Doctor's own diagnosis drives quest for a cancer cure

BETHESDA, United States - Christian Hinrichs knew his life had forever changed the day he thought he was pouring milk into a glass, but heard it splashing on the floor instead.

It was 2005, and the young cancer surgeon had just undergone the removal of his right eye because of a rare cancer, called ocular melanoma, which affects 6 in a million people.

Prior to the operation, his doctors had been optimistic that he'd make a full recovery and be able to return to practicing surgery.

"But the reality for me personally was after I lost the eye, it really threw off my depth perception," said Hinrichs.

"I knew I couldn't operate anymore. So I decided not to."

At the time, Hinrichs was 33, and had spent 13 years in training and in the operating theater.

Even before his own diagnosis, he'd decided to focus on cancer surgery.

He also had an interest in cancer research, particularly the burgeoning field of adoptive T-cell therapy, which involved genetically engineering the immune cells to recognize and attack cancer.

But after his eye was removed, he felt like a "square peg" that didn't fit anywhere.

"I was a surgeon who couldn't operate, and I was interested in oncology but I wasn't an internal medicine doctor," he said.

So he went back to school to train as an internal medicine doctor and oncologist, a process that took 4 years.

Going back to being a medical resident -- while married with a one-year-old son at home -- was "a huge drop down the ladder," he recalled.

But he was more driven than ever to find another way to beat cancer, when surgery, chemotherapy and radiation failed.

For Hinrichs, the fight was now personal.

"If the cancer ever came back in me at a site distant from the eye, I would be in that group of incurable patients," he said, explaining that his cancer would then be considered metastatic, and fatal.

The odds of a recurrence, for his type of cancer, were about 50 percent.

'SCANXIETY'

Hinrichs, now 46, is an investigator at the National Cancer Institute, and leads experimental trials aimed at training the body's T-cells to eradicate cancers caused by the human papillomavirus (HPV).

Two women who participated in one of his early clinical trials against cervical cancer have been disease-free for 5 years, and are now considered cured.

Many of the trials he runs at the National Institutes of Health Clinical Center, the nation's top research hospital, are considered "first-in-human," aimed at testing an experimental treatment in people for the first time.

They typically enroll one or 2 dozen patients with advanced cancers that have stopped responding to every other treatment.

Most patients aren't cured. But some see their cancers disappear in months. And that can lead to new treatments which may one day reach the broader public.

Colleagues describe Hinrichs as blunt, honest and direct, traits that may have been sharpened by his cancer ordeal.

"He told me on day one," about his experience with cancer, said NCI researcher Lindsey Draper, who works in Hinrichs' lab and is testing a next-generation T-cell therapy that arose from an earlier HPV trial.

"I think he wanted me to understand his sense of urgency in pushing this research forward."

Hinrichs sometimes tells patients about his back story if they ask how he got into this field, or if he thinks it will help them somehow.

One of them, Aricca Wallace, who has been cancer-free since 2012, said he helps her manage her fear each time she goes for follow-up scans. She even has a word for it: "scanxiety."

"He knows that I am on pins and needles and don't sleep. So he will take a quick look and shoot me a thumbs up," she said, describing their rapport as "more family than doctor-patient."

For his part, Hinrichs decided to stop getting follow-up MRI and CT scans about five years after his eye was removed.

A long-time Presbyterian, he says his faith carries him through times of uncertainty.

When it comes to his particular cancer, "the statistics are really of limited value, anyway," he added.

So he presses on, designing trials that are intended to cure advanced cancer with a single infusion of billions of super-charged T-cells that will take aim at tumors wherever they lie in the body.

Hinrichs thinks pursuing any other work would be unsatisfying.

"Cancer patients don't want researchers to be focused on things that slow down the cancer or may have relatively minor effects," he said.

"What they really want is for their cancers to go away."

source: news.abs-cbn.com

Study of cancer-causing toxins finds e-cigarettes much safer than smoking

Consuming e-cigarettes is far safer and less toxic than smoking conventional tobacco cigarettes, according to the findings of a study analyzing levels of dangerous and cancer-causing substances in the body.

Researchers found that people who switched from smoking regular cigarettes to e-cigarettes or nicotine replacement therapy (NRT) such as gum or patches for at least six months had much lower levels of toxins in their saliva and urine than those who continued to smoke.

"Our study adds to existing evidence showing that e-cigarettes and NRT are far safer than smoking, and suggests that there is a very low risk associated with their long-term use," said Lion Shahab, a specialist in epidemiology and public health at University College London who led the work.

E-cigarettes, which heat nicotine-laced liquid into vapor, have grown into an $8 billion-a-year market, according to Euromonitor International - more than three times that of NRT products. They are, however, still dwarfed by a tobacco market estimated by Euromonitor to be worth around $700 billion.

Many health experts think e-cigarettes, or vapes, which do not contain tobacco, are a lower-risk alternative to smoking and potentially a major public health tool.

But some question their long-term safety and worry that they may act as a "gateway" to taking up conventional cigarettes. The U.S. surgeon general in December urged lawmakers to impose price and tax policies that would discourage their use.

Monday's study, published in the journal Annals of Internal Medicine, analyzed saliva and urine samples from long-term e-cigarette and NRT users as well as smokers, and compared levels of key chemicals found in their bodies.

It found that smokers who switched completely to e-cigarettes or NRT had significantly lower levels of toxic chemicals and carcinogens compared to people who continued to smoke tobacco cigarettes.

Those who used e-cigarettes or NRT but did not completely quit smoking did not show the same drop in toxin levels. This underlined that a complete switch was needed to get the long-term health benefits of quitting tobacco, the researchers said.

The World Health Organization says tobacco is the world's biggest preventable killer, with a predicted cumulative death toll of a billion by the end of this century if current trends continue. Tobacco smoking currently kills around 6 million people a year.

Kevin Fenton, national director of health and well-being at the government authority Public Health England, said the findings held a clear message for tobacco smokers.

"Switching to e-cigarettes can significantly reduce harm to smokers, with greatly reduced exposure to carcinogens and toxins," he said in a statement. "The findings also make clear that the benefit is only realized if people stop smoking completely and make a total switch.

"The best thing a smoker can do, for themselves and those around them, is to quit now, completely and forever."

(Reporting by Kate Kelland; Editing by Kevin Liffey)

source: news.abs-cbn.com

Migraine sufferers at higher surgery stroke risk: study

PARIS - People who suffer migraines are at a higher risk of stroke after surgery, researchers said on Wednesday.

This means that a history of migraines, which affect about one in five people, should be taken into account when weighing the pros and cons of undergoing an operation, said a study in The BMJ medical journal.

"Given the high prevalence of migraine in the general population, the... association (with stroke) carries public health importance," the authors wrote.

A research team from the United States, Denmark and Germany analysed the records of nearly 125,000 surgical patients at Massachusetts General Hospital and two satellite campuses between January 2007 and August 2014.

Of the group, 771 (0.6 percent) suffered a stroke within 30 days of surgery.

Just over eight percent (10,179) of the surgery group had a history of migraine, compared to 11.5 percent (89) of the 771 who suffered a stroke.

The team calculated the risk of stroke at 2.4 attacks for every 1,000 surgeries -- a number which rose to 4.3 in 1,000 for migraine patients.

The risk was highest for those whose migraines had an "aura" -- described as flashing lights or other warning signals experienced before an attack.

According to the World Health Organization, about 6.7 million people died of stroke in 2012. Survivors often suffer long-term disability.

Stroke occurs when blood flow to an area of the brain is cut off due to a clot blocking the path or due to a leak in a blood vessel. Brain cells are starved of oxygen, and die.

Migraine, more common in women, is characterised by a severe headache often associated with disturbed vision, sensitivity to sounds, smells and light, and nausea.

Migraine has long been considered to increase the risk for stroke, the study authors said, but is still widely perceived as a benign condition.

This study was the first to assess whether migraines boost stroke risk after surgery.

"Physicians should be aware of this increased... risk," said the team. And further research was needed into preventing post-operative stroke in migraine sufferers.

source: news.abs-cbn.com