Thousands of NHS patients with fatal bladder cancer will soon have access to a promising new treatment.
In a landmark decision, UK health officials have approved nivolumab for patients who are too fragile to tolerate therapies like chemotherapy.
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After removing bladder tumors, doctors typically administer chemotherapy to eliminate any leftover cancer cells.
However, there are no options for people who cannot undergo chemotherapy due to its debilitating side effects; consequently, their disease typically returns within a year.
Trials have demonstrated that nivolumab, which assists the immune system in locating and destroying cancer cells, keeps the disease at bay for twice as long.
Some people show no indications of malignancy at least three years after discontinuing treatment.
Professor Tobias Arkenau, the consultant oncologist at the Sarah Cannon Research Institute in London, stated, “Many of my patients with bladder cancer cannot tolerate chemotherapy. After we’ve surgically removed what we can, they can only cross their fingers and hope it doesn’t return.
‘However, this medication is extraordinarily effective, and its adverse effects are significantly less terrible.’
Each year, around 10,000 Britons are diagnosed with bladder cancer. If detected early, patients are typically offered a minimally invasive procedure in which the tumor is removed using equipment delivered up to the bladder via the urethra – the tube through which urine exits the body. A brief course of chemotherapy is used to eliminate any residual cancer cells.
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However, around one-fourth of bladder cancer cases are identified at stages two or three, when the tumor has begun to invade the muscular wall of the bladder. These patients are offered either radiation to reduce the tumor or invasive surgery to remove the organ and adjacent tissues.
Tracey Emin has spoken openly about the big surgery she will undergo in 2020 to treat her bladder cancer, which will require the removal of various pelvic organs, including her bladder, and will leave her with a urostomy bag.
In one out of every five individuals who undergo bladder surgery, cancer cells persist. Chemotherapy can be administered to eliminate them, but one-third of patients are elderly or in poor health and unable to endure the severe side effects.
Instead, patients are closely monitored and only treated if cancer returns. This occurs in roughly half of patients within two years, at which point it becomes more difficult to treat.
Professor of Oncology at The Institute of Cancer Research in London, Dr. Robert Huddart, stated that relying solely on scans to detect small cancers is insufficient. It is easy to overlook a small tumor. Therefore, we must have a treatment that can eradicate the cancer cells that may be present in every patient.’
Nivolumab is the first therapy to offer this population the possibility of a cure. The drug, administered intravenously every two weeks for up to a year, inhibits proteins called PD-L1 that are attached to the tumor and renders it invisible to immune system fighter cells. This “switching off” of proteins enables the immune system to detect and attack cancer.
Numerous other cancers contain PD-L1 proteins, and nivolumab is effective against these cancers as well. The drug may be administered to NHS patients with skin cancer, kidney cancer, and certain cancers of the head and neck. Most side effects are mild, with skin itching, diarrhea, and fatigue being the most common.
Dr. Syed Hussain, Professor of Oncology at the University of Sheffield and participant in the nivolumab trial, stated, “I treated a 60-year-old man with nivolumab, and two years later, there are still no signs of cancer.”
Best of all, he had a high quality of life while taking the drug, with almost no side effects. It was extraordinary.
‘It is evident that nivolumab patients can lead normal lives, which is not the case for chemotherapy patients.’
Strange Science: puberty’s transformation of boys into men
In a Caribbean tribe, many boys do not develop sexual organs until puberty.
Due to a hormone deficit, these children are born with female-appearing genitalia and are referred to as Guevedoces, which translates to “penis at 12.”
Until approximately eight weeks after conception, when sex hormones take effect, newborns in the womb are neither male nor female.
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In boys, testosterone is transformed into the strong hormone dihydrotestosterone, which stimulates the development of sexual organs.
However, Guevedoces lack the enzyme responsible for this transformation, therefore they are born and nurtured as females.
The body responds only when kids reach adolescence and experience a second surge of testosterone.
