WeeklySA_AdminONSET: Recognising signs and symptoms earlier could reduce diagnostic delays and improve chances of survival…
By WSAM Correspondent
The number of young adults with colon cancer, also known as colorectal cancer, has nearly doubled in the United States in recent years.
This is according to researchers at Washington University School of Medicine in St. Louis (US), who have identified four important signs and symptoms that signal an elevated risk of early-onset of colon cancer. These red flags may be key to earlier detection and diagnosis of the disease among younger adults, whose colon cancer statistics have nearly doubled in recent years.
“Colorectal (colon) cancer is not simply a disease affecting older people; we want younger adults to be aware of and act on these potentially very telling signs and symptoms — particularly because people under 50 are considered to be at low risk, and they don’t receive routine colorectal cancer screening,” said Yin Cao, ScD, associate professor of surgery and a research member of Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.
According to the American Cancer Society, although the death rate from colorectal cancer has been dropping for several decades in older adults due to regular colonoscopies and improved treatment, more younger people are diagnosed with the disease at advanced stages, and many are dying of the disease. Such a shift suggests urgency in recognising symptoms as early as possible.
Cao’s research group is among the first to report that obesity, prolonged sitting, metabolic syndrome, diabetes, sugar-sweetened beverages and other risk factors may contribute to the rising incidence of early-onset colorectal cancer.
Studying data on more than 5 000 patients with early-onset of the disease — cancer that occurs before a person turns 50 — the researchers found that in the period between three months and two years before diagnosis, abdominal pain, rectal bleeding, diarrhea and iron deficiency anaemia each indicated an increased risk in those under the age of 50.
The researchers found that having a single one of the symptoms almost doubled the risk; having two symptoms increased risk by more than 3,5 times; and having three or more boosted the risk by more than 6,5 times.
The study is published May 4 in the Journal of the National Cancer Institute.
“It’s also crucial to spread awareness among primary care doctors, gastroenterologists and emergency medicine doctors,” Cao said. “To date, many early-onset colorectal cancers are detected in emergency rooms, and there often are significant diagnostic delays with this cancer.”
Cao said two symptoms in particular — rectal bleeding and iron deficiency anaemia, a condition in which there are not enough healthy red blood cells to carry oxygen — point to the need for timely endoscopy and follow-up.
In this study, Cao, with co-researchers Dr Cassandra DL Fritz, an assistant professor of medicine in the university’s Division of Gastroenterology, and Dr Ebunoluwa Otegbeye, analysed cases of early-onset colorectal cancer and matched controls using a big-data tool that provided information based on health insurance claims data from about 113 million insured adults aged from 18 to 64.
“It usually takes about three months to get a diagnosis from the time a person first goes to the doctor with one or more of the red-flag signs and symptoms we’ve identified,” Fritz said. “But in this analysis, we found that some young adults had symptoms for up to two years prior to their diagnoses.
That may be part of the reason many of these younger patients had more advanced disease at the time of diagnosis than what we normally see in older people who get screened regularly.”
What’s Eating at You?
PROCEDURE: A new pill regulates appetite through electrical stimulation of the gut…
By WSAM Correspondent
A new electrical “pill” may be able to regulate people’s appetites without any drugs or invasive medical procedures, a promising advancement in treating eating disorders and other medical conditions that benefit from adjusting someone’s food intake.
Developed by a research team from NYU Tandon School of Engineering and the Massachusetts Institute of Technology (MIT), the pill, dubbed FLASH, delivers electrical impulses to the stomach lining once it’s swallowed. This targeted stimulation triggers the brain to modulate gut hormones related to hunger.
In a study published in Science Robotics, the researchers revealed they were able to affect the release of the ghrelin – an appetite hormone – using FLASH in pig trials, by orally administering a single pill.
“The gut and brain communicate through a neural pathway known as the gut-brain axis, which regulates many bodily functions, including eating,” said Khalil Ramadi, co-researcher of the study and assistant professor of Bioengineering at NYU Tandon at NYU Abu Dhabi.
“FLASH is the first ingestible electronic device shown to engage with the gut to modulate hormones that regulate brain activity on the gut-brain axis. By using the nervous system to alter the release of certain gut hormones, FLASH can potentially treat a host of disorders related to metabolism and eating without pharmaceuticals or surgery. This is a big step forward in how we approach these diseases,” Ramadi said.
People with some medical conditions use appetite stimulants and anti-nausea medications to help increase their food consumption, said Ramadi, but that can produce unwanted side effects such as restlessness, fatigue, uncontrolled weight gain, headaches, and muscle spasms. While electrical stimulation of the gastrointestinal tract can increase appetite, this approach has typically required surgery, which comes with inherent risks, according to Ramadi, adding that the effectiveness of this method might be limited by the presence of fluids in the stomach and intestines, too.
Alternative approaches, such as deep brain stimulation and vagus nerve stimulation, had shown success in regulating appetite, but also involve invasive surgical procedures.
FLASH, with the absence of any side effects and no surgical intervention needed, overcomes drawbacks of those conventional methods used to boost appetite, according to the study. Its design is also noteworthy, featuring a unique surface that mimics the water-wicking skin of a thorny devil lizard. This innovative feature shields the capsule from degradation and enables it to operate effectively within the highly wet environment of the gastrointestinal tract.
“FLASH represents a breakthrough for several reasons,” said Giovanni Traverso, associate professor in the Department of Mechanical Engineering at MIT, who collaborated with Ramadi on the research.
“First, it proves that pills don’t have to contain drugs, and can instead be designed to deliver electrical impulses to regulate physiology. Unlike drugs which have broad uptake in the gut, electrical pulses can be designed to target specific cells and locations for targeted therapy. A second crucial innovation is the surface design,” said Traverso.
According to Ramadi, initial research demonstrates FLASH’s efficacy in increasing hunger, making it potentially therapeutic for eating disorders such as anorexia and Avoidant Restrictive Food Intake Disorder (ARFID).
But, by adjusting the type and location of stimulation, the technology may be able to modulate hormones in the opposite direction, reducing overall hunger and providing a treatment for metabolic disorders like obesity or diabetes. With further development it could potentially treat neuropsychiatric disorders, like depression or substance addiction, too.
FLASH’s research team is currently conducting additional preclinical testing with the goal of beginning human trials with an advanced prototype within five years.
