 'In pain-free survival, another secondary endpoint — which really is freedom from progression of pain over time — we see a very distinct difference' (median 15.2 vs 9.1 months, 1-year pain-free survival rate 54.1% vs 45.1%), he reported. 'Pain is a common and debilitating morbidity in patients with advanced pancreatic adenocarcinoma and a predictor of survival. Thus, by mitigating cancer pain, TTFields may preserve the quality of life of patients with LA-PAC, further supporting TTFields' utility as first-line treatment of this disease,' the authors write in the paper. Patients also performed quality-of-life analyses using the EORTC QLQ-C30 questionnaire, along with the pancreatic cancer–specific PAN26 addendum, 'and using these tools, there was an improvement in deterioration of global health status, pain, and digestive problems,' said Picozzi. Most serious adverse events (SAEs), occurring in 53.6% of the TTFields arm and 48% of controls, were related to chemotherapy or the underlying disease, and were not device-related, the authors wrote. The most common SAEs, which were relatively balanced between arms, were sepsis (6.9% TTFields vs 9.5% controls), cholangitis (5.8% vs 3.7%), bile duct obstruction (5.5% vs 3.3%), and pneumonia (5.1% vs 3.3%), which is a toxicity profile expected for gemcitabine/nab-paclitaxel, Picozzi said. Most device-related AEs were mild-to-moderate skin reactions, consistent with previous trials of TTFields, and could be managed with topical steroids and calcineurin cream. In total, 23 patients (8.4%) had device-related AEs leading to TTFields discontinuation, while discontinuation of chemotherapy due to chemotherapy-related AEs occurred in 17.2% in the TTFields group and 15.8% of controls. Pros and Cons of the Device Study discussant Brian M. Wolpin, MD, a medical oncologist and director of the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute, Boston, Massachusetts, said, 'Assuming appropriate regulatory approvals, I think the combination of the survival increase and quality-of-life benefits suggests this could be an approach that we could use in patients with locally advanced pancreatic cancer.' But 'there are some lifestyle constraints of wearing the device 18 hours a day continuously for months,' he noted. Wolpin's comments also raised the question of whether TTFields could be combined with other first-line choices for LA-PAC, and pointed out that some oncologists treat locally advanced disease with chemotherapy other than gemcitabine/nab-paclitaxel. 'Many of the newer trials have now started to use multi-agent chemotherapy, many different chemotherapy programs, and different lengths of of these trials have used radiation, some have not,' he said. Indeed, the addition of radiation to first-line chemotherapy for LA-PAC is 'very, very routine' in the United States, Michael Chuong, MD, told Medscape Medical News . Nevertheless, Chuong, a professor of radiation oncology at Florida International University in Miami and medical director of radiation oncology at Miami Cancer Institute, called PANOVA-3's results exciting. 'The use of chemotherapy, plus any other non-chemo treatment, has never before shown a survival difference,' he said. 'For example, randomized trials of chemotherapy, plus or minus definitive radiation therapy, showed only differences in local control. I would say [this trial] definitely is going to lead to this becoming a standard-of-care option now. Whether all patients with locally advanced pancreatic cancer should be getting this remains to be seen.' He said the trial's ad hoc finding of statistically significant benefit for TTFields in distant PFS — but not local PFS — suggests that TTFields may be most effective at delaying metastasis. 'If it's delaying onset of liver and peritoneal disease, which almost every one of these patients will ultimately develop, that's huge,' he said, adding that the trial's high number of participants with CA 19-9 levels greater than 1000 suggested a certain amount of metastatic disease in the cohort. Other TTFields Research Is Ongoing Chuong is conducting a single-arm, phase 2 study in the same type of population. In his study, TTFields is being combined with stereotactic ablative body radiation (SABR) in the first-line setting, and he has hypothesized that this will delay metastasis. 'From a mechanistic standpoint, this is a treatment that's applied to the entirety of the abdomen. These low electrical fields are delivered to the peritoneum, into the liver, and that's where the predominant site of distant metastatic disease is in these patients.' The study was funded by Novocure GmbH. Picozzi disclosed stock and other ownership interests in Amgen, Cigna, Iovance Biotherapeutics, Johnson & Johnson, Lilly, McKesson, and Thermo Fisher; a scientific consulting or advisory role with Revolution Medicines, TriSalus Life Sciences; and research funding from AbbVie, Amal Therapeutics, Astellas Pharma, FibroGen, Ipsen, and NovoCureBrian. Wolpin disclosed a consulting or advisory role with Agenus, BeiGene, EcoR1 Capital, Harbinger Health, Ipsen, Mirati Therapeutics, Revolution Medicines, Tango Therapeutics, and Third Rock Ventures; and research funding from Amgen (Inst), AstraZeneca (Inst), Harbinger Health (Inst), Lilly (Inst), Novartis (Inst), and Revolution Medicines (Inst). Chuong disclosed funding from Novocure, Viewray, and Stratpharma.
