Latest news with #JohnAdams
The Star
2 hours ago
- Health
- The Star
Prostate cancer no longer a death sentence with this superior treatment option
Prostate cancer has long posed a significant health challenge for men. It was first identified in 1853 by Dr John Adams in London Hospital (now The Royal London Hospital) following histological post-mortem examination of the prostate gland. At that time, prostate cancer was considered a very rare disease but it is currently the sixth most common cancer in Malaysia and fourth most common cancer worldwide. The first surgical attempt at treating the cancer was carried out by Theodor Billroth in 1867 via partial prostatectomy, a surgical procedure where a portion of the prostate gland is removed. However, it was only 37 years later in 1904 when Dr Hugh Hampton Young performed the first perineal radical prostatectomy which is still practiced today though with modification and improvement in technique. Medicine is continuously evolving and when radioactive radium was discovered in 1898, it paved the way for the first brachytherapy procedure in 1909. The emitted radiation from radium was used to destroy the diseased prostate tissue. Since the beginning of 20th century, increasingly more men were diagnosed with prostate cancer, with the majority having metastatic disease at presentation. Fortunately in 1941, future Nobel Laureates, Drs Charles Huggins and Clarence V. Hodges published the landmark paper on the effect of castration, of oestrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Their work accelerated studies on anti-androgen therapies which are still in use today. The prostate-specific antigen (PSA) test, discovered in 1980, revolutionised the detection and monitoring of prostate cancer. Over the past two decades, outlook for metastatic prostate cancer has evolved significantly with the introduction of various treatments such as denosumab, zolendronic acid, abiraterone, enzalutamide, olaparib and most recently the radionuclide-based PSMA (prostate-specific membrane antigen) therapy. Roots of PSMA PSMA was first identified by Murphy and Horoszewicz's team. They developed the capromab antibody which targeted the intracellular epitope of PSMA in 1987 and became the foundation of the first United States Food and Drug Administration (FDA)-approved molecular imaging agent for prostate cancer (ProstaScint) in 1996. Heston and Fair's group managed to clone the PSMA gene in 1993 and that led to a flurry of research up to the development of PSMA-based ligands for PET-CT imaging between 2011 and 2012. Since then, there has been many studies demonstrating the sensitivity and accuracy of PSMA PET-CT notably the ProPSMA trial. This multicentre phase 3 clinical trial demonstrated a 27% absolute improvement in diagnostic accuracy of PSMA PET-CT compared to conventional imaging of CT and bone scans. PSMA PET-CT imaging has been in Malaysia for many years but cost and availability of the services have always been an issue. It is expensive to set up and maintain the radiotracer generator and unless there is sufficient patient load and acceptable pricing, most hospitals do not offer PSMA services. Nonetheless, with the FDA-approval of Lutetium-177 PSMA Therapy ( Lu-PSMA) for metastatic castrate-resistant prostate cancer in 2022, there has been growing interest in PSMA PET-CT. Prostate cancers patients tend to present late as they are usually asymptomatic and most prostate cancers are found incidentally during blood test with elevated PSA levels. No man with a prostate gland is spared, and even former US President Joe Biden and the creator of Dilbert comic, Scott Adams, publicly revealed in May 2025 that they have metastatic prostate cancer. The 3D Ga68-PET images show the sites of the metastatic prostate cancer before and after treatment. There is significant reduction in the number of lesions and the PSA levels after three cycles of Lu-PSMA therapy. — Dr ALEX KHOO CHEEN HOE Differing treatment modalities Treatment for prostate cancer is very dependent on the stage of the disease. It is therefore very crucial for doctors to stage the disease accurately. The treatment for a patient with stage 1 prostate cancer is very different from a patient with stage 4 disease. PSMA PET-CT has been shown as aforementioned to accurately stage the cancer. For early stages and depending on the cancer-risks, treatment options include active surveillance, radical prostatectomy, brachytherapy, radical radiotherapy, long-term anti-androgen therapy (ADT) and various combinations. Fortunately for patients who develop metastatic disease, there are still treatment options available for those who are hormone naïve (ADT and novel therapies such as apalutamide, darolutamide, enzalutamide) or for those who developed castration-resistant disease (docetaxel, cabazitaxel, PARP inhibitors, Lu-PSMA therapy). In the past, having metastatic castrate-resistant prostate cancer was like a death sentence with clinician not having much treatment to offer. However, the 2015 introduction of Lu-PSMA therapy in the prostate cancer treatment armament has provided the much needed reprieve. Patient suitability Before doctors embark on treating metastatic castrate-resistant prostate cancer patients with Lu-PSMA therapy, PSMA PET-CT has to be done to determine if the patient is suitable for the treatment. If the cancerous lesions are not seen to demonstrate PSMA radiotracers on PET, then the patients are not suitable candidates for Lu-PSMA therapy. If the patient is suitable for treatment, the radioactive used – either gallium-68 (Ga-68) or fluorine-18 (18F) – in PSMA PET-CT of diagnostic value only is exchanged for a different radioactive (Lutetium-177) which has a therapeutic effect. Some clinicians would advocate doing both 18F-FDG (fludeoxyglucose) and PSMA-base ligand PET-CT upfront as baseline for better treatment selection but cost is usually an issue. Lu-PSMA therapy is a targeted therapy where intravenously administered radioactive (Lu-177) is is guided by the PSMA ligand to prostate cancer cells, which overexpress PSMA on their surfaces. The PSMA expression is 100-1,000 times higher in cancerous cells compared to normal tissue. This differs from conventional treatment (chemotherapy and radiotherapy) where the killing effect affects both normal and cancerous cells. With the highly selective target and short radiation range (1.5 to 3mm) in the body, the side effects from the radioactive treatment are relatively lower. This precision approach exemplifies the concept of 'theranostics,' where radioactive treatment can be imaged simultaneously, something unique to nuclear medicine. Following treatment with Lu-PSMA therapy, doctors are able to determine if the administered radioactive has been distributed to the targeted sites. Based on the post-therapy imaging, the doctors are also able to determine the next step in treatment. Prostate cancer continues to be a significant health concern, but early detection and the availability of advanced therapies offer hope. Men are encouraged to take proactive steps in maintaining prostate health, recognising that not all prostate issues stem from benign prostatic hyperplasia. With continuous advancements, particularly in PSMA-based theranostics, the outlook for patients with prostate cancer continues to improve. Lu-PSMA therapy stands at the forefront of this evolution, representing a critical step toward more effective and personalised cancer care. Dr Alex Khoo Cheen Hoe is a consultant nuclear medicine physician. For more information, email starhealth@ The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Express Tribune
2 days ago
- Entertainment
- Express Tribune
Major character exit changes course of The Gilded Age Season 3
In Season 3, Episode 6 of The Gilded Age, titled If You Want to Cook an Omelette, the story takes a dramatic turn with the unexpected death of John Adams, portrayed by Claybourne Elder. The character dies in a carriage accident shortly after an emotional farewell with Oscar van Rhijn, with whom he shared a covert romantic relationship. John's death occurs during a quiet walk in Central Park, moments after a scene where the two part ways on seemingly hopeful terms. The loss not only marks the end of their storyline but also serves as a catalyst for Oscar's character arc as the season moves forward. The episode also weaves in growing tension between George and Bertha Russell, social maneuvering among New York's elite, and shifting dynamics for characters like Peggy Scott and Marian Brook. Against this backdrop, the departure of John Adams adds emotional weight and narrative complexity. According to the show's creative team, the decision to write off the character was a deliberate one, aimed at deepening Oscar's storyline and exploring the consequences of his choices in a repressive social era. Though sudden, the development aligns with the series' ongoing themes of secrecy, class pressure, and societal expectation.
Yahoo
3 days ago
- Entertainment
- Yahoo
The Gilded Age EPs Defend That Tragic Twist in Episode 6: ‘I Jumped Out of My Skin When I Watched It'
The Gilded Age Oscar van Rhijn will never cross the street without looking both ways ever again. More from TVLine IT: Welcome to Derry Trailer: A Missing Child and Evil Spirit Cause a Small Maine Town to Freak - Plus, Get Premiere Month Save the Dates: Solar Opposites Swan Song, E! News Shuts Down and More The Gilded Age Star Takes Us Inside Marian and Larry's Romantic Moment in Episode 5: 'I Think Both of Us Cried' Sunday's episode ended with the shocking death of John Adams (Claybourne Elder), who was struck by a speeding horse carriage after sharing one last affectionate moment with Oscar on the streets of New York City. 'You've defied the odds,' John told Oscar after leaving an important meeting that set him back on the path to financial stability. 'You are my savior,' Oscar replied, practically bursting to express his love for John, yet forced to settle for a firm handshake. 'I thank you with all my heart.' Even if it wasn't the L-bomb per se, at least Oscar can take some solace in knowing that his final words to John were of affection; poor John stepped off the sidewalk moments later, leaving Oscar gasping for air as he watched his lover's limp body hit the ground. It was a bold swing, one viewers aren't necessarily accustomed to seeing on The Gilded Age. Sure, Ada lost her husband last season, but at least Luke's illness provided some warning, both for Ada and for the audience. John's sudden death on the city streets was brutal, shocking and, as many viewers are likely to point out, somewhat problematic. We weren't realistically expecting Oscar and John to live happily ever after as out gay men, certainly not in the late 1880s, but did their heartbreaking story really need to take yet another tragic turn? Even a life of secret trysts and unspoken love would be better than *checks sidewalk* no life at all. For what it's worth, co-showrunners Julian Fellowes and Sonja Warfield have no regrets about this particularly grim turn of events, as it apparently serves to propel Oscar's storyline in a significant way moving forward. That much will become clear in the next episode, once the initial shock of John's death has subsided. None of those upcoming developments 'would have been achievable if John Adams had lived,' Fellowes teases to TVLine, adding that they were 'quite careful to kill him with a straight accident, not with anything with political overtones. He's just killed in an accident, like anyone could be at any time.' 'Those shocking things are true in life,' adds Warfield. 'I've certainly experienced those traumas. They change you, and we wanted to bring about that change in Oscar.' Putting emotions aside, purely from a technical standpoint, Fellowes believes the show pulled off John's death 'quite well,' saying, 'I jumped out of my skin when I watched it for the first time.' Elsewhere in Season 3, Episode 6… Bertha made good on her promise to George, traveling to Buckingham to remind Lady Sarah who's really in charge now that Gladys and the Duke are married; rather than raking Maud across the coals, Oscar chose a more graceful path, giving her enough money to leave town and start over; furious that Larry lied about visiting an establishment of ill repute, Marian considered ending their engagement; Jack was awkwardly fired once Agnes learned how much he earned from his invention ('It's hard to believe there's a God in heaven!'); after realizing that her so-called 'psychic' is a total fraud, Ada found unexpected comfort in her sister's arms; and Peggy began to tell William about her complicated past, but he assured her that the present is far more important to him. If only his dear, sweet mother felt the same way. OK, let's talk: On a scale from one to 'WTF,' how surprised were you by John's death, and do you the think the show went too far by killing him off? Did you also relish Bertha's scenes with Lady Sarah in England? (She really has been in need of a worthy female sparring partner this season.) And which relationship has you more concerned — Peggy and William's, or Marian and Larry's? Drop a comment with your thoughts on all things below. Gilded Age IRL: See the Cast Out of Costume View List Best of TVLine Mrs. Maisel Flash-Forward List: All of Season 5's Futuristic Easter Eggs Yellowjackets Recap: The Morning After Yellowjackets Recap: The First Supper
BBC News
19-07-2025
- General
- BBC News
Bridgnorth man credits grief education campaign to mum's death
At just 12 years old, John Adams lost his mum, his father openly talked about death and grieving afterwards, Mr Adams found that in school, communication around the subject was "non-existent".Becoming a funeral director at Perry & Phillips in his hometown of Bridgnorth, Shropshire, opened his eyes - he said adults appeared scared to get children involved in funerals, or to speak to them about death at was in 2022 that he started campaigning to get grieving education into the curriculum, and this week, he has achieved that goal. On Tuesday, the Department for Education published its statutory guidance on relationships education, relationships and sex education and health said by the end of primary school, pupils should be taught that change, loss and bereavement can provoke a range of feelings, that grief is a natural response to bereavement, and that everyone grieves the end of secondary school, they should be taught how families and relationships change over time, including through birth, death, separation and new relationships. "I received a phone call on Tuesday," Mr Adams said, "to say it's happened and it's now going into the guidance, and to congratulate me." "It's been relentless. I haven't stopped, it's become who I am. So it's a moment to pause and reflect on what's been achieved."I'm also aware there's more work to do now – it's about what it looks like in the curriculum." 'Death is the only guarantee in life' It was a long road to this point - Mr Adams became president of the National Association of Funeral Directors in 2022, and spoke then about his goal."The idea of it, is that we have more of an idea of the emotions that are affiliated with when someone dies," he said."It's the only guarantee in life, and therefore we should be more informed about what these emotions are and how we deal with them."In October 2022, he launched a parliamentary petition which amassed more than 11,000 signatures. It was debated in Parliament in December 2024."Having a base level within school, I recognise that's where it needs to start," he said."So, when these young people become adults, they have more awareness of knowing how to communicate about death dying and bereavement." Looking ahead, Mr Adams has been asked to help shape how the subject is told the BBC that the first steps would be to provide support and reassurance for teachers who would be delivering the education."The right sessions will come from that," he on the announcement, he said: "My mum, Maria, has been the fuel for the whole of this process and campaign – she's pushed me on. "I hope that she'd be pleased and proud that despite being such a sad time when I was 12, that something good has come of it to help other people." Follow BBC Shropshire on BBC Sounds, Facebook, X and Instagram.
Japan Times
11-07-2025
- Politics
- Japan Times
Trump's rejection of America's founding principles
In late June and early July 1776, the Second Continental Congress framed, debated and adopted the Declaration of Independence. The document announced the creation of a new American republic and established its defining principles: a commitment to free trade, free immigration and internationalism. As the United States celebrated its 249th birthday on July 4, the determination of President Donald Trump's administration to abandon these founding principles has become starkly apparent. By doing so, they risk surrendering the key to America's prosperity and geopolitical influence at a moment when the world has never appeared so unstable. The Committee of Five — John Adams, Thomas Jefferson, Benjamin Franklin, Robert Livingston and Roger Sherman — who drafted the Declaration of Independence condemned King George III for 'cutting off our trade with all parts of the world.' Since George III's accession in 1760, the British imperial government had erected tariffs and nontariff barriers on American trade with the French and Spanish colonies in the Caribbean and South America, depriving Americans of a vital outlet for their products and access to hard currency. This led Jefferson, in 1774, to implore Britain not 'to exclude us from going to other markets.' The following year, Franklin called on the monarchy 'to give us the same privileges of trade as Scotland received at the union (of 1707) and allow us a free commerce with all the rest of the world.' The declaration echoed these sentiments: Free trade was a central tenet of America's founding document, albeit accompanied by state support for the development of new industries. The authors of the declaration also condemned George III for his misguided restrictions on immigration. Well-designed states, America's founders believed, should promote the movement of people. They denounced George III for endeavoring to 'prevent the population of these states' and reversing generations of imperial policy by 'refusing to pass' laws 'to encourage... migrations hither.' By contrast, American patriots welcomed immigrants, who brought new skills to enhance production and immediately proved to be good consumers. 'New settlers in America,' Franklin maintained, cleared farms and established villages and towns, creating 'a growing demand for our merchandise, to the greater employment of our manufacturers.' America's founders declared their independence from Britain not because they wanted to turn their backs on Europe, but because, as the opening sentence of the declaration says, they wanted to situate themselves 'among the powers of the Earth.' That way, European imperial powers such as the Dutch Republic, France and Spain could support them in a global struggle against George III's tyranny. America's founders sought internationalism, not isolation — a goal that many of their successors shared. On July 4, 1821, U.S. President John Quincy Adams, the son of one of the declaration's framers, reflected on the importance of America's founding document when he claimed that its goal was 'to form connections of friendship and of commerce with foreign nations.' Adams concluded that 'never, never for a moment have the great principles, consecrated by the declaration of this day, been renounced or abandoned.' President Abraham Lincoln reinforced the view that the declaration, more than any other founding document, outlines the principles of American government. In his first inaugural address on March 4, 1861, Lincoln declared that the U.S. government was 'much older than the Constitution.' A few weeks earlier, in the hall where the declaration had been signed, Lincoln insisted that he had 'never had a feeling politically that did not spring from the sentiments embodied in the Declaration of Independence.' Later, on July 4, 1864, Lincoln endorsed the free movement of people by signing into law the Act to Encourage Immigration. No one truly committed to the original meaning of America's constitutional document can abandon the principles of free trade, free immigration or internationalism, as framed by Franklin and Jefferson, embraced by Adams and Lincoln and presumably celebrated each year on the Fourth of July. But recent developments suggest that today's political leaders are doing just that. The Trump administration's flurry of tariffs and trade barriers, terrorization and deportation of immigrants and increasing isolationism are more reminiscent of George III's policies than of those defended by America's founders. Over the past 249 years, the U.S. was arguably at its greatest when it fervently pursued its founding mission to guarantee the free flow of people and goods and to build international alliances opposed to tyrannical and autocratic governments. As the country approaches its semiquincentennial, one fears that it is also approaching its nadir. Steve Pincus is professor of history at the University of Chicago and the author of "The Heart of the Declaration: The Founders' Case for Activist Government" (Yale University Press, 2016). © Project Syndicate, 2025
