Tuesday, October 09, 2007

Breakthrough test promises to cut cancer trauma

A SYDNEY scientist has created a world-first test which could save or extend the lives of cancer patients by drastically reducing the trauma of chemotherapy - and make tens of millions of dollars for the University of NSW. The test uses a dye to determine whether cancer cells are being destroyed, allowing for rapid changes in treatment and eliminating one of the most traumatic aspects of the cancer patient's ordeal: long, debilitating chemotherapy courses that can be found months later to be a waste of time.

Professor Philip Hogg, the director of the university's NSW Cancer Research Centre, has developed a family of molecules which attach themselves to dying or dead cancer cells, allowing doctors to determine if a particular course of treatment is working within 24 hours of the first dose. The US pharmaceutical giant Covidien has bought the development rights in an undisclosed worldwide deal worth tens of millions of dollars in royalties to the university. It hopes to have the dye on the market within five years.

Patients receiving chemotherapy or radiotherapy now have to undergo a full cycle of treatment, which can take up to six months, before doctors can determine whether the tumour has been reduced or has grown.

Professor Hogg said the dye would stop patients suffering unnecessarily from side effects if their combination of cytotoxic drugs proved ineffective. It would also allow doctors to personalise treatment. "Chemotherapy has three outcomes - the tumour is reduced, stays the same, or it grows and spreads - but we have no way of knowing which way things are going until the end of a cycle of treatment, or several cycles," he said. "If, at the end of a cycle, we find out the tumour has not been reduced, the oncologist must prescribe a new combination of drugs, or a different treatment, and the patient starts again. This means patients go through a lot of trauma and many don't have the time to waste on ineffective therapies."

Patients would be injected with the dye within 24 to 48 hours after the first dose of chemotherapy or radiotherapy. A CT scan would then show any dead or dying cancer cells. If there were none, or less than expected, an oncologist could immediately change the treatment. "This discovery stems from more than 10 years of research focused on the design of molecular probes to study cellular processes," Professor Hogg said. "We were working on another project when we found that these molecules attached to dead, cultured cells, so we decided to follow our noses and see where it took us. It is very exciting to be able to tailor treatment and to prevent people from the trauma of going through a chemotherapy cycle for months only to find out it didn't work."

Professor Hogg said clinical trials would begin within two years, but the dye was expected to work on all solid tumours, such as lung, breast, colon and prostate cancers. It would not be suitable for leukaemia. Mark Bennett, the chief executive of NewSouth Innovations, which brokered the deal, said he was thrilled with Professor Hogg's discovery. He said the deal validated the university's cancer research expertise. Covidien believes the dye could also be used for people suffering strokes and heart attacks.


Hope for the mentally ill

A PROGRAM designed to keep the mentally ill out of emergency departments and psychiatric units of hospitals has produced spectacular results, an evaluation by the charity Mission Australia shows. Hospital admissions fell by "an astonishing" 92 per cent in the year after people were enrolled in the program, potentially saving taxpayers thousands of dollars. "We've got great results from doing what appears quite simple - helping people get back into life," said Bronwyn Howlett, the charity's mental health operations manager.

The State Government-funded program, known as the Housing and Accommodation Support Initiative, is a joint effort between non-government agencies, the Department of Health and the Department of Housing. It aims to help the mentally ill find or maintain stable housing, and then get the support they need to manage their illness and forge ties in the community.

The evaluation, based on a sample of 24 Mission Australia clients, showed they had spent a combined 28 days in hospital in the year since having joined the program compared to 356 days in the previous year. "It's been successful because you have someone helping the whole person, not just the illness," Ms Howlett said.

Under the $29 million program, to reach 1000 people by the end of the year, a mental health worker from the Health Department visits to monitor medication and doctors' appointments, and a support worker from a non-government agency helps the client with the rest - cooking classes, outings, shopping, social groups, and simply lending an ear.

Tom Shimhame, 42, is typical of those who have benefited. Life has been tough since his diagnosis with schizophrenia 20 years ago. He spent two or three years on the street, he says. And in the year before he joined the program, he spent 30 days in hospital. But in the past 18 months, he has not spent a day in hospital thanks to regular visits from Laurie Bassett and Pat Smith, from Mission Australia, and from a mental health worker. "The main problem was his housekeeping," Mr Bassett said. "The Department of Housing was concerned they would have to evict him because his unit was in such a state." Mr Shimhame agrees: "It was very dirty."

Evictions and homelessness are common fates for unsupported people with mental illness, says Ms Howlett. Mission Australia estimates 70 to 80 per cent of people who seek help from its homeless services have mental illness. By helping Mr Shimhame maintain his tenancy, and sending him to cooking classes, the program has boosted his independence. "I'd rather be at home than in hospital," he said. "More liberty, you don't have to have regulations."

The Mission Australia evaluation is consistent with a bigger study of the program earlier this year by the Social Policy Research Centre at the University of NSW. Based on 600 interviews, including 219 with clients, it concluded the results were "remarkable". Not only had hospital admissions fallen but there was measured improvements in clients' mental health, and gains in their abilities to handle their own banking, diet, exercise and cooking. And the way they looked after their property, "is as good or better than other (public and community housing) tenants." Ninety-four per cent reported making friends compared to nearly a quarter who had none before entering the program.



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.


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