Category Archives: Medicine & Health 疗池

Advancing world-leading pancreatic cancer research

by Dr. Belinda Lee

Honorary, Medical Biology (W.E.H.I.)

Pancreatic cancer is the fifth most common cause of cancer death in Australia and predicted to become the second leading cause of cancer deaths globally by 2030. Dr Belinda Lee, from the Walter and Eliza Hall Institute of Medical Research, is an oncologist and researcher working to combat this alarming trend in pancreatic cancer. 

In 2016, Dr Lee established PURPLE, a first-of-its-kind pancreatic cancer translational database to help improve pancreatic cancer detection methods and develop more effective therapies for the aggressive disease. 

“Our aim is to increase data sharing and collaboration across cancer centres and research laboratories so that we can translate research from the laboratory into the clinic,” Dr Lee said.

The PURPLE registry currently supports crucial studies such as the DYNAMIC-Pancreas clinical trial. The DYNAMIC-Pancreas trial is investigating how cutting-edge blood biomarker technology that detects tiny amounts of residual circulating tumour DNA from a simple blood test can be used to determine whether a patient requires chemotherapy treatment after early stage pancreatic cancer surgery. The study is funded by a generous donation from The Marcus Foundation and sponsored by the Australian GI Trials Group (AGITG) and is recruiting at 20 cancer centres across Australia.

The PURPLE platform is also supporting a pancreatic cancer organoid program that aims to predict and identify the best personalised treatment combinations to improve outcomes for pancreatic cancer patients. The program is a collaborative effort between the Walter and Eliza Hall Institute, University of Melbourne, and 11 Victorian cancer centres. New therapeutic drugs developed at the Walter and Eliza Hall Institute will be tested through high-throughput drug screen to identify which drugs are most effective in the fight against pancreatic cancer. 

“By coordinating and linking translational research projects through the PURPLE initiative, we hope to gain crucial information for improving pancreatic cancer therapies and for combating factors that cause resistance to treatment,” Dr Lee said. 

website information on DYNAMIC-Pancreas clinical trial

gicancer.org.au/clinical-trial/dynamic-pancreas/ 

Inflammation

by Dr. Mecherl Lim 

MD (MA) Naturopath (ND), Holistic Kinesiology

Eat to beat inflammation

Inflammation is a healthy body response, but too much underlies many modern diseases such as diabetes, cancer and heart disease.

To keep inflammation under control, here are some delicious foods with anti-inflammatory properties & some good nutritional formulas.

Inflammation is your body’s normal immune response to help heal tissues when they are injured by bacteria, trauma, toxins, heat or any other causes.  The damaged tissue releases chemicals that cause blood vessels to leak fluid into the tissues, creating swelling.  This helps isolate the foreign substance from further contact with body tissues.  The chemicals attracted to the injured site are phagocytes (a type of white blood cell) which are responsible for “eating “microorganisms as well as dead or damage cells. 

In the short term, inflammation is a good thing.  It is when inflammation remains unchecked that it becomes one of the most troublesome processes in the body. An inflammatory response that lasts up to a few days is called acute inflammation, while a response of longer duration is referred to as chronic inflammation. Unchecked inflammation causes tissue destruction.  

In the case of allergies, excessive inflammation is a response to an environment agent such as pollen, which normally poses no threat to the individual. Autoimmune reactions are those in which chronic inflammation is triggered by the body’s immune response against its own tissues.

Chronic inflammation causes significant disruption of the normal functions of cells and unlike acute inflammation, is often silent, invisible and persistent, and is implicated in a host of health problems.

INFLAMMATION AND AGEING

Infectious disease has historically been the number-one killer of human beings, and possessing a strong immune response primed to keep us alive long enough to reproduce was an evolutionary response to this threat. During evolution, the human organism was set to live 40 to 50 years; Today, however, the immune system must remain active for a much longer time. This very long activity leads to chronic inflammation that slowly damages one or several organs and is considered the major risk factor for age-related chronic diseases such as Alzheimer’s disease, atherosclerosis, diabetes and even cancer. In other words, age related diseases are the result of a life-long active immune system.  Controlling inflammatory status may therefore allow you a better chance of successful ageing.

ALZHEIMER’S DISEASE

One of the characteristic features of Alzheimer’s disease is an inflammatory response associated with accumulation in the brain of a substance known as amyloid beta protein, which contributes to brain degeneration. It’s thought that toxic levels of amyloid beta protein are able to accumulate in the brain because of the malfunction of a that pushes it past the blood brain barrie. Researchers from Sain Louis University School of Medicine induced inflammation in mice and found that it switched off the pump, preventing amyloid beta protein from exiting the brain into the bloodstream and allowing it to accumulate.  Inflammation is therefore a key mechanism that promotes increased concentrations of amyloid beta protein in the brain. 

THE BIG THREE: DIABETES, CANCER AND HEART DISEASE

It has long been known that type 1 diabetes is an autoimmune disease in which the body attacks the islet cells in the pancreas that produce insulin.  In recent years, the immune system has also been implicated in type 2 diabetes and, in particular imbalances in the cytokines, an immune system component that causes inflammation.  It has also been suggested in recent years that chronic, low grade tissue inflammation in those who are overweight contributes to insulin resistance, the major cause of type 2 diabetes. 

In recent animal research, scientists from the University of California, demonstrated that inflammation provoked by macrophages (immune cells) can lead to insulin resistance and type 2 diabetes.  They also demonstrated that by disabling the macrophage inflammatory pathway, insulin resistance and the resultant type 2 diabetes could be prevented.

Chronic inflammation has also been identified as a risk factor for cancer.  Research has shown that people with the highest blood levels of C-reactive protein (marker for systemic inflammation) are more likely to contract certain forms cancer.  Several reports implicate inflammation as a significant risk factor in cancer development, with the cancer using inflammatory processes to spread. This includes inflammation associated with cigarette smoking and asbestos exposure, as well as inflammation of the bowel and pancreas. Just a few examples where inflammation has been linked to cancer development.

YOUR HEART

Atherosclerosis is a condition in which an artery wall thickens as the result of a build-up of fatty materials such as cholesterol. It involves a chronic inflammatory response in the walls of arteries and is commonly referred to as the hardening of arteries. It is caused by the formation of multiple plaques within the arteries.  Recent scientific advances have established the role of inflammation in mediating all stages of this disease.  The inflammatory process associated with atherosclerosis is thought to be caused by a response to badly oxidised LDL cholesterol.

The body’s immune system responds to the damage caused by the bad cholesterol to the artery wall by sending white blood cells to absorb the cholesterol. Unfortunately, these white blood cells are not able to process the cholesterol and they ultimately grow and rupture, depositing a greater amount of cholesterol in the artery wall. This triggers more white blood cells, continuing the cycle and contributing to further inflammation.

Recent research has provided evidence of a critical role of inflammation and metabolic factors in the development of hypertension (high blood pressure). For example, excess body fat, a known risk factor for high blood pressure, stimulates the release of inflammatory substances from fat cells. Other factors such as high LDL (bad cholesterol), low HDL (good cholesterol), insulin resistance and diabetes can further injure artery walls and produce inflammation. Clustering of these factors in what is known as metabolic syndrome is associated with increased inflammation in the body, as well as heart disease and hypertension. 

To be continue in the next issue: Joints, Bowels, Bones & Skin 

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Fracture in the Elderly

by Dr. Tan Boon Cheong

MBBS (MU),. MS Ortho (MU)

Not too long ago, I remember writing an article regarding osteoporosis for this column. Thus, I find it appropriate to bring up the topic regarding fragility fractures in the elderly. A fragility fracture is defined as a fracture that takes place due to a fall from a standing height or less.

Domestic falls in the elderly happen rather frequently when they get out of bed in the middle of the night to go to the toilet. Several reasons could have attributed to the fall, for example, giddiness, poor lighting, poor balance or a slippery floor. Fragility fractures are most common in three places, namely the wrist, spine and hip.

A wrist fracture is a common fracture seen in an osteoporotic bone. This fracture occurs more commonly in women compared to men with a ratio of 10:1 at the age of 70. This fracture usually occurs due to a fall on an outstretched hand (trying to stop a forward fall). Most of the time this fracture can be managed with casting, but occasionally surgical fixation might be necessary. 

In the spine, a vertebral body compression fracture can take place with an individual landing in a sitting position after a slip. In some patients, this fracture might even occur when driving at high speed across a road bump. The main symptom of a compression fracture is severe back pain. You will be surprised that some patients might not even know that they have a compression fracture, as they present with mild symptoms and it is only picked up during some other routine check-up. Majority of patients with this compression fracture are treated conservatively with medication, rest and physiotherapy. Some patients will choose to undergo procedures such as percutaneous vertebroplasty (injecting bone cement into the vertebral body) or kyphoplasty (jacking up the compression segment) for pain management. It is rare for the need of an open surgery unless there are obvious neurological deficits that require decompression of the spinal cord. 

Lastly, is the hip fracture. This is a fracture that will compromise the quality of life and shorten the life expectancy of a person. It has been shown that older patients have five to eight times higher risk of dying within the first three months of a hip fracture compared to those without a hip fracture. The two most common places at the hip which are most susceptible to fractures are the intertrochanteric (extra-capsular) and neck of femur (intra-capsular). Almost all hip fractures require surgical intervention. Without surgery, complications such as pressure ulcers or orthostatic pneumonia might occur.

A fragility fracture is something that is important to prevent and treat irrespective of where the fracture occurs. This fracture can bring about depression, loss of function, loss of mobility, loss of independence and loss of quality of life. Thus, screening and treatment for osteoporosis should be emphasized on. It is essential to make sure one has healthy and strong bones and not regret only after a fracture has taken place.