BOWEL cancer is one of the most common types of cancer diagnosed in the UK. Most people diagnosed with it are over the age of 60. A recent study has found an indicator of the disease, which might put you at risk of colon cancer.
A SURVEY by Blood Cancer UK has found that over half of UK adults cannot name a single symptom of blood cancer, despite it being the third biggest cause of cancer deaths in the UK. Knowing the signs and symptoms of blood cancer could be the difference between survival or not, as diagnosing the disease early holds the best chance of successful treatment.
GOLF LEGEND Tony Jacklin was the most successful British player of his generation. Now, the sporting legend has opened up about his life in a tell-all autobiography that reveals some shocking details about his health.
Ovarian cancer is a serious condition and the early signs of it should not be ignored. Having ovarian cancer can affect your day to day life during and after treatment. Like most cancers the sooner you recognise it and seek treatment the better your chances of recovery are.
The symptoms of ovarian cancer – especially the early signs – can be hard rot recognise.
They can often be confused with less serious conditions such as irritable bowel syndrome (IBS).
Ovarian cancer can cause several signs and symptoms.
Women are most likely to have symptoms of the disease if it has spread, but even early-stage ovarian cancer can cause them so you must take action if you develop these.
Most common symptoms
The American Cancer Society has outlined four of the “most common” signs of ovarian cancer these include:
Feeling constantly or frequently bloated, or having a swollen tummy.
Pain or discomfort in your pelvic or abdominal (tummy) area.
Trouble eating, feeling full quickly or a drop in appetite.
Urinary symptoms such as needing to pee more often or more urgently than normal.
The NHS recommends you see a GP if you have been feeling bloated, especially if this occurs more than 12 times a month.
READ MORE: The 11 most common causes of raised blood pressure in hot weather
It is worth noting that not everyone’s experience and symptoms of ovarian cancer will be the same.
Other symptoms could indicate you have ovarian cancer and these should not be dismissed.
Other symptoms can include:
Feeling sick often or persistent indigestion
Feeling pain during sex
A change in your bowel habits
Feeling constant fatigue
Unintentional weight loss
It is always worth seeing a GP if you have any concerns. Tests can be quick and easy to do.
The NHS said: “A GP can do some simple test for ovarian cancer to see if you have it.”
The newly issued comprehensive ‘Oncology Medical Home’ standards can act as a roadmap for how practices can deliver high-quality cancer care.
“Every single patient has the right to high-quality, evidence-based, and cost-effective cancer care,” said Everett E. Vokes, MD, current president of the American Society of Clinical Oncology (ASCO).
“However, our challenge as clinicians and as a broader oncology community has been to define what that high-quality cancer care looks like.”
“These new, comprehensive standards will remove ambiguity and serve as a strong foundation for all stakeholders to work together to ensure that every single person receives the care they deserve, throughout the entire patient journey,” he said in a statement.
The new standards, issued jointly by ASCO and the Community Oncology Alliance (COA), were published online July 13 in JCO Oncology Practice.
‘Oncology Medical Home’ is a system of care delivery that features coordinated, efficient, accessible, and evidence-based care and includes a process for measurement of outcomes to facilitate continuous quality improvement.
Its origins go back to 1967, when the American Academy of Pediatrics introduced the Patient-Centered Medical Home (PCMH), with a goal of improving coordination of care to pediatric patients with special needs. This model was increasingly adapted by specialists in family medicine and, in 2007, the Patient-Centered Primary Care Collaborative (PCMH) was created. In the years that followed, the PCMH came to be regarded as a system for healthcare transformation.
In oncology, the program dates back to 2012. At that time, ASCO launched a new initiative, developed in collaboration with Innovative Oncology Business Solutions Inc (IOBS), which pioneered the model under its Community Oncology Medical Home (COME HOME) program. This pilot COME HOME program implemented specialty medical homes in seven oncology practices across the country.
Subsequent models had some modifications. For example, an early OMH effort was tied to an alternative payment model, with incentives to improve value for patients with cancer undergoing systemic therapy.
Need for Quality Care Model
The COA also developed an Oncology Medical Home, beginning some 9 years ago. “We had a certification program with five standards and 16 measures, and it lasted for 3 years,” Bo Gamble, director of strategic practice initiatives at COA, told Medscape Medical News.
The OMH accreditation model was implemented by the American College of Surgeons’ Commission on Cancer, but “it was crickets for 3 years,” he said. “The practices in the pilot were excited about it, but we really don’t know what happened.”
Gamble explained that ASCO approached the COA about 3 years ago with the idea of working together. “At that time we counted about 35 different cancer care programs that were ongoing in the US,” he said. “They were all different in their methodology and measures — in four states there were seven models.”
Thus, it was confusing to figure out what models were being used and how well they were working. For the current standards, Gamble explained that they spoke with practices and payers, to see if they could all agree on criteria for one high-quality cancer care model.
Standard of Care
To develop the new standards, an expert panel was convened and conducted a systematic review of the literature on the topics of OMH, clinical pathways, and survivorship care plans. Using this evidence base and an informal consensus process, a set of OMH standards was developed.
The new standards feature seven domains of cancer care:
Patient engagement and empowerment to share in decision-making about their cancer care, including individualized treatment plans, survivorship plans, and access to financial navigation.
Patient access to cancer care at the right time and in the right setting. Clinicians should employ a symptom triage system and offer expanded access to timely office care to minimize emergency room visits.
Evidence and value-based treatment. Clinicians should adhere, as well as document their adherence, to comprehensive clinical pathways that reflect the latest clinical research, and as appropriate, recommend and refer patients to clinical trials.
Patient access to equitable, comprehensive, and coordinated, team-based care. Oncology care teams should closely coordinate care, which should include patient navigation, psychosocial care, and support services. Practices must have policies in place to address health equity, including awareness of conscious/unconscious bias.
Continuous-practice quality improvement using data, including patient surveys and patient-reported outcomes, to evaluate and improve processes and outcomes.
Patient access to advance care planning discussions, palliative, and end-of-life care.
Practice adherence to the highest-level chemotherapy safety standards (as per QOPI Certification Program Standards)
Right now, there are eleven practices that have come on board, and the 2-year pilot began on July 1. “We want to be a source of encouragement; we’re not here to police them,” Gamble commented “We have some tough challenges, but this makes sense and we can make it happen.”
Of course, there are some issues in oncology that will take more than an OMH model to resolve, such as the high costs of much cancer treatment.
“But we have proven that if you follow pathways, you can control some of the prices,” Gamble said. “We don’t want a payer formulary, we want a pathway that recognizes quality and value and here we are demonstrating how we can work together on this.”
JCO Oncology Practice. Published online July 13, 2021. Full text
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Parkin protein (green signal) is in a different part of the cell than the mitochondria (red signal) at time 0 (left image) but then co-localizes with the mitochondria after 60 minutes (right image). Credit: Salk Institute
Enzyme with central role in cancer and type 2 diabetes also activates “clean-up” protein in Parkinson’s.
When cells are stressed, chemical alarms go off, setting in motion a flurry of activity that protects the cell’s most important players. During the rush, a protein called Parkin hurries to protect the mitochondria, the power stations that generate energy for the cell. Now Salk researchers have discovered a direct link between a master sensor of cell stress and Parkin itself. The same pathway is also tied to type 2 diabetes and cancer, which could open a new avenue for treating all three diseases.
“Our findings represent the earliest step in Parkin’s alarm response that anyone’s ever found by a long shot. All the other known biochemical events happen at one hour; we’ve now found something that happens within five minutes,” says Professor Reuben Shaw, director of the NCI-designated Salk Cancer Center and senior author of the new work, detailed in Science Advances on April 7, 2021. “Decoding this major step in the way cells dispose of defective mitochondria has implications for a number of diseases.”
Parkin’s job is to clear away mitochondria that have been damaged by cellular stress so that new ones can take their place, a process called mitophagy. However, Parkin is mutated in familial Parkinson’s disease, making the protein unable to clear away damaged mitochondria. While scientists have known for some time that Parkin somehow senses mitochondrial stress and initiates the process of mitophagy, no one understood exactly how Parkin was first sensing problems with the mitochondria—Parkin somehow knew to migrate to the mitochondria after mitochondrial damage, but there was no known signal to Parkin until after it arrived there.
Shaw’s lab, which is well known for their work in the fields of metabolism and cancer, spent years intensely researching how the cell regulates a more general process of cellular cleaning and recycling called autophagy. About ten years ago, they discovered that an enzyme called AMPK, which is highly sensitive to cellular stress of many kinds, including mitochondrial damage, controls autophagy by activating an enzyme called ULK1.
Following that discovery, Shaw and graduate student Portia Lombardo began searching for autophagy-related proteins directly activated by ULK1. They screened about 50 different proteins, expecting about 10 percent to fit. They were shocked when Parkin topped the list. Biochemical pathways are usually very convoluted, involving up to 50 participants, each activating the next. Finding that a process as important as mitophagy is initiated by only three participants—first AMPK, then ULK1, then Parkin—was so surprising that Shaw could scarcely believe it.
To confirm the findings were correct, the team used mass spectrometry to reveal precisely where ULK1 was attaching a phosphate group to Parkin. They found that it landed in a new region other researchers had recently found to be critical for Parkin activation but hadn’t known why. A postdoctoral fellow in Shaw’s lab, Chien-Min Hung, then did precise biochemical studies to prove each aspect of the timeline and delineated which proteins were doing what, and where. Shaw’s research now begins to explain this key first step in Parkin activation, which Shaw hypothesizes may serve as a “heads-up” signal from AMPK down the chain of command through ULK1 to Parkin to go check out the mitochondria after a first wave of incoming damage, and, if necessary, trigger destruction of those mitochondria that are too gravely damaged to regain function.
The findings have wide-ranging implications. AMPK, the central sensor of the cell’s metabolism, is itself activated by a tumor suppressor protein called LKB1 that is involved in a number of cancers, as established by Shaw in prior work, and it is activated by a type 2 diabetes drug called metformin. Meanwhile, numerous studies show that diabetes patients taking metformin exhibit lower risks of both cancer and aging comorbidities. Indeed, metformin is currently being pursued as one of the first ever “anti-aging” therapeutics in clinical trials.
“The big takeaway for me is that metabolism and changes in the health of your mitochondria are critical in cancer, they’re critical in diabetes, and they’re critical in neurodegenerative diseases,” says Shaw, who holds the William R. Brody Chair. “Our finding says that a diabetes drug that activates AMPK, which we previously showed can suppress cancer, may also help restore function in patients with neurodegenerative disease. That’s because the general mechanisms that underpin the health of the cells in our bodies are way more integrated than anyone could have ever imagined.”
Reference: “AMPK/ULK1-mediated phosphorylation of Parkin ACT domain mediates an early step in mitophagy” by Chien-Min Hung, Portia S. Lombardo, Nazma Malik, Sonja N. Brun, Kristina Hellberg, Jeanine L. Van Nostrand, Daniel Garcia, Joshua Baumgart, Ken Diffenderfer, John M. Asara and Reuben J. Shaw, 7 April 2021, Science Advances. DOI: 10.1126/sciadv.abg4544
Two-time Lions captain and Grand Slam winner Sam Warburton did it all, but how did twin brother Ben support him throughout? Prostate Cancer UK celebrates the importance of men showing appreciation for one another
Last Updated: 17/07/21 3:52pm
Two-time Lions captain and Grand Slam winner Sam Warburton did it all in the world of rugby, but how did twin brother Ben support him throughout?
British and Irish Lions tour-winning captain Sam Warburton knows all about the support that it takes to reach the top.
You don’t win a Lions Tour, Grand Slams and become one of the great back-row forwards of a generation on your own.
Away from the support of the team or athlete environment though, we all receive support from a lot of other areas, and this couldn’t be more true for Sam, who has support from his twin brother Ben, and vice versa as they have carved different and successful careers in the world of rugby union.
Now. as part of a campaign supporting Prostate Cancer UK, Sam and Ben want to encourage men to show how much they care for one another, how much they mean to each other and that’s why it’s so important to have open, honest conversations about subjects like this.
So we asked Ben and Sam to have some pretty open and honest conversations with each other, about how they supported each other through the many challenges that life has thrown at these twin brothers.
While Sam’s CV is well-known: A winning Lions captain, skipper of Grand Slam and Six Nations-winning Wales, Ben is a little less known but equally successful in his own field of sports physiotherapy, and has even taken care of his brother, as physio with Cardiff Blues.
Although as Sam says: “He’s a lot less busy now that I’ve stopped playing as he used to spend so much time looking after me!”
After premature births that saw the pair in incubators for the first six weeks of their lives and their mother told they would never be rugby players, being twins has led this pair to being inextricably close.
Sam says: “I love being a twin, it’s great. Growing up, you’ve always got someone there. It’s weird. If I go through something that is highly pressurised, or you (talking to Ben), go through something highly pressurised, you both go through those nerves with each other. Without sounding deep, you are almost a part of each other.
“We are best mates. When we got married, I didn’t have to ask Ben to be Best Man, and he didn’t have to ask me. We just knew.”
The pair spoke to Sky and Prostate Cancer UK at Cardiff Arms Park, where both worked as professionals, Sam talked about their on-field interactions: “We’ve been here matchdays. Ben has treated me on the pitch and given me a bit of tough love. It was nice to be able to be at the same club together.
Ben: “It was lovely, obviously we wanted to play together but this was the next best thing. Sam has supported me a lot through the years.
“In the early days, I had a bad shoulder injury, which I have still got now. I haven’t got a muscle basically in my right arm. So as weird as it sounds, he didn’t make a big deal out of it and that helped the most.
“As a physio, and because Sam has had a lot of experience of other physios, he gives me lots of advice of what to do, what not to do, and I will always make sure if I am seeing someone, I’ve always got that voice in the back of my mind: ‘don’t be lazy, do this and do that’, and that has definitely helped me through my career, because you know that the player needs to have and what they expect of a good physio.”
The pair have clearly been there for each other throughout and as such it comes as no surprise as to how well they know each other and just how similar they are.
Asked to describe each other in three words, the same phrases come from both Warburton mouths.
Ben says of Sam: “For rugby, competitive and ambitious but it’s not all about rugby, and it’s two words but I’ll join them to make them one, family–orientated.
While Sam says of Ben: “Competitive, again, we were both ridiculously competitive but not rivals with each other, we were each others’ best supporters. You are very loyal, family and friends, and family would be the third word too because our family is very tight.”
The final word from the pair comes on their support for Prostate Cancer UK and the importance of talking about potential issues with the people you trust.
Ben says: “I think as you get older, you can’t be shy because if you are too slow to say something to someone you could end up in a bit of knock.”
Sam adds: “Prostate cancer is the most diagnosed cancer in the UK. One in eight men will get it in their lifetime, that’s one man in every scrum, two in every team. It puts rugby in perspective. Being fearful, or not willing to speak or be seen to, can you cost you your life you know, it can. That’s why it’s such an important message to get out.”
To find out more: https://prostatecanceruk.org/risk-checker