Women with hormone receptor-positive, early-stage breast cancer who adhere to adjuvant endocrine therapy (AET) reduce the risk of cancer recurrence and mortality.
AET, however, is associated with adverse symptoms that often result in poor adherence. We applied participatory action research (PAR) principles to conduct focus groups and interviews to refine and enhance a web-enabled app intervention that facilitates patient-provider communication about AET-related symptoms and other barriers to adherence.
THRIVE app content reflects researchers’ partnership with a racially diverse sample of breast cancer survivors and healthcare providers and adherence to participatory design by incorporating patient-requested app features, app aesthetics, and message content.
The app has the potential to improve AET adherence and quality of life among breast cancer survivors and reduce disparities in mortality rates for Black women by facilitating communication with healthcare providers.
Personalized medicine is hoping to reach new heights thanks to the Cancer Moonshot, but won't get off the ground without a community-wide commitment to sharing big data.
The precision medicine community has long since recognized that sharing big data, including clinical records, genomic sequencing data, community-level health indicators, and research results, will be critical to making progress against cancer, neurodegenerative diseases, inherited conditions, and expensive chronic diseases like diabetes.
“Why is data sharing important? Because cancer is complex,” said Kenneth C. Anderson, MD, President-elect of the American Society of Hematology (ASH). Anderson specializes in multiple myeloma, a blood cancer with treatment options that hinge on the genetic variances of each and every patient.
“We’re learning so much about cancer, and applying these insights to drug development has been incredibly fruitful,” he continued. “Now we have treatments that are specifically targeted to patients’ genetic mutations. Not only are these treatments more effective — because they correct a specific mutation — they also minimize harmful side effects that we see with traditional total-body anticancer medicines.”
However, the continued development of these treatments cannot be sustained without a commitment to data sharing, he added.
Which apps can be used by chronic cancer patients to help them with their illness and overall health?
There are literally thousands of medical apps in the marketplace and it is very difficult to sift through them and find out which ones are easy to use, practical and helpful.
Joan Justice did some research, asked some patients, and read a lot of reviews to try and get an idea of which ones were helpful for chronic cancer patients and published this...
It includes some of my recommendations: ClinicalTrialsSeek and Pillboxie along with many others...
Since the beginning of the 21st century, mobile phones have become nearly ubiquitous. At the end of 2011, there were an estimated 6 billion mobile subscriptions, accounting for approximately 87% of the global population
Rapid technological convergence has led to the emergence of smartphones—feature-rich phones that combine the voice and text messaging functions of basic phones with powerful computing technology that can support third-party applications, sensing, Internet access, and wireless connectivity with other devices.
According to a 2012 report from the Pew Internet and American Life Project, 85% of US adults own a cell phone of some kind and 53% own a smartphone
The combination of their popularity, technical capabilities, and proximity to their owners makes them an attractive platform for the delivery of health promotion and disease management interventions
Systematic review methodology, as described by Moher et al , was used to guide the collection and characterization of eligible apps from the official smartphone stores and the evidence on app utility or effectiveness from the health literature. We developed a systematic search strategy that attempted to identify all relevant apps and studies and we provide a systematic presentation and synthesis of the characteristics of the apps and the studies.
RESULTS:
The search of the mobile phone market yielded 1314 potentially relevant apps, of which 309 apps met our selection criteria (Figure 1); 90.3% (279/309) of apps were available on the iPhone or Android markets . Twelve apps were available on more than one platform (10 were available in two stores and 2 in three stores). Therefore, there were a total of 295 unique apps.
Release date information was available for only 38.0% (112/295) of the apps from Apple, Android, and BlackBerry, as the remainder had produced updated versions and only published their date of update. Release date information was not available for apps on the Nokia market.
Half of the apps (50.2%, 148/295) were free to download. Of those free-to-download apps, 8 were trial versions of the full pay-for-download applications. These free apps offered limited versions of the full apps, restricting access to the full suite of features.
The majority of the apps did not describe their organizational affiliation (64.1%, 189/295). Of those that provided organizational information, 63.2% (67/106) were affiliated with a non-profit, 26.4% (28/106) with a commercial company (eg, Health Monitor Network), 9.4% (10/106) with a university or medical institution, and 1 app was affiliated with a government institution (eg, National Institutes for Health).
Apps affiliated with not-for-profit organizations (non-profit, university, medical institution, or government) were more likely to be free (?21=16.3, P<.001). Apps that did not disclose their affiliation were more likely to have a price (?21=50.1, P<.001).
The field of medical technology is incredibly exciting these days. Each breakthrough has the potential to impact the lives of thousands of patients, sometimes changing the course of medical history and forever improving the human experience. Such can be argued for antibiotics, x-rays, vaccines, or even things as seemingly simple as disposable medical instruments (an extremely important sanitary innovation). Year after year, teams of research physicians and engineers work to advance our knowledge and abilities.
This article reviews some of the most influential medical innovations of the past year. From new insights in the treatment of diabetes to a new type of optical surgical procedure, incredible innovations and advancements have been achieved this year.
Implant Relieving Severe Headache Pain
A new type of neuromodulation therapy has emerged that seems to be an effective treatment for cluster and migraine headaches. Neuromodulation therapy treats a cluster of nerves behind the face that signal headache pain. This device, implanted in the face by way of the mouth, is positioned to stimulate the facial nerve that relieves headaches when stimulated. A separate device, placed on the cheek, activates the device, relieving pain in as quickly as five to ten minutes.
Bariatric Surgeries Treating Diabetes
Doctors who have performed bariatric surgery, also known as gastric bypass, have noted in the past that many of their patients had gone into diabetes remission as they recovered from surgery. This evidence has some health care professionals advocating gastric bypass treatment as an early tactic for fighting diabetes, instead of as a last-resort effort.
Bee Venom Treats HIV
One toxin found in bee venom, melittin, has been found to destroy HIV particles. Researchers claim that the particles break apart the physical structure of the virus, but are too small to have an impact on other cells within the body. A proposed method for distributing the chemical is a topical virucidal agent.
Detecting Skin Cancer with a Hand-held Device
Caught at an early stage, the survival rate for melanoma is 99 percent. In advanced stages, though, that rate drops to a mere 15 percent.
The good thing about the skin and its relation to cancer is that we can observe it. Visual detection is the best way to prevent advanced stage melanoma. Therefore checking moles and other discoloration on the skin regularly can be the best form of early detection. If a patient notices a change and brings it to the attention of their dermatologist, this new device is able to scan the area and report to the physician whether or not melanoma is present within a few seconds. It works by analyzing a database of over 10,000 images alongside a structural scan of the skin using military-grade optical technology. Clinical trials show that this device is nearly 98% effective.
Cataract Surgery at one Quadrillionth of a Second
Femtosecond laser technology will help improve the outcome in the more than 1.6 million annual cataract surgeries that are performed in the US annually. The apparatus, which separates the tissue by ablating and cleaving it, instead of cutting it, operates in one quadrillionth of a second. Its speed and precision help reduce swelling post-op, allow less time to be spent on the eye, and help the surgeon be more accurate with the implant. Optical surgeons across the globe are eager to implement this new device in order to improve their practice.
These days medical technologies are growing really fast. With the amount of hard work and effort scientists, researchers, and doctors have put in, many medical problems are being solved. I can't wait to enter the medical field and see what my knowledge can do to save people's lives.
An understanding of Online Profile Management for Oncologists, with an Indian perspective.
Covers Digitally Aware Patients and Social Networks, The Need for Online Profile Management, an understanding of Local Reputation vs Global Reputation, Tips for How to do it while avoiding the traps and describing techniques for Maximizing Online Exposure for Oncologists
Deep mind will use data available to it via a new partnership with Jikei University Hospital in Japan to refine its artificially intelligent (AI) breast cancer detection algorithms.
Google AI subsidiary DeepMind has partnered with Jikei University Hospital in Japan to analyze mammagrophy scans from 30,000 women.
DeepMind is furthering its cancer research efforts with a newly announced partnership.
The London-based Google subsidiary said it has been given access to mammograms from roughly 30,000 women that were taken at Jikei University Hospital in Tokyo, Japan between 2007 and 2018.
Deep mind will use that data to refine its artificially intelligent (AI) breast cancer detection algorithms.
Over the course of the next five years, DeepMind researchers will review the 30,000 images, along with 3,500 images from magnetic resonance imaging (MRI) scans and historical mammograms provided by the U.K.’s Optimam (an image database of over 80,000 scans extracted from the NHS’ National Breast Screening System), to investigate whether its AI systems can accurately spot signs of cancerous tissue.
Healthcare data is increasingly being analyzed and complex algorithms created to help various aspects of the healthcare ecosystem.
A big problem is the availability of huge data sets, and where available, the prevention of their misuse. Its great that Deepmind is able to source data sets , (being a sub of Google, am sure plays a role), and hopefully they will put their deep mind ;) to good use and be able to improve detection algorithms.
I have written previously on this, and it will be useful for patients and if the data sets do help create both faster as well as more accurate detection algorithms in the future.
In 2011, a 52-year-old runner and yoga enthusiast walked into the office of Monica Loghin, a neuro-oncologist at MD Anderson Cancer Center in Houston, complaining of numbness and weakness in her lower limbs and difficulty controlling her bladder.
The symptoms were of grave concern, as the patient had previously undergone surgery for breast cancer that had spread to her brain. If such a cancer returns post-surgery, that is often a sign the patient doesn’t have much time left.
An MRI confirmed that the breast cancer had again spread to the woman’s cerebrospinal fluid. Loghin ordered testing of that fluid to see if the patient might have certain biomarkers that could be targeted by existing drugs. (A biomarker is a DNA sequence or protein associated with the disease; different biomarkers can suggest specific treatments, depending on the disease and other factors.) She asked for tests that could detect tumor cells circulating in the blood.
The cancer cells in the fluid bathing the woman’s spinal cord and brain chambers did, in fact, have a lot of the protein that controls a glucose (sugar) transporter that drives cancer cells. The cancer cells in the fluid also had a lot of HER2, a protein associated with aggressive breast cancers but also treatable with a drug called Herceptin (trastuzumab). The drug is usually taken intravenously, but Loghin had heard of a couple of cases in which Herceptin was delivered directly into the cerebrospinal fluid via a flexible tube, or catheter. The patient agreed to this experimental treatment.
It took only a week for the news to improve. After the first infusion of Herceptin, the patient’s cancer numbers were down. Within a few weeks, her cancer cell numbers had fallen so low that her immune system had begun to take over, clearing out the remaining cancer cells. Nearly two and a half years later, the patient is still alive and well enough to do yoga. Another MD Anderson patient who had a similar disease profile and therapy is also alive and well one year after treatment.
This case outlines the dream of personalized medicine: A disease is analyzed at the molecular level. The analysis identifies a drug target. The drug gets delivered where it needs to go. The patient gets better. And while this hopeful scenario has yet to become commonplace, it is becoming more and more the norm for many breast cancer patients.
“If you’re dealing with a disease like cancer that can be arrived at by multiple pathways, it makes sense that you’re not going to find that each patient has taken the same path” - John McDonald, a professor in the School of Biology at the Georgia Institute of Technology in Atlanta.
If a driver is traveling to New York City, I-95 might be their route of choice. But they could also take I-78, I-87 or any number of alternate routes. Most cancers begin similarly, with many possible routes to the same disease. A new study found evidence that assessing the route to cancer on a case-by-case basis might make more sense than basing a patient’s cancer treatment on commonly disrupted genes and pathways.
The study found little or no overlap in the most prominent genetic malfunction associated with each individual patient’s disease compared to malfunctions shared among the group of cancer patients as a whole. “This paper argues for the importance of personalized medicine, where we treat each person by looking for the etiology of the disease in patients individually,” said McDonald,
“The findings have ramifications on how we might best optimize cancer treatments as we enter the era of targeted gene therapy.”
The research was published February 11 online in the journal PANCREAS and was funded by the Georgia Tech Foundation and the St. Joseph’s Mercy Foundation.
In the study, researchers collected cancer and normal tissue samples from four patients with pancreatic cancer and also analyzed data from eight other pancreatic cancer patients that had been previously reported in the scientific literature by a separate research group.
McDonald’s team compiled a list of the most aberrantly expressed genes in the cancer tissues isolated from these patients relative to adjacent normal pancreatic tissue.
The study found that collectively 287 genes displayed significant differences in expression in the cancers vs normal tissues. Twenty-two cellular pathways were enriched in cancer samples, with more than half related to the body’s immune response. The researchers ran statistical analyses to determine if the genes most significantly abnormally expressed on an individual patient basis were the same as those identified as most abnormally expressed across the entire group of patients.
The researchers found that the molecular profile of each individual cancer patient was unique in terms of the most significantly disrupted genes and pathways.
“If you’re dealing with a disease like cancer that can be arrived at by multiple pathways, it makes sense that you’re not going to find that each patient has taken the same path” - John McDonald, a professor in the School of Biology at the Georgia Institute of Technology in Atlanta.
Cancer research is something I'm particularly interested in and would try to go into someday and I found this interesting because it shows how medicine has evolved and becoming more personalized.
Personalized medicine is the art and science of “coupling established clinical–pathological indexes with state-of-the-art molecular profiling to create diagnostic, prognostic and therapeutic strategies precisely tailored to each patient’s requirements.”1
The clinical development and regulatory approval of targeted agents that have therapeutic benefit in molecularly defined patient subsets has highlighted the value of personalized medicine, which can be leveraged in clinical trials so that the identification of eligible patients for certain trials is optimized based on the patient’s molecular testing. These targeted patient groups are often rare and expensive to identify, particularly in the field of oncology, making clinical trials targeting these populations difficult to enroll.
Patient pre-profiling, determining a patient’s tumor-specific molecular profile, could have great value for physicians and patients as they consider potential clinical trial options. To the extent that a molecular profile is broad, encompassing many potential target alterations, one can easily imagine benefits such as more efficient enrollment, increased participation by physicians and patients and more informed treatment decisions. Pre-profiling before a trial is set up at a particular site offers a more efficient approach to enrollment while also providing greater molecular testing to support patient care.
Our current understanding of cancer biology indicates that cancer is a large number of niche diseases that may be targeted with therapies against specific molecular alterations. Drug development under this model creates new challenges for both the development program itself and for patient care. Patient preprofiling promises to leverage high throughput genomic profiling, bioinformatics and, where possible, new trial designs to drive better trial matching and faster enrollment to clinical trials.
Preprofiling may require new relationships and business models, most notably, among patients, clinical sites, biopharmaceutical sponsors and CROs to enable data sharing, site start-up and funding of the genomic testing. The adoption of a new model of patient genomic profiling linked to novel clinical trial designs testing targeted therapies in development is becoming a key response to the challenge to develop many compounds in niche populations in a cost and time sensitive manner.
La gestión de ensayos clínicos es complicada. En este caso, se añade la dificultad de dividir a los pacientes según sus mutaciones. A medida que la medicina personalizada avanza, se hace más necesaria una colaboración internacional entre centros u hospitales para abarcar a todos los pacientes posibles en los ensayos clínicos. Esto también hace necesario tener en cuenta las diferencias que puedan existir entre las leyes regulatorias de los ensayos clínicos de los distintos países.
Every year IBM makes predictions about 5 technology innovations that stand to change the way we live within the next 5 years.
This year, one of those 5 is Personalized Cancer Treatment.
In five years, doctors will routinely use your DNA to keep you well. Cancer will be treated on a DNA level in both the patient and tumor, at a scale and speed never before possible.
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