All posts by A

Breakthrough immunotherapy drug approved

skincancermelanomariskhist_826746Hi everyone,

A story from BBC Health caught my attention as it involved a oncological breakthrough regarding the treatment of cancerous tumors. As someone who is extremely prone to melanoma due to my pale complexion, this is fantastic news.

After over 2 years of trials, exciting news arrives in the area of immunotherapy. Two drugs, ipilimumab and nivolumab have been approved by the National Institute for Health and Care Excellence (NICE) and will be paid for by the NHS to treat cancerous tumors.

Professor Carole Longson, from NICE, said: ‘These promising new immunotherapy treatments for advanced melanoma look set to significantly extend the life of people with the condition.’

Advanced melanoma is also known as stage 4 melanoma, which is skin cancer, which usually develops from abnormal moles. Advanced melanoma means that the melanoma has spread from its original area to another part of the body. This is incurable but treatment can reduce the size of the melanoma or stop it growing.

However, due to this breakthrough in the area of immunotherapy, an exciting field in cancer treatment, sufferers of melanoma have been given hope.

In trials, 69% of patients’ cancer has shrunk as a result of the combination therapy, even on the most aggressive and deadly types. Furthermore, two years after being given both drugs more than half experienced their tumors shrinking and a fifth had no sign of cancer at all.

The drugs work by interrupting the chemical signals that are used by cancer cells to trick the immune system into thinking that they are healthy tissue. By interrupting these signals the immune system can recognize and fight the cancerous tissue easier. Nivolumab blocks the ‘off-switch’ , PD-1, whilst Ipilimumab blocks the switch CTLA-4 found on white blood cells.

The chief clinician at Cancer Research UK, Prof Peter Johnson, said: “These results give new hope to melanoma patients. But, it’s important to remember that more powerful treatment comes with an increased chance of severe side effects.”

Known side effects have included inflammation in the bowels and liver as the immune system can attack healthy tissue.

However, this breakthrough highlights the important work in the upcoming field of immunotherapy. Dr Paul Nathan, from the Mount Vernon Cancer Centre in Middlesex: “Immunotherapy is genuinely exciting, it is starting to have a profound effect on many cancers and I’m in no doubt there will be patients that have long-term durable control of their disease… it really is a game-changer.”

These breakthroughs are always good to see and it is reassuring to see researchers paving the way to the eradication of cancer.

Alannah

 

Working in a Nursing Home

Hi everyone,

Today I’m going to talk about my weekly work in a nursing home near where I go to school. Every Tuesday for about 2 hours myself and a few other girls go straight from school to a nursing home for predominantly women with roughly 15 residents. I started visiting in early September and I have had the opportunity to experience a multitude of situations and has caused me to become very interested in this element of medicine.

One of the ladies who is particularly dear to my heart at the nursing home is a lady called Catherine*. We bonded over our mutual love of cats and she takes pride in looking after the residential cat, Daisy. Unfortunately Catherine has been suffering from a dislocated shoulder for over 5 years now in addition to a permanently broken wrist. Only recently she told me how she received these injuries, and she had fallen down the stairs. However since her husband had passed away several years earlier, no one was there to call the ambulance and she lay there for hours in pain. After inquiring with one of the nurses I found out that Catherine was in fact suffering from a separated shoulder and nothing could be done due to her poor bone strength  and the risks that surgery could pose to her. She was on several painkillers and drugs to improve bone density, including Actonel with Calcium. After having to take this for several years however, Catherine has recently been told by the doctor she can come off her medication. Unfortunately however she can no longer lift her right arm above her head and a once fantastic artist can’t even grip a pencil properly.

I think I would be on the verge of psychopathic if I didn’t feel emotional witnessing someone like Catherine suffering through such great pain every day and no one being able to help her. I feel like these experiences not only fuel my determination to be in a position to help people but affirm my desire to work with people.

The nursing home can be a really sad place and I feel that the presence of young people really does make many of the residence’s week. Many of the ladies always give us a really warm welcome, even though many of them don’t remember our names or tell us the same childhood story. Their enthusiasm on good days is uncomparable, however there are some not very good days and it would be unrealistic to assume otherwise.

Several incidents stick out for me including when a fight ensued among two of the residents, both of which have cognitive impairment, possibly due to degenerative diseases. One of the ladies whose speech ability is almost non-existent grabbed another ladies zimmaframe whilst I was helping her into the next room. The lady I was assisting was obviously displeased and began to shout, causing the other lady to join her. A nurse came to help diffuse the situation but in those moments I felt almost helpless and had a moment of panic. What could I do?

Another incident occurred today actually. A resident called Dolly* who is usually a very coherent lovely lady had a bad day. I knew from speaking with the nurses (who are real life superheroes lest I forget) that she was severely diabetic and saw the doctor every day for checkups. Today she must have been frustrated and angry and whatever set her off she was adamant that she wanted to leave the home. She stood at the door barring our exit and quarrelled profusely with one of the nurses. Soon there were threatening language towards the nurse and even with the nurse coercing her, Dolly would not be moved. From the nurses point of view it was a frustrating situation but Dolly was probably homesick and angry. It really highlighted for me that medicine will be full of frustration and true patience is required when entering into this field.

While I will continue to work at this particular nursing home up until my summer holidays in July, I thought I would write about just a few of my experiences so far and maybe in the future I can look back and see how far I have come in terms of my own self growth on my journey towards medical school. The sad truth about these nursing homes is that death is a reality and many of these people arrive here feeling that their fate is sealed. I hope that by helping out and having a conversation with some of these ladies that I, and the girls I visit with, can take their mind off this daunting reality, even if it is for a few hours in a day.

Thank you for reading and come back soon!

Alannah

*names were changed

 

I just want a burrito?

Hi everyone,

Today I thought I would talk about something that came up in the news back in December of 2015. The story centred around the US Mexican Grill food chain Chipotle, one of my favourite places to go and eat (despite the fact that guac is extra). As of December 4th, there had been a total of 53 cases of E-coli O26 infections in over nine states, including California, Illinois, Maryland, Minnesota, New York, Ohio, Oregon, Pennsylvania, and Washington. 27 of those cases had occurred in Washington, which is a state which is particularly close to my heart as that is technically where I live. The connection between all these cases? Everyone who had contracted E-coli had eaten at a Chipotle in the week before they had started to show their symptoms.

In response to the early outbreaks in November in Oregon and Washington, Chipotle closed 43 restaurants and, in partnership with the FDA ( US Food and Drug Administration) started undergoing a series of tests in order to locate the source of the Shiga-toxin producing Escherichia coli O26 or STEC O26. Chipotle confirmed that all microbial testing performed by the company did not yield E. coli (more than 2,500 tests of Chipotle’s food, restaurant surfaces, and equipment all showed no E. coli) and no employees in these restaurants were sickened from this incident. After further testing of fresh produce, raw meat, and dairy items prior to restocking restaurants, Chipotle then continued to implement additional safety procedures, and audits, in all of its 2,000 restaurants to ensure that robust food safety standards are in place. Not only that but deep cleans and sanitations took place in all of the closed restaurants in each one of the states.

Now my favourite restaurant is open again but it may appear that their reputation may be tarnished for the foreseeable future. But why was this outbreak taken so seriously? I of course have heard of E-coli and know you can get it from some types of beef. However I don’t really know why it is so bad and how much damage it can really do. I surely can’t be the only person who doesn’t really know what is going on? So of course I did some research and here are my findings.

E. coli is a type of bacteria that lives in the intestines of humans and animals. There are many different  types of E. coli many of which are harmless. However there are several  types can make people very sick.

The most prevalent and in many cases the worst type of E. coli, is known as E. coli O157:H7. This strain causes bloody diarrhea and can sometimes cause kidney failure and even death. This is because this particular strain makes a toxin called Shiga toxin and is known as a Shiga toxin-producing E. coli (STEC).  This is the same toxin present in the E-coli associated with the Chipotle outbreak. Shiga toxins act to inhibit protein synthesis within target cells. They do this by cleaving a specific adenine nucleobase from the 28S RNA of the 60S subunit of the ribosome, thereby halting protein synthesis. From studying this in A level Biology, I know that the consequences of this can be catastrophic.

One severe complication associated with E. coli infection is hemolytic uremic syndrome (HUS). The infection produces toxic substances that destroy red blood cells, causing damage to the kidneys and those suffering from it can require intensive care, kidney dialysis, and transfusions.

Thankfully no one who contracted E-coli from Chipotle died but 10 people were hospitalized as a result. Whilst they are still under investigation from the FDA to find the specific food source of the outbreak, Chipotle have opened up their stores again, to the joy of many of their hardcore mexican food fans. For now however I may just make my own burrito at home.

For more information about the outbreak go to:  http://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm470410.htm  https://www.chipotle.com/update or http://www.cdc.gov/ecoli/2015/o26-11-15/

Thanks for reading!

Alannah x

How are those resolutions?

Hey everyone,

As January is coming to a close, I thought to ask around about the mysterious disappearance of the ‘new year’s resolutions’. The motivation behind my madness was fuelled by the BBC’s show ‘Trust Me, I’m a Doctor’ (you may start to see a recurring theme here). However, the show is focused on sorting out the myths from the scientific truths, especially regarding health, fitness, diet and weight loss as it seems that most people welcome the new year by trying to start a new, healthier lifestyle.

My own resolution focused on my love of Nutella and cutting down on the chocolaty goodness for the month. I did a little research during Christmas and found that there is 11g of sugar per tablespoon of my favourite spread. Not only that but it contains high amounts of modified palm oil, a highly processed and refined oil which, research shows, could be doing damage to my internal organs. Therefore, Nutella was off the cards for the sake of my dental health and my waistline. Whilst this is very interesting, I am sure, I was intrigued at the thought of an entire 1 hour programme looking into similar issues surrounding the food we eat, exercise and general lifestyle choices.

The particular episode I’ll be discussing in my blog today talked about; the truth behind the ‘heart-healthy’ vegetable oils, whether or not meat is good for you, if beards are unhygienic, how to get rid of mouth ulcers and finally a moving segment from survivors of a deadly disease most known to us as septicaemia and how to spot the symptoms early.

Sepsis, mostly known as septicaemia or blood poisoning killed over 44,000 people in the UK last year and 8 million people worldwide. This number is greater than the number of deaths from breast, bowel and prostate cancer combined but is not a disease that has much awareness despite it’s deadly nature. Those affected can go into shock, organ failure and death and survivors often have to deal with amputations and life-long health problems as the organs are slowly starved of oxygen. This reaction can be triggered by something as small as a cut finger but it is only when the immune system reacts in an unusual or dangerous way that it can become life threatening. Lack of knowledge about this killer contributes significantly as early symptoms are usually ignored. There are 6 red flag symptoms that people should look out for and they are; extreme shivering, slurred speech and confusion, severe breathlessness, not passing urine in one day and the ominous feeling that you’re going to die or that your organs are being crushed.

Raising awareness of these symptoms could cut down on the number of deaths as sepsis is treatable if diagnosed early.

Therefore, I decided to write this piece and hopefully the information can be passed on and awareness of sepsis can be achieved. A healthy lifestyle in which I can choose wether or not I should have Nutella can only be achieved if I, and those around me, look after the sacred vessel which is our bodies. Devastating illnesses such as sepsis are crushingly debilitating and with some publicity and the help of the general public, more people can stay healthy and have a life to live.

For those wondering, olive oil actually improves heart health and research during the episode showed that consumption of 20g of raw olive oil lowered the number of heart disease indicating proteins in urine by a significant amount. In addition, beards are not unhygienic and some home remedies for ulcers include chilli powder, peppermint oils and bicarbonate of soda mouthwash. Furthermore, processed meats do cause cancer if consumed daily in high quantities however the government suggests 70g of red meat a day is alright, however if you wish to live a long and healthy life I would suggest looking into pescatarianism.

In summary, my new, new years resolution is to try and raise awareness for diseases like sepsis and others which need some attention from the public and social media. For more information visit the UK Sepsis Trust at http://sepsistrust.org/ where you can read about some of the stories and donate to their cause.

Thank you so much for reading and come back soon!

Alannah x

Hello world!

Hi everyone!

My name is Alannah, I’m 17 years old and if you hadn’t already guessed from the title of this blog, I want to be a doctor.

This area, I hope, is a place where I can talk about not only my experiences on my daunting journey into the world of medicine but also relevant news and cool articles or videos that have sparked my attention and hopefully will spark yours as well!

I read a book a few years ago written by a young doctor called Max Pemberton called, ‘Trust Me, I’m a (Junior) Doctor’. Not only was the book hilarious, it really resonated with me and I feel it was at that moment I really wanted to be a doctor. As a school student I’ve always been the one to rip off other people’s plasters or mop up the nosebleed on the floor while some of my classmates go pale/green. Perhaps it is a feeble attempt at humour but this statement; ‘trust me, I want to be a doctor’ is not only a relatively accurate representation of my life but is a phrase I use daily.

I will try and amuse and enlighten my readers and maybe you’ll learn something new! I really hope that I do.

Come back and have a read,

Alannah x