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Cancer, asthma and transplant patients are ditched from Government’s coronavirus shielding list

Fury as cancer, asthma and organ transplant patients are ditched from Government’s coronavirus shielding list in an abrupt text message and told their food packages are getting cut off

Cancer, asthma and organ transplant patients were dropped from the Government’s coronavirus shielding list in an abrupt text message, it emerged last night.

Patients with various health conditions that raise their risk of dying from Covid-19 were told they had been removed from the scheme in the GOV.UK text.

The message – which has caused confusion and upset – also informed them they would no longer qualify for state-provided food parcels.

Those who received the text included liver transplant patients, those with brittle asthma, certain types of cancer, liver disease and people on immunosuppressant medications.

Many patients were alarmed that they had been dropped from the National Shielding Service without being talked through the decision by their GP.

It’s unclear how many patients received the text last week, but more than 2million people in England were put on the shielding list at the start of the pandemic.

Cancer, asthma and organ transplant patients were dropped from the Government’s coronavirus shielding list in an abrupt text message, it emerged last night.

Patients with various health conditions that raise their risk of dying from Covid-19 were told they had been removed from the scheme in the GOV.UK text.

The message – which has caused confusion and upset – also informed them they would no longer qualify for state-provided food parcels.

Those who received the text included liver transplant patients, those with brittle asthma, certain types of cancer, liver disease and people on immunosuppressant medications.

Many patients were alarmed that they had been dropped from the National Shielding Service without being talked through the decision by their GP.

It’s unclear how many patients received the text last week, but more than 2million people in England were put on the shielding list at the start of the pandemic.

‘This will not affect your eligibility for a supermarket priority delivery slot or any slots you already have in place.’

Leading health charities and several MPs have demanded the Department of Health give the patients some clarity.

The British Liver Trust said the decision had ’caused real worry for patients’ and urged those who had received a text to ‘continue to shield unless you have spoken to your doctor’.

Asthma UK said: ‘We have heard from people with severe asthma and lung disease who have been alarmed about receiving text messages with no explanation, dropping them from shielding. Some are saying their GP had also not been told. This is an utter mess.’

A spokesman for the Government said: ‘The government is committed to supporting the clinically extremely vulnerable and all decisions about whether someone should shield are clinically led.

‘In some cases health experts have advised that a patient no longer needs to shield themselves from coronavirus. Where this is the case, the person will be informed that they are not on the shielded patient list.

‘Those advised that they no longer need to shield may still access forms of support including the NHS Volunteers network, and will retain their supermarket priority delivery slots.’

An official shielding list was assembled at the start of the pandemic, which included patients with health woes that put them at risk of coronavirus complications.

They were advised to ‘stay at home at all times’ and offered food packages so they did not need to venture to the shops where they could be exposed to the disease.

One in 25 people in England are on the shielding list and classified as extremely vulnerable.

Care assistant Louisa Fenton, 24, who suffers from severe asthma, said getting the message on Friday had caused her extreme distress.

She told the Guardian: ‘This has made me feel awful. Throughout lockdown I’ve been living on my own and I’ve been relying on the food boxes.’

Ms Fenton said she felt like ‘a guinea pig in some kind of experiment’.

It comes just weeks after more than 100,000 people were wrongly told that they were ‘extremely vulnerable’ to coronavirus.

Letters were sent to 2.16million people advising them to ‘shield’ themselves by not leaving their homes and minimising all face-to-face contact – even more stringently than the measures applied to everyone else.

But around five per cent of the recipients were incorrectly included. It follows the revelation that 10,000 letters had been sent to the homes of people who had died, causing distress to families.

The initial list of qualifying patients was put together in haste in mid-March, around the same time Prime Minister Boris Johnson began addressing the nation about the impending crisis.

But the speed and complexity of the process meant errors were included. After GPs were asked to validate the initial shielded patient list, around 107,000 patients were removed, the Department of Health and Social Care said.

WHO IS AT HIGH RISK OF COVID-19 AND NEEDS TO ‘SHIELD’?

Some groups of people are considered to be at extremely high risk of severe illness with coronavirus and should strictly follow shielding measures.

According to NHS Inform, this includes people who:

  • have had solid organ transplants
  • have cancer and are receiving active chemotherapy
  • have lung cancer and are either receiving or previously received radical radiotherapy
  • have cancers of the blood or bone marrow
  • are receiving immunotherapy or other continuing antibody treatments for cancer
  • are receiving other targeted cancer treatments, such as protein kinase inhibitors or PARP inhibitors
  • have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  • have severe chest conditions such as cystic fibrosis or severe asthma and severe COPD
  • have rare diseases that significantly increase the risk of infections
  • are receiving immunosuppression therapies

source: http://dlvr.it/RXXfGr

Too expensive: Asians cannot afford to buy life-saving cancer drugs

Queen donates RM30,000 to cancer institute

Cancer virus discovery helped by delayed flight

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Electron micrograph of the Epstein Barr virus, DR GOPAL MURTI/SCIENCE PHOTO LIBRARY

 

Bad weather and a delayed flight might be a recipe for misery – but in one instance 50 years ago it led to a discovery that has saved countless thousands of lives.

The discovery of the Epstein Barr virus – named after British doctor Anthony Epstein – resulted from his specialist knowledge of viruses which caused tumours in chickens plus his skills gained using one of the first commercially-available electron microscopes.

His hunch was assisted by a longer than expected journey of some tumour cells from Uganda, which were nearly thrown in the bin.

But it would never have happened if Epstein’s curiosity hadn’t been fired up by a lecture by the Irish doctor turned “bush surgeon”, Denis Burkitt.

In the lecture, billed as a staff meeting on “The Commonest Children’s Cancer in Tropical Africa”, Burkitt described how he had noticed a number of cases of debilitating tumours which grew around the jawbone of children in specific regions – particularly those with high temperatures and high rainfall.

We now know this as Burkitt lymphoma.

Sir Anthony Epstein
British doctor Sir Anthony Epstein

Sir Anthony Epstein, now 93, speaking to the BBC’s Health Check programme, recalls: “I thought there must be some biological agent involved. I was working on chicken viruses which cause cancer. I had virus-inducing tumours at the front of my head. I thought… [it] was being carried by some insect vector, or some tic. That’s why it was temperature-related.”

The Epstein Barr virus belongs to the family of herpes viruses – and is linked to a number of different conditions, depending on where you live.

Most people are infected with the Epstein Barr virus. It’s best known in high-income countries for causing glandular fever which causes a sore throat, extreme fatigue and swollen glands in the neck.

According to Dorothy Crawford, emeritus professor of microbiology at Edinburgh University, up to 95% of all adults are infected with the virus.

“The virus is spread in childhood at different rates – in the saliva, so through close contact. In African countries most children have it by the age of two because they share cups in their household.

“The rate is lower in middle-class areas of England, so if you haven’t already been exposed by your early teens it can cause glandular fever.”

This has given it the nickname the kissing disease because, she explained: “People kissing in the back row of the cinema exchange more saliva than young children sharing toys.”

Epstein asked for samples of the tumours from Burkitt and they were sent back on overnight flights from Uganda.

Epstein and Barr
Sir Anthony Epstein and Dr Yvonne Barr, courtesy of Anthony Epstein

For almost three years Epstein’s efforts to retrieve virus from the tumour cells failed, despite trying several culture methods used successfully for other viruses like influenza and measles.

In the end bad weather came to the rescue.

Fog delayed one flight which was diverted to Manchester, 200 miles from London. So the sample taken from the upper jaw of a nine-year-old girl with Burkitt lymphoma didn’t get to Epstein until late one Friday afternoon on 5 December 1963.

At that point it looked past its sell-by date.

“The fluid was cloudy. This suggested it had been contaminated on the way,” Epstein said.

“Was it full of multiplying bacteria? Before we threw it away I looked at it under a wet preparation microscope and saw huge numbers of free-floating, healthy looking tumour cells which had been shed from the edge of the tumour.”

Traditionally, growing cells successfully in culture had involved sticking them to a glass surface for support, but the lymphoma cells seemed to favour growing in a suspension.

Once all other conventional tests for identifying the virus from the cultured cells had failed, Epstein tried electron microscopy. The very first grid square he viewed included a cell filled with herpes virus.

Exhilarated by what he’d seen, Epstein went for a walk in the winter snow and came back feeling calmer.

“I was extremely frightened in case the electron beam [of the microscope] burned up the sample. I recognised at once the herpes virus – there were five then, now nine. Any of the then-known ones would have wiped the culture out when they were replicating but this wasn’t happening. I had the feeling that this was something special.”

Virus particles
Virus particles in the nucleus of a cancerous white blood cell

Our understanding of this pervasive virus, named after Epstein and one of his PhD students Yvonne Barr who helped to prepare the samples, has increased over the years since Epstein confirmed his findings with American virologist colleagues.

Burkitt’s data helped to identify that the tumour named after him was seen in children with chronic malaria, which reduced their resistance to the Epstein Barr virus, allowing it to thrive.

But most of us live quite happily with the virus.

“If you disturb the host-virus balance in any way then changes take place which lead to very unpleasant consequences,” says Epstein.

“Once the link between Epstein Barr virus and Burkitt lymphoma was established, other seemingly unrelated conditions followed. These include a cancer at the back of the nose which is the commonest cancer seen in men in southern China and the second commonest in women in the same region.

There is also a link to Hodgkins lymphoma, a cancer of the white blood cells.

“Each one came out of the blue,” according to Epstein, “and we’ve just heard about another. About 20% of Japanese cancers of the stomach are associated with the virus.”

Yet another connection was made by Professor Dorothy Crawford, while waiting for the lift at the Royal Free hospital in London.

“It’s such a tall building everyone meets outside the lifts. I was standing next to a renal [kidney] transplant surgeon and overheard him say they’d just had their first case of post-transplant lymphoma. So I went with him to the pathology department and asked for some sections of the tissue to look at under the microscope.”

Burkitt lymphoma can now often be treated successfully with chemotherapy.

At a recent meeting in Oxford of the Epstein Barr Virus Association future directions for research were explored.

Attention is now focusing on a vaccine for the Epstein Barr virus – and some efficacy has already been demonstrated.

Epstein hopes that a vaccine will lead to the kind of success seen in other cancers caused by viruses – such as Hepatitis B and the human papillomavirus, which cause liver and cervical cancer respectively.

via BBC News – Cancer virus discovery helped by delayed flight.

Cancer ‘existed 3,000 years ago’, says new research

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New research suggests that cancer could have existed 3,000 years ago, according to journal Plos One.

The discovery was made in the skeleton of a 25-year-old man who lived in ancient Egyptian times.

Pallab Ghosh reports.

via BBC News – Cancer ‘existed 3,000 years ago’, says new research.

Vitamin C keeps cancer at bay, US research suggests

Vitamin C:
Vitamin C has long been used as an alternative cancer therapy but evidence is mixed

High-dose vitamin C can boost the cancer-killing effect of chemotherapy in the lab and mice, research suggests.

Given by injection, it could potentially be a safe, effective and low-cost treatment for ovarian and other cancers, say US scientists.

Reporting in Science Translational Medicine, they call for large-scale government clinical trials.

Pharmaceutical companies are unlikely to run trials, as vitamins cannot be patented.

Vitamin C has long been used as an alternative therapy for cancer.

In the 1970s, chemist Linus Pauling reported that vitamin C given intravenously was effective in treating cancer.


Further studies are needed before we know for sure what benefits high dose vitamin C may have for patients”

Dr Kat ArneyCancer Research UK

However, clinical trials of vitamin C given by mouth failed to replicate the effect, and research was abandoned.

It is now known that the human body quickly excretes vitamin C when it is taken by mouth.

However, scientists at the University of Kansas say that when given by injection vitamin C is absorbed into the body, and can kill cancer cells without harming normal ones.

The researchers injected vitamin C into human ovarian cancer cells in the lab, into mice, and into patients with advanced ovarian cancer.

They found ovarian cancer cells were sensitive to vitamin C treatment, but normal cells were unharmed.

The treatment worked in tandem with standard chemotherapy drugs to slow tumour growth in mouse studies. Meanwhile, a small group of patients reported fewer side-effects when given vitamin C alongside chemotherapy.

No patent potential

Co-researcher Dr Jeanne Drisko said there was growing interest in the use of vitamin C by oncologists.

“Patients are looking for safe and low-cost choices in their management of cancer,” she told BBC News. “Intravenous vitamin C has that potential based on our basic science research and early clinical data.”

One potential hurdle is that pharmaceutical companies are unlikely to fund trials of intravenous vitamin C because there is no ability to patent natural products.

“Because vitamin C has no patent potential, its development will not be supported by pharmaceutical companies,” said lead researcher Qi Chen.

“We believe that the time has arrived for research agencies to vigorously support thoughtful and meticulous clinical trials with intravenous vitamin C.”

Dr Kat Arney, science communications manager for Cancer Research UK, said there was a long history of research into vitamin C for treating cancer.

“It’s difficult to tell with such a small trial – just 22 patients – whether high-dose vitamin C injections had any effect on survival, but it’s interesting that it seemed to reduce the side-effects of chemotherapy,” she said.

“Any potential treatment for cancer needs to be thoroughly evaluated in large clinical trials to make sure it’s safe and effective, so further studies are needed before we know for sure what benefits high dose vitamin C may have for patients.”

via BBC News – Vitamin C keeps cancer at bay, US research suggests.

UK cancer diagnoses top 330,000

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Nearly a third of a million people are being diagnosed with cancer each year in the UK, according to the charity Cancer Research UK.

It says around 50,000 more people are finding out they have cancer every year than a decade ago.

The rise is due to more people living to a ripe old age.

Meanwhile, research by the University of Exeter suggests patients want cancer symptoms to be checked out more quickly than NHS guidelines recommend.

Age is the biggest risk factor for cancer.

And as life expectancies have increased in the UK, so too has the number of people being diagnosed with cancer.

In 2001, 283,000 people were told they had cancer. This increased to 331,000 in 2011.

‘Devastating impact’

Dr Harpal Kumar, chief executive of Cancer Research UK, said: “As the population ages, more people than ever before will be told, ‘You have cancer’.

“Research is the only way we’ll be able to reduce the devastating impact of the disease. One day we will beat cancer. The more research we do, the sooner that day will come.”

The World Health Organization says the number of people being diagnosed around the world each year leapt to more than 14 million in 2012, up from 13.7 million in 2008.

Breast cancer is one of the commonest types.

Eluned Hughes, of Breakthrough Breast Cancer, says: “Breast cancer is not a done deal and, as increasing numbers of people face the possibility of one day being told they have breast cancer, this is exactly why it is imperative that we continue our research.”

Meanwhile, a study on 3,649 people, published in the Lancet Oncology, suggested patients wanted any symptoms linked to cancer to be checked as quickly as possible for peace of mind.

The researchers say patients often need to have a one-in-20 chance of having cancer, based on their symptoms, before further tests to identify a tumour.

‘Strong preference’

The study suggests the majority of patients want to be checked out when there is a one-in-100 chance of cancer.

Dr Jonathan Banks, of the University of Bristol, said: “This large study provides a clear and comprehensive account of public preference for investigation for cancer.

“It shows for the first time that there’s a strong preference for diagnostic cancer testing, even if the risk is very low.

“This desire far exceeds what is actually being offered by the NHS, and we hope the findings can help policymakers and doctors in shaping guidelines and practice.”

via BBC News – UK cancer diagnoses top 330,000.

Many cancer patients ‘not referred to specialist by GP’

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The data allows patients to see how their GP performs

 

Thousands of people who go on to be diagnosed with cancer were not referred to a specialist by their GP.

NHS England data from around 4,000 GP practices suggests symptoms were picked up in other ways, for example in accident and emergency departments.

The NHS said not all cancer patients went to their GPs and the figures were not a clear measure of performance.

Patients who do go to their GP with cancer symptoms are seen within two weeks in 95% of cases, the NHS said.

Health Secretary Jeremy Hunt said the government was tackling the “unacceptable variation” across different practices.

National performance data allows patients to look up their GP surgery and see how it performs against dozens of diagnosis and treatment indicators.

NHS England collected the figures on cancer referral rates from GP surgeries across the country as part of a drive to make the health service more transparent.

‘Transparency applauded’

The NHS has a target that 95% of patients with suspected cancer should be seen by a specialist within two weeks – a target it says is consistently met.

But in around half of the GP practices sampled, fewer than 50% of patients on their books who were subsequently found to have the disease were referred to a specialist by their doctor.

Sean Duffy from NHS England said: “We know that early diagnosis is the single most important factor in cancer survival, and that’s why patients who visit their GP with ‘red flag’ symptoms like very persistent coughs, blood in urine or faeces or breast lumps should always be referred for further tests on two-week pathways.

“But not all patients visit their GP about these symptoms and others may have cancer without developing specific symptoms.

“These patients will therefore have their cancer diagnosed after going to a hospital as an emergency, or have it spotted incidentally while receiving treatment for another, unrelated issue.”

Rigorous inspection regime

Stuart Barber, from Beating Bowel Cancer, said it was “intolerable” that some patients were having to wait.

“GPs have the tools. There are clear symptoms, there is a clear screening programme and if a patient visits their doctor with what are symptoms of bowel cancer they should have the confidence they are going to be referred quickly,” he said.

Mr Hunt said: “Every single patient in the NHS has the right to the very best care – and to see a GP who can spot cancer symptoms early enough to make a difference.

“That’s why we’ve introduced a rigorous new inspection regime for GP surgeries.”

Under the regime, a new chief inspector would rate each surgery so the government could take action against those “not up to scratch”, he said.

via BBC News – Many cancer patients ‘not referred to specialist by GP’.

Cancer diversity has ‘huge implications’

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A single tumour can be made up of many separate cancers needing different treatments, say researchers.

 

A team at the Institute of Cancer Research, London, have developed a new technique for measuring the diversity within a cancer.

They showed “extraordinary” differences between cancerous cells and say new targeted drugs may fail as they may be unable to kill all the mutated tissue.

Experts said the findings would have “profound implications” for treatments.

A tumour starts as a single cell, which acquires mutations and eventually divides uncontrollably. But that is not the end of the process.

Cancerous cells continue to mutate and become more aggressive, move round the body and resist drugs.


Every patient has a completely new tree and doesn’t have one cancer, they have multiple cancers”

Prof Mel GreavesInstitute of Cancer Research

This process is chaotic and results in a “diverse” tumour containing cancerous cells that have mutated in different ways.

“This has huge implications for medicine,” researcher Prof Mel Greaves told the BBC.

His team at the Institute of Cancer Research investigated cancer diversity in five children with leukaemia. They compared mutations in individual cancerous cells with a known database of mutations.

Their results, published in the journal Genome Research, showed patients had between two and 10 genetically distinct leukaemias.

Prof Greaves said: “Every patient has a completely new tree and doesn’t have one cancer, they have multiple cancers.

“This is really a technical advance to get at this extraordinary complex diversity, it helps explain why we have such difficulty with advanced diseases.”

Tree of cancer

Scientists compare cancer diversity to a tree. The initial mutations – the trunk – will be common to all cancer cells. But then the tumour branches out.

Tree
Drugs need to target the trunk of a tumour say researchers

It means a treatment that targets one “branch” or sub-clone of the cancer might slow the disease, but they will never stop it.

Prof Charles Swanton, who researches diversity at the University College London Cancer Institute, told the BBC: “We call it pruning the branches not cutting down the tree, targeted therapies will remove some of the sub-clones, but chopping down the tree is hard to do.”


The bottom line is we need to understand cancer diversity to limit further adaptations, reduce the pace of evolution and prolong the activity of drugs”

Prof Charles SwantonUCL

The study investigated leukaemia as it is less diverse than other types of cancer. Other tumours such as melanoma could feasibly be made of hundreds of branches.

Prof Greaves says one implication of the research is that therapies need to be developed which target the trunk of the tumour and that current targeted therapies being researched may not tackle advanced cancers.

Another idea he suggests is focusing on the cancer’s surroundings as well.

“If it is diversifying like species in a habitat, why not target the habitat – the blood vessels supplying oxygen or inflammation. There’s a lot of interest in that,” he said.

The research also emphasises the importance of catching cancers early before they have become too diverse to treat.

Prof Charles Swanton argues: “The bottom line is we need to understand cancer diversity to limit further adaptations, reduce the pace of evolution and prolong the activity of drugs.”

Prof Chris Bunce, the research director at Leukaemia and Lymphoma Research, commented: “We are beginning to understand how unique and complex each patient’s cancer is and the profound implications that this can have on the success of treatment.

“This study significantly advances our understanding of how cancers start and evolve.”

via BBC News – Cancer diversity has ‘huge implications’.

A*STAR scientists find way to boost body’s immune surveillance in fight against cancer

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Researchers at A*STAR’s Singapore Immunology Network (SIgN) have discovered a new mechanism involving p53, the famous tumour suppressor, to fight against aggressive cancers.

SINGAPORE: Researchers at A*STAR’s Singapore Immunology Network (SIgN) have discovered a new mechanism involving p53, the famous tumour suppressor, to fight against aggressive cancers.

It said the strategy works by sabotaging the ability of cancer cells to hide from the immune system.

A*STAR said the research opens a new avenue to improve targeted cancer therapy by harnessing the body’s own immune system to control and eliminate cancer cells.

Also known as the “Guardian of the Genome”, p53 fights cancer by causing damaged cells to die or by halting the growth of mutant cells before they become cancerous and spread to the rest of the body.

The team leader, Associate Professor Ren Ee Chee from SIgN, said: “We were surprised to discover that p53 regulates MHC class I production by acting through ERAP1. This may explain how cancer cells escape detection by our body’s immune system.

“More importantly, it opens up exciting avenues of research to explore how restoration of p53 with drugs such as those that target ERAP1 can help to harness the immune system to recognise and destroy cancer cells.”

Acting executive director of SIgN, Associate Professor Laurent Rénia, said: “The team has uncovered a new door to manipulate one of the most studied yet enigmatic cancer-associated genes of our time.

“I am confident that this work will pave the way for more targeted, efficient and cost-effective treatment for the millions of cancer patients globally.”

– CNA/ac

via A*STAR scientists find way to boost body’s immune surveillance in fight against cancer – Channel NewsAsia.

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