Liverpool University Strikes Again!
In the latest alumni newsletter from my old University, there is a link to this page on the University web site, which is entitled Cancer Drug Trial Success.
This is said.
The University of Liverpool has led a successful trial of a drug trial aimed at developing new therapeutic approaches to cancer.
The trial (APR-246) aimed to test the effects of a novel compound on a specific protein, p53, found to be mutated in more than 50% of all cancers.
The p53 gene is from a class of genes called tumour suppressors which are mutated in all cases of one form of ovarian cancer (high grade serous), but have proved difficult to target in the past.
This research was also done in the Institute of Translational Medicine, where the pancreatic cancer research I wrote about in There’s More To Liverpool Than Football And The Beatles! was carried out.
It certainly would appear that something is being done correctly!
Snot Wars
There is no other title for a post about this article on the BBC, which is entitled Antibiotic resistance: ‘Snot wars’ study yields new class of drugs.
The research has been done at the University of Tübingen, which is one of Germany’s classical universities. Wikipedia says this.
Tübingen is one of five classical “university towns” in Germany; the other four being Marburg, Göttingen, Freiburg and Heidelberg.
It certainly sounds to me that ideas for this research, possibly started after a good academic dinner with lots of food and alcohol, if classical German universities are anything like our’s.
After all the idea has been literally up researchers noses for years.
These last two paragraphs of the BBC report describes how the antibiotic-like action was possibly created in the human body.
Prof Kim Lewis and Dr Philip Strandwitz, from the antimicrobial discovery centre at Northeastern University in the US, commented: “It may seem surprising that a member of the human microbiota – the community of bacteria that inhabits the body – produces an antibiotic.
“However, the microbiota is composed of more than a thousand species, many of which compete for space and nutrients, and the selective pressure to eliminate bacterial neighbours is high.”
So why hasn’t this new class of antibiotics been found before?
Could it be that medical research is too much about Loadsamoney and Big Pharma, rather than about ideas, seriously out-of-the-box thinking and dilligent research?
Brains are a lot easier to throw at a problem, than money. Except that good brains are much more difficult to find than good money.
My Mid-Life Crisis
They were talking midlife crises on Radio 5 yesterday, so I sent in a text, which was broadcast.
My mid-life crisis was caused by the death of my wife and our youngest son to cancer smd then my stroke at 63. But I survived and raised money for pancreatic research at mine and my late wife’s University of Liverpool. Yesterday, I visited the unit and left feeling that there is now some hope for people suffering from this awful cancer. My mid-life crisis seemed to be receding as I took the train home.
Hopefully, life can only get better!
Incidentally, since my visit to Liverpool, I’ve spoken to three or four people, who have been affected by pancreatic cancer and I hope my attitude has given them a bit of strength to face the future.
Is A Secondary Effect Of London’s Air Pollution Making Me Ill?
There is no doubt, that i am suffering from a vitamin D deficiency, as it has been measured and I have several of the classic symptoms. Several of my friends seem to be suffering too!
As a coeliac, I get no or little vitamin D from my food, as vitamin D is not added to gluten-free food, so I rely on the sun for my vitamin D.
And there has been very little of that over the last few years in London and the South East of England.
I take vitamin D supplements and these help, but if say I get half an hour in strong sunlight, I feel a lift and a lot better.
I got to wondering, if London’s pollution is cutting out the UVB radiation that I need to generate vitamin D in my skin.
I can’t find any scientific paper, which shows the effect of airpollution on UVB radiation.
Now my health has got worse over the l;ast decade or so, which is a time that corresponds to more diesel cars polluting the atmosphere.
I may be talking sabsolute claptrap, but if I could find a scientific paper, I might be able to be proven wrong.
But I can’t get iot out of my head, that all these diesels are producing pollution, that is cutting the UVB radiation. As my health was appalling in the 1950s, during the legendary London smogs, I wonder if there is a connection.
Unfortunately, to many UVB radiation is an evil as it causes skin cancer. So anything that cuts UVB radiation levels is to be welcomed.
The Diamond Light Source And Ebola
The headline of Ibuprofen ‘disables’ Ebola virus, drew me to this article on the BBC’s web site. This is said.
The painkiller ibuprofen and the cancer drug toremifene can disable the Ebola virus, say researchers.
Scientists used the UK’s national synchrotron facility – Diamond Light Source – to analyse the virus in incredible detail.
They revealed the two drugs could bind to the crucial part of Ebola that the virus needs to infect cells.
It may be only a starting point, but it looks like a success for the Diamond Light Source. I am indebted to Wikipedia for this description of the Diamond Light Source.
Diamond Light Source (“Diamond”) is the UK’s national synchrotron science facility located at the Harwell Science and Innovation Campus in Oxfordshire. Its purpose is to produce intense beams of light whose special characteristics are useful in many areas of scientific research. In particular it can be used to investigate the structure and properties of a wide range of materials from proteins (to provide information for designing new and better drugs), and engineering components (such as a fan blade from an aero-engine) to conservation of archeological artifacts (for example Henry VIII’s flagship the Mary Rose.
This is a UK-funded and based facility, I hope that, after Brexit, this type of scientific machine, which cost £260million will still be able to be funded.
Why I Support Cancer Research UK
In yesterday’s post; There’s More To Liverpool Than Football And The Beatles, I talked about how researchers at Liverpool University had developed a better prostate cancer treatment. I posted this from an An article in The Guardian.
The ESPAC trials, which began publishing findings in 2004, showed that chemotherapy with gemcitabine brings five-year survival up to 15-17%, doubling the rate of survival with surgery alone. The latest research, presented at theAmerican Society of Clinical Oncology meeting in Chicago, showed the two-drug combination nearly doubles the survival rate again to 29%.
It showed, said Neoptolemos, that chemotherapy does work in pancreatic cancer, even though most attention in cancer research is now focused onimmunotherapy, and precision or targeted medicine.
But the trial would not have happened without funding from the charity CancerResearch UK (CRUK), because both drugs are old and off-patent, meaning they can be made by any generic drug manufacturer and are consequently cheap. Drug companies would not foot the bill for such a trial because the profits to be made are small.
“This is an academic-led presentation,” said Neoptolemos. “This shows the enormous value of CRUK. Without them, none of this would have happened. There is a lot of pressure [on doctors] to do drug company trials because you get £2,000 to £3,000 a patient. For something like this, you don’t get anything. It has been quite tough to do.”
That is a very strong endorsement of Cancer Research UK.
Today, there is this story on the BBC web site, which is entitled Bowel cancer: Stents ‘may prevent need for colostomy bags’. This is said.
Bowel cancer patients may avoid the need for colostomy bags if they are first treated by having an expandable tube inserted at the site of their blockage, cancer doctors have said.
The new approach, presented at the world’s biggest cancer conference, showed that the tube, or stent, cut the risk of complications from surgery.
The trial took place at Central Manchester University Hospitals! And who funded the trial? Cancer Research UK!
So I shall keep supporting the work of Cancer Research UK!
There’s More To Liverpool Than Football And The Beatles!
This morning, this story on the BBC web site entitled ‘Major Win’ In Pancreatic Cancer Fight is one of the top stories. This is said.
A new combination of chemotherapy drugs should become the main therapy for pancreatic cancer, say UK researchers.
The disease is so hard to treat that survival rates have barely changed for decades.
But data, presented at the world’s biggest cancer conference, showed long-term survival could be increased from 16% to 29%.
The findings have been described as a “major win”, “incredibly exciting” and as offering new hope to patients.
I must admit that I feel a touch of pride, as the study was led by Professor John Neoptolemos at Liverpool University, which was where my late wife and I met when we were both students at the University.
But I also feel a touch of relief for others, who might get this awful cancer in the future, as now they may stand a better chance of survival, than did our youngest son; George, who survived just a few months after diagnosis.
I also raised a small sum of money for the research by visiting all 92 English and Welsh football clubs in alphabetical order by public transport. The main funding for the research included Cancer Research UK and I think some EU money!
The BBC story also says this.
The trial on 732 patients – in hospitals in the UK, Sweden, France and Germany – compared the standard chemotherapy drug gemcitabine against a combination of gemcitabine and capecitabine.
I’ve looked up the two drugs mentioned and both are on the WHO Model List of Essential Medicines, which are the most important drugs needed in a basic health system.
An article in The Guardian is also illuminating. This is said.
The ESPAC trials, which began publishing findings in 2004, showed that chemotherapy with gemcitabine brings five-year survival up to 15-17%, doubling the rate of survival with surgery alone. The latest research, presented at the American Society of Clinical Oncology meeting in Chicago, showed the two-drug combination nearly doubles the survival rate again to 29%.
It showed, said Neoptolemos, that chemotherapy does work in pancreatic cancer, even though most attention in cancer research is now focused on immunotherapy, and precision or targeted medicine.
But the trial would not have happened without funding from the charity CancerResearch UK (CRUK), because both drugs are old and off-patent, meaning they can be made by any generic drug manufacturer and are consequently cheap. Drug companies would not foot the bill for such a trial because the profits to be made are small.
“This is an academic-led presentation,” said Neoptolemos. “This shows the enormous value of CRUK. Without them, none of this would have happened. There is a lot of pressure [on doctors] to do drug company trials because you get £2,000 to £3,000 a patient. For something like this, you don’t get anything. It has been quite tough to do.”
So this is not some elite drug for the rich, famous and powerful, but one that might even be applied everywhere.
I must admit, that I’ve shed the odd tear this morning!
Thoughts On My Vitamin D Deficiency
I’m now convinced that the cause of my bad springs and substantial absences from school as a child, and periods of bad health since, is due to a periodic vitamin D deficiency.
I suffer from several of the same symptoms as my father, who was most likely the parent from whom I inherited coeliac disease.
As a child, I didn’t go out in the son much, as I think I found it a bit painful and I burned. My father was the same in those days and was very much a man for his garage or shed. He only ventured out to smoke his pipe.
The problems dropped, when I went to Liverpool University and met my future wife. But then she would drag me out into the sun for a walk, with great regularity.
When I was diagnosed as a coeliac, I thought this would be the end of it all. And it did get a bit better, with the bonus that I could now sunbathe without burning. I also stopped being bitten by mossies.
Since the death of my wife, my stroke and moving to London, the bad springs and a lot of the other symptoms have returned.
But no-one could say the weather in London and it seems much of North and Central Europe has been very sunny over the last few years.
I even took a holiday in Croatia for some sun, but in My Home Run From Dubrobnik, I saw probably a day and a half of sun at most!
I’m now on vitamin D3 tablets and they appear to help.
But I think, what I need is a good scientific book on vitamin D, how it is absorbed by the body and what it actually does.
So much of what I get told seems to only have vague science behind it!
If I could find a top class University, where they were doing serious research into vitamin D, I’d go halfway round the world to talk to them.
Vitamin D Deficiency And Atrial Fibrillation
I’ve just found a paper in the International Journal of Cardiology with this title.
As according to two cardiologists in Cambridge, the reason I had my stroke was atrial fibrillation, I should discuss this with a cardiologist.
I think my story goes something like this.
- For some reason, I didn’t like the sun and kept out of it.
- When I was diagnosed as a coeliac, I went gluten-free and didn’t get added Vitamin D in my food.
- But C dragged me off to the sunnier climes, where now I can stay in the sun without problem.
- When she died, I retreated into myself and didn’t go to the sun.
- So did I get low vitamin D?
- My GP thought so and I decided to drive around in my Lotus with the top down.
- I eventually, had the stroke, I’d probably been just missing since C died.
- Atrial fibrillation was diagnosed and it was said to have caused the stroke.
- Warfarin has been prescribed to protect me!
I’ve added sun and vitamin D for good measure.
Until I can prove otherwise, my father who gave me coeliac disease, wasn’t so lucky and died of a stroke.
Did he have atrial fibrillation and low vitamin D?
My Endoscopy
This is an old post from an earlier blog, which is dated October the third, 2003, but I’ve been asked about it a couple of times lately, so I thought I’d copy it over.
Introduction
I have written this in quite a lot of detail so that it can help others who are undergoing the procedure.
The only thing I might say, is that I am a reasonably fit, fifty-six year old, who has a strong scientific training. So on the one hand, my body should be able take most things and on the other I do have a basic understanding of what’s going on!
Before
I wasn’t that sure to expect when I went for a endoscopy.
I am also not the bravest where hospitals or operations are concerned!
I had the instructions, which said that there was a 1-in-10,000 chance of something going wrong, that I was to wear comfortable easily washed clothes and that I wasn’t to eat or drink anything for six hours before.
It also said that there was the choice of a sedative or a throat spray and if I had the first I wouldn’t be able to drive, use machinery or drink alcohol for 24 hours.
Hmm!
Would I be brave enough to have the throat spray, as it would also mean I wouldn’t have to find someone to go with me? Not easy when your wife works full time and your children live miles away!
It said phone if you wanted any help. So I did!
I was given a direct line by the receptionist and after a couple of tries, I got through to a helpful nurse who said that most people are alright with the throat spray.
So it was to be the throat spray!
I also remembered the advice given to me by a scientist who created some of the world’s best anaesthetics. He said to avoid them at all costs!
I didn’t sleep too badly the night before, but I did get up about six.
Nothing unusual here, as Celia is often out by half past on her way to all Courts east, west, north and occassionally south. I also find that the early morning is the best time to work!
But I did want to have a last drink of a cup of tea before the requisite six hours of abstinance arrived at half past six.
It was a long wait, as I am one of those who just like others have a thinking cigarette, when I work I have a thinking drink, or a snack. I did bite my fingers a bit, until I realised that could count as food!
In the end I gave up on work about twelve and disappeared off on a series of useful, but on the whole rather time-wasting errands.
I had tried to arrange a game of tennis before, but that all came to nothing. I was dressed for the game though, as the clothes fitted the requirements.
I drove all the way to Bury St. Edmunds to collect my spare car keys from last night and then wasted a good fifteen minutes talking to the salesman about the new higher powered MG-ZT-T-230. (I would have bought one a few years ago, but now cars are just a means of getting around. Well not quite, but they aren’t so important!)
I then picked up the enlargements of the family photo taken at Imogen’s christening. I think I paid a cheque into the bank!
All things that needed to be done, but they could have waited until the Saturday!
Finally, about two I parked the car in the lane that leads to Addenbrookes.
When I visit the hospital I tend to do that, as on a sunny day (It was!) it is a nice walk and you avoid all the hassle of finding a car parking space.
Procedure
If you don’t know Addenbrokes it is not the most attractive of buildings, being a 60’s, brutal construction designed by an architect, who probably designed down to a cost, rather than up to a standard.
It’s also rather a maze, so when I entered the Out-Patients I looked around for someone to give me directions. As when I came for my first appointment, I was given proper directions to Endoscopy, which seemed to be rather an afterthought for the building, reached up what looked to be a fire-escape!
As I had forgotten to bring some suitable reading, I bought a magazine. I think it was Autocar.
Often when I go to the doctors, I’ll take a rather academic book, so that I don’t get treated like an idiot. Also something with substance and length as that seems to ensure I get seen quickly!
I waited for perhaps half an hour until twenty minutes after my appointment before I was seen by a nurse, who then asked whether I was taking the sedative. I said not, but I got the impression that most of the others were taking one.
She also said that as I have a crown on a front tooth, I was less likely to break that if I had a spray, as I wouldn’t bite so hard on the mouth piece through which the probe would pass.
Then at about a quarter past three, I was called in by the doctor.
The doctor, a Mr. Hardwick, again asked about the sedative and then outlined the procedure.
I did question him, as to why the consent form asked so many silly questions! I really don’t care at all about what happens to my body after I die, so long as it gets the respect it deserves. If it deserves any that is!
A few minutes later and he walked me through to the room where it was to be carried out.
Now I realised that except for the facts that a camera was being passed down my throat, through the stomach and into the duodenum, before a biopsy was to be taken, I didn’t know much else.
Would I be standing, sitting or lying? How big was the camera tube? After all I did know that sword swallowers appeared to take something substantial!
It’s funny, but whether because I was apprehensive or whether I didn’t want to interfere with the procedure, I didn’t take a look at the equipment out of my normal rather excessive curiosity. All I can remember is that it was made by Olympus. I hoped it gave better pictures than the last camera I bought of that make!
I was told that the throat spray was rather unpleasant and tasted of bananas. Why should bananas be unpleasant? I’ve always eaten at least one a day since I first saw one at the age of about five! (There weren’t any in London for several years after the war!)
The spray was fine and after a couple of sprays, I could feel my throat going numbish. But I still had full control and could swallow as required.
I was then asked to lie on the trolley and then I was turned onto my side.
Other instructions were given to try and swallow the probe and also to breathe normally. He also said that it was easier as I had not had the sedation and could co-operate with him. That sounded very reasonable!
I now had the mouth piece between my teeth and the doctor started to pass the probe down into my stomach. The probe was perhaps three to four millimetres in diameter. In other words considerably smaller than the occassional mint imperial, that I have swallowed by accident.
At this point, I should say that I am predominately a mouth breather and even with the mouth piece in, I was still breathing almost normally through my mouth, rather than the nose. Although I was trying to use it! I don’t think I was very successful!
As the tube progressed, I was asked to swallow and after a few attempts was able to progress it down my throat. I didn’t swallow more than about six to eight times.
I had also been worried because dentists have told me I have a strong gag reaction. It didn’t seem to be a problem!
Obviously, I was quiet and couldn’t talk. However, I did have a rather macabre thought as to whether they used the same probe if they were looking from the other end! I never asked the question!
It wasn’t that unpleasant and was no worse that having teeth drilled! It was a lot quieter and I only dribbled a very small amount.
It was also certainly better than the day in a dentist’s surgery in Smithdown Road in Liverpool, when I had the first crown fitted on my front tooth. I can still remember the smell of burning teeth!
I had been warned to expect wind as the probe entered my stomach, but really didn’t notice much and after perhaps two to three minutes the probe was in the duodenum. I hadn’t felt anything inside as the probe progressed. Was this due to the spray? I suspect it was.
So the first part was over and it wasn’t too bad at all! I hadn’t broken out in a sweat or anything like that, but it did find a bruise later on my knee, where the other one had been pushing into it, whilst I was trying to lie still!
They then took two biopsies by passing a tool down the probe. I thought I might have felt a slight prick as each was taken, but it may be that I was looking for something!
And that really was that!
A couple of minutes later, the probe had been removed and I was sitting on the trolley.
I was told that everything appeared normal and that they had got a couple of good biopsies. What constitutes a good one?
I was then told not to drink or eat anything before twenty to four and after a few minutes sitting on a chair, I walked out of the department, out of the hospital and back to my car.
My throat seemed slightly sore, but after a drink and some crisps as I filled up with petrol at the garage, everything seemed fine!
I ate a hearty meal that evening.
Conclusions
I think the first thing I should say, is that everything at Addenbrookes was very professional and I would have no complaint as to care.
Or any complaint about anything else for that matter!
Take the case of phoning before the procedure for advice about the throat spray!
This should always be available and I certainly found it very helpful as looking back, I think I made the right decision to have the spray rather than the sedative :-
1. The very fact that I was awake and fully conscious during the procedure must be a help to the staff, as they could tell me to do things and at least I could try to carry them out!
2. This must make the procedure quicker and more efficient, especially as there is no need for a recovery bed.
3. The nurse also told me that as I have full control of my jaw, which I wouldn’t have with the sedative, that there is less chance of dental damage.
Now having crowns fitted is definitely not pleasant!
4. But the biggest advantage to me of the throat spray, is that I walked out a few minutes later, drove home and within half an hour I was almost back to normal.
There is only one thing I would do to improve the system and that is to give more information to the patient.
If I had known more before I went to the hospital and had perhaps read an experience like this, I would have been less apprehensive.
It probably didn’t make any difference to me in the end, but someone of a more nervous disposition than myself, might just decide to be sedated rather than choose the spray.
So looking back about a week later as I write this, it doesn’t seem terrifying at all and I would recommend anybody who is asked to have a endoscopy, to have one without worrying too much!
And have the throat spray rather than the sedative!
Just relax and let the doctors and nurses get on with the job!
The Anonymous Widower 