Alien cells protect

Male origin microchimerism and ovarian cancer

https://tinyurl.com/vaqxp2g

            Many of us have cells in our blood which are not our own. This condition called microchimerism occurs most often in women after pregnancy but may also occur with twin-to-twin circulation in the uterus, after blood transfusion, or following organ transplantation. These foreign cells can also be found in solid organs such as the brain and may cause autoimmune conditions and cancer, notably in the breast.

            This prospective study of women in the Danish Diet, Cancer, and Health group, looked for the presence of male cells in blood samples, and measured the frequency of ovarian cancer in women who did carry male cells versus those who did not.

            The findings were that the presence of male cells in circulating blood is protective with the risk of ovarian cancer being reduced. The reason is unknown, there was no associated hormonal change detected.

Blood transfusion suggests bad outcome

Impact of perioperative red blood cell transfusion on postoperative recovery and long-term outcome in patients undergoing surgery for ovarian cancer: A propensity score-matched analysis

https://tinyurl.com/tfx6mrb

            It is well known that blood transfusion during or immediately after surgery has short and long-term consequences. The usual indication for blood transfusion is low blood iron with a haemoglobin measurement of less than 70. This may be caused before surgery by bleeding, poor nutrition, and general ill health. Excess blood loss may occur when the surgery is more complicated and extensive or be related to difficulty in blood clotting.

            This retrospective study looked at a thousand women operated on for ovarian cancer, they were divided into two groups; those who received blood transfusion during or shortly after surgery and those who did not.

            Women who needed transfusion had more problems immediately after surgery with longer hospital stays. Also, the same group had three year survival reduced by about one-fifth. Hopefully improved surgical technique and proper preparation for surgery can reduce the need for blood transfusion and improve outcomes.

Common sense in Israel

Notes from A Bystander to A Medical Revolution

https://tinyurl.com/sm4cthu

            Ashkenazi women in Israel will celebrate the recent decision of the Israel Ministry of Health; to provide genetic testing to them through it’s universal healthcare system. 16,000 will be tested this year with an expected 400 positive cases (1 in 40).

            BRCA mutations are associated with a high risk of breast and ovarian cancer. It is estimated that 50,000 women in Israel carry the genetic mutation. The discovery of the mutation before cancer occurs means that risk reduction surgery can be performed. Also, those who have been identified as having the BRCA variant are actively monitored enabling diagnosis of cancer at an early stage, which has a proved survival benefit. 

            Initial resistance from religious leaders has now been overcome, with senior Rabbis supporting the procedure and stating that it is a “Biblical” obligation. The struggle to provide genetic screening to the 50,000 women has been hard-fought; the decision to make the test freely available is a triumph.

Dope does not prevent pain

Cannabinoids for adult cancer-related pain: systematic review and meta-analysis

https://tinyurl.com/vwssoeh

         Cannabinoids are naturally occurring compounds found in marijuana. There is a subjective push for the medical use of these substances claiming anti-convulsant, anti-emetic and analgesic properties. Most of these claims do not meet the burden of proof. 

         This study looked at the available evidence in a meta-analysis of all trials comparing randomised clinical trials of cannabinoids versus placebo using standardised pain intensity measures.

         Six trials complied with the criteria, all were deemed to be low bias. There was no demonstrable benefit seen when cannabinoids were added to normal therapy.  Adverse effects increased with drowsiness and dizziness.