PSM News

June 12,2024 New Delhi: Observing that the state has to exercise its parens patriae jurisdiction in cases concerning those with mental health issues and without family support, Madras high court directed the state to take into custody a 20-year-old youth with mental health issues, house him in appropriate accommodation and provide him “lifelong medicare”, reports K Kaushik. The court was hearing a plea filed by parents of a man whose has serious mental health issues. He was admitted to Tirunelveli Medical College and Hospital’s psychiatry ward on May 5, 2022 and discharged on June 6, 2022. He has been diagnosed with bipolar affective disorder and has current episodic mania with psychotic symptoms. Unable to support their son, the petitioners, daily wage labourers, wanted govt to take over his upbringing. Justice G R Swaminathan, allowing the plea, said: “The moot question that arises for consideration is whether the state can be saddled with liability in such cases. My answer is yes.” He said the state must exercise its parens patriae jurisdiction in the case of the mentally disabled who are without family support. When the state fails to exercise its duty, the constitutional court, exercising jurisdiction under Article 226 of Constitution, will direct the authorities to discharge the aforesaid function. The judge observed that the state is obliged to set up residential homes for the mentally disabled in every district. This alone will reduce overcrowding. There are NGOs who have set up such shelter homes, the state should liberally support them financially. Source: Healthworld

June 12,2024 New Delhi: BJP president JP Nadda, who took charge of the health ministry on Tuesday, held a brief meeting with senior officials and asked them to focus on the agenda for the first 100 days. Ministers of state for health Anupriya Patel and Prataprao Jadhav also attended the meeting. Extending coverage under the Ayushman Bharat scheme to people aged 70 years and above, and the launch of a vaccine portal, U-Win, are among the top items on 100-day plan. “The Ministry of Health and Family Welfare plays a crucial role in the nation’s progress and the well-being of its people. As the backbone of the country, the health sector not only promotes public health but also stands as a strong force in addressing and overcoming health challenges,” the minister posted on X after taking charge. Nadda also assumed charge of chemicals and fertilisers ministry. Source: Healthworld

June 12,2024 Bangor: It is becoming increasingly clear that spending time in nature can benefit our mental health and wellbeing. But a new study by my colleagues and me shows that you don’t have to actually be in nature to reap the rewards. Simply directing your gaze towards natural elements, even in the middle of a city, can enhance wellbeing. Our paper, published in the journal People and Nature, used eye-tracking technology to explore how focusing on natural versus man-made elements affects mental health. Urban living, with its fast pace and high levels of stress, has been linked to numerous mental health issues, including anxiety and depression. Our research team, which was led by me and consisting of my colleagues Brian Rizowy and Assaf Shwartz, recruited 117 adults for the study. Participants were randomly assigned to one of three groups: one that focused on natural elements such as trees (green group), one that focused on man-made elements such as buildings (grey group) and a third group that focused on a mix of both (mixed group). Each participant wore specialised eye-tracking glasses during a 45-minute guided walk around town and the campus. The route included ten designated stopping points designed to emphasise either natural or man-made elements, depending on the group. Before and after the walk, participants completed surveys assessing their mood, anxiety levels and the restorative quality of the walk. The surveys included standardised measures such as the positive and negative affect schedule (Panas) and the state-trait anxiety inventory (Stai). The eye-tracking glasses recorded where participants were looking throughout the walk, allowing researchers to quantify the amount of time spent focusing on green (natural) or grey (man-made) elements. In fact, our technique offered a precise and objective measure of visual engagement, strengthening the link between nature exposure and improved wellbeing. The data confirmed that each group really did spend more time looking at the scenery we had asked them to focus on. The results were striking. Participants who focused more on green elements reported significant improvements in mood and reductions in anxiety compared to those who focused on grey elements. And they showed higher levels of positive emotions and lower levels of anxiety after the walk. They also reported feeling more refreshed and rejuvenated. In contrast, the grey group did not show these improvements, and the mixed group had intermediate results, suggesting that even a partial focus on nature can be beneficial. Implications for urban planning These findings have important implications for urban planning and mental health practices. Designing urban spaces that incorporate natural elements and encourage visual engagement with nature could help reduce the mental health burden of city living. For instance, planners could prioritise green spaces, tree-lined streets, parks and ponds that invite people to pause and take in the natural beauty. The findings could also be useful for mental health professionals. For example, they may want to incorporate guided attention exercises into therapy, encouraging patients to specifically focus on natural elements during walks or other outdoor activities. This simple, cost-effective strategy could enhance traditional treatments for anxiety and depression. The study highlights the importance of visual engagement with nature, providing robust evidence that the mental health benefits of nature are closely tied to where we focus our attention. For the average person, this study suggests an easy way to boost mental health: spend more time looking at trees, flowers and other natural elements. Whether during a daily commute, a walk in the park or a weekend hike, consciously directing your gaze towards nature could make a significant difference in how you feel. Our research underscores the potential for simple, everyday actions to have a profound impact on mental health. As urban areas continue to grow, c into cityscapes and encouraging people to engage visually with these elements could play a crucial role in enhancing public wellbeing. Source: Healthworld

June 12,2024 Mumbai: Of late, the weight loss drugs market has been booming, and it has created a ripple effect globally. These drugs were developed for diabetes management, but they have created a lot of buzz not only in managing diabetes but also in helping with weight loss, benefits in heart, kidney, and liver diseases, and more. Such is the demand for these so-called blockbuster drugs, which have become the most sought-after drugs globally. Since late, style disorders and diseases have posed a significant challenge; obesity being one of the major concerns, there is a need to address it. According to a recent study published in the Lancet, 70 per cent of India’s urban population is classified as obese or overweight, placing the country amid an obesity crisis. It also states 30 million adults in India are either overweight or obese, and 62 million diabetic Indians exhibit obesity-related characteristics such as excess body fat, abdominal adiposity, and fat deposition in ectopic sites. Currently, Abbott’s Leptos (sibutramine hydrochloride) is approved for obesity medication in India; the same drug branded as Meridia in 2010 was withdrawn in the US for its increased risk of heart attack and stroke. Eli Lilly’s Zepbound (tirzepatide) and Novo Nordisk’s Wegovy (semaglutideinjection), are expected to make their entry by 2025 and 2026, respectively, in India. As the frenzy for these weight-loss drugs catches on in India, so does the interest in these therapies, as there are limited options in the country: (Source: GlobalData). Indian doctors have been prescribing these weight-loss drugs even though they aren’t yet commercially sold in India. To better understand this scenario, ETHealthworld interacted with leading diabetologists on how these drugs are procured and administered if they are not available in the Indian market, and there is a global shortfall as well due to high demands. Sharing his opinion, Dr Rajiv Kovil, Head of Diabetology, Zandra Healthcare, and Co-Founder, Rang De Neela Initiative, shared, “Oral semaglutide has approval in India. Injectable semaglutide at a higher dose has approval in India for obesity. Oral semaglutide which goes by the brand name Rybelsus, has been marketed in India, and its approval is for diabetes, it can be prescribed by doctors in India. Injectable semaglutide is not marketed in India, and injectable semaglutide with a higher dose, which has the brand name Wegovy, has DCGI approval but has not yet been launched and marketed in India. Hence, doctors in India cannot prescribe injectable semaglutide as it has not been marketed in India.” Dr V Mohan, Chairman and Chief of Diabetology, Dr Mohan’s Diabetes Specialities Centre, added, “Semaglutide is available in both oral (tablet) form, which is known as Rybelsus, as well as injectable form, which is known as Ozempic and Wegovy. Rybelsus has already been available in India for the last few years, and that is being used (prescribed) by all of us. While it is effective, it is not as effective as the injectable forms, namely Ozempic and Wegovy. Wegovy was approved earlier this year by the Drug Controller General of India (DCGI), and the company has been permitted to market it in India. However, the fact is that despite the injectable form, both Ozempic and Wegovy are much more effective in weight reduction and controlling diabetes, but they are unable to bring them to India immediately because of the heavy demand for their production. They have been struggling to produce enough to sell in Europe, the US, the Middle East, and other countries where the drug is available. Inquiring about how Indian medical practitioners prescribe these drugs for weight loss in non-diabetic patients, Dr Kovil said, “Indian prescriptions cannot be used to obtain these drugs from overseas markets, but whichever country semaglutide has been launched in, whether it is the UAE, Saudi Arabia, the UK, or the US, the healthcare practitioner based in the country is required to prescribe this drug as this is not an over-the-counter medication. The medication has to be prescribed only by experts in the field. Semaglutide injectable has been approved for diabetes as well as weight loss. Though injectable semaglutide has been approved in India, it has not been marketed. Oral semaglutide which is approved, marketed, and available in India, has received approval only for the management of type 2 diabetes and cannot be used for the treatment of obesity in people without diabetes. There are a lot of people with diabetes who are fighting obesity, and breaking the obesity pandemic in people with diabetes is itself a challenge. So, semaglutide oral, which goes by the brand name Rybelsus, is the drug of choice or pill for diabetics who want to lose weight or who don’t want to gain weight.” Dr Mohan mentioned that since it is not available in the Indian market, some Indians are procuring these drugs from Dubai or other sources and using them. He stated, “The problem if the drugs are used without being available in India is that if any side effects develop, then the question of who is responsible will arise. Will the current company still be held responsible if the patient has illegally obtained the drug from some other country? If a legal issue like this arises, it could lead to complications. Hence, in my view, until it is officially available through proper sources, that is, through hospitals, clinics, or pharmacies in India, people shouldn’t import the drugs and use them on their own.” The side effects that are seen are mostly gastrointestinal, nausea, vomiting, and diarrhoea being the most common. Very rarely, they can lead to a condition called paralysis of the stomach and intestine. Even more rarely, pancreatitis and medullary carcinoma of the thyroid have been reported. However, these are more common in animal models when higher doses are used, and they are very uncommon in human trials. If the patients start using these drugs, they lose weight, and the sugars get under control. However, they have to be on it long term because if they stop it, they tend

June 12,2024 New Delhi: US based vaccine developer, Moderna announced the Phase III trial data for its COVID-19/influenza combination vaccine, mRNA-1083. The data suggest that the vaccine has potential to counter infectious diseases, says GlobalData, a data-analysis company. In the study the investigational combination mRNA vaccine generated statistically higher immune responses in comparison to the licensed comparator vaccines used in the randomised, observer-blind, active control study among 8,000 adults aged 50 years and older. Moderna in the trials reported that a single dose of mRNA-1083 met immunogenicity non-inferiority criteria versus the licensed comparator vaccines: Fluzone high-dose and Fluarix for influenza, and Spikevax for COVID-19, and has generated higher immune responses against the influenza strains including H1N1, H3N2, and B/Victoria, as well as SARS-CoV-2. The investigational combination vaccine displayed an acceptable safety and tolerability profile, with the most commonly reported adverse reactions being injection site pain, fatigue, myalgia, and headache. The development comes less than two weeks after Moderna’s FDA approval of the first mRNA respiratory syncytial virus (RSV) vaccine, mRESVIA, further demonstrating the potential of mRNA technology in combating infectious diseases. Commenting over it an expert Stephanie Kurdach, Infectious Disease Analyst, GlobalData said, “The development of a COVID-19/influenza combination vaccine could be advantageous to patients, as it would decrease the number of injections needed to provide sufficient protection against multiple respiratory illnesses. The development of a combination vaccine is strategic for pharmaceutical companies, as successful uptake of the vaccine can translate to significant market shares under multiple indications.” “If approved, Moderna’s COVID-19/influenza combination vaccine will be an important addition to the vaccines market. The positive Phase III data provides further validation of how mRNA technology is advancing the infectious diseases pipeline,” Kurdach added. Many experts have expressed positive opinions on the development of a COVID-19/influenza combination vaccine, as well as the advancement of vaccines for infectious diseases due to mRNA technology considering that mRNA vaccines require a shorter production time, have the potential to incorporate large numbers of antigens, and may therefore be more efficacious than traditional vaccines. Source: Pharma

June 13,2024 New Delhi: Children and foetuses exposed to hot and cold environments impact their brain’s white matter, responsible for connecting various brain regions and enabling communication, a new research has found. Researchers said that children are especially vulnerable to extreme environments as their bodies’ temperature regulation processes are still immature. They also found that early exposure could have lasting effects on the microstructure of white matter in the brain. These findings are published in the journal Nature Climate Change. “We know that the developing brain of foetuses and children is particularly susceptible to environmental exposures, and there is some preliminary evidence suggesting that exposure to cold and heat may affect mental well-being and cognitive performance in children and adolescents,” said lead researcher Monica Guxens, Barcelona Institute for Global Health (ISGlobal), Spain, and the study’s corresponding author. However, there is a lack of evidence with regards to how such exposure can bring about structural changes in the brain, Guxens said. The research team studied the exposure of close to 2,700 preteens to monthly temperatures from birth until they turned eight years old. They used magnetic resonance imaging (MRI) brain scans. The impacts of the exposure were measured between nine-12 years of age. For this, the researchers assessed the preteens’ white matter connectivity by measuring how water flowed and spread in their brains, or ‘mean diffusivity’. In more mature brains, water flows more in one direction than in all directions, showing lower mean diffusivity, the study said. The team found that exposure to colder-than-usual temperatures during pregnancy and the first year of life, and exposure to hotter-than-usual environments from birth until three years of age were linked with more mean diffusivity at preadolescence, pointing to a slower maturation of their white matter. “The fibres of the white matter are responsible for connecting the different areas of the brain, enabling communication between them. As the white matter develops, this communication becomes faster and more efficient,” said first author Laura Granes, a researcher at ISGlobal. “Our study is like a photograph at a particular moment in time and what we see in that image is that participants more exposed to cold and heat show differences in a parameter — the mean diffusivity — which is related to a lower level of maturation of the white matter,” said Granes. Previous studies have shown changes in mean diffusivity to be related with poorer cognitive function and mental health problems. Source: Healthworld

June 13,2024 Chennai: Apollo Hospitals has identified a much-needed intervention in fatty liver diagnosis in India. Out of over 50,000 people (53,946), who underwent comprehensive preventive health checks at Apollo Hospitals, 33 per cent were diagnosed with fatty liver. However, among those with fatty liver, only one in three had their liver enzymes elevated, indicating that diagnosis interventions in our healthcare systems need to go beyond just relying on blood tests for early detection and reversal of such conditions in all individuals. Currently, the diagnosis of fatty liver disease mainly relies on a combination of patient history, physical examination, and blood tests, including liver enzyme levels and markers of liver function. Imaging studies, such as ultrasound and fibro scan, can help visualise the liver and detect fat accumulation, even in cases where liver enzyme levels may not show any significant deviation. Despite this, ultrasound is not always the first choice due to accessibility and perceived necessity based on initial non-imaging assessments. MASLD increases mortality related to liver diseases and cardiovascular, and oncological complications. Commenting on this, Dr N Murugan, Senior Consultant Hepatologist & Liver Transplant Physician, Apollo Hospitals, Chennai, said, “The lack of timely diagnosis of fatty liver disease (FLD) is a growing concern. Particularly metabolic dysfunction-associated steatotic liver disease (MASLD), caused by factors other than excessive alcohol use, is increasingly prevalent in India due to rising rates of obesity, diabetes, and metabolic syndrome. Despite its growing incidence, FLD often goes undiagnosed because it’s largely asymptomatic in early stages and would not necessarily reflect through a LFT blood test.” “Early and accurate detection through imaging techniques like ultrasound could lead to timely interventions, lifestyle modifications, and treatment plans that could significantly improve patient outcomes. Therefore, I urge healthcare professionals to consider adopting ultrasound as a more routine diagnostic tool for fatty liver disease and using its benefits are more widely utilised to enhance patient care,” added Dr Akash Roy, Senior Hepatologist, Apollo Hospitals, Kolkata. Weight reduction is known to be one of the ways to reverse fatty liver in its early stages. Even a 5 per cent to 10 per cent reduction in body weight can significantly reduce liver fat and inflammation. Dr Sathya Sriram, CEO, Preventive Health, Apollo Hospitals, said, “We have also advocated for integrating ultrasound as a safe and critical component of health checks, recognising its significant clinical benefits for true preventive care. We hope more and more healthcare providers start utilising imaging for enhancing patient care, especially in early detection of fatty liver disease.” Fatty liver disease is related to obesity and diabetes, all of which indicate metabolic dysfunction. Consuming excessive carbs raises insulin levels, and chronic high insulin levels lead to insulin resistance. This disrupts metabolism and converts excess glucose into fatty acids, which are stored in the liver. FLD can be classified into two main types: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD/MASLD). MASLD can further progress to non-alcoholic steatohepatitis (NASH/MASH), which involves liver inflammation and damage and can eventually lead to fibrosis, cirrhosis, or liver cancer. Source: Healthworld

June 13,2024 New Delhi: After witnessing the horrors, devastation, and large-scale human suffering caused by a once-in-a-generation global pandemic, it seemed like things were getting back on track and the Indian healthcare ecosystem is in recovery mode. However, the recent bird flu cases in India serve as a reminder of the persistent threat posed by zoonotic disease developments. From the episodes of Nipah virus outbreaks to the recent bird flu cases underscore the need for robust surveillance and preventive measures to manage zoonotic diseases effectively, informed experts. Last week the World Health Organisation (WHO) confirmed the first ever death of a human being due to bird flu in Mexico, while in India the issue started hitting the headlines after the world health body confirmed the second-ever case in the country and the first since 2019 of a human infection attributed to the avian influenza A (H9N2) virus, commonly referred to as bird flu, in a four-year-old child from West Bengal. Understanding the gravitas of the problem and to dissect its overlooked aspects ET HealthWorld spoke to several experts Providing the basic description of the problem Dr Mohan Kumar Singh, Senior Consultant Internal Medicine, Marengo Asia Hospital, Gurugram said, “So far we know that H9N2 is a subtype of avian influenza virus, commonly found in birds. While it primarily infects birds, it can occasionally infect humans, including children. This is the second such case in our country, as confirmed by WHO. The virus can spread through two different ways: direct contact with infected animals or indirect contact with polluted settings and environment.” On being asked about the prevention and precautions from the disease Dr Singh suggested, “To prevent H9N2 infection, it is essential to limit exposure to live poultry and bird markets since these types of environments can act as hotspots for viral transmission. Maintaining good hygiene by washing hands frequently, especially after handling birds or their environments, is crucial. Wearing protective gear, such as gloves and masks, when working with birds can reduce direct contact with potential viral sources. Furthermore, getting the yearly flu shot can provide some cross-protection against H9N2, even if there isn’t a specialized vaccination for it.” Talking about its management the expert suggested, “Antiviral drugs like zanamivir (Relenza) or oseltamivir (Tamiflu) must be used as soon as possible if you are infected in order to lessen the frequency and severity of your symptoms. Supportive care is equally important, focusing on staying well-hydrated, getting a good amount of rest, and using fever reducers to manage symptoms effectively. Seek immediate medical attention, in case of breathing difficulties as it may require hospitalisation.” Voicing his stance on the problem another expert Dr Nasiruddin G, Consultant-Internal Medicine, Fortis Hospital, said,” The WHO confirmed a 4-year-old in India tested positive for H9N2 bird flu, the second such case in the country. This strain typically causes mild illness, but this child did require hospitalisation. The infection likely occurred through contact with poultry, as the child had no reported close contacts with other cases. H9N2 rarely spreads between people, but health officials monitor these cases because flu viruses can mutate.” “As a precaution, people in India, especially those around poultry farms, should practice good hygiene, avoid close contact with sick birds, and cook poultry products thoroughly,” Dr Nasiruddin added. Dr Praveen Gupta, Principal Director and Chief of Neurology, Fortis Hospital voiced similar views and urged for extensive monitoring at various hotspots. He said, “The recent report of a bird flu case in India is alarming and necessitates immediate action. Forest officials and wildlife personnel must adopt stringent safety protocols, such as wearing gloves and protective gear when handling dead birds.” “Alongside, there should be an increase in monitoring and preventive measures to swiftly identify and contain new cases. This includes setting up checkpoints for wildlife health, increasing testing in areas with previous outbreaks, and educating the public about the signs of bird flu and the importance of avoiding contact with wild birds. Proactive steps in surveillance and hygiene can help to mitigate the spread of this potentially dangerous virus.” Dr Gupta added. Commenting over the potential diagnostic strategies to detect the rare disease Dr Manish Mannan, HOD – Paediatrics and Neonatology, Paras Health, Gurugram said,” Diagnosing H9N2 requires a combination of clinical suspicion and laboratory testing. If a child presents with symptoms suggestive of bird flu and has a history of bird exposure, a respiratory sample (swab or wash) will be collected and tested for the specific influenza virus strain. Early diagnosis is crucial for prompt treatment and isolation to prevent further spread. Adding to the management aspect Dr Mannan said, “The infection primarily involves supportive care to manage symptoms like fever and dehydration. Antiviral medications are typically used to shorten the illness duration and reduce the risk of complications. In severe cases, additional supportive measures like oxygen therapy or respiratory assistance might be needed. Sharing her opinion on how to mitigate the risk in the initial stages Dr Neha Rastogi Panda, Consultant-Infectious Diseases, Fortis Gurugram suggested to, “Ensure that poultry reaches an internal temperature of 165°F (74°C) to kill any virus; avoid live bird markets: If possible, opt for poultry from reputable sources.” Mentioning that the disease is mild in humans, and treatment is similar to that of other influenza viruses, including antiviral medications like Tamiflu, Dr Sushila Kataria, Senior Director, Internal Medicine, Medanta,said, “H9N2 bird flu is a type of influenza A virus primarily found in birds. Human transmission is possible due to the same, usually occurring through close contact with infected birds. This includes individuals handling poultry, such as those working in hatcheries, who are at a higher risk of infection. H9N2 bird flu is not highly transmissible and does not have the potential to become a pandemic, as its R0 (basic reproduction number) is very low. Therefore, there is no cause for widespread concern. But, people with comorbid conditions, children, and the elderly with low immunity are more susceptible to infections and should take extra precautions. By adhering

June 01,2024 New Delhi: Amid a global rise in metabolic disorders such as gut health issues, heart diseases, and obesity, organic jaggery is gaining significant recognition for its exceptional health benefits in both Indian and international markets. India’s jaggery market is projected to expand at a Compound Annual Growth Rate (CAGR) of 12.31 per cent from 2024 to 2032, with the market size reaching INR 63.51 1 billion in 2023. Clinical Dietitian and Diabetes Educator Ms. Kanikka Malhotra says, “Jaggery’s appeal goes beyond its delicious taste. Unlike refined sugar, which is stripped of its nutrients during processing, jaggery retains a wealth of antioxidants. These antioxidants help combat free radicals in the body, potentially reducing the risk of chronic diseases like cancer and heart disease.” Malhotra further highlights jaggery’s potential for digestive health and asserts, “Jaggery is a natural source of minerals like potassium, magnesium, and iron. These minerals may play a role in aiding digestion and preventing constipation. Additionally, the presence of potassium in jaggery may help regulate blood pressure, potentially contributing to better heart health However, Malhotra emphasises moderation as key, stating, “Remember, jaggery is still a form of sugar. It’s best to consume it in moderation and limit your overall intake of added sugars. Jaggery offers a natural sweetness with a potential health boost, making it a compelling option for those seeking a more balanced approach to their diet.” With obesity affecting 1 in 8 people globally2, according to a World Health Organisation report, metabolic disorders like obesity, diabetes, and high blood pressure are widespread. Incorporating jaggery into diets offers a hopeful solution. Mukesh Singh, Founder and Director of Jivamrit Agro Organic Foods, says, “Given the health benefits and growing demand for organic jaggery, our goal is to make organic food products, including jaggery, affordable and accessible to everyone. This will help people include these healthy options in their diet, supporting their efforts to stay fit and prevent metabolic diseases.” Singh adds further, “Jivamrit’s organic jaggery is naturally processed from specially grown sugarcane and is rich in essential vitamins and minerals. It helps reduce water retention, boosts metabolism, and supports weight loss. Recognising the needs of health-conscious consumers, Jivamrit has introduced both organic jaggery and jaggery powder.” Globally, the Netherlands is the top jaggery exporter, followed by the United States, Germany, Malaysia, and Slovakia3. Organic jaggery’s health benefits are gaining worldwide acceptance. Organic jaggery is gaining global acceptance due to its significant health benefits. By providing naturally processed jaggery, Jivamrit aims to contribute to a healthier nation, ensuring that consumers have access to a nutritious alternative to refined sugar. Source: Healthworld

June 02,2024 Washington DC: Scaling back treatment for three kinds of cancer can make life easier for patients without compromising outcomes, doctors reported at the world’s largest cancer conference. It’s part of a long-term trend toward studying whether doing less – less surgery, less chemotherapy or less radiation – can help patients live longer and feel better. The latest studies involved ovarian and esophageal cancer and Hodgkin lymphoma. Thirty years ago, cancer research was about doing more, not less. In one sobering example, women with advanced breast cancer were pushed to the brink of death with massive doses of chemotherapy and bone marrow transplants. The approach didn’t work any better than chemotherapy and patients suffered. Now, in a quest to optimize cancer care, researchers are asking: “Do we need all that treatment that we have used in the past?” It’s a question, “that should be asked over and over again,” said Dr. Tatjana Kolevska, medical director for the Kaiser Permanente National Cancer Excellence Program, who was not involved in the new research. Often, doing less works because of improved drugs. “The good news is that cancer treatment is not only becoming more effective, it’s becoming easier to tolerate and associated with less short-term and long-term complications,” said Dr. William G. Nelson of Johns Hopkins School of Medicine, who was also not involved in the new research. Studies demonstrating the trend were discussed over the weekend at an American Society of Clinical Oncology conference in Chicago. Here are the highlights: French researchers found that it’s safe to avoid removing lymph nodes that appear healthy during surgery for advanced ovarian cancer. The study compared the results for 379 patients – half had their lymph nodes removed and half did not. After nine years, there was no difference in how long the patients lived and those with less-extreme surgery had fewer complications, such as the need for blood transfusions. The research was funded by the National Institute of Cancer in France. This German study looked at 438 people with a type of cancer of the esophagus that can be treated with surgery. Half received a common treatment plan that included chemotherapy and surgery on the esophagus, the tube that carries food from the throat to the stomach. Half got another approach that includes radiation too. Both techniques are considered standard. Which one patients get can depend on where they get treatment. After three years, 57% of those who got chemo and surgery were alive, compared to 51% of those who got chemo, surgery and radiation. The German Research Foundation funded the study. A comparison of two chemotherapy regimens for advanced Hodgkin lymphoma found the less intensive treatment was more effective for the blood cancer and caused fewer side effects. After four years, the less harsh chemo kept the disease in check in 94% of people, compared to 91% of those who had the more intense treatment. The trial included 1,482 people in nine countries – Germany, Austria, Switzerland, the Netherlands, Denmark, Sweden, Norway, Australia and New Zealand – and was funded by Takeda Oncology, the maker of one of the drugs used in the gentler chemo that was studied. The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The is solely responsible for all content. Source: Healthworld