IN CANCER care, different types of doctors, including medical oncologists, surgeons, and radiation oncologists, often work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is...

PAHO Director calls for action to reduce maternal mortality

Cristina Mitchell

18 Jun 2024

West Indian Cherries are great to help reduce sickness and diseases that men are susceptible to such as heart disease, cancers and depression, and helps in fitness and endurance

View the full post West Indian Cherries and men’s health on NOW Grenada.

The prohibition on smoking medicinal cannabis in Barbados is sparking mixed reactions among patients and doctors, according to Chief Executive Officer of the Barbados Medicinal Cannabis Licensing Authority (BMLA), Shanika Roberts-Odle. 

At present, medicinal cannabis is mostly administered topically through dermal sprays, gels and creams. 

Appearing on a recent radio programme, Roberts-Odle, highlighted the divergent opinions on this policy, its implications and alternatives.

Her comments come amid an ongoing national dialogue around appropriate medicinal cannabis policies. Since legalising medicinal cannabis in November 2019, authorities have taken a cautious approach, prohibiting smoking as a method of administration, while focusing on the growth of an export industry.

“There are significant amounts of persons who I have met who have indicated that for them, there’s a certain level of hypocrisy involved in that particular position,” Roberts-Odle told the programme.

“Doctors that I’ve spoken with have said smoking anything, in their position, is not recommended. Others have said if there is someone for whom that is their preferred method of use, then, as long as they know that their patient is getting what they need and the patient is aware of the risk that they’re taking, they are fine with that.”

This regulatory stance has drawn criticism from some patients who prefer the rapid onset provided by smoking over other delivery methods like topical applications or oral consumption. 

Some medical experts have voiced concerns about the potential health risks of inhaling cannabis smoke. Critics counter that smoking for palliative care provides relief that far exceeds risk to a terminally ill patient. They argue that a paternalistic approach undercuts patient autonomy and the medical benefits that smoking can provide for certain conditions.

Despite the current prohibition, Roberts-Odle noted that many patients, particularly those in palliative care, prefer smoking as a method of administration, sharing that they are “disappointed that they’re not allowed that avenue at this point in time”.

Anaesthesiologist Dr Adrian Waterman acknowledged the appeal of smoking cannabis due to its quick onset of action, crucial for those seeking immediate relief. But he raised concerns about potential lung damage from tar and other particulates in smoke.

“I can understand why some patients will like that route of administration because, especially in the past, it was a much easier route because the plant, basically the raw product, was [involved]…. People would say that it was a faster route of administration and they liked that,” he said.

“Today, with therapeutic development, they have found ways to administer the chemicals in cannabis, whereby we don’t have to use the inhalation route as much to get a faster onset of action.

“Doctors will tell you, especially in the pulmonary field, that they are very concerned when people smoke and that travels into the lungs.”

Roberts-Odle countered by distinguishing between recreational and medicinal cannabis usage, noting that medicinal cannabis typically does not contain additives like “fanta” used in recreational smoking.

“Generally, the tar comes from the additional things that you put in it,” she said. “For medicinal cannabis, what is actually being smoked is just the cannabis… you don’t add ‘fanta’ and those kinds of things.” 

She also addressed the risk of public smoking and secondhand exposure, stating that if legal, there would need to be restrictions on where medicinal cannabis could be smoked to prevent exposure to non-users.

Pharmacist David Workman, another guest, suggested an alternative rapid-relief method without smoking risks: “Drops or a spray under the tongue where there is a rich blood vessel supply and allows for rapid absorption. I can’t say it’s going to be as fast, but it’s going to be fairly quick.”

Roberts-Odle shed light on patient-specific treatment plans, noting that legislation does not restrict what doctors can prescribe medicinal cannabis for, as “its usage continues to grow and your doctor knows you.”

“They’re able to make an informed decision on whether this is good for you and so we have not restricted the kinds of things that they can prescribe you medicinal cannabis for,” she added.

So far, the BMCLA chief revealed, the drug has treated patients with epilepsy, pain, muscle spasms and anxiety. Underscoring responsible usage, she said: “The same way we have to be responsible with any kind of other medicine that we’re using, medicinal cannabis would have to be under those kinds of context as well… everything in moderation and in the correct usage patterns.” (SM)

The post Debate flares over smoking medicinal cannabis appeared first on Barbados Today.

FG-M701 is a fully human monoclonal antibody targeting TL1A, a clinically validated target in IBD. FG-M701 is uniquely engineered with potential best-in-class functional characteristics compared to first-generation TL1A antibodies with the goal to drive greater efficacy and less frequent dosing as a therapy for IBD.

"The prevalence of IBD continues to increase, and many people living with ulcerative colitis and Crohn's disease do not respond to current therapies," said Jonathon Sedgwick, Ph.D., senior vice president and global head of discovery research, AbbVie. "AbbVie's mission to raise the standard of care includes the pursuit of transformative therapies that help more patients living with autoimmune diseases achieve remission. We look forward to our collaboration with FutureGen in advancing development of FG-M701 for the treatment of IBD."

"We are very pleased to partner with AbbVie, a world-leader in the development and commercialization of innovative inflammation and autoimmune therapies," said Zhaoyu Jin, Ph.D., founder and chief executive officer, FutureGen Biopharmaceutical (Beijing) Co., Ltd. "We believe that AbbVie is a great partner, with the ability to apply their expertise and global scale to realizing FG-M701's therapeutic potential and rapidly advancing this therapy for patients suffering from IBD. The collaboration with AbbVie also highlights FutureGen's ability to generate potential best-in-class product candidates with our proprietary Structure-based Targeted Evolution Platform (STEP) technology platform."

Under the terms of the agreement, AbbVie will receive an exclusive global license to develop, manufacture and commercialize FG-M701. FutureGen will receive $150 million in upfront and near-term milestone payments and will be eligible to receive up to an additional $1.56 billion in clinical development, regulatory and commercial milestones, as well as tiered royalties up to low-double digits on net sales.

FutureGen has developed the proprietary STEP by integrating structural biology, advanced antibody engineering, and AI technologies to enable highly efficient, rapid and high-throughput drug screening and optimization. FutureGen has utilized STEP to develop CLDN18.2 antibody-dependent cellular cytotoxicity (ADCC) enhanced antibody (FG-M108), a potential best-in-class product with excellent efficacy and superior safety in the first-line treatment of advanced G/GEJ and pancreatic cancer, currently in Phase 3. Additionally, FutureGen possesses several innovative multi-specific antibodies and antibody-drug conjugates (ADC) for immuno-oncology therapy, including a CD40-PDL1 bi-specific antibody in clinical stage. 

Read also: AbbVie concludes acquisition of Landos Biopharma

St James will be the only parish visited this week when the Ministry of Health and Wellness continues its fogging programme.

On Monday when the team from the Vector Control Unit makes its first stop, Lancaster, Endeavour with Avenues, Apes Hill Development, and environs will be sprayed.

A return to that parish on Tuesday will see fogging at Wanstead Terrace 1 to 11 Avenues, Oxnards, Oxnards Heights, and surrounding areas.

The following day, Wednesday, fogging will occur at Oxnards Heights, Desert Rose Ridge, Wanstead Gardens Heights, Rose Drive, Lily Drive, Alamanda Drive, Carnation Drive, Begonia, Daisy Drive, and environs.

On Thursday the Unit will visit Independence Drive, Trident Avenue, Sugar Cane Avenue, Pelican Avenue, and neighbouring districts.

The exercise culminates on Friday in Blue Bell Drive, Croton Drive, Orchid Drive, and environs.

Fogging of districts will run from 4:30 p.m. to 8:30 p.m., each day. Householders are asked to assist in the control of the Aedes aegypti mosquito by opening all windows and doors to allow the fog to enter. Persons with respiratory problems are asked to protect themselves from inhaling the fog.

Pedestrians and motorists should proceed with caution when encountering fogging operations on the street and parents are instructed to prohibit children from playing in the fog or running behind the fogging machine.

Members of the public are advised that the completion of scheduled fogging activities may be affected by events beyond the Unit’s control. In such circumstances, the Unit will return to affected communities as soon as possible. (PR)

The post Fogging in St James this week appeared first on Barbados Today.

Dr Kristyn Kirton, a resident in internal medicine at the Queen Elizabeth Hospital, revealed that nearly 700 stroke cases were documented across the island in 2021 alone. “To put it into perspective, 700 cases might not sound massive in global terms, but for a small island nation like ours, it’s significant,” she told Barbados TODAY.
The statistics indicate that most strokes are caused by brain attacks, known as ischemic strokes, specifically blood clots in the brain, which aligns with global trends. Only about 10 per cent of the cases were attributed to brain haemorrhages. “This data is consistent with what we see worldwide, where ischemic strokes are more prevalent than hemorrhagic strokes,” Dr Kirton said.
She was speaking on the sidelines of a Barbados Physical Therapy Association Symposium on Strokes, at the Horatio Cooke Auditorium of the National Union of Public Workers on Dalkeith, aimed at educating the public on stroke prevention, management and rehabilitation.
Kirton noted that there had been a shift in the demographic affected by strokes. Traditionally seen as a disease of the elderly, strokes are now affecting younger populations.

She said: “When you were growing up, you’d hear about strokes affecting your grandparents. But now, we’re seeing 50-year-olds, 52-year-olds, even people in their late 50s. This is still relatively young, and these individuals are often still active in the workforce. This shift is alarming because it impacts not only health but also productivity and quality of life”.
The implications of this demographic shift are profound, especially with the retirement age being extended.  She pointed to the loss of productive years due to stroke as a significant economic and social issue.
“These are precious years that could have been spent contributing to the economy and supporting families. Now, due to stroke, many of these individuals are unable to work, which has a ripple effect on society,” Dr Kirton emphasised.
Comparing the situation in Barbados to the United States, she noted: “In the U.S., statistics show that someone suffers a stroke every 40 seconds. This highlights the global relevance of the issue and underscores the importance of taking action to mitigate stroke risk”.
Despite the lack of more recent data, the 2021 figures show a troubling reality, the medical practitioner suggested. “We see nearly equal numbers of men and women affected by strokes, which is somewhat unusual as certain populations might show a gender bias. This parity indicates that stroke is a widespread issue across our population”.
Adding to the concern is the fact that other non-communicable diseases, such as heart and kidney diseases, also plague the population. “We haven’t even touched on these other diseases yet, which further complicates the health landscape in Barbados,” Dr Kirton said.
She also shared her experiences with patients who, despite being at high risk for stroke, often display a lack of concern for their health. “When working with patients, especially those with diabetes, there’s often a sense of invincibility. They think: ‘My blood sugar is just a little high, or my blood pressure is slightly elevated; nothing will happen to me.’ It’s a dangerous mindset. Many of these patients end up experiencing a stroke, often on what could be the worst day of their lives.”
Dr Kirton also noted a worrying trend among middle-aged patients who, despite being aware of their hypertension, fail to take prescribed medications. “This is a recurring pattern I’m seeing more frequently. These individuals know they have high blood pressure and have been prescribed medication, yet they aren’t taking it. This neglect could lead to severe consequences,” Dr Kirton warned.  “High blood pressure, for example, is often symptomless until it reaches a critical point. Without symptoms, many people don’t feel the urgency to act. It’s not until they experience severe consequences, like headaches or blurred vision, that they seek medical help and start taking their health seriously.”

The post Stroke crisis – Case spike in younger people, says medic appeared first on Barbados Today.

Grenada is awaiting the result of samples sent to CARPHA in Trinidad to determine the type of virus or bacteria that is responsible for an outbreak of gastroenteritis

View the full post Health official confirms gastro outbreak on NOW Grenada.

This study was recently published in the JAMA Network Open by Kylie M. and colleagues.

Prostate cancer is a significant health concern, with racial disparities affecting outcomes and treatment responses. Previous studies suggested that Black men might have heightened sensitivity to radiation therapy, resulting in better outcomes in equal-access settings. However, the impact of ADT on these outcomes has remained uncharacterized until now. This study aimed to explore the modification of prostate cancer outcomes by ADT in Black men receiving radiation therapy.

The study analyzed data from 26,542 patients (8,716 Black and 17,826 White) treated between 2000 and 2020. All patients received definitive radiation therapy for localized prostate cancer, with some receiving ADT within six months of radiation. The main outcomes measured were biochemical recurrence (BCR), development of metastatic disease, and prostate cancer mortality (PCSM).

• Among the patients studied, 5,144 experienced BCR, including 1,760 Black and 3,384 White patients.

• The cumulative incidence of BCR at 10 years was similar between Black and White men (22.14% vs 20.13%, respectively).

• However, key differences emerged when ADT was considered.

• Black men receiving ADT had a lower hazard ratio (HR) for BCR (0.90, 95% CI, 0.82-0.99; P = .03) compared to White men.

• Conversely, without ADT, Black men had a higher HR for BCR (1.13, 95% CI, 1.05-1.22; P = .002).

• Black men showed a decreased risk of developing metastatic disease (HR, 0.90; 95% CI, 0.82-0.98; P = .02) and a significantly lower risk of prostate cancer mortality (subdistribution HR, 0.72; 95% CI, 0.63-0.82; P < .001) from the time of BCR.

The study highlights that Black men with prostate cancer benefit significantly from the addition of ADT to radiation therapy, achieving better biochemical control and reduced rates of metastasis and mortality. These findings suggest that ADT may play a crucial role in enhancing the radiosensitivity of prostate cancer in Black patients, leading to improved clinical outcomes.

This study underscores the importance of ADT in conjunction with radiation therapy for Black men with localized prostate cancer. The addition of ADT not only enhances biochemical control but also reduces the risk of metastatic disease and mortality. Future research should further investigate the role of ADT in modifying radiosensitivity and improving prostate cancer outcomes in Black patients.

Reference:

Morgan, K. M., Riviere, P., Nelson, T. J., Guram, K., Deshler, L. N., Sabater Minarim, D., Duran, E. A., Banegas, M. P., & Rose, B. S. (2024). Androgen deprivation therapy and outcomes after radiation therapy in Black patients with prostate cancer. JAMA Network Open, 7(6), e2415911. https://doi.org/10.1001/jamanetworkopen.2024.15911