
Health Rounds: Vaccine keeps advanced kidney cancer from recurring
Feb 7 (Reuters) - Patients with advanced kidney cancer who received an experimental vaccine after their tumors were removed were still cancer-free years later in a small early-stage trial, researchers reported in Nature, opens new tab.
These were patients "where you know the risk of the cancer coming back is very high," said Dr. Toni Choueiri of Dana-Farber Cancer Institute in Boston, who helped lead the study. "And after a median follow up of almost four years, none of the nine vaccinated patients has experienced a recurrence from their kidney cancer."
Standard treatment for stage III or stage IV clear cell renal cell carcinoma is surgery followed by immunotherapy with Merck's (MRK.N), opens new tab Keytruda. In most patients, however, the cancer recurs, typically within three years, and there are no good treatments at that point.
The new vaccine is "personalized," meaning it is designed to train the patient's immune system to recognize and eliminate any remaining cells of that person's cancer.
Using tumor samples removed during surgery, the researchers identified neoantigens, which are tiny fragments of mutant proteins that exist in the cancer but not in any other cells in the body. Then they determined which of these neoantigens to include in the vaccine based on the likelihood that the immune system would respond strongly to them.
"We pick targets that are unique to the cancer and different from any normal part of the body, so the immune system can be effectively 'steered' towards the cancer in a very specific way," study co-author Dr. David Braun of Yale School of Medicine in New Haven, Connecticut said in a statement.
Working with Merck, the researchers are now testing a similar kidney cancer vaccine in a randomized trial with 272 patients.
In the meantime, Choueiri said, "We're very excited about these results."
AT-HOME URINE TEST SCREENS FOR PROSTATE CANCER
A simple at-home urine test is highly accurate at screening for prostate cancer, according to researchers.
Traditional prostate cancer screening starts with a blood test to measure levels of prostate-specific antigen (PSA), a protein produced by the prostate gland. But the results are frequently unreliable, often leading to biopsies that turn out to have been unnecessary because no cancer was present.
The new test, which analyzes 18 genes associated with prostate cancer, "is highly accurate for ruling out the presence of clinically significant prostate cancers - those that merit treatment - so that patients with a negative test result can confidently avoid having to undergo MRI or biopsy," study leader Dr. Jeffrey Tosoian of Vanderbilt University Medical Center in Nashville, Tennessee, said in a statement.
Tosoian and colleagues had previously validated the urine test in men who also underwent digital rectal exams to detect prostate cancer. The new study found the test - MyProstateScore 2.0, from biotechnology startup Lynx Dx of Ann Arbor, Michigan - was just as accurate on its own, they reported in The Journal of Urology, opens new tab.
"Rectal exams are no fun," Tosoian said. "These findings will increase the impact of the (urine) test, as it can now be used for at-home testing."
In the study of 266 men, including 103 with at least grade group 2, or moderately aggressive, prostate cancer, the noninvasive urine test "would have allowed patients with an elevated PSA to avoid 34-53% of unnecessary biopsies," Tosoian said.
If the test is eventually proven to be similarly accurate in patients being monitored for progression of low-risk prostate cancers, it could potentially "eliminate or reduce the need for prostate biopsies during active surveillance," Tosoian said.
CONTACT LENSES KEEP NEARSIGHTEDNESS FROM WORSENING IN KIDS
Nearsighted children and teens who wear bifocal contact lenses to prevent their vision impairment from worsening do not lose the benefits of the treatment once they stop wearing the lenses, according to new research.
Normally, eye length grows quickly in early childhood, then slows down until it stops around age 12. In myopia, or near-sightedness, the eye's axial length grows too quickly and can continue to grow into the late teens. Slowing this elongation can control myopia.
In an attempt to keep their nearsighted eyes from growing too much, the 235 youngsters in the study, ages 11 to 17, wore soft multifocal contact lenses with a high level of correction for near vision for two years.
The lenses significantly curbed abnormal lengthening of the eyes, and slowed or prevented worsening of the children's near-sightedness. But the researchers wondered whether discontinuing the treatment might cause a rebound of faster-than-normal eye growth that would wipe out the benefit.
During a third year when the children switched to wearing single-vision contact lenses, the researchers saw no evidence that the treatment effect declined, they reported in JAMA Ophthalmology, opens new tab.
"You don't lose the benefits that you gain with this treatment," study leader Dr. Jeffrey Walline of the Ohio State University said in a statement.
The treatment landscape for nearsighted children "is a burgeoning area," Walline said. "The standard of care has switched from providing kids with single-vision glasses or contact lenses to things that slow down the progression of myopia, or the growth of the eye," such as contact lenses or atropine eye drops.
With regard to these new treatments, an editorial, opens new tab published with the study noted that "the fundamental question remains: will myopia control treatments in childhood decrease the lifetime risk of visual impairment from sequelae, such as retinal detachment and myopic macular degeneration?"
"If so, then we will know that these interventions are truly impactful," it added.
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Reuters
13 hours ago
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Russia says it tests new laser defences against drones
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Wales Online
17 hours ago
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My cancer was missed by infamous test then I had to pay £890 for life-saving scan
My cancer was missed by infamous test then I had to pay £890 for life-saving scan 'I could have been walking around totally blind to the danger that I was in' Raymond Starr was diagnosed with prostate cancer after years of uncertainty A pensioner had to fork out £890 for a life-saving scan after his prostate cancer was missed by a rectal exam. Raymond Starr, a 70-year-old from Abergele in Conwy county, was found to have a slightly elevated PSA – prostate-specific antigen – level in 2014 during a routine medical at his GP surgery. As his levels continued to rise Raymond underwent a rectal exam and biopsies which failed to detect his cancer. It was not until July 2017 that he received a diagnosis – and only after he had paid for a multiparametric MRI (mpMRI) scan. Despite a recommendation from Raymond's GP he had to pay £890 for an mpMRI because no scanners were available on the NHS in north Wales. "Thankfully my cancer was caught before it had a chance to spread to other parts of my body," said the retired civil servant, who is cancer-free following the removal of his prostate gland. "But if it wasn't for the mpMRI I could have been walking around totally blind to the danger that I was in after the other tests didn't catch my cancer." Raymond successfully campaigned with the Prostate Cancer UK charity for mpMRI scans to be made accessible across the NHS in Wales but he is now sharing his story to call for another change. He is backing Prostate Cancer UK's message that the first test for prostate cancer should be a simple blood test rather than a rectal exam. It comes after the British Association of Urological Surgeons made the landmark decision to join the charity in calling for an end to the routine use of the rectal exam, which they have branded a 'poor test'. Article continues below A Prostate Cancer UK spokeswoman said: "Alarmingly, despite the rectal exam's poor ability to detect cancer, new data shows it's still being offered to men. "In a recent survey of men who had completed Prostate Cancer UK's risk checker around 750 men said they'd asked their GP for a PSA blood test. A third of these men were offered a rectal examination as well as a PSA blood test. Concerningly 3% of men were offered a rectal exam instead of a PSA blood test. "The infamous 'finger' test has long been associated with prostate cancer and stigma around it makes lots of men feel too scared or embarrassed to talk to their GP about the disease." The British Association of Urological Surgeons says guidelines for GPs – which have not been updated since 2016 – must be changed to reflect that the blood test is superior and that digital rectal exams (DREs) are "no longer necessary". The current guidelines recommend that men with symptoms have a DRE and a PSA blood test. It's important to note that men aged 50 or over can ask their GP for a PSA blood test even if they do not have symptoms. The Royal College of GPs says it is vital to use the most evidence-based methods but that it is 'sensible to wait for the evidence to become available before we change current clinical practice and move away from DRE altogether'. Raymond added that he has been "doing well" since his prostatectomy. "I've been living life to the full and got married to my partner. I'm positive about the future and I'm passionate about raising awareness of this disease. "Fear of having a 'finger up the bum' is still putting people off when actually you don't need to have it and it's not a good test. That's why this movement is so vital to get the message out that you don't need a rectal exam to test for prostate cancer – it's just a simple blood test." According to Prostate Cancer UK one in eight men will get this type of cancer. If you're over 50, a Black man over 45, or you've got a family history of prostate cancer you're at higher risk of getting the disease so should think about getting a free blood test from your GP, says the charity. Article continues below The Welsh Government has been approached for comment on the concerns over the rectal exam.


Metro
18 hours ago
- Metro
I have terminal cancer and won't wait around for the painful death my wife had
It started, as these things often do, with something small – I was getting up to urinate three or four times a night. At first, I thought nothing of it. But my wife Irene insisted I get a second opinion, so I went to the GP. He suggested a PSA test and within 48 hours I got the call: 'Your results are high, Barry. You'd better come in for a chat.' After that, everything moved quickly. Scans confirmed what I feared most: Advanced prostate cancer with just five years to live. It had already spread to my ribs. I'd been feeling tired, but I was in my eighties – I thought that was just life. Suddenly it all made sense. The diagnosis hit hard, not because I feared death, but because I knew how much pain it could cause. I'd seen it before. My first wife, Sheila, died of cancer at just 52, and her death was the most traumatic thing I've ever witnessed. Sheila's symptoms started on the flight home from Florida in March 1998. She was struggling to breathe, then came the coughing and breathlessness. At first we thought it was her medication, but it continued to get worse so we consulted a doctor in August. She was diagnosed with lung cancer by September. At the time, they told us they'd caught it early. This gave us hope, but it didn't last. The cancer spread fast. She went through chemotherapy over Christmas – it made her incredibly sick and did nothing to slow the disease. She had surgery a few months later, but I knew something was wrong the next morning when she was still in intensive care. The doctors told me it had spread to her heart and that there was nothing more they could do. From there, it was straight to the hospice. The staff were brilliant – warm, skilled, tireless – but they couldn't relieve her pain. Sheila was in agony. She was screaming out that she wanted to die, injecting morphine herself and begging for the agony to end. It wasn't depression. It was desperation. She knew she wasn't going to get better and she didn't want to suffer through to the end. Sheila spent three months in that hospice. She came home briefly when they thought the cancer might be in remission, but within 10 days she was back. She died on December 28, 1999, roughly a year and a half after her diagnosis. I was there, holding her hand. My son had been keeping vigil for weeks and, that day, I finally convinced him to go home and rest. She passed within an hour of him leaving. Symptoms of prostate cancer can include: Blood in urine or blood in semen Needing to pee more frequently, often during the night Needing to rush to the toilet Difficulty in starting to pee (hesitancy) Straining or taking a long time while peeing Weak flow Feeling that your bladder has not emptied fully Source: NHS We never talked about assisted dying – back then, we didn't know it existed. But if it had been legal, I have no doubt she would have chosen it. When I was diagnosed in January 2020, I made a clear decision: No chemotherapy. Not after seeing what it did to Sheila. I started hormone treatment instead, which I still receive every 12 weeks, and it's worked really well so far. I'm proud to say that my PSA levels are low and, against the odds, I'm still here over five years later. In 2017, I started researching assisted dying and joined a Swiss organisation, lifecircle, that helps people end their lives peacefully and legally, which has provided some comfort that I won't face what Sheila faced. Barry Gleeson is a supporter of Humanists UK. He writes in a personal capacity. But not everyone can afford to go abroad, and there are still legal implications that put my loved ones at risk if they want to join me in my final days. We've spoken about this as a family and my son is happy to take the risk, but it shouldn't have to be this way. Why do I have to leave my own country and subject my family to criminal prosecution in order to die at peace? The assisted dying bill currently being debated in Parliament could change everything. It would give terminally ill people the legal right to die with medical support. It's not about encouraging death – it's about giving people the choice to die with compassion. Polling shows that 75% of the British public support this, so why is it still up for debate? Some people oppose it for religious or moral reasons. I respect that – for them. But their beliefs shouldn't get to decide how I die. More Trending This is about giving people the freedom of choice, to make the decision for themselves. If you've never sat beside someone who's screaming in pain for months, it's easy to talk about hope and palliative care. But for some, like Sheila, even the best hospice care isn't enough. If the law changes, I'll be able to live the rest of my life with peace of mind. Not because I'm in a rush to die, but because I'll know that I don't have to suffer. That I won't have to put my family through what I went through with Sheila. I hope Parliament listens, not just to campaigners, but to the people who've lived through the trauma watching their loved ones die painfully, and the families who can't forget it. Do you have a story you'd like to share? Get in touch by emailing Share your views in the comments below. MORE: The GP thought my 51-year-old husband had depression until he started forgetting things MORE: I married my husband – then we both fell in love with Kasey MORE: I want to enjoy sex but I can't stop worrying about my breasts