A PATIENT-FOCUSED ORGANIZATION
COLORECTAL CANCER TREATMENT & CLINICAL RESEARCH UPDATES
Month Ending June 18th, 2021
The following colorectal cancer treatment and research updates extend from May 13th, 2021 to June 25th, 2021, inclusive and are intended for informational purposes only.
This content is not intended to be a substitute for professional medical advice. Always consult your treating physician or guidance of a qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional or delay in seeking it because of something you have read on this website.
1. Phase II LEAP Clinical Trial to Treat mCRC.
2. TRK Fusion Cancer and How to Test For It
3. A Phase II, Open-Label, Multicentre, Study of an Immunotherapeutic Treatment for the MSI High Colorectal Cancer Metastatic Population
4. Phase III Study at the Odette Cancer Centre Comparing Arfolitixorin vs. Leucovorin: Both in Combination with 5FU, Oxaliplatin, and Bevacizumab in Patients with Advanced Colorectal Cancer
5. Overall Survival Rates in Advanced CRC May be Improved with Lenvatinib Plus Pembrolizumab
6. Capecitabine Maintenance Improves Progression-Free Survival in mCRC
7. Daiichi Sankyo’s Enhertu Benefits HER2-Positive CRC Patients
8. Integrative Medicine and Cancer Care
9. Why Many Stage 3 CRC Patients Skip Chemo
10. Chemotherapy Induced Neutropenia Increases the Risk of Infection
11. Announcement Regarding the Funding Recommendation of Encorafenib (Braftovi)
12. Announcement Regarding the Funding Recommendation of Pembrolizumab (Keytruda)
13. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program – Sunnybrook Hospital
14. Living Donor Liver Transplantation for Unresectable Colorectal Cancer Liver Metastases
15. Study Offered at the Odette Cancer Centre to Treat Recurrent Rectal Cancer
16. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age
17. Screening for CRC: US Preventive Services Task Force Recommendation Statement
18. US panel trims CRC screening age, opens door to annual Cologuard use
19. “45 is the new 50” as age for CRC screening is lowered
20. Computer-Aided Colon Polyp Detection (CADe) Tool for CRC Screening Could Reduce Cancer Rates by More Than 40%
21. One Quarter of 30–49-Year-Olds Have Abnormal Colonoscopy Results
22. Young Adult CRC Clinic Available at Sunnybrook Hospital
23. Ask the Experts About Circulating Tumor DNA in the Management of Cancer
24. May top 7 in GI: ACG, CRC, Digestive Disease Week 2021
25. Sugary Drinks Tied to Spike in CRC
26. Sequencing Study Suggests Mechanistic Link between Red Meat Consumption and CRC
27. Eating Fibre Before CRC Surgery Reduces Complication Risk
28. Intake of sugar-sweetened beverages linked to early-onset colorectal cancer
29. Canadian Vaccination Rollout by Jurisdiction
30. Why You Need to Get Vaccinated Even If You’ve Already Had COVID-19
31. No, COVID-19 Vaccines Do Not Cause New Coronavirus Variants
32. Clinical Trial Evaluating Mixed COVID-19 Vaccine Schedules Begins
33. Mix ‘N’ Match COVID Vaccines; Fauci’s Emails Studied; Indian Variant Rising Rapidly
34. The ‘Lab Leak’ Debate Matters
35. How Do COVID-19 Vaccines Compare?
36. Getting a Pfizer or Moderna COVID-19 Vaccine Can Drop Your Risk for Infection by 91%
37. Doctors Debunk 9 Popular COVID-19 Vaccine Myths and Conspiracy Theories
38. Frequently Asked Questions for COVID-19
DRUGS / SYSTEMIC THERAPIES
- Phase II LEAP Clinical Trial For mCRC (Mar.01/20)
The purpose of this study is to determine the safety and efficacy of combination therapy with pembrolizumab (MK-3475) and Levantine (E7080/MK-7902) in patients with triple-negative breast cancer (TNBC), ovarian cancer, gastric cancer, colorectal cancer (CRC), glioblastoma (GBM), or biliary tract cancers (BTC). Participants will be enrolled in initial tumor-specific cohorts, which will be expanded if adequate efficacy is determined. The trial is available at the Odette Cancer Centre and at the Princess Margaret Cancer Centre in Toronto as well as the following Centres throughout Canada: Abbotsford, BC; Winnipeg, MB; CHU de Quebec. For information, visit the link below.
2. TRK Fusion Cancer And How to Test For It (Feb.16/21)
3. A Phase 2, Open-label, Multicenter, Study of an Immunotherapeutic Treatment for the MSI High CRC Metastatic Population (Oct.01/20)
The purpose of this study is to look at the effectiveness of the vaccine DPX-Survivac in combination with the drugs cyclophosphamide and the immunotherapy Pembrolizumab in patients with solid cancers who are identified to be MSI-High. All patients will receive combination therapy of DPX-Survivac, cyclophosphamide, and pembrolizumab. Patients participating will know which treatment they are receiving. The trial is currently hosted at the Odette Cancer Centre, and a new site is opening at Mt. Sinai Hospital.
4. Phase III Study at the Odette Cancer Centre Comparing Arfolitixorin vs. Leucovorin in Combination with 5FU, Oxaliplatin and Bevacizumab in Patients with Advanced CRC (Oct.01/20)
The purpose of this study is to look at the effectiveness of the drug Arfolitixorin in combination with 5-fluorouracil (5FU), oxaliplatin, and bevacizumab in patients with colorectal cancer (CRC). Patients with advanced/metastatic CRC who meet certain criteria may be able to participate. There will be two groups of patients participating in this study;
- one group will receive Arfolitixorin in combination with 5FU), oxaliplatin, and bevacizumab,
- while the other group will receive the drug Leucovorin in combination with 5FU, oxaliplatin, and bevacizumab (standard of care).
The doctor and study staff will not know which group a patient is in. Patients will be randomized to receive one treatment or the other.
Arfolitixorin is Isofol’s proprietary drug candidate being developed to increase the efficacy of standard of care chemotherapy for advanced CRC. The drug candidate is currently being studied in a global Phase 3 clinical trial. As the key active metabolite of the widely used folate-based drugs, arfolitixorin can potentially benefit all patients with advanced CRC, as it does not require complicated metabolic activation to become effective.
Treating cancer patients with arfolitixorin – The goals:
- When treating CRC, for example, arfolitixorin is administered in combination with 5-FU to increase cell mortality in circulating cancer cells and in cancerous tumours.
- Arfolitixorin is administered in conjunction with rescue therapy after high-dose treatment with the cytotoxic agent, methotrexate, in order to suppress the cytotoxic effect in surrounding healthy tissue. The treatment is used for certain types of cancer, such as osteosarcoma, a type of bone cancer. This involves administering arfolitixorin separately, 24 hours after the chemotherapy.
5. Overall Survival Rates in Advanced CRC May be Improved with Lenvatinib Plus Pembrolizumab (Jun.04/21)
“Patients with previously treated advanced non-MSI-high or (proficient mismatch repair) colorectal cancer (CRC), lenvatinib plus pembrolizumab demonstrated promising antitumor activity and a manageable safety profile,” said lead study author Carlos A. Gomez-Roca, MD, cancer specialist at the Institut Universitaire du Cancer de Toulouse in France, during the presentation.
The nonrandomized, open-label, phase 2 study included 32 adult patients (median age, 56 years; 19% women; 91% received two prior lines of treatment) with advanced CRC. “Pembrolizumab was administered at a dose of 200 milligrams every 3 weeks, and lenvatinib was received orally once a day at a dose of 20 milligrams,” Gomez-Roca explained, noting that they were administered for up to 35 cycles or until disease progression, unacceptable toxicity or withdrawal of consent. Treatment with lenvatinib could continue beyond 2 years in patients with clinical benefit.
The median treatment cutoff was 10.6 months. Patients had an overall response rate of 22%, all of which were partial responses. “Of note, responders had PD-L1-positive tumors by CPS score equal or more than 1,” Gomez-Roca said. “25% of patients experienced stable disease, while 38% had progressive disease. The median duration of response was not reached.” The 6-month progression free survival rate was 31% with a 6-month overall survival rate of 62%. All patients reported one or more treatment-related adverse events, with the most common being hypertension (44%) and decreased appetite (31%). Grade 3 and 4 treatment-related adverse events occurred in 47% of patients.
6. Capecitabine Maintenance Improves Progression-Free Survival in mCRC (Jun.10/21)
Data presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting by Richard Adams, MD, of Cardiff University in the United Kingdom, suggested capecitabine maintenance improved progression-free survival (PFS), but not overall survival (OS), when compared with active monitoring in patients with metastatic colorectal cancer (mCRC).
FOCUS4 researchers performed biomarker analysis on patients’ tumors during the first 16 weeks of first-line chemotherapy. The patients were then stratified based on their molecular subtypes and enrolled in trials of therapies targeting their subtype, including BRAF-mutant, PIK3CA-mutant, KRAS– and TP53-mutant, and wild-type mCRC.
Capecitabine conferred an improvement in PFS compared with active monitoring. The median PFS was 3.84 months with capecitabine and 1.87 months with active monitoring. There was no significant difference in OS between the arms. The median OS was 14.8 months in the capecitabine arm and 15.2 months in the active monitoring arm. Adverse events that were more frequent in the capecitabine arm than the active monitoring arm were fatigue, diarrhea, nausea, and hand-foot syndrome. There were no significant differences in quality of life between the arms.
“Capecitabine maintenance strategy is a reasonable option for a clinician to discuss with their patients at the end of their first-line induction chemotherapy, as it essentially doubles the time until the need to return to full-dose/induction systemic anticancer therapy,” Dr Adams said.
7. Daiichi Sankyo’s Enhertu Benefits HER2-Positive CRC Patients (Jun.09/21)
In DESTINY-CRC01, from which data were presented at the American Society of Clinical Oncology’s virtual annual meeting, researchers looked at trastuzumab deruxtecan’s efficacy in 86 previously treated colorectal cancer (CRC) patients across three cohorts: a HER2-positive group, which included those with HER2 expression scores of 3 or higher according to immunohistochemistry testing (dubbed IHC3-plus), and two HER2-low expressing groups, in which patients had IHC scores of 1 and 2 (IHC2 and IHC3).
HER2-positive, IHC3 patients in cohort A had the best response to trastuzumab deruxtecan, with a response rate of 45%; 24 patients had a partial response, but no patients had a complete response. The median duration of response was 7 months and median duration of treatment was 5 months. In the two cohorts with HER2-low expressing patients, none had partial or complete responses. However, 9 patients in cohort B and 4 patients in cohort C reached stable disease. HER2-positive CRC patients in cohort A also experienced better progression-free survival and overall survival outcomes. This group had a median progression-free survival of 6.9 months compared to 2.1 and 1.4 months for patients in cohorts B and C, respectively. The median overall survival for cohort A was 15.5 months, which Yoshino called “very impressive in heavily pretreated patients.” Comparatively, the median overall survival was 7.3 months for cohort B and 7.7 months for cohort C.
Daiichi Sankyo will continue to study trastuzumab deruxtecan in HER2-positive CRC. Based on data from the DESTINY-CRC01 trial, the company is currently conducting another Phase II study, DESTINY-CRC02, focused on the HER2-positive IHC3-plus group.
8. Integrative Medicine and Cancer Care (Jun.17/21)
Integrative medicine refers to the coordinated delivery of both conventional and complementary medical treatment. Research suggests that certain types of complementary therapies may help manage symptoms and side effects and improve a person’s overall sense of well-being. Integrative medicine generally focuses on complementary therapies that have at least some high-quality evidence to support their efficacy and safety.
Integrative medicine takes advantage of complementary therapies such as:
- guided imagery, and
The field especially emphasizes the crucial importance of good nutrition and physical activity. Always along with—not instead of—conventional cancer care, integrative medicine incorporates these and other modalities to manage symptoms that may occur during cancer treatment and remain after its completion.
Integrative therapies reduce both short- and long-term side effects, such as pain and anxiety. They can relieve stress, promote general well-being, and, in some cases, reduce the risk of cancer recurrence. According to the Consortium of Academic Health Centers for Integrative Medicine, there are yet other integrative medicine benefits: it “reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.”
Integrative medicine essentially puts the ball back in your court. It offers a broad array of therapies and lifestyle choices that not only make a real difference for your health and happiness but also give you back a sense and reality of control and confidence. To explore types of complementary and integrative therapies, follow the link below.
9. Why Many Stage 3 CRC Patients Skip Adjuvant Chemo (Jun.11/21)
Chemotherapy after stage 3 colorectal cancer (CRC) surgery is effective and its side effects are usually limited, yet about 1/3rd of patients do not receive the treatment. To better understand why — and to inform practices that encourage patients to undergo chemo — Arden Morris, MD, a professor of surgery, and her colleagues surveyed patients.
Chemotherapy after surgery for stage 3 CRC is associated with a 30% increase in five-year survival rates, according to the study. The treatment is generally less debilitating than treatments for other forms of cancer, Morris said, adding that many patients can work while receiving chemotherapy. The study found that 38% of Americans with stage 3 CRC still do not receive it. They also asked about the patients’ social support and found that among patients who reported little social support, 60% of those who listed no risk factors completed chemotherapy, while 40% of those with six or more risk factors did. Among patients who reported having a high level of social support, 90% of those with no risk factors completed the treatments, while 75% of those with six or more risk factors did. Other patients might feel overwhelmed by other responsibilities, such as caring for an aging parent, she said. Sometimes they are struggling with health problems besides the cancer, so patients and their physicians may perceive chemotherapy as too much of a burden.
“Instead of just talking to the patient, we need to get better at listening — asking questions and ascertaining what patients understand and value,” Morris said. “Surgeons and oncologists also need to work together and present a united voice for patients. Fortunately, this is increasingly common in cancer clinics. If patients hear the same recommendations from all their doctors, they’ll have more trust in us.”
10. Chemotherapy Induced Neutropenia Increases the Risk of Infection (Jun.17/21)
What is neutropenia?
Neutropenia is a condition characterized by abnormally low blood levels of infection-fighting neutrophils, a specific kind of white blood cell. Neutropenia increases your risk of bacterial and fungal infections. The most common reason that cancer patients experience neutropenia is as a side effect of chemotherapy. Chemotherapy-induced neutropenia typically occurs 3-7 days following administration of chemotherapy and continues for several days before neutrophil levels return to normal. The type and dose of chemotherapy affects how low the neutrophil count drops and how long it will take to recover.
Why is chemotherapy induced neutropenia important?
Chemotherapy-induced neutropenia is important because it may:
- Increase your risk of life-threatening infection.
- Disrupt delivery of your cancer treatment, resulting in a change to the planned dose and time.
- In some cases, it can be severe enough that your chemotherapy treatment may need to be delayed or dose reduced, which might reduce some patients’ chance for cure
Who is at a higher risk for chemotherapy induced neutropenia?
- Patients receiving chemotherapy that decreases the number of white blood cells
- Patients who already have a low white blood cell count, or who have previously received chemotherapy or radiation treatment
- Patients age 70 and older who may be at risk of more severe infection and longer hospitalizations
- Patients with other conditions affecting their immune system
Can neutropenia be prevented?
Chemotherapy-induced neutropenia can be prevented in most patients with the use of white blood cell growth factors. Blood cell growth factors are naturally occurring substances called cytokines that regulate certain critical functions in the body. They are responsible for stimulating cells in the bone marrow to produce more blood cells.
11. Announcement Regarding the Funding Recommendation of Encorafenib (Braftovi)
The CADTH pCODR Expert Review Committee (pERC) has recommended that Encorafenib be reimbursed for the treatment of patients with metastatic colorectal cancer (mCRC) with a BRAF V600E mutation, as detected by a validated test, after prior therapy, with some conditions. CCRAN is delighted with the recommendation!
For a review of the draft recommendation, please visit the CADTH website: encorafenib | CADTH
12. Announcement Regarding the Funding Recommendation of Pembrolizumab (Keytruda)
The CADTH pCODR Expert Review Committee (pERC) recommends that Pembrolizumab should be reimbursed as monotherapy for the first line treatment of metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer, with some conditions. CCRAN was very pleased with the decision on behalf of its MSI-H/dMMR patient population. For a review of the draft recommendation, please visit the CADTH website: pembrolizumab | CADTH
13. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program — Sunnybrook Odette Cancer Centre (July 16/20)
The HAIP program is a first-in-Canada for individuals where colon or rectal cancer (colorectal cancer) has spread to the liver and cannot be removed with surgery. The program involves a coordinated, multidisciplinary team approach to care, with close collaboration across surgical oncology, medical oncology (chemotherapy), interventional radiology, nuclear medicine, and oncology nursing. The Hepatic Artery Infusion Pump (HAIP) is a small, disc-shaped device that is surgically implanted just below the skin of the patient and is connected via a catheter to the hepatic (main) artery of the liver. About 95 percent of the chemotherapy that is directed through this pump stays in the liver, sparing the rest of the body from side effects. Patients receive HAIP-directed chemotherapy in addition to regular intravenous (IV) chemotherapy (systemic chemotherapy), to reduce the number and size of tumours. Drs. Paul Karanicolas and Yooj Ko are the program leads and happy to see patients eligible for the therapy.
Presently at Sunnybrook Odette Cancer Centre, HAIP is being used in patients with colorectal cancer that has spread to the liver that cannot be removed surgically and has not spread to anywhere else in the body. Patients who have few (1-5) and very small tumors in the lungs may be considered if the lung disease is deemed treatable prior to HAIP. If you believe you may benefit from this therapy and/or would like to learn more about the clinical trial, your medical oncologist or surgeon may fax a referral to 416-480-6179. For more information on the HAIP clinical trial, please click on the link provided below.
14. Living Donor Liver Transplantation for Unresectable Colorectal Cancer Liver Metastases (July 12/20)
Approximately half of all colorectal cancer (CRC) patients develop metastases, commonly to the liver and lung. Surgical removal of liver metastases (LM) is the only treatment option, though only 20-40% of patients are candidates for surgical therapy. Surgical therapy adds a significant survival benefit, with 5-year survival after liver resection for LM of 40-50%, compared to 10-20% 5-year survival for chemotherapy alone. Liver transplantation (LT) would remove all evident disease in cases where the colorectal metastases are isolated to the liver but considered unresectable.
Image Source: https://www.slideshare.net/AhmedAdel65/preoperative
While CRC LM is considered a contraindication for LT at most cancer centers, a single center in Oslo, Norway demonstrated a 5-year survival of 56%. A clinical trial sponsored by the University Health Network in Toronto will offer live donor liver transplantation (LDLT) to select patients with unresectable metastases limited to the liver and are non-progressing on standard chemotherapy. Patients will be screened for liver transplant suitability and must also have a healthy living donor come forward for evaluation. Patients who undergo LDLT will be followed for survival, disease-free survival, and quality of life for 5 years and compared to a control group who discontinue the study before transplantation due to reasons other than cancer progression. Despite the trial’s negative outcome, investigation of HIPEC, and other strategies to prevent peritoneal metastasis, should continue, they concluded in Lancet Gastroenterology & Hepatology. “The 21% peritoneal recurrence noted in the overall study population indicates the magnitude of the clinical problem in locally advanced colon cancer, and therapeutic strategies have to be further explored,” they said. “Outcomes of other trials investigating adjuvant HIPEC are eagerly awaited.”
RADIATION THERAPIES/INTERVENTIONAL RADIOLOGY
15. Study Offered at the Odette Cancer Centre to Treat Recurrent Rectal Cancer (Mar.12/20)
Magnetic resonance-guided focused ultrasound (MRg-FU) is a lessinvasive, outpatient modality being investigated for the thermal treatment of cancer. In MRg-FU, a specially designed transducer is used to focus a beam of low-intensity ultrasound energy into a small volume at a specific target site in the body. MR is used to identify and delineate the tumour, focus the ultrasound beam on the target, and provide a real-time thermal mapping to ensure accurate heating of the designated target with minimal effect to the adjacent healthy tissue. The focused ultrasound beam produces therapeutic hyperthermia (40-42°C) in the target field, causing protein denaturation and cell damage. Currently, there is no prospective clinical data reported on the use of MRg-FU in the setting of recurrent rectal cancer. Recurrent rectal cancer is a vexing clinical problem. Current retreatment protocols have limited efficacy. The addition of hyperthermia to radiation and chemotherapy may enhance the therapeutic response. With recent advances in technology, the investigators hypothesize that MRg-FU is technically feasible and can be safely used in combination with concurrent reirradiation and chemotherapy for the treatment of recurrent rectal cancer without increased side-effects. The study is being offered at the Odette Cancer Centre. Here is the link to the study protocol:
16. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age (Apr.10/21)
With recent evidence for the increasing risk of young-onset colorectal cancer (yCRC), the objective of this population-based longitudinal study was to evaluate the incidence of yCRC in one-year age increments, particularly focusing on the screening age of 50 years. The study was conducted using linked administrative health databases in British Columbia, Canada including a provincial cancer registry, inpatient/outpatient visits, and vital statistics from January 1, 1986 to December 31, 2016. We calculated incidence rates per 100,000 at every age from 20 to 60 years and estimated annual percent change in incidence (APCi) of yCRC using joinpoint regression analysis.
3,614 individuals were identified with yCRC (49.9% women). The incidence of CRC steadily rose from 20 to 60 years, with a marked increase from 49 to 50 years. Furthermore, there was a trend of increased incidence of yCRC among women. Analyses stratified by age yielded APCi’s of 2.49% and 0.12% for women aged 30-39 years and 40-49 years, respectively and 2.97% and 1.86% for men. These findings indicate a steady increase over one-year age increments in the risk of yCRC during the years approaching and beyond screening age. These findings highlight the need to raise awareness as well as continue discussions regarding considerations of lowering the screening age.
17. Screening for CRC: US Preventive Services Task Force Recommendation Statement (May.18/21)
To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for CRC in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity.
They concluded with high certainty that screening for CRC in adults aged; 50 to 75 years has substantial net benefit; 45 to 49 years has moderate net benefit; 76 to 85 years who have been previously screened has small net benefit. Adults who have never been screened for CRC are more likely to benefit. It was also noted that age is one of the most important risk factors for CRC, with incidence rates increasing with age and nearly 94% of new cases of CRC occurring in adults 45 years or older. Rates of CRC incidence are higher in Black adults and American Indian and Alaskan Native adults, persons with a family history of CRC (even in the absence of any known inherited syndrome such as Lynch syndrome or familial adenomatous polyposis), men, and persons with other risk factors (such as obesity, diabetes, long-term smoking, and unhealthy alcohol use). However, all adults 45 years or older should be offered screening, even if these risk factors are absent.
The USPSTF recommends:
- Screening for CRC in all adults aged 50 to 75 years. (A recommendation)
- Screening for CRC in adults aged 45 to 49 years. (B recommendation)
- Clinicians selectively offer screening for CRC in adults aged 76 to 85 years.
- Evidence indicates that the net benefit of screening all persons in this age group is small.
- In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient’s overall health, prior screening history, and preferences. (C recommendation)
18. US Panel Trims CRC Screening Age, Opens Door to Annual Cologuard Use (May.19/21)
The headline takeaway from the final USPSTF recommendations is that the body now recommends the screening of adults aged 45 to 49 years old for colorectal cancer (CRC). The younger cohort is covered by a grade B recommendation compared to the grade A recommendation in the over 50s, but that still means private insurers have to cover the screening of adults aged 45 to 49 years under the Affordable Care Act.
USPSTF has recommended Exact Sciences’ stool-based test Cologuard since 2016. The U.S. task force recommends two other stool-based tests, namely high-sensitivity gFOBT and FIT, as well as direct visualization approaches such as colonoscopy. Exact Sciences is betting the sensitivity and non-invasive nature of its test will help it win share and is tipped to step up its efforts to reach younger people.
USPSTF revised details of its recommendations on Cologuard and other stool-based tests in the final document, while leaving its core conclusions unchanged. The draft version said screening with Cologuard every year “would result in more colonoscopies than annual screening with FIT.” USPSTF has softened its position in the final text, explaining that view is based on “modeling estimates” and adding the statement that “[Cologuard] every 1 to 3 years is estimated to provide a reasonable balance of life years gained per estimated follow-up colonoscopy compared with no screening.”
19. “45 is the new 50” as age for CRC screening is lowered (May.18/21)
The guideline changes by the U.S. Preventive Services Task Force (USPSTF), published in the current issue of JAMA, updates its 2016 recommendations and aligns them with those of the American Cancer Society, which lowered the age for initiation of colorectal cancer (CRC) screening to 45 years in 2018.
Lowering the recommended age to initiate screening “will make CRC screening, which is so important, available to millions more people in the United States, and hopefully many more lives will be saved by catching CRC earlier, as well as by preventing CRC,” said Kimmie Ng, MD, MPH, first author of an editorial in JAMA accompanying the article about the guideline change of the USPSTF, and director of the Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute.
The accompanying JAMA editorial asked rhetorically whether the age of screening should be lowered even younger than age 45. While the majority of young-onset CRC diagnoses and deaths occurs in persons 45 to 49, the rate of increase in young-onset CRC is actually steepest in the very youngest patients. Colon cancer incidence is increasing by 2% per year in 20 to 29-year-olds, compared with 1.3% in 40 to 49-year-olds. Rectal cancer incidence is increasing by 3.2% per year in 20 to 29-year-olds and 30 to 39-year-olds, versus 2.3% in 40 to 49-year-olds.
“We are now seeing patients even younger than 45 – in their 20s and 30s – who are being diagnosed with this cancer and often at very late stages,” said Ng. “Clearly the USPSTF recommendation to start screening at age 45 will not be enough to catch those young people who are being diagnosed.” Ultimately, optimal prevention and early detection of CRC in people younger than 45 will require further research into the underlying causes and risk factors of young-onset CRC, which have thus far remained elusive, said the editorial authors.
20. Computer-Aided Colon Polyp Detection (CADe) Tool for CRC Screening Could Reduce Cancer Rates by More Than 40% (Jun.04/21)
The Ohio State University is the first academic medical center in the United States to utilize a new computer-aided system for screening colonoscopy in patients undergoing testing at the Ohio State Wexner Medical Center and Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
During the colonoscopy procedure, a long flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon and remove concerning growths. This enhanced colonoscopy visualization module applies real-time data and deep computer learning to help gastroenterologists detect and treat concerning growths in the colorectal tract while they are in a precancerous state. Previously published, peer-reviewed medical studies suggest that this tool increases precancerous polyp (adenoma) detection rates by 14%, potentially leading to a 42% reduction in colorectal cancers.
“This is truly a game-changer for early detection of colorectal cancer because it pairs the expertise of a highly trained physician with the power of artificial intelligence to identify potential high-risk lesions that may have gone undetected with the human eye alone,” says Dr. Darwin L. Conwell, director of the Division of Gastroenterology, Hepatology and Nutrition at the Ohio State College of Medicine. Conwell is a gastroenterologist at the OSUCCC – James and the Wexner Medical Center.
21. One Quarter of 30–49-Year-Olds Have Abnormal Colonoscopy Results (Jun.07/21)
More than one quarter of colonoscopies carried out in Americans aged 30 to 49 years reveal some type of neoplasm, and slightly over 6% of these patients have advanced cancer, results of a nationally representative endoscopic registry show.
The study’s dataset 563,000 analyzable procedures — 146,000 of which were performed on patients aged 18 to 44, and 80,000 of which were performed on patients aged 45 to 49. Among patients between 45 and 49 years of age, the most frequent indication for the colonoscopy was for routine screening, at over 41%, investigators note.
The investigators used standard definitions of advanced adenoma and advanced sessile serrated polyp and grouped them either as advanced premalignant lesions (APL) or advanced colorectal neoplasia (APL plus CRC). “The prevalence of all neoplastic findings progressively increased with increasing age, ranging from over 15% for 30- to 34-year-olds to over 37% for 50–54-year-olds,” the investigators report. Each 1-year increase in age was associated with an 8% greater risk of finding an advanced colorectal neoplasia (ACRN). Most importantly, in light of the new lower age limit for CRC screening, 7.5% of those between 45 and 49 years of age had APL, and 0.58% had frank CRC.
Table. Prevalence of Neoplasia by Age Group
“As you might expect, people with a family history of colon cancer had higher rates of neoplasia than those without a family history,” said Steven Itzkowitz, MD, professor of medicine, oncological sciences, and medical education, Icahn School of Medicine at Mount Sinai, in New York City, told Medscape Medical News. Among 40-year-olds who had a family history of CRC, the prevalence of pathology was similar to that among 45-year-old patients who did not have a family history — “so if you have a positive family history of CRC, it’s almost as if you are 5 years older,” he emphasized. “We need a lot more data on family history in younger people, but there is no doubt that having a family history of CRC puts you at higher risk, so early messaging is key for everyone but especially if patients have a positive family history,” Itzkowitz emphasized.
22. Young Adult CRC Clinic Available at Sunnybrook (Apr.12/21)
A recent study led by the University of Toronto doctors has observed a rise in colorectal cancer rates in patients under the age of 50. The study mirrors findings from the U.S., Australia and Europe. The growing colorectal cancer rates in young people come after decades of declining rates in people over 50, which have occurred most likely due to increased use of colorectal cancer screening (through population-based screening programs) which can identify and remove precancerous polyps. Patients diagnosed under the age of 50 have a unique set of needs, challenges and worries. They are unlike those diagnosed over the age of 50. Dr. Shady Ashamalla (colorectal cancer surgical oncologist), and his team at the Sunnybrook Health Sciences Centre understand the needs of this patient population.
Dr. Ashamalla belongs to a multidisciplinary team of experts in the Young Adult Colorectal Cancer Clinic who will work with young colorectal cancer patients, regardless of disease stage, to create an individualized treatment plan to support each patient through their cancer journey. Their needs and concerns will be addressed as they relate to:
- Fertility concerns and issues
- Young children at home
- Dating/intimacy issues
- Challenges at work
- Concerns about hereditary cancer
- Relationships with family and friends
- Psychological stress due to any or all of the above
The team of experts consists of:
- Oncologists (medical, surgical, radiation)
- Social workers
- Nurse navigator
Should a patient wish to be referred to Sunnybrook, they may have their primary care physician, or their specialist refer them to Sunnybrook via the e-referral form, which can be accessed through the link appearing below. Once the referral is received, the Young Adult Colorectal Cancer Clinic will be notified if the patient is under the age of 50. An appointment will then be issued wherein the patient will meet with various members of the team to address their specific set of concerns.
23. Ask the Experts About Circulating Tumor DNA in the Management of Cancer (Jun.05/21)
What is circulating tumor DNA (ctDNA)?
Circulating tumor DNA (ctDNA) is 150–200-base-pair fragments of DNA, which originate from cancer cells and are present in the bloodstream or other body fluids.
How can ctDNA help manage cancer?
There are currently four clinical applications of ctDNA to guide precision medicine in patients with cancer:
- Detection of minimal residual disease (MRD) following surgery.
- Monitoring the treatment response in the metastatic setting.
- Identifying genomic drivers of therapeutic sensitivity and resistance.
- Guiding treatment strategies to overcome resistance to treatment.
How is ctDNA used for the management of early-stage cancers?
Across all stages of surgically removed cancer, detection of ctDNA following surgery is a strong predictor of cancer recurrence. The detection of ctDNA could lead clinicians to intensify therapy in certain situations. Conversely, the absence of ctDNA could provide an opportunity to minimize surveillance or adjuvant treatment.
How is ctDNA used for the management of metastatic cancer?
ctDNA can be used to monitor treatment response, identify genomic drivers of treatment sensitivity or resistance, or identify new therapies that could overcome genomic drivers of treatment resistance.
24. Top GI: ACG, CRC, Digestive Disease Week 2021 (Jun.12/21)
Below are reports on the top peer-tested stories in May. These stories include ACG guidelines for the preferred treatment of adults with Clostridioides difficile, U.S. Preventive Services Task Force updated recommendations for colorectal cancer (CRC) screening, coverage from Digestive Disease Week and more.
Link found between family history of colorectal polyps, risk for CRC
Family history of colorectal polyps linked to a higher risk for CRC in a Swedish cohort, according to research published in BMJ.
Young IBD patients fail to develop neutralizing antibodies for SARS-CoV-2
Among young patients with inflammatory bowel disease, most who were positive for SARS-CoV-2, had a non-neutralizing antibody, according to data presented at Digestive Disease Week.
Patients prefer FIT over blood test for CRC screening
When given a choice, participants preferred fecal immunochemical test-based screening for CRC compared with a blood test, according to research presented at Digestive Disease Week.
To read more about each story, follow the link below.
25. Sugary Drinks Tied to Spike in CRC (May.10/21)
Drinking too many sugar-sweetened beverages in adolescence and young adulthood could partially explain the recent rapid rise in early-onset colorectal cancer (EO-CRC) — at least in women, according to a new study.
This analysis prospectively investigated the association of SSB intake among 95,464 female registered nurses who were aged between 25 and 42 years at enrollment and followed them for the development of EO-CRC, defined as onset before the age of 50 years. The nurses filled out food frequency questionnaires every 4 years, which asked about SSBs, defined as soft drinks, fruit drinks, sports drinks, and sweetened tea beverages. Information on potential CRC risk factors was also collected, including family history of bowel cancer, lifestyle, regular use of aspirin or non-steroidal anti-inflammatory drugs and vitamin supplements, and colonoscopy/sigmoidoscopy.
Over a maximum follow-up of 24 years (average, about 14 years), the study documented 109 cases of incident EO-CRC, and suggested a 2.2-fold higher risk among women who reported drinking two or more SSB per day, compared to those who reported drinking less than one 12-ounce SSB per week. Each additional serving of SSB was associated with further risk: 16% in young adults and 32% in adolescents. The researchers also investigated the impact of substituting SSBs with artificially sweetened beverages (ASBs), as well as coffee, reduced fat milk, or total milk and found a 17% – 36% lower risk of EO-CRC. The findings “reinforce the public health importance of limiting SSB intake for better health outcomes,” noted senior author Yin Cao, MD, from Washington University School of Medicine in St. Louis, Missouri.
However, experts reacting to this study on the UK Science Media Centre were less convinced by the research. “Overall, these findings should be considered as preliminary and exploratory until larger studies are done in other populations,” said Carmen Piernas, MSC, PhD, university research lecturer and nutrition scientist at Nuffield Department of Primary Care Health Sciences, University of Oxford, England.
Image Source: https://www.eatthis.com/sugary-drinks/
26. Sequencing Study Suggests Mechanistic Link between Red Meat Consumption and CRC (Jun.17/21)
Researchers at Dana-Farber Cancer Institute, Harvard Medical School (HMS), and the Broad Institute of MIT and Harvard, have linked a gene mutation signature that is indicative of DNA damage, with high red meat consumption and increased cancer-related mortality in patients with colorectal cancer (CRC). The results, the scientists suggest, could feasibly lead to the development of new CRC risk or diagnostic biomarkers, and point to therapeutic opportunities.
“We have known for some time that consumption of processed meat and red meat is a risk factor for colorectal cancer,” Marios Giannakis, MD, PhD, an assistant professor of medicine at HMS and a physician at Dana-Farber Cancer Institute, explained. The International Agency for Research on Cancer declared back in 2015 that processed meat was carcinogenic and that red meat was probably carcinogenic to humans.
To test whether dietary components contributed to the alkylating signature in CRC, researchers leveraged prospectively collected repeated measurements of meat, poultry, and fish consumption in grams per day in the Nurses’ Health Studies I and II (NHS), and the Health Professionals Follow-up Study (HPFS) cohorts. The team’s analysis of the DNA sequencing data revealed the presence of several mutational signatures in normal and cancerous colon tissue, including a signature indicative of alkylation, a form of DNA damage. The alkylating signature was significantly associated with prediagnosis intake of processed or unprocessed red meat, but not with prediagnosis intake of poultry or fish, or with other lifestyle factors. “All available red meat variables showed significant positive associations between prediagnosis intakes and alkylating damage in CRCs.” Conversely, red meat consumption was not associated with any of the other mutational signatures identified in the investigators’ study. “In addition, no other CRC mutational process showed a significant association with red meat intake,” the authors pointed out.
27. Eating Fibre Before CRC Surgery Reduces Complication Risk (Jun.16/21)
People who include fibre from fruits, vegetables, and other sources in their diets before colorectal cancer (CRC) surgery can lower their risk for complications after the procedure, a study published Wednesday by JAMA Surgery found. For every 10 grams, about one-third of an ounce, of dietary fibre consumed per day, people who underwent surgery to treat colon or bowel cancer reduced their risk for complications by about 25%, the data showed. The effects of higher dietary fibre intake reduced the risk for post-surgical complications most notably in women, with a lesser effect seen in men.
“Generally, we believe that eating a healthy and varied diet is a better and safer approach than taking dietary supplements,” said Dieuwertje Kok, a researcher in human nutrition at Wageningen University in the Netherlands. Dietary fibre can help soften patients’ stools and thus reduce stress on their bowels following surgery, Kok and her colleagues said.
For this study, researchers analyzed data on roughly 1,400 adults ages 61 to 72 who underwent CRC surgery at 11 hospitals in the Netherlands. About 400, or 28%, of the patients developed complications and 235, or 17%, had complications related specifically to surgery, the data showed. Of the more than 1,200 patients in the study who had an anastomosis — a procedure in which a section of the bowel is removed, and the two remaining sections are reattached — 67, or 5%, developed a leakage at the surgical site. The findings indicate that increasing “dietary fiber intake before surgery, for example by eating fruits and vegetables and choosing wholegrain products,” might improve outcomes after the procedure, Kok said.
28. Intake of sugar-sweetened beverages linked to early-onset colorectal cancer
Among women, a higher intake of sugar-sweetened beverages in adulthood and adolescence correlated with a higher risk for early-onset colorectal cancer, according to research published in Gut. “Early-onset colorectal cancer (EO-CRC, age <50 years at diagnosis) is rapidly rising in the U.S., with an unclear understanding of its etiology and contributors to the rise. Sugar-sweetened beverages (SSBs) exert adverse metabolic repercussions throughout the life course, including insulin resistance and inflammation. Higher SSB intake was also associated with obesity, which has been previously linked to risk of EO-CRC,” Yin Cao, MPH, ScD, division of public health sciences, department of surgery, Washington University School of Medicine, told Healio. “Thus, we expect SSB may be an emerging risk factor for EO-CRC and likely contribute to the rising incidence of EO-CRC.” READ MORE.
29. Canadian Vaccination Rollout by Jurisdiction (May.27/21)
30. Why You Need to Get Vaccinated Even If You’ve Already Had COVID-19 (Jun.02/21)
Health experts are urging people who have already had COVID-19 to get vaccinated. Dr. William Schaffner, an expert in infectious diseases at Vanderbilt University in Tennessee, says the recommendation for people who have already had COVID-19 to still get vaccinated is based on two factors. “The first is that the antibody levels after vaccination are much higher than the antibody levels after natural infection. And higher antibody levels are usually associated with a longer duration of protection,” Schaffner told Healthline. “The second is, to use Tony Fauci’s word, higher antibody levels provide a greater cushion of protection against some of the variants” he added.
“A substantial number of people who are unvaccinated will continue to support the transmission of the virus and I think this will be more prominent in some communities than others,” said Schaffner. “Every time a new person is infected with the virus, the virus multiplies million and billions of times,” he added. “As it multiplies it mutates. Most of those mutations are harmless, but any one of those people could be a variant factory. They could suddenly develop a mutation or series of mutations by chance alone that would create a new and very dangerous variant. That’s a concept that’s not understood at all by the vast majority of people.”
31. No, COVID-19 Vaccines Do Not Cause New Coronavirus Variants (Jun.02/21)
False stories that vaccines are responsible for creating the new SARS-CoV-2 variants began rapidly spreading online after French virologist Luc Montagnier was reported to have made the claim in a recent interview for a documentary called “Hold-Up.” In a video clip of the interview circulating on sites like Facebook, Montagnier claims that the novel coronavirus does not die when faced with the antibodies that are produced by the vaccines. Instead, it finds “another solution,” and that solution is the variants. However, other medical experts say Montagnier is wrong and that the science shows the opposite to be true.
Kartik Chandran, PhD, professor in the department of microbiology and immunology, Harold and Muriel Block Faculty Scholar in Virology at Albert Einstein College of Medicine, explained that the virus is “always mutating.” This is because it’s “sloppy” at copying its own genetic information and makes errors every time it makes a copy. “These random errors are the mutations, and it follows that the more copies the virus makes, the more mutations it acquires,” he said. Chandran explained that most of these mutations either do nothing or are harmful to the virus because they hobble it. “Every once in a while though, a mutant has some kind of advantage, either in being able to grow in a person, spread from person to person, and/or escape antibodies the person is making. Such a mutant could successfully out-compete other viruses in the population and become a variant of concern,” he said.
Chandran also said it’s important to note that it’s largely the immune system of unvaccinated people that seems to be driving the selection of variants that can escape some antibodies. “Many of the vaccines are so effective at mounting an immune response that they can squash most of the variants that are currently circulating,” he said. He added that if we could vaccinate most people, the probability of viruses jumping from one person to another person would be greatly reduced.
32. Clinical Trial Evaluating Mixed COVID-19 Vaccine Schedules Begins (Jun.01/21)
The National Institutes of Health has started a Phase 1/2 clinical trial in which adult volunteers who have been fully vaccinated against COVID-19 will receive booster doses of different COVID-19 vaccines to determine the safety and immunogenicity of mixed boosted regimens. “Although the vaccines currently authorized by the U.S. Food and Drug Administration offer strong protection against COVID-19, we need to prepare for the possibility of needing booster shots to counter waning immunity and to keep pace with an evolving virus,” said NIAID Director Anthony S. Fauci, M.D. “The results of this trial are intended to inform public health policy decisions on the potential use of mixed vaccine schedules should booster doses be indicated.”
The trial is led by principal investigators Robert L. Atmar, M.D., at Baylor College of Medicine, Houston, and Kirsten E. Lyke, M.D., at the University of Maryland School of Medicine, Baltimore. It will include approximately 150 individuals who already have received one of the three COVID-19 vaccine regimens currently available under FDA Emergency Use Authorization in the United States: the Johnson & Johnson COVID-19 vaccine, the Moderna COVID-19 vaccine, and the Pfizer-BioNTech COVID-19 vaccine. Each vaccine group will enroll about 25 people ages 18 through 55 years and approximately 25 people age 56 years and older. 12-20 weeks following their initial vaccination regimen, participants will receive a single booster dose of the Moderna COVID-19 vaccine as part of the trial. People who have not yet received an FDA authorized COVID-19 vaccine are also eligible to enroll in the trial in a separate cohort. Initially, these volunteers will receive the two-dose Moderna COVID-19 vaccine regimen and will be assigned to receive a booster dose of a vaccine about 12 to 20 weeks later. Initial trial results are expected in late summer 2021.
33. Mix ‘N’ Match COVID Vaccines; Fauci’s Emails Studied; Indian Variant Rising Rapidly (Jun.02/21)
Listed below are COVID-19 Updates, each with their own articles, found using the link below;
- The NIH announced that it has started a trial of mixed COVID-19 vaccine booster regimens.
- On a related note, the Public Health Agency of Canada has authorized some mixing of COVID vaccines.
- “We will get through this together.” — The Washington Post takes a look at the emails of Anthony Fauci, MD, during the height of the COVID-19 pandemic; sometimes he received 1,000 emails in a single day.
- The COVID-19 variant that first showed up in India is spreading rapidly in the U.S., researchers said. (New York Post)
34. The ‘Lab Leak’ Debate Matters (Jun.01/21)
Right now, the two most widely discussed possibilities of the origin of COVID-19 are; the virus underwent zoonotic transmission (from some animal to a person), possibly at a wet market; and that it escaped from the Wuhan Institute of Virology due to poor safety protocols in a biosafety level (BSL) 3 or 4 laboratory.
The author identifies the real lesson of “lab leak,” as the way in which the idea moved from a taboo subject — a conspiracy theory — to a perfectly acceptable topic of discussion. In fact, last week, Facebook removed its ban on posts discussing the laboratory escape of the virus as a possibility. How could this happen? What was misinformation yesterday is something that needs investigating today? Other writers have discussed how prominent social media accounts took extreme positions that dissuaded the media from fairly considering the possibility of a lab leak, and on the heels of an election, turned the lab-leak idea into a political issue.
If we learn anything from the shift on the lab-leak theory, it is that curtailing free expression and limiting reasonable debate is a mistake. That’s especially true when information is dynamic, and you are making unprecedented decisions. In human history, we have never asked so many people to deprive themselves of social interaction for so long. We have never closed schools for so many kids and for so long. Naturally, these policies will spark disagreements, even fierce ones. Restricting the bounds of what’s appropriate — particularly with the brute force of platforms like Facebook — is a fool’s errand.
35. How Do COVID-19 Vaccines Compare? (Mar.05/21)
36. Getting a Pfizer or Moderna COVID-19 Vaccine Can Drop Your Risk for Infection by 91% (Jun.08/21)
New research from the Centers for Disease Control and Prevention (CDC) has found that the messenger RNA (mRNA) vaccines reduce the risk of COVID-19 infection by 91% in people who are fully vaccinated. For people who are partially vaccinated, the reduced risk drops to 81%.
The study, which was released this month as a preprint on MedRxiv, also shows that the vaccines reduce the severity of illness in both fully and partially vaccinated people who develop COVID-19. On average, vaccinated people who got COVID-19 spent about 6 fewer days feeling sick and 2 fewer days sick in bed. Compared to unvaccinated people, those who had one or both doses of the shots also had a up to a 66% lower chance of developing symptoms like fever and chills. Other studies have found that vaccinated people who contract the coronavirus have lower viral loads. As a result, they’re less likely to pass the virus to other people.
Researchers will need to continue to study the shots in the months and years ahead to understand their durability and whether we may need booster shots.
37. Doctors Debunk 9 Popular COVID-19 Vaccine Myths and Conspiracy Theories (Jun.22/21)
Myth: Vaccines don’t work
Dr. Robert Amler, dean of New York Medical College School of Health Sciences and Practice and a former CDC chief medical officer, says overwhelming evidence shows that vaccines have caused reductions in disease in the United States and worldwide. “Through vaccination, smallpox has been eradicated worldwide. Through vaccination, polio has been eliminated from the Western Hemisphere, Europe, and Oceania, with only a few pockets left in a few countries. And through mass vaccination, COVID-19 rates have declined dramatically in the second quarter of 2021,” Amler told Healthline.
Myth: The COVID-19 vaccine makes you magnetic
“It’s difficult to say anything about this except it’s clearly untrue. If this is the case, it’s strange that we haven’t seen all of our neighbors who are vaccinated walking around with metal on them. I’ve been vaccinated, and I can assure you I’m not magnetic,” said Schaffner.
Myth: The COVID-19 vaccines are causing COVID-19 variants
In fact, the COVID-19 virus itself, not the vaccines, produces the variants. Schaffner explains that the virus in a human being multiplies and creates new viruses that generate genetic variation. When this happens, most variations are harmless with no effect, he says. “But on rare occasion, you can get one mutation or a series of them coincidentally occurring that will create a variant… that will continue to reproduce,” he said.
Myth: The COVID-19 vaccine makes you infertile
For decades, risk of infertility has been used as a way to frighten people away from legitimate treatments, says Amler. This myth is false when it comes to the COVID-19 vaccines because the vaccines do not go near DNA in your cells, explains Schaffner. According to the Centers for Disease Control and Prevention (CDC), mRNA vaccines teach our cells how to make a protein — or even just a piece of a protein — that triggers an immune response inside our bodies. “It’s like bringing a blueprint to the body to create a protection, and the vaccine itself is so labile that it falls apart immediately. We excrete it right away as soon as the message has been delivered to our cells, so it does not linger in your body,” said Schaffner.
Myth: The government put a microchip in COVID-19 vaccines to track you
“Physically, chips are not small enough that they could be inoculated with a needle. The COVID-19 vaccines are old-fashioned simple public health. Bad disease; good vaccine. Let’s get the vaccine in order to prevent the bad disease. It’s nothing more complicated than that,” said Schaffner. For a list of ingredients in the COVID vaccines, visit the CDC website.
Myth: The J&J vaccine was created from fetal tissue
This misconception is derived from a grain of truth from past vaccines that has been amplified inappropriately. “Many years ago, a strain of cells that was derived from a miscarriage was used initially in general vaccine research for coronaviruses,” said Schaffner. However, the current vaccines do not consist of any fetal tissue.
Myth: Vaccines cause autism
“This is demonstrably incorrect, as evidenced by a considerable array of peer-reviewed and published investigations. The perpetrators of this particular myth have been widely discredited,” said Amler.
Myth: The COVID-19 vaccines rewrite your DNA
While mRNA does transmit information to the body in the cells, Schaffner explains that it does not go near the cell’s nucleus, which is where DNA is located. “It stays away from that. It doesn’t interact with the DNA at all. It just provides a message to the protein developing apparatus in our cell. So, it transmits its message and then disintegrates,” said Schaffner.
Myth: The COVID-19 vaccine will cause long-term complications
Schaffner says of the long list of vaccines that have been used for decades, none have proven to create long-term effects. “This comes as a big surprise to most people, but the adverse effects associated with most vaccines become evident within 2 to 3 months of the administration of the vaccine. We’re beyond that now with the COVID vaccines, and have given millions of doses of it, so we know what the side effects profile is,” he said. Amler adds that vaccines are continuously monitored post-market.
38. Frequently Asked Questions for COVID-19
Q: What is COVID-19 (or novel Coronavirus Disease – 19)?
A: Coronaviruses are a large family of viruses that can cause illnesses in humans and animals. Coronaviruses can cause illnesses that range in severity from the common cold, to more severe diseases such as Severe Acute Respiratory Syndrome (SARS) and most recently, COVID-19. COVID-19 or novel coronavirus originated from an outbreak in Wuhan, China in December 2019. The most common symptoms associated with COVID-19 can include fever, fatigue, and a dry cough. Though additional symptoms have now been linked with the disease, which may include aches and pains, nasal congestion, runny nose, sore throat, diarrhea, skin rash and vomiting. It is also possible to become infected with COVID-19 and not experience any symptoms or feeling ill. The spread of COVID-19 is mainly through the transmission of droplets from the nose or mouth when a person coughs, exhales or sneezes. These droplets land on surfaces around a nearby person. COVID-19 can be transmitted to that nearby person who may end up touching the surface contaminated with COVID-19 and then end up touching their nose, mouth, or eyes. A person can also contract COVID-19 through inhaling these droplets from someone with COVID-19. Although research is still ongoing, it is important to note that older populations (over the age of 65), those with a compromised immune system and those with pre-existing conditions including heart disease, high blood pressure, lung disease, diabetes or cancer may be at a higher risk of severe illness due to COVID-19.
Q: What can I do to avoid getting Coronavirus?
A: There are various ways in which we can reduce our risk of contracting COVID-19. Below are some measures suggested by the World Health Organization
- Keep at least 2 metres (or 6 feet) between yourself and other people. This will reduce the risk of inhaling droplets from those infected with COVID-19.
- Regularly clean your hands for at least 20 seconds with warm water and soap, or an alcohol-based hand rub. This will kill any viruses on your hands.
- Avoid touching your eyes, nose and mouth. If the virus is on your hands, it can enter the body through these areas.
- Follow good respiratory hygiene by covering your mouth and nose with a tissue or elbow when you cough and sneeze. This prevents the droplets from settling on surfaces or being released into the air around you.
- Stay home as much as possible, especially if you are feeling unwell. If you think you may have the Coronavirus, please see “What should I do if I think I have Coronavirus?” section.
- Please wear a face covering or mask in public when physical distancing is not possible.
Q: Are there any treatments available for Coronavirus?
A: People with cancer are at a higher risk of severe illness due to COVID-19 as cancer is considered a pre-existing health issue. Some cancer treatments including chemotherapy, radiation and surgery can weaken the immune system, making it harder for the body to fight infections and viruses, such as Coronavirus. It is important to diligently follow the World Health Organization’s recommendations above to reduce the risk of contracting COVID-19. If you have any concerns about your risk, it is best to contact your doctor or healthcare team.
There are currently no treatments available for COVID-19 but trials are underway to determine how to best treat and manage those afflicted with the virus. Vaccine candidates are being vigorously tested in a number of countries around the world, Canada included. The US government is funding 3 major phase 3 trials on potential COVID-19 vaccines and all 3 trials are being conducted by 3 different pharmaceutical companies looking at different vaccine candidates. The hope is to have a vaccine by the end of the year!
Q: Are there special precautions that people with cancer can take?
A: People with cancer (and other chronic ailments such as heart disease, diabetes, high blood pressure and lung disease) are at a higher risk of severe illness due to COVID-19 as cancer is considered a pre-existing health issue. Some cancer treatments including chemotherapy, radiation and surgery can weaken the immune system, making it harder for the body to fight infections and viruses, such as Coronavirus. It is important to diligently follow the World Health Organization’s recommendations above to reduce the risk of contracting COVID-19. If you have any concerns about your risk, it is best to contact your doctor or healthcare team.
Will anything change with regards to my cancer related medical visits? As each patient and treatment plan is unique, it is always best to contact your health care provider for updated information about your treatment plan. In some cases, it is safe to delay cancer treatment until after the pandemic risk has decreased. In other cases, it may be safe to attend a clinic that is separate from where COVID-19 patients are being treated. Oral treatment options could be prescribed by your care provider virtually, without the need to attend the clinic. Finally, some follow-up appointments or discussions could be held virtually (via skype or zoom for example) or over the phone to minimize your risk. As we know, conditions and protocols are changing daily due to the nature of the COVID-19 outbreak, and vary based on location, therefore, the best first step is to reach out to your care provider for guidance.
Should you wish to contact your local public health agency, please see below.
COVID-19 info for Albertans
Social media: Instagram @albertahealthservices, Facebook @albertahealthservices, Twitter @GoAHealth
Phone number: 811
British Columbia COVID-19
Social media: Facebook @ImmunizeBC, Twitter @CDCofBC
Phone number: 811
Social media: Facebook @manitobagovernment, Twitter @mbgov
Phone number: 1-888-315-9257
New Brunswick Coronavirus
Social media: Facebook @GovNB, Twitter @Gov_NB, Instagram @gnbca
Phone number: 811
Newfoundland and Labrador
Newfoundland and Labrador COVID-19 information
Social media: Facebook @GovNL, Twitter @GovNL, Instagram @govnlsocial
Phone number: 811 or 1-888-709-2929
Northwest Territories coronavirus disease (COVID-19)
Social media: Facebook @NTHSSA
Phone number: 811
Nova Scotia novel coronavirus (COVID-19)
Social media: Facebook @NovaScotiaHealthAuthority , Twitter @healthns, Instagram @novascotiahealthauthority
Phone number: 811
Nunavut COVID-19 (novel coronavirus)
Social media: Facebook @GovofNunavut , Twitter @GovofNunavut, Instagram @governmentofnunavut
Phone number: 1-888-975-8601
Ontario: The 2019 Novel Coronavirus (COVID-19)
Social media: Facebook @ONThealth, Twitter @ONThealth , Instagram @ongov
Phone number: 1-866-797-0000
Prince Edward Island
Prince Edward Island COVID-19
Social media: Facebook @GovPe, Twitter @InfoPEI,
Coronavirus disease (COVID-19) in Québec
Social media: Facebook @GouvQc, Twitter @sante_qc
Phone number: 1-877-644-4545
Social media: Facebook @SKGov, Twitter @SKGov
Phone number: 811
Yukon: Find information about coronavirus (COVID-19)
Social media: Facebook @yukonhss, Twitter @hssyukon
Phone number: 811