This was my first full day at Oakhaven hospice in which I would be on the day patient unit. I arrived that morning not sure what to expect and whether anyone knew I was turning up that day. Luckily they did and I was quickly thrusted into a morning meeting with all the other normal day volunteers and staff. We discussed the patients attending that day, going into some detail with certain patients their conditions.
One of the many problems with cancer is it’s ability to cloak itself from the body’s immune system. White blood cells, specifically T-lymphocytes or ‘T-cells’, should recognise foreign material in the body and destroy it. But the tumour has evolved to cloak itself from the t-cells by producing a surface molecule called Ligand. The Ligand fuses with receptors of the T-cells known as PD-1. The receptor is activated and so the T-cells treat the tumour as safe, thus the tumour has fooled the immune system. But if you can stop the interaction between the Ligand and PD-1 then then the immune system should act to destroy the tumour.
In recent research on 135 people with melanoma, 54 of those had their tumour more than halve in volume when treated with the antibody Lambrolizumab. 57 of the 135 people were given very high doses of the drug and 6 of these people their tumours were eradicated.
With a second antibody, Nivolumab, the tumours more than halved in volume for 21 out of 53 people.
With a third antibody it targeted the Ligand molecule rather than the PD-1 receptor. This also produces impressive results for other types of cancer including lung and kidney cancer.
One of the researchers, Jedd Wolchok of the Memorial-Sloan Kettering Cancer Centre New York, said ‘They [the remedy] treat the patient, not the tumour.’ I think this is looking like a promising start to what might be the future of curative care for cancer sufferers.
I have started volunteering at a local Hospice serving the community. I would say my first day but it was only a two hour induction but I still loved it. I was placed on the IPU (In Patient Unit) with another lady. Although I was there for only a short space of time I realised this was going to be different from any hospital volunteering. The whole dynamic of the hospice is different to hospitals from the obvious change from curative to palliative care but also how the staff and volunteers relate to the visitors. It was hard to see visitors grieving for suffering relatives and I didn’t know what to say. I wanted to put my arm round them and support them but I knew that wouldn’t help. I can see that if palliative care is a speciality I might consider then it will be something I will have to think long and hard about.
I have also realised that they will want me in the holidays more than I expected. This is a very good thing as the more experience the better but also I might be able to shadow a Doctor which would be a priceless opportunity to have.
The most valuable experience I can take away from the hospice will be the way I will have to learn how to work with those who are suffering from pain or bereavement.
One of the hardest things for me about going for medicine is that I only decided I wanted to study medicine about 1 month ago. This means whilst all my friends who plan on studying medicine have been volunteering at the hospital, have work experience with doctors in the summer and study biology, I have non of this.
Luckily I have just set up some volunteering at my hospital now which I start at the end of this month. But trying to sort out work experience is a nightmare. I wonder if I have left it too late. Another problem is that I do not study biology, and whilst this isn’t too much of a problem in terms of UCAS applications, I still lack a good understanding the human anatomy and body functions. This means there is a lot of reading ahead of me over the summer to try and catch up. So on the recommendation of a friend I went and bought ‘Gray’s Anatomy’. When I received it in the post though I knew something was wrong when all the illustrations were hand drawn. It turned out to be the original 1901 edition which has taught me too read the descriptions of products when I buy things off Amazon, or at least for books anyway!
One of the things I have tried to do is to increase my knowledge of medical issues in the media. Using the BMJ student and BBC news websites I am now putting together a collection of articles with all the issues I should know about for medicine, or for my interview at least.
Physicists at St Andrews University have developed methods of using white light to fight cancer. The idea goes that the light could carry drugs deeper into the tissue allowing the drugs to be place into groups of cells painlessly and instantaneously. And the light could also act as microscopic ‘tweezers’ to move cancer cells around the body and isolate them so that they can be treated. The researchers have already been able to remove chromosomes from a cell. Over Easter I was fortunate enough to meet some of the researchers at St Andrews responsible for this finding and they were telling me how this could, slowly, become a huge tool to fighting cancer.
Research is also being done like this in the US where researches are using light to activate drugs that will then stick to cancerous cells. But the drugs only seem to respond to certain wavelengths of light. At the National Cancer Institute, Maryland, they have used an antibody which targets the proteins of cancerous cells. This antibody has the chemical IR700, which is then activated by Infrared light. Infrared is particularly useful as it can quite easily penetrate several centimetres of tissue.
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