Tag: 28/1/25

Categories : Cancer DermatologyTags : Leave a comment

New Viral Treatment for Basal Cell Carcinoma Shines in Trials

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Dermoscopy of an approximately 16mm nodular basal cell carcinoma showing telangiectatic vessels. Source: Wikimedia CC4.0

Basal cell carcinomas, the most common form of skin cancer, occur in chronically sun-exposed areas such as the face.  Locally advanced tumours in particular can be difficult to treat surgically. A research team from MedUni Vienna and University Hospital Vienna has now investigated the effectiveness of a new type of therapy and achieved promising results: The active substance TVEC led to a reduction in the size of the basal cell carcinoma in all study participants, which not only improved surgical removal, but also led to a complete regression of the tumour in some of the patients. The study was published in the top journal Nature Cancer.

In the study Talimogene Laherparepvec (TVEC) was used, which has so far only been approved for the treatment of superficial melanoma metastases. TVEC is a genetically modified herpes simplex virus that specifically destroys tumour cells and simultaneously activates the immune system. The aim of the study was to reduce the size of the tumour before a planned operation so that patients would not suffer any functional or cosmetic restrictions after the procedure. The study included 18 patients who would have required a flap or skin graft due to the size and localisation of their basal cell carcinoma. They each received six intralesional injections of TVEC over a period of 13 weeks before the tumour was surgically removed.

“This enabled the tumour to be reduced in size in half of the patients to such an extent that surgery with direct wound closure was possible. In a third of the cases, the subsequent histological examination even showed no more living tumour cells. All treated tumours at least became smaller, and no tumour grew further under the therapy. The treatment was well tolerated by the patients,” says the principal investigator Christoph Höller, Head of the Skin Tumour Centre at the Department of Dermatology, summarising the results. “The new treatment option for basal cell carcinoma can not only simplify surgery, but also help to avoid disfiguring operations and functional limitations,” adds first author Julia Ressler, also from the Department of Dermatology. In addition to the clinical studies, the researchers from the Department of Dermatology, in cooperation with the St. Anna Children’s Hospital, carried out comprehensive analyses that show that the immune defence in the tumour tissue is strengthened in the course of therapy with TVEC.  

These results suggest that TVEC could be a promising option for the neoadjuvant, i.e. pre-surgical, treatment of basal cell carcinoma, particularly in patients for whom major surgery should be avoided. Further studies are to follow in order to confirm the benefits of this new option in a larger patient population.

Source: Medical University of Vienna

Categories : Mental HealthTags : Leave a comment

Challenges in Caring for Adopted Patients with Limited Family Medical History

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Photo by Cottonbro on Pexels

A study based on interviews with primary care physicians has found that treating patients who were adopted is challenging due to limited access to their family medical history. The study, published in Annals of Family Medicine, also found that there was a desire by physicians to fill the information using genetic testing.

Adopted individuals often only have limited information about their biological family, or even none at all, complicating their treatment. The growing availability and popularity of direct-to-consumer genetic testing kits amplifies the need for physicians to be prepared to address genetic testing for adoptees with limited family medical history. To address this, the present study explored the approaches of primary care physicians when caring for adult adopted patients with limited family medical history.

In-depth interviews were conducted by the researchers, including hypothetical clinical scenarios,  with 23 primary care physicians from Rhode Island and Minnesota to understand their experiences, practices, knowledge, and training gaps when addressing limited family medical history and adoption-related issues.

The researchers found that primary care physicians report knowledge gaps and receive little training or resources on adult adoptees with limited family medical history. As a result, they seek guidance around appropriate preventative screening and genetic testing. Limited interaction with adoptees compared to non-adopted patients also influenced perceptions. There was also an over-reliance on stereotypes and the danger of inaccurate media representation affecting how physicians interacted with adoptee patients. Likewise, those physicians who had experience with adoption might be at risk of over-generalising those experiences, especially given how heterogeneous adoptees are as a population.

Furthermore, the researchers found that mental illness and trauma are under-recognised and under-addressed. Care for adoptees includes trauma-informed care which can address factors such as loss, grief, identity development, and to helping adoptees in searching for biological family, reunion, or with complex family dynamics.

To make matters worse, primary care physicians often obtain family medical history imprecisely, risking miscommunication, microaggressions, and damage to the patient-physician relationship.

The findings of this study highlight the significant gaps in knowledge and training for primary care physicians caring for adult adopted patients with limited family medical history. Addressing these gaps may improve the quality of care and strengthen physician-patient relationships. 

Source: EurekAlert!

Categories : Lab Tests and ImagingTags : Leave a comment

Taking Blood Pressure in Public or Noisy Settings does not Affect Reading

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Photo by Hush Naidoo on Unsplash

A randomised crossover trial found minimal difference between blood pressure (BP) readings obtained in public spaces versus those taken in private offices. These findings suggest that public spaces can be an acceptable setting for BP screenings, despite prior clinical guideline recommendations advising quiet settings for BP measurement. The results are published in Annals of Internal Medicine.   

Researchers from Johns Hopkins University randomly assigned 108 adults in Baltimore, MD to  the order in which they had triplicate BP measurements in each of 3 settings: 1) private quiet office (private quiet [reference]); 2) noisy public space (public loud); and 3) noisy public space plus earplugs  (public quiet) to evaluate the effect of noise and public environment on BP readings. The primary outcomes were differences between the mean BPs obtained in each public setting with those obtained in the private setting. The average noise level in the private quiet setting was 37 decibels (dB) and the average noise level in the public setting was 74dB.

In the private quiet setting, the average systolic BP (SBP) and diastolic BP (DBP) were 128.9 and 74.2mmHg, respectively. In the public loud setting, the mean SBP and DBP were 128.3 and 75.9mmHg and in the public quiet setting, the mean SBP and DPB were 129.0 and 75.7mmHg. The results indicate that the differences in BP readings in public, loud spaces versus the clinically recommended setting of a private office are small and not clinically significant. The researchers say these results support the implementation of mass hypertension-screening programs in settings including supermarkets, places of worship and schools.   

Source: EurekAlert!

Categories : Cancer Pain ManagementTags : Leave a comment

Radiology’s Role in Managing Pain in Cancer Patients

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SCP – Dr Winter performing a CT-guided interventional procedure

World Cancer Day, observed every 4 February, aims to raise awareness about cancer, encourage prevention and look at ways of improving a cancer patient’s quality of life. Interventional radiology plays a significant role in pain management for cancer patients.

Traditionally, radiology was used for diagnosing the cause of the pain but interventional radiology has changed this paradigm. Since American radiologist Charles Dotter, first used a guidewire and catheter to perform an interventional procedure in 1964, radiologists have become actively involved in intervention, including interventions for pain management. Today, many minimally invasive procedures are routinely performed in busy radiology departments.

Dr Arthur Winter, a radiologist at SCP Radiology says, ‘Interventional radiology has developed rapidly. Pain management procedures are becoming a daily part of busy radiology departments and play a crucial role in managing pain for cancer patients.

‘Cancer-related pain can be a significant burden, affecting patients’ quality of life and hindering their ability to carry out daily activities,’ says Dr Winter. ‘Radiology offers various techniques and treatments that help alleviate this pain effectively. These therapeutic interventions in pain management include image-guided interventional radiology procedures and radiation therapy.’

Understanding pain

Pain is a signal from the nervous system to let you know that something is wrong in your body. It is transmitted in a complex interaction between specialised nerves, the spinal cord and the brain. It can take many forms, be localised to one part of the body or appear to be widespread.

The nature of cancer pain

Cancer pain can arise from multiple sources, including the tumour itself, which may invade or compress surrounding tissues, organs or nerves. Metastases, the spread of cancer to other parts of the body, can also cause significant pain. Additionally, pain can result from the treatment of cancer, such as chemotherapy and radiation therapy.

Multidisciplinary approach to pain management

Effective pain management for cancer patients requires a comprehensive, multidisciplinary approach. Oncologists, radiologists, pain specialists and other healthcare providers collaborate to develop individualised care plans. Radiology is essential in both the diagnostic and therapeutic phases of this process, providing crucial insights and treatment options.

These personalised care plans, tailored to each patient’s needs, ensure:

  • Accurate diagnosis and identification of pain source or sources
  • Targeted and effective treatment interventions
  • Ongoing monitoring and adjustment of pain management strategies

Imaging techniques

Diagnostic radiology initially uses various imaging techniques to identify the source and extent of pain in cancer patients. These techniques include: X-rays, CT scans, MRI, PET scans and ultrasound.

By identifying the precise location and cause of pain, radiology can help:

  • Determine the most appropriate interventions, such as surgery, radiation therapy or minimally invasive interventional procedures
  • Monitor the effectiveness of pain management strategies and make necessary adjustments
  • Avoid unnecessary treatments that may not address the underlying cause of pain

Interventional radiology

Interventional radiology uses minimally invasive techniques to diagnose and treat various conditions and, for cancer patients experiencing pain, it offers several effective treatments:

  • Radiofrequency ablation (RFA): This uses heat, generated by radiofrequency energy to destroy cancerous tissues – often to treat painful bone metastases or tumours that are difficult to reach surgically
  • Cryoablation: Involves freezing cancerous tissues to destroy them. It is particularly useful for treating painful bone or soft tissue tumours, providing rapid pain relief
  • Nerve blocks: Involve the injection of anaesthetic agents or steroids near specific nerves to block pain signals. They can provide significant pain relief for patients with nerve-related pain

Palliative radiation therapy

In this instance, radiologists are involved with planning imaging only. The actual radiotherapy is performed by the radiation therapist, who works under the supervision of a radiation oncologist. Palliative radiation therapy is specifically designed to relieve symptoms and improve the quality of life for cancer patients. It focuses on pain control and symptom management rather than curing the disease.

Radiation oncologists deliver targeted doses of radiation to cancerous tissues, this palliative radiation therapy can help:

  • Reduce tumour size, alleviating pressure on surrounding tissues and nerves
  • Control bleeding or ulceration caused by tumours
  • Provide rapid pain relief, often within days to weeks of treatment

Improving quality of life

Dr Winter highlights that chronic pain can significantly diminish quality of life and contribute to depression, particularly in patients with underlying cancer. ‘These patients, in particular, should be considered for interventional procedures. For instance, there are highly effective treatments available to manage pain associated with pancreatic and pelvic cancers’.

‘Specialists, such as oncologists and neurologists, acknowledge the significant role of interventional radiology in pain management and collaborate closely with us to support their patients. As a rapidly advancing branch of radiology, it provides minimally invasive solutions and it is incredibly rewarding to witness patients regain their quality of life through effective symptom relief.’

Categories : General InterestTags : Leave a comment

MMBCh Tops Applications as Wits University Welcomes First-year Students for 2025

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Photo by Element5 Digital on Unsplash

Among the 85 000 undergraduate applications for 2025 Wits received for 2025, the single most-applied for degree was for the Bachelor of Medicine and Bachelor of Surgery (MBBCh). Of these applications, the university could only register around 6000 first-year students. These students represent the best of the best, earning their place in one of Africa’s most competitive academic environments, with an average of over five distinctions per student in their matric results.

From KZN, Glenwood High School’s Brydyn Le’Jean Barnabas, who was offered a place to study MBBCh, says, “I’ve been hearing from friends and family that this is such a prestigious university. It’s not only backed by impressive statistics but also has a rich culture and heritage, having been around for decades. Compared to other universities, it’s truly a privilege to be here. When I received my acceptance letter, my heart dropped – not just with joy but with  gratitude for this opportunity.”

Bachelor of Pharmacy was also a popular degree, coming in at the fifth most applied-for.

Recent enrolment trend assessments indicate that the majority of students offered a place at Wits have achieved an Admission Point Score (APS) exceeding 30, with most scoring 34 or higher. The minimum APS required for degree programmes at Wits is 30, making entry into the university a significant accomplishment.

Wits continues to uphold its reputation as a hub for academic excellence and innovation, attracting top-performing students from across the country and the continent. The university remains committed to nurturing the next generation of leaders, thinkers, and innovators.

For more information about the experiences of first-year students and why they chose Wits, read more here: Wits News.