Latest news with #patients
Sky News
6 hours ago
- Business
- Sky News
New three-drug combination could help women with aggressive breast cancer live longer, study suggests
A new three-drug combination could help women with a common form of aggressive breast cancer live longer, a study has suggested. The trial, which included 325 patients from across 28 countries, showed the treatment more than doubled the time before the cancer "progressed or worsened", according to the lead author, and could delay the need for chemotherapy. The combination may become the "new go-to option" for women with PIK3CA-mutated hormone receptor positive (HR+) human epidermal growth factor receptor 2 negative (HER2-) breast cancer, said the researchers. This mutation in the PIK3CA gene causes cells to divide and replicate uncontrollably. More than half of the patients in the trial had metastatic breast cancer that had spread to three or more organs and the majority had already had chemotherapy. Researchers used a blood test known as a liquid biopsy, which detects tumour DNA in the blood, to test for the PIK3CA mutation. Of the total, 161 were given a three-drug combination comprising two targeted drugs - palbociclib, a type of cancer growth blocker, and a new drug called inavolisib, which blocks the activity of the PI3K protein - as well as the hormone therapy fulvestrant. The placebo group, which included 164 patients, was given a dummy pill plus palbociclib and fulvestrant. The median overall survival in the inavolisib group was 34 months, compared with 27 months in the placebo group. The three-drug therapy also delayed disease progression by 17.2 months, compared with 7.3 months in the placebo group, with patients also able to delay chemotherapy treatment by almost two years longer. The combined therapy of inavolisib, palbociclib and fulvestrant is not approved in the UK. However, the combination of palbociclib and fulvestrant has been available as an option for patients with certain types of breast cancer on the NHS since 2022. 1:48 'More time before needing chemotherapy' Lead author Nick Turner, a professor of molecular oncology, said: "The key findings from this study showed that the inavolisib-based therapy not only helped patients live longer but it more than doubled the time before their cancer progressed or worsened. "It also gave them more time before needing subsequent chemotherapy which we know is something that patients really fear and want to delay for as long as possible. The final results of the trial, by experts at the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust in London, have been published in the New England Journal of Medicine and presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. About 55,000 women are diagnosed with breast cancer in the UK every year, some 70% of whom will have HR+, HER2- breast cancer. PIK3CA mutations are found in 35-40% of HR+ breast cancers. Prof Kristian Helin, chief executive of the Institute of Cancer Research, London, said: "One of the challenges with combination therapies is ensuring the right drug dosages and understanding their individual effects. "It is extremely encouraging that this study not only demonstrates the effectiveness of this approach but also shows that the therapy was generally well tolerated by patients." Dr Simon Vincent, director of research, support and influencing at Breast Cancer Now, called the findings "a significant breakthrough".
Daily Mail
7 hours ago
- Business
- Daily Mail
Thousands of women with incurable breast cancer thrown a lifeline - doctors say hope is now possible
A first-of-its-kind daily pill that slows the spread of aggressive breast cancer is set to revolutionise the treatment of thousands, experts say. A trial has found that the drug, vepdegestrant, is twice as effective as existing treatments at extending the lives of patients with incurable breast cancer—buying them precious time with loved ones. Experts say that vepdegestrant also has far fewer side effects than medicines used on the NHS, and can be taken at home. One in seven women in the UK are diagnosed with breast cancer in their lifetime—around 56,000 a year—making it the most common cancer in the UK. While nine out ten patients survive, the disease still claims the lives of more than 11,000 annually. Around two-thirds of breast cancer patients in the UK have a form of the disease called ER positive HER-2 negative breast cancer. Of these, up to half with an advanced form can develop a genetic mutation which makes their cancer resistant to treatment. Patients who get this mutation—called ESR1—typically have less than two years to live. Currently, these patients receive a once-a-month injection called fulvestrant, which stops cancer cells from feeding off oestrogen, the female sex hormone that research shows helps tumours to grow. However, fulvestrant, which has to be adminstered by a healthcare professional, has a number of uncomfortable side effects including hot flushes, nausea and muscle pain. In some cases, it can also damage the liver. Even then, the injection can only keep the disease at bay for, on average, two months, the trial showed. And only a fifth of fulvestrant patients go six months without their cancer spreading. But the vepdegestrant trial, presented at the American Society for Clinical Oncology conference in Chicago, found that the tablet halted the spread of breast cancer for, on average, five months. Moreover, nearly half of the 300 patients given vepdegestrant went six months without their cancer spreading. The study found that the drug, which also blocks cancer cells from consuming oestrogen, has no major side effects. Experts say it is too soon to say exactly how much longer vepdegestrant patients live than those on fulvestrant, but they expect the difference to be significant. The drug is already being fast-tracked for use in the US and has been sent for approval in the UK. Experts believe it could get the greenlight in the UK because it is so much better than the existing options. 'Fulvestrant is incredibly painful and uncomfortable for patients, the majority of whom are forced to have to come to the clinic for it,' says Professor Komal Jhaveri, an oncologist at the Memorial Sloan Kettering Cancer Centre in New York. 'Oral tablets can be taken at home.' Dr Jane Meisel, a medical oncology professor at Emory University in Georgia, said: 'This drug will be a very exciting option for patients that could transform treatment.' Given it can be taken at home, does not leave patients suffering debilitating side effects, 'it's definitely the first of its kind', she added.
Yahoo
8 hours ago
- Health
- Yahoo
PSA: You Probably Don't Need To Be Weighed At The Doctor's Office
For many struggling with body image, heading to the doctor for a specific health issue or even just a routine checkup is more stressful than it needs to be. Weigh-ins are a standard practice before you see your doctor, but if you've experienced an eating disorder or are self-conscious about your weight, jumping on a scale in the middle of a busy hallway is a tall order. But here's an underdiscussed secret: You really don't have to be weighed every time you go to the doctor. 'It is entirely correct that after age 18, most people do not need to be weighed at the doctor's office,' Jennifer Gaudiani, a Denver-based physician who treats patients with eating disorders, told HuffPost. Of course, there are a handful of exceptions: Weight understandably needs to be tracked when a patient with an eating disorder has specific weight needs in order to treat the disease. If someone comes in and is concerned about unexplained weight loss, that needs to be measured and watched, too. 'And young children need to have weight and height monitored to make sure growth is proceeding properly,' Gaudiani said. 'Pregnant people also need to have weights followed ― although they don't need to have the weights revealed or discussed ― to be sure baby is getting what baby needs.' But outside of exceptions like these, Gaudiani said she's confident that '90%' of weigh-ins taken at medical offices are entirely unnecessary. 'What that means is someone coming in to talk about their depression, digestion, substance use or twisted ankle can find themselves on the other end of a lecture about weight and weight loss,' she said. That sometimes results in weight-conscious patients avoiding health checkups altogether. 'Unnecessary weigh-ins chill patients' willingness to see medical providers, waste everyone's time, fail to address the most important concerns of the patient, and may push individuals into cycles of dieting, maybe some weight loss, then regaining even more,' she said. Given Gaudiani's thoughts on weigh-ins, she was thrilled last month when she saw these 'Please Don't Weigh Me' cards trending on Twitter: The cards, created by eating disorder recovery site read: 'Please don't weigh me unless it's (really) medically necessary,' adding: 'If you really need my weight, please tell me why so that I can give you my informed consent.' The cards were initially free for individuals but now cost $1 each due to demand. There's an option for health care providers to purchase a batch, at $35 per 100 cards. The site also offers 'please don't talk about my child's weight' cards to parents, to kick off important conversations with kids about the often unfair conflation of weight with good health in advance of a checkup. (Children need to be weighed but the card says, 'If you have any questions, ask me when my child is not present.') 'I'm a fan of these cards because it's a starting point where the patient or parent doesn't have to come up with all the words and reasons themselves, but rather has the support of the card as a neutral object to try and advocate for their bodies,' Gaudiani said. Ginny Jones, the founder of created the initial batch of cards back in 2019. In recovery from her eating disorder, Jones had begun asking not to be weighed at doctor's appointments. She soon realized not everyone knew that was an option. Getting health care providers on board with the cards has been great ― 200 providers have ordered anywhere from 100 to 500 cards for their offices, Jones said ― but the responses she's received from individuals has been the most heartening. 'The best feedback I hear from patients is, 'I made my first appointment in years!'' Jones said. 'I'm shocked to hear personally from so many people who are delaying health care because they hate stepping on the scale. I love that these cards give them the confidence to walk back into a health care provider's office.' Gregory Walters, a writer and educator from Vancouver, British Columbia, who was diagnosed with anorexia in his 50s, sees the card as a simple but effective tool to empower patients to advocate for themselves. Being weighed triggers Walters, but in the past, he struggled to discuss it with health care providers. 'Under no circumstances can I know my weight,' he told HuffPost. 'If it's more than I expect, I amp up my eating disorder behaviors. If it's less, it becomes a weird game where I decide to see how much lower I can go.' Walters hasn't weighed himself in more than 10 years. When he spent six weeks in the hospital in 2019 for eating disorder treatment, they did blind weigh-ins around 6 a.m. every Monday. 'We always stood on the scale, facing away from it, which as a method of weighing me was affirming,' he said. 'It told me the doctors and staff understood how traumatizing a number related to one's weight can be.' Before that, he would just close his eyes when stepping on a scale at a doctor's office and say emphatically, 'I don't want to know.' These days, Walters' family doctor has learned about his triggers, but he knows how hard it can be to speak up for yourself. 'It can be challenging for anyone to talk with doctors,' he said. 'Their time can feel limited. As a patient you can feel intimidated due to a perceived imbalance in terms of education and knowledge.' The card 'allows a patient to quickly get a message across without having to stumble and bumble through an extremely uncomfortable conversation,' he said. In an ideal world, it wouldn't be such an uncomfortable conversation. Asking not to be weighed should be as simple as stating, 'I'd prefer not to be weighed today.' Unfortunately, it's not always that easy, according to Gaudiani. If you say you don't want to be weighed and are challenged, Gaudiani said to tell the nurse, 'Thanks for letting me know it's standard, but this is my body, and I'm electing not to be weighed. You may write 'declined' on my note for insurance purposes. I'm happy to discuss it further with my doctor.' If the doctor challenges you, bring up the medical issue that brought you into their office in the first place. 'That might sound like, 'I have a short amount of time with you, and I really need to discuss my back pain, my constipation and my asthma today. Let's focus on that, please,'' Gaudiani said. Since going viral, the cards have received some criticism from people online who think the cards are enabling or will do damage to public health given the obesity epidemic in America. Shana Spence, a registered dietitian nutritionist based in New York, said she thinks weight stigma and a larger trend of fatphobia in the medical field does greater damage to the quality of health care and health outcomes than any card could ever do. 'Fatphobia in the medical field often translates into a lack of diagnosing for ailments,' she said. 'When someone goes in for pain or whatever ailment, it's extremely discouraging to be told to just lose weight or simply ignored altogether. What are those in thinner bodies told for the same ailments?' Spence said there are many instances when people in larger bodies are congratulated on weight loss, no matter how unnatural or unhealthy it is. 'Even a thin or straight-sized person is congratulated on weight loss because we as a society are very weight-centric,' Spence said. A 2012 survey of almost 2,500 U.S. women found that 69% reported feeling stigmatized for their weight by their doctors and 52% endured recurring fat bias. As Spence pointed out, diagnoses are often missed because providers are fixated on the number on the scale rather than the full picture of health. A review of studies published in the journal Obesity Reviews in 2015 showed that health care professionals' negative feelings about fat bodies can lead to misdiagnosis and late or missed diagnoses, negatively impacting patient outcomes. Studies have also shown that this bias makes women and people in larger-sized bodies less likely to seek health care in the first place. The good news is, more weight- and body-neutral doctors seem to be entering the profession. Some doctors have adopted a Health at Every Size, or HAES, approach to public health. HAES-aligned health care providers seek to deemphasize weight loss as a health goal while reducing stigma toward larger bodies in the medical field. Most HAES health care providers believe that the current practice of linking weight to health using body mass index standards is not only biased but unhelpful when it comes to weight loss. (If you're looking for a HAES-informed health care provider in your area, there's an online database that you can search by area or specialty.) A 2017 study out of the University of Pennsylvania found that when people feel shamed because of their weight, they are more likely to avoid exercise and consume more calories to cope with this stress. Spence noted that healthy solutions include encouraging patients to incorporate more fruits, vegetables and fiber-rich foods into their diets, work on strategies to quit smoking and focus on mental health, since stress can contribute to many health problems, including high blood pressure, heart disease, obesity and diabetes. 'There is no need to concentrate on numbers constantly,' she said. At the very least, medical professionals should start asking patients if they want to be told their weight. When Gaudiani consults with fellow medical practitioners who aren't quite on board with radically reduced weight checks, she asks them at least to consider asking for consent. 'A doctor or staff could say, 'Would you be willing for me to check your weight today? I was worried last month when you said you were feeling low energy and having a harder time getting in your meals, and I'd like to follow up,'' Gaudiani said. 'So much of medicine assumes permission to act upon patients' bodies, when in fact we need to be honoring body autonomy and seeking consent much more.' What To Do If Your Doctor Fat Shames You Being Fat Is Not A Moral Failure. Here's How To Teach Your Kids That. Your Body On Alcohol: How It Affects Your Heart, Liver, Weight And Cancer Risk
Medscape
13 hours ago
- Health
- Medscape
Fast Five Quiz: Multiple Sclerosis and Depression
Depression is among the most common comorbidities of multiple sclerosis (MS), leading to psychological quality-of-life issues that can further exacerbate a patient's functional capacity. The significant burden of depression in patients with MS is typically associated with neuroinflammatory processes which are directly correlated to depression severity. Understanding the relationship between depression and MS is crucial for healthcare providers, to develop effective treatment strategies that address both the neurologic and psychological aspects of the disease. What do you know about the interplay of MS and depression? Check your knowledge with this quick quiz. The prevalence of depression in the general population is approximately 13%, according to the Centers for Disease Control and Prevention (CDC). Other data indicate that it falls between 25% and 54% in patients with MS. Depression, along with other disorders such as anxiety and fatigue, are among the most common comorbidities of MS. These comorbidities further degrade quality of life in patients who are already affected by the functional disabilities caused by the diseases. A multidisciplinary approach can help to holistically manage MS to ensure that quality of life is optimized across specific healthcare needs. Learn more about guidelines for MS. A recent systematic review reported that depression symptoms do not significantly improve after smoking cessation in patients with MS, although these patients do see improvements in anxiety. The same review noted that depression is associated with a 1.3- to 2.3-fold increased prevalence in patients with MS who also smoke tobacco. Although smoking cessation is known to cause short-term mood changes, a recent cross-sectional analysis of the NHANES study found that longer duration of cessation is associated with lower risk for depression. However, the persistence of depression in former smokers with MS might be due to depression's strong association with MS, and clinicians should not assume that depression symptoms will improve when a patient quits smoking. Learn more about tobacco product use and depression. Though depression and anxiety can occur in any subtype of MS, an extensive review and meta-analysis found that both were more prevalent in progressive MS (defined by the researchers as PPMS and SPMS) compared with RRMS. In contrast, the same meta-analysis reported that patients with MS and an Expanded Disability Status Scale (EDSS) score of less than 3 had higher rates of depression compared with patients with an EDSS score of greater than 3, while the prevalence of anxiety was higher in patients with an EDSS score greater than 3 compared with an EDSS score below 3. Proinflammatory cytokines in MS have been shown to disrupt the monoaminergic system, which is a component of the pathogenesis of depression. As such, treatments that enhance monoamine neurotransmission (such as SSRIs, SNRIs, and dopaminergic psychostimulants) are indicated for use in depression and MS-associated depression. Learn more about the pathophysiology of MS. Although comorbid depression in MS often presents similarly to fatigue, several characteristics can help clinicians distinguish between the two and guide appropriate treatment. According to a recent review, patients with depression typically have better functioning in the evening while those with fatigue typically have better functioning in the morning. Other characteristics of depression tend to include hypersomnia and hopelessness; patients with fatigue usually experience insomnia and strong hopefulness for recovery. Learn more about symptom management of depression and fatigue in MS. According to a systematic review and meta-analysis assessing exercise best practices for depression in MS, programs implementing ergometer training protocols had the largest effect size. The data reviewed indicated immediate improvements in depression scores with exercise, and depression symptoms were found to improve regardless of exercise frequency, duration, or activity. This is consistent with another review that cited a range of nonpharmacologic interventions for improving depression in MS, including exercise as well as cognitive-behavioral therapy, yoga, dietary habits, and sleep hygiene. Further, data on Hatha yoga, circuit training at moderate intensity, and resistance training with active rest periods in patients with MS and depression are limited. Learn more about exercise for depression. Editor's Note: This article was created using several editorial tools, including generative AI models, as part of the process. Human review and editing of this content were performed prior to publication.
Forbes
a day ago
- Business
- Forbes
Why Some Travelers Skip The Big Cities For Domestic Medical Tourism
Historically, the best medical treatment has been exclusive to large cities, which possess the necessary infrastructure and funding. That trend is starting to change with more travelers seeking comparable care in select suburban and rural destinations. Domestic medical tourism is gaining popularity, offering opportunities to receive similar care while exploring existing destinations. Sandhill Crane (Grus canadensis) flock flying with mountain backdrop, Kalispell, Montana, USA, October. (Photo by: Avalon/Universal Images Group via Getty Images) Universal Images Group via Getty Images Mid-tier cities and suburban areas are more likely to offer advanced medical treatment than in the past, thanks to increased travel flexibility and changing population trends. As a result, providers can leave the big city and thrive within their specialty. While major cities like New York and Boston are home to some of the top hospitals, they are also some of the most expensive places to live and work. Following the COVID-19 pandemic, many professionals sought a more affordable work-life balance, which led to smaller cities attracting top talent, including both healthcare workers and potential patients. For instance, many residents from expensive counties in California, such as Los Angeles and San Francisco, relocated to more affordable states like Arizona, Texas, and New Mexico during the pandemic. As a result, medical facilities expanded. Cities like Tucson and El Paso have been able to provide quality care without incurring the costs associated with a major city. Dr. Siona Motufau is a prime example of blending advanced care with serene surroundings that big cities cannot provide. He specializes in cosmetic implant dentistry and founded Ohana Dental Implant Centers in Montrose and Grand Junction, Colorado. Yet, it's still easy and affordable to reach by car or air. His clinic has handled over 300 complex restorative cases, many of which were deemed untreatable by other providers. Ohana also has an in-house dental lab to control every detail and provide consistent results for local and visiting patients. 'When you control the entire process—from surgery to final prosthetics—you can deliver results that are not just functional, but flawless,' says Motufau. Motufau studied under Dr. Carl Misch, the father of modern implant dentistry, and Dr. Tavelli, Harvard's leader in managing implant complications. He combines their knowledge with his vision to blend aesthetics with advanced surgery to become the go-to destination for complex full-mouth restorations that require surgical skill and artistic vision. Some examples of procedures that people are willing to travel for include dentistry, cancer treatments, fertility services, orthopedic surgery, cosmetic procedures, bariatric surgery, and organ transplants. Choosing a treatment destination is one of the most appealing aspects of medical tourism. Staying in a busy metropolitan area is costly, with lodging and transportation adding an extra financial burden to medical expenses. Not everybody is comfortable in busy urban areas, and the atmosphere can present additional stress that delays recovery or inhibits rest and relaxation. Dr. Motafu partially chose to practice on Colorado's Western Slope for its scenery. Patients can enjoy exploring one of the state's most scenic areas and enjoy a small-town setting during their downtime. The greater Grand Junction area also has a thriving medical infrastructure with reputable providers. Local residents and long-distance patients alike receive the treatment they need with the ability to enjoy nature unimpeded. Recovery is a crucial factor when researching medical tourism, and having a comfortable space to recuperate is vital for maintaining one's health. Being able to explore the fresh mountain air or relax on a sunny beach between appointments can make the medical experience more enjoyable. Some medical facilities have even been able to save hospitals that were on the brink of shutdown. Staff in Kalispell, Montana, have been able to attract patients with nearby ski resorts and lakes. They have also built the first pediatric hospital in rural Montana. Major medical facilities offer diverse treatment options, but the personalized attention can be lacking due to high patient volumes. While there is a time and place to visit these locations, smaller providers can provide more hands-on care and attention from staff members. Patients can get to know their caregivers and vice versa. A population boom in McKenzie County, North Dakota, for example, enabled funding for a medical facility, making it easier for patients to receive medical care. The smaller facility allows patients and people living in the nearby counties to benefit from personalized care. A tiny farm house is seen in the background off of U.S. Hwy 85 going throughout Arnegard, N.D., Sept 24, 2013. In 2008 the North Dakota oil boom started its ongoing period of extraction of oil from the Bakken formation. The amount of jobs the oil boom has provided North Dakota has helped give it the lowest unemployment rate in the United States and and gave it a billion dollar surplus. Shale gas reserves has given the United States more independence over other nations such as Venezuela and count (Photo by Ken Cedeno/Corbis via Getty Images) Corbis via Getty Images There is also the possibility of visiting different facilities when a single specialist cannot provide integrated care. In this situation, providers can improve coordination so patients receive the necessary care without delay. Dr. Motafu believes the future of medicine includes converging the functional and aesthetic components. He plans on expanding his clinical model into other high-demand markets so patients have greater access to cosmetic implant dentistry nationwide. 'Too many people walk into a dental office expecting a new smile, and walk out with a lifetime of complications. That's the problem I've dedicated my life to solving,' Dr. Motafu says. Leading healthcare institutions are more expensive than smaller clinics that offer similar treatment or quality of care in most cases. Higher demand helps spur pricing power, but it's also costly to maintain state-of-the-art infrastructure and staff. Prices can also vary across locations for big-name providers, such as the Mayo Clinic, which operates campuses in several states. Treatment can be cheaper in states with a lower cost of living, with major providers and highly skilled independent practitioners. While medical treatment within the United States is more expensive than overseas, the transportation costs can be lower when driving or booking affordable flights. Some travel brands may also offer special rates for medical travel, though this varies by airline, rental company, and hotel. However, it may be worth investing in travel insurance, depending on the procedure and destination. Additionally, the potential cost savings are less substantial for minor procedures or when overseas travel costs are pricier than anticipated. You also don't run the risk of post-treatment complications that the overseas destination may not have the resources to address. It's worth mentioning that between 150,000 and 200,000 international visitors come to the United States each year specifically for medical care that is unavailable in their home country. While it may cost more for medical assistance in the United States, the quality of care provides peace of mind and can reduce the need for follow-up procedures due to rushed work or inexperienced staff. The domestic healthcare space is adapting as more citizens want regional, state-of-the-art care. There is strong demand in many mid-tier communities that are easily accessible. Domestic medical tourism can be more affordable and more personal, depending on the location. Related Articles:
