Lewis Christie is an acute myeloid leukemia (AML) survivor. He is a peer mentor with the National Bone Marrow Transplant Link (nbmtLINK) and Imerman Angels, where he assists other people with cancer near his age who are either contemplating a bone marrow transplant or who have already had one. He is also a patient advisor to a company developing artificial intelligence (AI) applications to help people with cancer. He is retired from his work as an information technology professional and is now an avid reader of history books, loves to listen to music, and likes to cook.

My story begins as a 9/11 cancer survivor. I had been in a building at Ground Zero on September 11, 2001, and returned there every day afterward for over a year, breathing in the carcinogenic ash that would compromise my immune system. Then, 10 years later, at the age of 71, I was diagnosed with acute myeloid leukemia (AML).

I received my diagnosis after having a bone marrow biopsy, where a needle was inserted in my lower back to remove some fluid. The doctor evaluating the biopsy sample said that my white Blood cell count was way too high, and my red Blood cells were being squeezed out. He immediately sent me to the hospital to receive 2 Blood transfusions. There, I learned that my red Blood cell count was dangerously low.

Receiving my cancer diagnosis was devastating because I had always been in good health. Also, I had no idea what I should do next. The first oncologist I consulted advised me that my prognosis was very bad and that I only had 1 year left to live. My wife and I then scheduled appointments with other oncologists who told me to take a vacation while I could, since they also felt I had 1 year left to live. So far, there was no encouragement or path to take to survive.

Turning to bone marrow transplant for life-saving treatment

Eventually, my wife and I found an oncologist who provided some hope. I started Chemotherapy, which lasted for 14 months. When planning treatment, my oncologist said that I should think about receiving a bone marrow transplant after Chemotherapy because my cancer could come back much worse, and she typically only saw success with the Chemotherapy for about 14 months. She gave me hope that a transplant could save or prolong my life. So, my oncologist searched for a donor through the national bone marrow registry and found a donor who was a match.

In March 2014, I received the transplant. I spent 30 days in the hospital and had relatively few side effects. However, 6 months later, the transplant failed for unknown reasons. My red and white Blood counts dropped to 0. I was then put back on Chemotherapy while my doctor searched for another donor. But, unfortunately, another donor could not be found through the registry.

At that point, my oncologist advised that she had seen transplant success using stem cells from the children of the person with cancer. So, in September 2014, my younger daughter donated her stem cells. She spent a day in the hospital where they took her Blood through a machine. Her stem cells were taken out, and the rest of her Blood was returned to her body. After, I was given a Blood transfusion with her stem cells.

Recovering from my bone marrow transplant

After this transplant, the side effects were completely different from my first transplant. I could hardly walk and experienced rashes, coughing, blurred eyesight, uncontrollable hiccups, loss of appetite, muscle cramping, indigestion, numbness in my feet, and night sweats. But after 30 days, when I could walk again, I was released from the hospital.

Being home was not easy. Our home had to be thoroughly cleaned so that I would not develop an infection, and I had to be very careful of what I ate. There was a list of things I could not eat, including any deli meats, fruits like strawberries and raspberries that could not be properly washed, and any bakery products. My wife cooked all of our meals; we had absolutely no takeout food. I was also generally confined to my home for 1 year. If I went out, I had to wear gloves and a mask. I only went out to doctor visits.

After coming home, I still had low Blood counts, so I went to the cancer center weekly to receive Blood platelets to help stop me from bleeding and an injection to boost my white Blood cell count. It took months before I was feeling much better. I slowly returned to where I could start eating normally, going outside to walk, and seeing friends and relatives. I had to avoid any physical contact with them so that I wouldn’t get an infection.

Life after bone marrow transplant

It has now been nearly 11 years since I first received my leukemia diagnosis. I feel very good and back to an almost normal life. My brother got me started playing golf, and my wife and I walk every day. I used to be a runner, but that is something I am no longer able to do.

However, my cancer story does not end there. After my second transplant, I developed chronic graft-versus-host disease (GVHD), a sometimes serious disease that only affects people with cancer who have received a bone marrow transplant using donor cells. With GVHD, the donor cells attack your body. Thankfully, my case of chronic GVHD has not been very bad. The symptoms I have experienced include easily bruising, constant skin peeling, trouble swallowing, hardening and cracking of my toenails and fingernails, dry eyes, reduced lung capacity that makes it hard to breathe at times, tooth decay, and annoying white patches in my mouth. While this may sound terrible, it’s not as bad as it seems. After being through 2 transplants, I can certainly handle all of this because I am still here!

I have found that being positive is probably one key to getting better. What really helped me as I was navigating cancer treatment and survivorship was attending support groups, talking to other people with cancer who had either thought about having a bone marrow transplant or who had received one, and working as a patient advisor to a company that was developing a computer program to relieve stress in people with cancer. Now, I have a lot of good things to look forward to for the rest of my life.

The author has no relevant relationships to disclose.

cancerCare’s monthly staff feature recognizes the vital contributions of the many client-facing and behind-the-scenes teams that make our free programs and services possible.

This month, we’re excited to highlight cancerCare‘s Older Adult Program and Danielle S., cancerCare‘s Older Adult Program Coordinator. cancerCare‘s Older Adult Program provides information, resources and support to help older adults better cope with cancer. Our older adult resources include the Pen Pal Program and our upcoming Older Adult Book and Movie Clubs.

Name: Danielle S.
Title: Older Adult Program Coordinator
Team: Social Work
Team: Almost 5 years

What do you do at cancerCare?
I am a bilingual oncology social worker providing practical and emotional support to caregivers, patients and the bereaved.

What is your favorite thing about your job?
My favorite aspect of my job is establishing connections with my clients and fellow social workers. Building relationships with clients, being there for them during their challenging moments and offering support is a meaningful experience. Additionally, the sense of community and shared purpose among my colleagues creates a supportive and nurturing work environment. Being able to contribute to our client’s well-being and witnessing their resilience fills me with a deep sense of fulfillment and purpose.

What sets cancerCare apart from other organizations?
What sets cancerCare apart is its unwavering commitment to addressing the whole spectrum of challenges faced by individuals affected by cancer.

For example, our Sephora Brave Beauty program offers beauty and wellness resources, allowing individuals to feel confident and empowering them throughout their cancer journey. Additionally, our wigs and prosthesis clinics play a crucial role in enhancing their quality of life by providing access to items that may be financially burdensome. In addition, through initiatives like our Back-to-School and Winter Warmth programs, we aim to alleviate practical challenges that our clients frequently encounter.

cancerCare‘s commitment to compassionate support through many different programs shines through these initiatives. We strive to make a positive difference, ensuring our clients and their families feel cared for and supported throughout their cancer journey.

What is an important memory you have at cancerCare?
During the Winter Wonderland client party in 2019, I had the pleasure of connecting with a client on a deeper level, where we spoke about their diagnosis, treatment and the impact of cancerCare during this difficult time.

Over time, this client expressed their desire to seek counseling and specifically requested to work with me. The fact that our bond formed during the holiday party played a significant role in their decision was humbling and gratifying. It speaks to the importance of human connection and its positive effect on a cancer journey.

Moments like these reinforce my passion for my work and the incredible privilege of being a part of cancerCare.

What is something surprising about working at cancerCare?
One surprising aspect of working at a nonprofit is the incredible dedication of the staff in all departments. The passion and commitment displayed by staff members is remarkable. They invest their hearts into their work, demonstrating a deep sense of purpose and belief in the organization’s mission. This level of dedication creates a collaborative and supportive atmosphere where everyone comes together to make a meaningful impact in the lives of those we serve.

A new research perspective titled “CDK9 INHIBITORS: a promising combination partner in the treatment of hematological malignancies” has been published in Oncotarget.

In their new perspective, researchers Daniel Morillo, Gala Vega and Victor Moreno from Hospital Fundación Jiménez Díaz discuss cyclin-dependent kinases (CDK) in hematological malignancies. CDKs belong to a family of serine/threonine kinases that need to form heterodimeric complexes with cyclins to perform their functions. These kinases are involved in multiple processes within cells, including cell cycle, apoptosis, transcription and differentiation. These kinases are often overexpressed in different malignancies, making them potential targets for new drugs.

Most hematological malignancies are characterized by overexpression of certain cancer-promoting genes, such as MYC, MCL1 and cyclin D1. Preclinical studies in animal models have shown that CDK9 inhibitors suppress the transcription of these anti-apoptotic and pro-survival proteins, and suggest their potential synergism with other drugs. In its first in-human trial, enitociclib demonstrated clinical activity in a small cohort of patients with high grade B Lymphoma with MYC and BCL2 and/or BCL6 rearrangements, inducing complete responses in 2 of 7 subjects (29%) in monotherapy.

“In summary, most hematological malignancies are characterized by overexpression of certain cancer promoting genes, such as MYC and MCL1. CDK9 inhibitors are relatively new drugs that inhibit transcription of these anti-apoptotic and pro-survival proteins,” the researchers write.

Provided by
Impact Journals LLC

Can the NHS survive? This is one thing that has been on my mind for many years, but particularly since covid. We can all argue about why we are in this position, but we are! It will be a close run thing, if we can bring our NHS back from where we are today. Personally I believe that it is political will, to destroy it. Otherwise why would there be such little concern for the service and it’s staff? Healthcare in the UK may be so problematic, that it is now too expensive for the public purse? Below I have laid out some of the issues to be urgently considered.

Introduction:

The National Health Service (NHS) has long been a symbol of pride for the United Kingdom, providing healthcare services to its citizens since its inception in 1948. However, in recent years, concerns about the sustainability and future of the NHS have emerged. In this blog post, we will delve into the challenges, and potential solutions facing the NHS. Analysing whether it will be able to survive and continue serving the needs of the UK population.

Rising Demand and Funding Pressures

The NHS faces the constant challenge of rising demand for healthcare services, due to various factors such as an aging population, increasing prevalence of chronic diseases, and advancements in medical treatments. This surge in demand, puts immense pressure on the NHS, exacerbating funding constraints, and stretching resources thin. To ensure the NHS’s survival, it is crucial to address these challenges, through long-term funding commitments, innovative financing models, and proactive health promotion strategies.

The aging population in the UK has led to a significant increase in the number of individuals requiring healthcare services. As people live longer, they tend to develop more complex conditions, leading to higher demand for specialized care. Additionally, the rising prevalence of chronic diseases further burdens the NHS as these require ongoing management.

Technological Advancements and Digital Transformation

Moreover, constant advancements in medical treatments and technologies, have expanded healthcare possibilities. But often come with a hefty price tag. New medications, equipment, and procedures contribute to rising healthcare costs. The NHS must balance, providing the latest treatments, whilst managing its finances effectively.

While technology presents opportunities, through digitization and automation, to streamline processes and improve patient care. Implementing these, requires substantial investment, robust cybersecurity, and comprehensive training for healthcare professionals. Efforts should ensure vulnerable populations are not left behind, during the NHS’s digital transformation.

Workforce Crisis and Staffing Shortages

The NHS has been grappling with a workforce crisis. With shortages of healthcare professionals partly due to increasing workloads, burnout, and limited funding for training and recruitment. Addressing these challenges by targeting recruitment, improving retention strategies, and investing in professional development is vital to secure the NHS’s survival.

The demanding nature of healthcare work, has led to increased burnout and high turnover rates, making it difficult to retain experienced staff. Moreover, limited funding for training and recruitment, exacerbates this problem. Investing in workforce programs, improving working conditions, and providing adequate support systems can contribute to a more resilient workforce.

Political Will and Public Support

The survival of the NHS, is linked to political will and public support. Policymakers must prioritize healthcare in their agendas, and allocate sufficient resources to ensure the NHS’s sustainability. Fostering public awareness and support can also drive necessary policy changes.

Maintaining public support requires transparent communication, about the complexities of funding and resources. By making healthcare a priority, policymakers can enact policies supporting the NHS’s long-term sustainability through strategic investments.

Potential Solutions for a Sustainable Future

To ensure the NHS’s survival, a long-term funding commitment is needed, to meet rising demand. Exploring financing models, like public-private partnerships can help bridge funding gaps. Investing in preventive care and public health initiatives can also alleviate the burden by reducing the need for costly interventions.

Embracing technology advancements and digitization, can enhance efficiency and effectiveness. Targeted recruitment, improved retention strategies, and professional development investment are essential to address the workforce crisis.

Conclusion

While the NHS faces numerous challenges, viable solutions of long-term funding, technology adoption, workforce strategies, and political support can pave the way for a sustainable future. We must recognize the NHS’s importance, and work towards its preservation, ensuring accessible, high-quality care for generations.

Our NHS has gone backwards in at least the last 10 years. Therefore, even if we can save it, we won’t again have a service we can be proud of, for possibly 20 years, if you include sorting out it’s decaying infrastructure too. The policy that we have seen, has not saved our country money, but cost it so much! Both financially, and the welfare of our people. We are now more reliant on big pharma than we were. Was that the plan all along? If you think that inequality is bad now, don’t even give any thought to private healthcare!

As always these are my personal thoughts and opinions based on my experiences. Please feel free to share your own below.

The 2023 American Society of Clinical oncology (ASCO) Breakthrough meeting will be held in person and online August 3 to 5 in Yokohama, Japan. This meeting shines a light on the cutting-edge advances that are transforming cancer care in Asia and beyond. Research highlighted at ASCO Breakthrough will explore how new technologies may intersect with clinical care today to improve patients’ lives and well-being.

You can learn more about research from this meeting by following the #ASCOBT23 hashtag on Twitter.

Below are summaries of 4 studies that will be presented at the meeting:

Stool DNA test accurately detects gastrointestinal cancers and identifies tumor location

Who does this study affect: People at risk for gastrointestinal cancers.

What did this study find: A study out of China found that a new, noninvasive multi-target stool DNA test was able to accurately detect gastrointestinal (GI) cancers and identify the location where the cancer started.

GI cancers are cancers that affect the body’s GI tract, which is the bodily system involved in swallowing and digesting food, absorbing nutrients, and removing waste from the body. These cancers include cancer.net/cancer-types/bile-duct-cancer-cholangiocarcinoma”>bile duct cancer, colorectal cancer, esophageal cancer, pancreatic cancer, and stomach cancer, among others. Overall, GI cancers make up one-fourth of cancer cases around the world, according to the World Health Organization.

While tests using either stool (feces) or Blood have been approved by the U.S. Food and Drug Administration for the early detection of colorectal cancer, there are currently no similar tests approved for the early detection of other GI cancers. Stool tests are noninvasive, and most people can do the test at home. In this study, researchers wanted to learn whether using a new stool DNA test could detect and locate more GI cancers early.

The study included 124 Chinese people who had been diagnosed with GI cancer but had not received treatment, as well as 92 people who did not have cancer but received GI cancer-related examinations every 3 years.

The study showed that the test was able to accurately detect GI cancers and identify the location where the cancer started. Overall, of the patients who had cancer, 79% tested positive for cancer with the test, and of the patients who did not have cancer, 96% tested negative for cancer. Of the 4 participants who did not have cancer but received a positive result from the test, 3 were diagnosed with advanced adenomas, which are benign tumors that can become cancerous, and 1 person was pregnant.

For each of the specific GI cancer types included in the study, the test positively identified 71% of colorectal cancer cases, 83% of stomach cancer cases, 75% of esophageal cancer cases, 81% of pancreatic cancer cases, and 91% of ampullary cancer cases. Ampullary cancer is cancer of the ampulla of Vater, which is where the pancreatic duct and bile duct meet and empty into the first part of the small intestine.

The researchers also evaluated how effective the test was in identifying the type of GI cancer, which is called sensitivity. Sensitivity is the percentage of people with cancer who were correctly identified by the test as having cancer. The sensitivity of the test was 88% for colorectal cancer, 91% for stomach cancer, 88% for esophageal cancer, 90% for pancreatic cancer, and 95% for ampullary cancer.

What does this mean for patients: This noninvasive stool DNA test could help detect different GI cancers early and accurately, including the location where the cancer started.

“Stool is a promising sample for GI cancer detection because it contains the host’s exfoliated cells and circulating-free DNA derived from GI cancer cells. Our study aims to develop a noninvasive, multi-target stool DNA methylation test for the early detection and localization of GI cancers.”

—      lead study author Li-Yue Sun, MD
Guangdong Second Provincial General Hospital
Guangzhou, China

Exercise helps improve sexual health for people with prostate cancer 

Who does this study affect: People with cancer.net/cancer-t%C3%BDpes/prostate-cancer“>prostate cancer.

What did this study find: Results from a randomized, controlled clinical trial from Australia found that patients who followed a supervised exercise program had improved sexual health. Prostate cancer and its treatment can lead to problems with sexual health, including erectile dysfunction and a loss of sexual desire. These sexual side effects may be temporary, but some can last for a long time. Side effects that change sexual health can affect a person mentally, emotionally, and physically.

In this study, the researchers wanted to see whether supervised resistance and aerobic exercise given in the clinic would improve sexual health. Aerobic exercise is also known as cardio, and it is the type of exercise that raises your heart rate. Resistance exercise is also called strength training. The researchers also wanted to explore whether adding a type of counseling called psychosexual therapy would help.

The study included 112 men with prostate cancer who had or were receiving cancer treatment and who had concerns about problems with sexual health. This study was done at exercise clinics that were connected to universities between 2014 and 2018. The participants were divided into 3 study groups. Group 1 included 39 people who received 6 months of supervised resistance and aerobic exercise in a group setting for 3 days per week. The 36 patients in Group 2 received the same exercise program plus psychosexual therapy. The 37 patients in Group 3 received usual care for prostate cancer, which does not include supervised exercise instruction.

The researchers evaluated whether the participants in Groups 1 and 2 were more satisfied with their sexual function than those in Group 3. To do this, participants were asked to complete a questionnaire called the International Index of Erectile Function (IIEF), which scores a person’s sexual ability and satisfaction with sexual activity. Those who participated in the supervised exercise program had a 5.1-point increase in their ability to have an erection of the penis compared with a 1.0-point increase in those who received usual care. Those who received supervised exercise also were more satisfied with sexual intercourse. Their satisfaction with sex increased by 2.2 points, compared with 0.2 points for those who received usual care. The psychosexual therapy, which was self-managed, did not add any improvements for the participants.

What does this mean for patients? Supervised resistance and aerobic exercise improved ability to have an erection and satisfaction with sexual intercourse for patients with prostate cancer.

“Nearly half of patients with prostate cancer report having unmet sexual health care needs, highlighting the lack of current health care services to adequately address the demand for management of sexual dysfunction after prostate cancer treatment. Our study shows that these patients can immediately benefit from supervised exercise interventions to improve their sexual health and that exercise should be considered as an integral part of treatment for prostate cancer.”  

—lead study author Daniel Abido Galvao, PhD
Edith Cowan University
Perth, Australia 

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Artificial intelligence can accurately identify cervical precancerous lesions during colposcopy

Who does this study affect: People at increased risk for cancer.net/cancer-types/cervical-cancer“>cervical cancer.

What did this study find: A study out of Japan found that a new artificial intelligence (AI)-based model can accurately identify cervical intraepithelial neoplasia (CIN) lesions from videos taken during colposcopy. CIN, which may also be called cervical dysplasia, is an abnormal growth of cells on the cervix, which is part of the female reproductive system. While some of these abnormal cells may go away without treatment, others may eventually become cervical cancer.

A colposcopy is a procedure used to find cancerous or abnormal cells in the cervix, vagina, or vulva. A colposcopy may be recommended for people who received abnormal results following a Pap test so the doctor can confirm and diagnose certain problems, including CIN. During a colposcopy, the doctor may also perform a biopsy, which is the removal of a small amount of tissue for examination under a microscope, to determine whether abnormal areas found during the colposcopy may be cancerous or precancerous.

Extensive colposcopy training is required to teach doctors how to accurately detect CIN and perform more precise biopsies of suspicious areas. In this study, researchers wanted to learn whether an AI-based model could be used to accurately identify precancerous lesions from colposcopy results and help guide where biopsies should be performed.

Researchers conducted an analysis using 8,341 videos recorded during colposcopies from 2013 to 2019. The videos included 7 early-stage cervical cancer cases, 203 CIN3 cases, 276 CIN2 cases, and 456 CIN1 cases. CIN1 lesions have the lowest risk of becoming cancer, while CIN3 lesions have the highest risk of becoming cancer.

Researchers then trained the AI-based lesion detection model by showing it videos of 60 cases of cervical cancer and CIN3. The AI-based model was then shown 150 cases to test how accurately it could diagnose CIN lesions and cervical cancer.

The study found that the AI-based model was able to identify cervical precancerous lesions with high accuracy. In identifying lesions, the model had:

• A sensitivity of 85% for CIN3 lesions, 86% for CIN2 lesions, and 87% for CIN1 lesions. Sensitivity is the percentage of people with a lesion who were correctly identified by the model as having a lesion.

• A specificity of 73% for CIN3 lesions, 67% for CIN2 lesions, and 70% for CIN1 lesions. Specificity is the percentage of people who did not have a lesion and were correctly identified by the model as not having a lesion.

• An area under the curve of 89% for the lesion area for CIN3 lesions and of 81% for both CIN2 and CIN1 lesions. The area under the curve indicates the overall accuracy of the model.

• An accuracy of 95% for the number of lesions identified among CIN3 lesions, 93% for CIN2 lesions, and 97% for CIN1 lesions.

The model was also able to display a heatmap of the affected area with the highest acetic acid intensity, indicating where it was most likely for abnormal cells to be found, that corresponded with the actual biopsy location.

What does this mean for patients: For people who require a colposcopy after receiving abnormal Pap test results, an AI-based model may be helpful in accurately identifying cervical precancerous lesions, thus improving early detection and likelihood of curative therapy. This model could be especially useful in places where there may be fewer doctors trained in reading colposcopy results.

“Currently, there is no certification system for performing colposcopies in Japan, and the quality and interpretation of these examinations varies. Our study aimed to develop an artificial intelligence (AI)-based tool that reproduced colposcopy examination techniques of specialists to be used as a diagnostic aid by accurately identifying CIN lesions and guiding tissue sampling locations.”

—      lead study author Akihiko Ueda, MD
Kyoto University
Kyoto, Japan

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Liquid biopsy may help find common cancers before symptoms develop

Who does this study affect: People who have a moderate to high risk of cancer but no symptoms.

What did this study find: Results from the K-DETEK clinical trial in Vietnam have shown that a type of liquid biopsy called SPOT-MAS (Screening for the Presence Of Tumor by Methylation And Size) may be useful for detecting certain common cancers in people with no symptoms. The SPOT-MAS only looks for the 5 most common cancers in Vietnam: liver, breast, colorectal, stomach, and lung cancer. It is a type of liquid biopsy called a multiple cancer early detection test or MCED.

The researchers in this study wanted to see if the SPOT-MAS test could be used to successfully find early cases of cancer among Vietnamese people. This study includes 10,000 people aged 40 years or older with no symptoms of cancer but moderate to high risk of developing cancer. It was conducted in 13 large hospitals and 1 research institute in Vietnam. The participants were observed at 6 and 12 months. When the researchers analyzed the data, they had completed analyses for 2,795 study participants.   They found that the SPOT-MAS correctly detected cancer in 60% of cases, meaning that for every 100 positive tests, 60 of them will actually have cancer. In addition, the test was able to correctly identify the tumor’s location in 83.3% of cases. If SPOT-MAS detected cancer, then a patient received additional testing by doctors to confirm whether they really had cancer and then guide treatment decisions.

cancer screening tools, such as mammography and colonoscopy, usually only test for a single type of cancer and require separate appointments and procedures. In some parts of the world, this makes cancer screening difficult. Giving a single Blood test to screen people for several common types of cancer may be a convenient way to find cancer in people before they develop symptoms.

What does this mean for patients? The SPOT-MAS may be a helpful tool for initially screening people for common types of cancer, particularly in lower- and middle-income countries.

“Common screening methods are often invasive, inaccessible, and involve separate procedures to screen individual cancer types. Affordable, accessible, noninvasive multicancer screening tests are needed for early detection, especially in a lower-middle income country like Vietnam. Our study provides clinical evidence for the applicability of the SPOT-MAS circulating tumor DNA-based assay as a complementary method in early cancer detection.”  

—senior study author Le Son Tran, PhD
Medical Genetics Institute
Ho Chi Minh City, Vietnam 

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