Thousands of NHS patients with deadly bladder cancer stand to benefit from a drug that offers new hope for a cure.
In a landmark decision, UK health chiefs have approved nivolumab for patients who are too frail to endure treatments such as chemotherapy.
Doctors usually give chemotherapy after removing tumors from the bladder to kill any remaining cancer cells.
But there’s no alternative for patients who can’t get chemo because of the crippling side effects, so their cancer usually comes back within a year.
However, trials have shown that nivolumab, which helps the body’s immune system seek out and destroy cancer cells, keeps the disease at bay twice this time.
Some patients have no signs of cancer for at least three years after stopping the drug.
Professor Tobias Arkenau, consultant oncologist at the Sarah Cannon Research Institute in London, said: ‘Many of my bladder cancer patients cannot tolerate chemotherapy. After we remove what we could with surgery, they just have to cross their fingers and hope it doesn’t come back.
It is thought the new drug could offer hope to patients who cannot undergo chemotherapy (stock image)
“But this drug works incredibly well and the side effects are much less horrific.”
More than 10,000 Britons are diagnosed with bladder cancer every year. If caught early, patients are usually offered a minimally invasive operation where the tumor is cut out using instruments that are routed to the bladder via the urethra – the passage through which urine leaves the body. A short course of chemotherapy is given to eliminate any remaining cancer cells.
But about a quarter of bladder cancer cases are diagnosed later, at stages two to three, when the tumor has started to grow into the muscular wall that lines the bladder. These patients are offered either radiation therapy to shrink the cancer or invasive surgery to remove the organ along with surrounding tissue.
Artist Tracey Emin has spoken candidly about the major procedure in 2020 to treat her bladder cancer, which involved the removal of several pelvic organs, including her bladder, which left her using a urostomy bag to urine.
In one out of five patients with bladder surgery, cancer cells remain. Chemotherapy can be given to destroy them, but a third of patients are elderly or in poor health and unable to bear the grueling side effects.
Instead, they are closely monitored and treated only when the cancer comes back. It occurs within two years for about half of patients, at which time it is more difficult to treat.
Dr Robert Huddart, professor of oncology at the Institute of Cancer Research in London, said: “Relying on scans to make sure we’re picking up small cancers can only go so far.” It’s easy to miss a small tumor. This is why it is vital that we have a treatment capable of erasing the cancer cells that may be hiding in each patient.
Nivolumab is the first treatment to offer this group hope for a cure. The drug, given as a drip every two weeks for up to a year, works by deactivating proteins called PD-L1 attached to the tumour, making it invisible to fighting cells of the immune system. This “turning off” of proteins allows the immune system to spot the cancer and attack it.
Artist Tracey Emin (pictured) has spoken candidly about having a major procedure to treat her bladder cancer in 2020
Many other tumors have PD-L1 proteins attached to them, and nivolumab has been shown to work effectively on other cancers in the same way. NHS patients with skin cancer, kidney cancer and certain head and neck cancers can be treated with the drug. Side effects are mostly mild, the most common being itchy skin, diarrhea, and fatigue.
Dr Syed Hussain, professor of oncology at the University of Sheffield, who was involved in the nivolumab trial, said: “I treated a 60-year-old man with nivolumab and there is still no no signs of cancer even two years later.
“Best of all, he had an excellent quality of life on the drug, with virtually no side effects. It was quite remarkable.
“It’s clear that patients on nivolumab can happily go about their daily lives, which is much trickier with chemotherapy.”
Weird science: boys who become boys at puberty
There’s a village in the Caribbean where a lot of boys don’t develop sexual relationships until they reach the organs of puberty.
Known as Guevedoces, which translates to ’12-year-old penis’, the children are born with what looks like female genitalia due to a hormone deficiency.
Normally, in the womb, there is no male or female until about eight weeks after conception, when sex hormones kick in.
In boys, testosterone is converted into a powerful hormone called dihydro-testosterone which triggers the development of sex organs.
But Guevedoces are deficient in an enzyme that triggers this process, so they appear female at birth and are raised that way.
It’s not until they hit puberty and have a second surge of testosterone that the body reacts.
your amazing body
Researchers believe having wrinkly hands in water is an evolutionary advantage
Soaking too long in the bath causes fingers and feet to wrinkle – but this quirk of our bodies may once have served an important purpose.
Experts believe the ridges that form in the skin gave our ancestors an evolutionary advantage, helping them grip wet objects or surfaces by wicking water away, much like the tread of a tire. car.
Wrinkles appear when the brain sends signals to blood vessels under the skin, telling them to contract.
This decreases blood flow to the fingers and feet, slightly reducing their size and forming loose folds of skin.
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