Jim Hoffman’s Post

So important to help expand the range of diagnostic tools.

53,000 Americans are expected to die from colon or rectal cancer this year. I usually write here on topics of death and dying. I don't usually write on diseases that can lead to death. But we know so much about inflammation leading to diseases, and in particular the relationship between dysregulation of the gut and disease. I just can't not write about this today. We can take the leap that an inflamed microbiome will result in problems downstream in the colon, or large intestine. Are you with me? Colonoscopies are widely used, but there is another option available: fecal tests. A colonoscopy is where a doctor inserts a colonoscope — a flexible tube with a video camera at the end — into the rectum and colon and looks for polyps and cancers to remove. The doctor may also take samples for study in a lab. If no polyps or cancers are found, the average patient can wait 10 years before having another colonoscopy. Fecal tests can be done at home. Patients collect a stool sample and mail it to or drop it off at a testing lab. The fecal immunochemical test, or FIT, should be repeated annually. A lab analyzes the sample for traces of blood, which can indicate a polyp or cancer. If blood is detected, the patient must have a colonoscopy. One study found that after 30 years, people who had fecal tests had a 33 percent lower death rate from colon cancer than people who were not screened. A 10-year European study of colonoscopy found a 30 percent reduction in the risk of getting colon cancer. If one test is highly invasive with certain risks that are associated with inserting instruments into the body, and the other is simple and easy done in one's home, and both have about the same rate of success in identifying colon cancer, why isn't the fecal test considered best practice? The answer, of course, has to do with profits. “Colonoscopy is a massive revenue generator for hospital systems,” said Dr. Adewole Adamson, of the University of Texas in Austin, who studies cancer screening. I have never had to drink that awful colon-clearing liquid on the day before a colonoscopy. I have never had a colonoscopy. I have never been wiped out for a day or two after a colonoscopy. Need I say more? I have had annual fecal tests for ten years. Ask your doctor about fecal tests. Stop the madness! #deathdoula #coloncancer #fecal tests https://lnkd.in/gvqjk8gP

Day 2 Hereditary cancer awareness week-September 30, 2024 Whenever I ask my patients about their family history of cancer, they immediately panic that their disease is transferrable to their kids. They will come up with what is the reason and how to test to rule out hereditary disease? Today I will explain about genetic mutation and about the most common hereditary syndrome, Hereditary Breast & Ovarian Cancer Syndrome. What is genetic mutation or genetic faults? Genes are the basic unit of heredity and are passed from parents to offspring. Genes are like instructions that tell our bodies how to work, help to make proteins, which are building blocks of our body, or they can control other genes also. What happens when there is a genetic fault or genetic mutation? Genetic mutations or faults are like a spelling mistake in the instruction manual which changes how faults work. For example, everyone has BRCA (breast cancer) genes, which we get from our parents. Function of BRCA genes. The help to fix damaged cells helps an(HBOC)d stop them growing too fast. If there is any fault in these genes, they can’t do their job and cause cells to grow fast. These cause an increased risk of breast and ovarian cancer. Hereditary Breast Ovarian Cancer Syndrome(HBOC): Genetic faults in BRCA 1 and BRCA 2 genes cause HBOC syndrome. The BRCA1 mutation causes the lifetime risk of developing breast cancer of 72% and ovarian cancer risk of 44% in females. In males, there is a 0.4% risk of developing breast cancer. Those people with BRCA 2 mutations or faults that cause lifetime risk of developing breast cancer is 69%, ovarian cancer risk 17% and 2%, pancreatic cancer risk in females and in males, breast cancer risk is 4%, prostate cancer risk 41%and pancreatic cancer risk 3%. How to reduce cancer risk if BRCA gene mutation is positive? Females: 1. Learn to be aware of changes in breasts from 18 years of age 2. From age 25- clinical breast examination by a doctor every 6–12 months 3. Breast MRI once a year from 25 years to upto 75 years of age 4. Mammogram once a year from 30 years of age 5. At any age, you can discuss the benefits, costs and risks of double mastectomy. Although double mastectomy reduces the risk of breast cancer by 90%, there is no improvement in overall survival. 6. Discuss the options of removal of fallopian tubes and ovaries after completing family with your doctor 7. Discuss the benefits and risks of medicines to reduce breast cancer risk 8. Learn to know symptoms of ovarian cancer 9. From 50 years of age, yearly once MRI / MRCP to screen for pancreatic cancer Male: 1. From 35 years, monthly self breast examination and clinical breast examination by a doctor every 6–12 months 2. Mammogram once a year from 50 years of age 3. From 40 years of age, yearly, digital rectal examination and PSA blood test. 4. From 50 years of age, yearly once MRI / MRCP to screen for pancreatic cancer Dr Anbarasi K, MD , DMRT

Inducible #CCR2+ nonclassical monocytes mediate the regression of cancer metastasis:- •Immunotherapy's main limitation is resistance from cancer-mediated inhibition of host lymphocytes. Cancer cells release CCL2 to recruit classical monocytes, promoting metastasis and immunosurveillance resistance. A subset of naturally underrepresented CCR2-expressing nonclassical monocytes is expanded during inflammatory states, which can be induced by treating classical monocytes with small-molecule activators of NOD2. These monocytes infiltrate metastatic sites and recruit NK cells, potentially aiding in immunotherapy-resistant cancers. •Tumors promote monopoiesis and epigenetic reprogramming of CCR2+ classical monocytes into tumor-associated macrophages, driving immune suppression and tumor progression. These monocytes are recruited to the tumor microenvironment via the CCR2/CCL2 axis, which has been identified as a potential target in slowing cancer progression. Some CMs differentiate into intermediate and nonclassical monocytes, patrolling the vasculature to mitigate metastasis. •The study reveals that LY6Cint IntM cells, precursors of NCMs, have varying expression levels, suggesting an alternate pathway for their development. Muramyl dipeptide (MDP) and SARS-CoV-2 virus infection increase the abundance of LY6Clo NCMs. NR4A1 is dominant during homeostasis, driving NCM differentiation with canonical markers. NOD2 activation promotes differentiation towards an inducible NCM (I-NCM) phenotype with noncanonical markers. I-NCMs inhibit tumor seeding and regression, and migrate into tumor microenvironments via the CCR2/CCL2 axis. This suggests that I-NCMs can attenuate tumor metastasis independently of conventional immune pathways. https://lnkd.in/dy-Dhudr

Low oxygen levels in tumors could enhance some of the body's immune responses against cancer: In the complex landscape of cancer, tumors create their own microenvironment, often marked by low oxygen levels, a condition known as hypoxia. Hypoxia arises as tumors grow rapidly, outpacing their blood supply due to the lack of an efficient vascular system within the tumor. This oxygen-starved environment forces cancer cells and surrounding tissues to adapt in ways that typically promote tumor survival and growth. This is also the case for the immune cells already in the tumor microenvironment, that are taught by cancer cells to tolerate the condition and even promote cancer growth by failing to comply with their main job. Therefore, hypoxia is generally associated with more aggressive cancers and poor patient outcomes, as it drives changes that make tumors more resistant to treatment. This well-established paradigm is not absolute, however. Dr. Esteban Ballestar's group at the Josep Carreras Institute has recently published a study in the journal Science Advances reporting the identification and characterization of an immune cell population that, under hypoxia, is more effective in their responses against cancer cells. Such an immune cell population is characterized by certain epigenetic alterationsand the participation of a specific group of factors that contribute to the acquisition of such features. This surprising discovery expands our understanding of the effects of hypoxia in cancer. While hypoxia is known for contributing to cancer progression, this new study reveals that at least part of the body's immune system can fight back. The research focused on macrophages, a type of immune cell critical for maintaining tissue health and fighting infections. In the tumor microenvironment, macrophages are usually reprogrammed to suppress the immune system, leading to worse outcomes for patients. However, this study found that, when exposed to hypoxia, some macrophages undergo significant changes that actually enhance their ability to trigger an immune response against tumors. Read: https://lnkd.in/ek2_m8CW Stay in touch with all the leading stories, events and opportunities by subscribing to my weekly LinkedIn Newsletter here:  https://bit.ly/3KQs0mD

October is Liver Cancer Awareness Month Over 4.5 years ago I typed ‘liver cancer ’ for the first time into my mobile phone. I had developed some intermittent back pain and at some point also some pain under my ribs on the right side, and as many of us would be, I was curious – could it be? What came up on the NHS website were symptoms that I didn’t have – ( jaundice, weight loss, tiredness ) and risk groups that I wasn’t a part of (being over 65, obese, drinking, smoking). This was reassuring and I didn’t bother getting a GP appointment. But in October 2020 I found myself getting to A&E and being admitted to hospital. I had nausea and jaundice then, was exhausted, and lost about 5 kg in a week. When after some tests, doctors told me: ‘You have something in your liver’, I knew instantly what it was. But what I didn’t know is that my tumour (by then about 8cm already) was not the most common liver cancer, the one I was googling when I had a bit of pain. My cancer is bile duct cancer aka cholangiocarcinoma (CCA) – have you ever heard about it? AMMF, the UK’s cholangiocarcinoma charity, tries raising awareness about bile duct cancer as a primary liver cancer. According to the Rethink Liver Cancer report: - Cholangiocarcinoma is the world’s second most common primary liver cancer after hepatocellular carcinoma (HCC). - Incidence is rising sharply, with significant increases in the number of cases recorded in the UK, Europe and across the world. - It is no longer a disease of the elderly. More and more cases are being diagnosed in adults of working age, and we don’t know why. - Cholangiocarcinoma has one of the worst survival rates of any cancer. The 5-year survival rate of 6-9% for CCA in Europe drops to 2% for some types that are not caught early (across all cancers in England, 5-year survival is 54%). - Potentially curable if caught early. Surgery (liver resection) is currently the only potentially curative treatment. - Difficult to spot early due to signs and symptoms that can be vague and non-specific to cholangiocarcinoma. - Mostly diagnosed late and as an emergency via A&E. More needs to be done to help diagnose cholangiocarcinoma at a much earlier stage. - Often missed, misdiagnosed and managed too late. If you have a few minutes to spare, do a little bit of reading, or spread awareness of this cancer. When I was diagnosed, I had no idea about it. My colleagues, my family, my friends – nobody had heard about it. It’s time to stop thinking about liver cancer as something that only affects older generations, those with unhealthy lifestyles, those smoking and drinking or those with liver cirrhosis. It can happen to anyone. https://lnkd.in/e5NgXAyZ #AMMF #livercancer #cholangiocarcinoma #terminalcancer #bileductcancer #October2024 #LiverCancerAwarenessMonth

New Post: A blood test for colon cancer performed well in a study, expanding options for screening – Boston Herald -By CARLA K. JOHNSON (AP Medical Writer) A blood test for colon cancer performed well in a study published Wednesday, offering a new kind of screening for a leading cause of cancer deaths. The test looks for DNA fragments shed by tumor cells and precancerous growths. It’s already for sale in the U.S. for $895,... By CARLA K. JOHNSON (AP Medical Writer) A blood test for colon cancer performed well in a study published Wednesday, offering a new kind of screening for a leading cause of cancer deaths. The test looks for DNA fragments shed by tumor cells and precancerous growths. It’s already for sale in the U.S. for $895, but has not been approved by the Food and Drug Administration and most insurers do not cover it. The maker of the test, Guardant Health, anticipates an FDA decision this year. In the study, the test caught 83% of the cancers but very few of the precancerous growths found by colonoscopy, the gold standard for colon cancer screening. Besides spotting tumors, colonoscopies can prevent the disease by removing precancerous growths called polyps. But some people avoid the exam because of the hassle of getting time off work or the day-ahead preparation that involves drinking a strong laxative to empty the bowels. A convenient alternative is an annual stool test, where people send a stool sample to a lab for analysis. “The best test is the one someone will actually complete,” said Dr. Douglas Corley, chief research officer for Kaiser Permanente, Northern California, who was not involved in the study. “Giving people a choice increases the number of people who will get screened.” In the U.S., screening is recommended for healthy adults ages 45 to 75 at average risk for colon cancer. Frequency depends on the test: a routine colonoscopy is every 10 years. Screening is inching up but falls well short of the 80% of age-eligible adults goal set by the American Cancer Society and other groups. Guardant recommends testing with its blood test called Shield every three years. Like a stool test, the blood test requires a follow-up colonoscopy if there’s an abnormal result, which could lead to more out-of-pocket costs. The study, sponsored by Guardant and published in the New England Journal of Medicine, involved 7,861 people in the U.S. who had both a colonoscopy and a blood test. While the blood test caught 83% of the cancers found by colonoscopy, it missed 17%. That’s on par with stool-based tests. There were also false alarms: For 10% of the people where the colonoscopy found nothing, the blood test falsely indicated they might have colon cancer. That means a sizeable number of people would face the anxiety of follow-up colonoscopies. The blood test is tuned to pick up the signature of colon cancer but more research is needed to determine if it might pick up other cancers as well and give misleading

📃Scientific paper: Interaction between Bacteria and the Immune System for Cancer Immunotherapy: The α-GalCer Alliance Abstract: International audience; Non-conventional T cells, such as γδ T and invariant natural killer T (iNKT) cells, are emerging players in fighting cancer. Alpha-galactosylceramide (α-GalCer) is used as an exogenous ligand to activate iNKT cells. Human cells don’t have a direct pathway producing α-GalCer, which, however, can be produced by bacteria. We searched the literature for bacteria strains that are able to produce α-GalCer and used available sequencing data to analyze their presence in human tumor tissues and their association with survival. The modulatory effect of antibiotics on the concentration of α-GalCer was analyzed in mice. The human gut bacteria Bacteroides fragilis, Bacteroides vulgatus, and Prevotella copri produce α-GalCer structures that are able to activate iNKT cells. In mice, α-GalCer was depleted upon treatment with vancomycin. The three species were detected in colon adenocarcinoma (COAD) and rectum adenocarcinoma tissues, and Prevotella copri was also detected in bone tumors and glioblastoma tissues. Bacteroides vulgatus in COAD tissues correlated with better survival. In conclusion, α-GalCer-producing bacteria are part of the human gut microbiome and can infiltrate tumor tissues. These results suggest a new mechanism of interaction between bacteria and immune cells: α-GalCer produced by bacteria may activate non-conventional T cells in tumor tissues, where they can exert a direct or indirect anti-tumor activity. Continued on ES/IODE ➡️ https://etcse.fr/hIM ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

New Post: A blood test for colon cancer performed well in a study, expanding options for screening – Boston Herald -By CARLA K. JOHNSON (AP Medical Writer) A blood test for colon cancer performed well in a study published Wednesday, offering a new kind of screening for a leading cause of cancer deaths. The test looks for DNA fragments shed by tumor cells and precancerous growths. It’s already for sale in the U.S. for $895,... By CARLA K. JOHNSON (AP Medical Writer) A blood test for colon cancer performed well in a study published Wednesday, offering a new kind of screening for a leading cause of cancer deaths. The test looks for DNA fragments shed by tumor cells and precancerous growths. It’s already for sale in the U.S. for $895, but has not been approved by the Food and Drug Administration and most insurers do not cover it. The maker of the test, Guardant Health, anticipates an FDA decision this year. In the study, the test caught 83% of the cancers but very few of the precancerous growths found by colonoscopy, the gold standard for colon cancer screening. Besides spotting tumors, colonoscopies can prevent the disease by removing precancerous growths called polyps. But some people avoid the exam because of the hassle of getting time off work or the day-ahead preparation that involves drinking a strong laxative to empty the bowels. A convenient alternative is an annual stool test, where people send a stool sample to a lab for analysis. “The best test is the one someone will actually complete,” said Dr. Douglas Corley, chief research officer for Kaiser Permanente, Northern California, who was not involved in the study. “Giving people a choice increases the number of people who will get screened.” In the U.S., screening is recommended for healthy adults ages 45 to 75 at average risk for colon cancer. Frequency depends on the test: a routine colonoscopy is every 10 years. Screening is inching up but falls well short of the 80% of age-eligible adults goal set by the American Cancer Society and other groups. Guardant recommends testing with its blood test called Shield every three years. Like a stool test, the blood test requires a follow-up colonoscopy if there’s an abnormal result, which could lead to more out-of-pocket costs. The study, sponsored by Guardant and published in the New England Journal of Medicine, involved 7,861 people in the U.S. who had both a colonoscopy and a blood test. While the blood test caught 83% of the cancers found by colonoscopy, it missed 17%. That’s on par with stool-based tests. There were also false alarms: For 10% of the people where the colonoscopy found nothing, the blood test falsely indicated they might have colon cancer. That means a sizeable number of people would face the anxiety of follow-up colonoscopies. The blood test is tuned to pick up the signature of colon cancer but more research is needed to determine if it might pick up other cancers as well and give misleading

New Post: A blood test for colon cancer performed well in a study, expanding options for screening – Boston Herald -By CARLA K. JOHNSON (AP Medical Writer) A blood test for colon cancer performed well in a study published Wednesday, offering a new kind of screening for a leading cause of cancer deaths. The test looks for DNA fragments shed by tumor cells and precancerous growths. It’s already for sale in the U.S. for $895,... By CARLA K. JOHNSON (AP Medical Writer) A blood test for colon cancer performed well in a study published Wednesday, offering a new kind of screening for a leading cause of cancer deaths. The test looks for DNA fragments shed by tumor cells and precancerous growths. It’s already for sale in the U.S. for $895, but has not been approved by the Food and Drug Administration and most insurers do not cover it. The maker of the test, Guardant Health, anticipates an FDA decision this year. In the study, the test caught 83% of the cancers but very few of the precancerous growths found by colonoscopy, the gold standard for colon cancer screening. Besides spotting tumors, colonoscopies can prevent the disease by removing precancerous growths called polyps. But some people avoid the exam because of the hassle of getting time off work or the day-ahead preparation that involves drinking a strong laxative to empty the bowels. A convenient alternative is an annual stool test, where people send a stool sample to a lab for analysis. “The best test is the one someone will actually complete,” said Dr. Douglas Corley, chief research officer for Kaiser Permanente, Northern California, who was not involved in the study. “Giving people a choice increases the number of people who will get screened.” In the U.S., screening is recommended for healthy adults ages 45 to 75 at average risk for colon cancer. Frequency depends on the test: a routine colonoscopy is every 10 years. Screening is inching up but falls well short of the 80% of age-eligible adults goal set by the American Cancer Society and other groups. Guardant recommends testing with its blood test called Shield every three years. Like a stool test, the blood test requires a follow-up colonoscopy if there’s an abnormal result, which could lead to more out-of-pocket costs. The study, sponsored by Guardant and published in the New England Journal of Medicine, involved 7,861 people in the U.S. who had both a colonoscopy and a blood test. While the blood test caught 83% of the cancers found by colonoscopy, it missed 17%. That’s on par with stool-based tests. There were also false alarms: For 10% of the people where the colonoscopy found nothing, the blood test falsely indicated they might have colon cancer. That means a sizeable number of people would face the anxiety of follow-up colonoscopies. The blood test is tuned to pick up the signature of colon cancer but more research is needed to determine if it might pick up other cancers as well and give misleading