TRAITEMENT DU CANCER COLORECTAL ET MISES À JOUR SUR LA RECHERCHE CLINIQUE
Month Ending May 12th, 2022
The following colorectal cancer treatment and research updates extend from April 14,, 2022, to May 12,, 2022, inclusive and are intended for informational purposes only.
Ce contenu n'est pas destiné à se substituer à un avis médical professionnel. Consultez toujours votre médecin traitant ou les conseils d'un professionnel de la santé qualifié pour toute question concernant votre santé ou un problème médical. Ne négligez jamais l'avis d'un professionnel de la santé et ne tardez jamais à le solliciter en raison d'un élément que vous avez lu sur ce site web.
CONTENU
1. Essai clinique LEAP de phase II pour le traitement du CCRm
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 CRC 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 CRC
5. Novartis Enters KRAS G12C Space with Positive Phase I/II Data in CRC
6. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program – Sunnybrook Hospital
7. Living Donor Liver Transplantation for Unresectable CRC Liver Metastases
8. Étude proposée au centre de cancérologie d'Odette pour traiter les cancers rectaux récurrents
9. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age
10. Guardant Debuts its First Cancer Screening Blood Test for Catching Colorectal Tumors
11. Empirical Evidence Points to Benefit of Earlier Colon Cancer Screening
12. Young Adult CRC Clinic Available at Sunnybrook Hospital
13. Updates from The Colorectal Cancer Project
14. Early-Age-Onset CRC in Canada: Evidence, Issues and Calls to Action
15. Colon Cancer Survivors Suffer Less Recurrence and Live Longer with Healthy Lifestyle
16. Increasing Incidence of Early-Onset CRC
17. Wireless Device to Provide New Options for CRC Treatment
18. Payer Targets Health Equity in CRC Prevention
19. “Keto” Molecule May Be Useful in Preventing and Treating CRC
20. Mixed Messaging on Red Wine
21. Moderna Asks FDA to OK Its COVID-19 Vaccine for Kids Under 5
22. People with Long COVID Benefit from Rehab Therapy
23. National COVID-19 Guidelines
24.Foire Aux Questions Pour Covid-19
MÉDICAMENTS / THÉRAPIES SYSTÉMIQUES
1. Phase II LEAP Clinical Trial For mCRC (May 15/22)
Le but de cette étude est de déterminer la sécurité et l'efficacité de la thérapie combinée avec le pembrolizumab (MK-3475) et la levantine (E7080/MK-7902) chez les patients atteints de cancer du sein triple négatif (TNBC), de cancer des ovaires, de cancer gastrique, de cancer colorectal (CCR), de glioblastome (GBM) ou de cancers des voies biliaires (BTC). Les participants seront inscrits dans des cohortes initiales spécifiques aux tumeurs, qui seront élargies si une efficacité adéquate est déterminée. L'essai est disponible au centre de cancérologie Odette et au centre de cancérologie Princess Margaret à Toronto ainsi que dans les centres suivants au Canada : Abbotsford, BC; Winnipeg, MB; CHU de Québec. Pour plus d'informations, consultez le lien ci-dessous.
2. TRK Fusion Cancer and How to Test for It (May 15/22)
https://www.bayer.ca/en/media/news/?dt=TmpBPQ==&st=1
3. A Phase II, Open-label, Multicenter, Study of an Immunotherapeutic Treatment for the MSI High CRC Metastatic Population (May 12/22)
L'objectif de cette étude est d'examiner l'efficacité du vaccin DPX-Survivac en combinaison avec les médicaments cyclophosphamide et l'immunothérapie 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 centre de cancérologie Odette Comparing Arfolitixorin vs. Leucovorin in Combination with 5FU, Oxaliplatin and Bevacizumab in Patients with Advanced CRC (May 1/22)
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;
- un groupe recevra de L'arfolitixorine en combinaison avec du 5FU), de l'oxaliplatine et du bevacizumab,
- tandis que l'autre groupe recevra le médicament Leucovorin en combinaison avec le 5FU, l'oxaliplatine et le bevacizumab (norme de soins).
Le médecin et le personnel de l'étude ne sauront pas dans quel groupe se trouve un patient. Les patients seront répartis au hasard pour recevoir l'un ou l'autre traitement.
A propos d'Arfolitixorine:
L'arfolitixorine 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.
Traiter les patients atteints de cancer avec de l'arfolitixorine - Les objectifs :
- 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.
https://sunnybrook.ca/trials/item/?i=293&page=49335 et https://clinicaltrials.gov/ct2/show/NCT03750786
(https://isofolmedical.com/arfolitixorin/ )
5. Novartis Enters KRAS G12C Space with Positive Phase I/II Data in CRC (Apr.15/22)
Novartis researchers presented data from the Phase I/II KontRASt-01 trial at the American Association for Cancer Research’s annual meeting in New Orleans. The Phase I portion of the study evaluated Novartis’ JDQ443 in patients with advanced KRAS G12C-mutated solid tumors, and the Phase II portion of the study focused on advanced KRAS G12C-mutant colorectal and non-small cell lung cancer. Patients needed to have received prior standard-of-care therapy, be intolerant of or ineligible for approved therapies, and no prior KRAS inhibitor treatment.
Of 39 evaluable patients in the study, 11 patients (28.2%) had a confirmed or unconfirmed response with all of the responses in patients with non-small cell lung cancer (NSCLC) and colorectal cancer (CRC). Based on this data, Novartis is expanding its JDQ443 monotherapy NSCLC and CRC cohorts in the KontRASt-01 trial. The company is also beginning to enroll patients with KRAS G12C-mutant solid tumors in combination arms of the trial. One arm will evaluate JDQ443 plus Novartis’ SHP2 inhibitor TNO115 in solid tumors, and another arm will enroll solid tumor patients for treatment with JDQ443 and Novartis’ anti-PD1 drug tislelizumab. Finally, Novartis is also planning a randomized Phase III trial, KontRASt-02, of JDQ443 versus docetaxel in previously treated patients with advanced or metastatic KRAS G12C-mutant NSCLC. That trial has not opened yet, but the company expects to begin enrolling patients by mid-2022.
LES THÉRAPIES CHIRURGICALES
6. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program – Sunnybrook Odette Cancer Centre (May 1/22)
Le programme PPAH est une première au Canada pour les personnes dont le cancer du côlon ou du rectum (cancer colorectal) s'est propagé au foie et ne peut être retiré par une intervention chirurgicale. Le programme implique une approche coordonnée et multidisciplinaire des soins, avec une étroite collaboration entre l'oncologie chirurgicale, l'oncologie médicale (chimiothérapie), la radiologie interventionnelle, la médecine nucléaire et les soins infirmiers en oncologie. La pompe à perfusion de l'artère hépatique (PPAH) est un petit dispositif en forme de disque qui est chirurgicalement implanté juste sous la peau du patient et est relié par un cathéter à l'artère hépatique (principale) du foie. Environ 95 % de la chimiothérapie administrée par cette pompe reste dans le foie, épargnant ainsi le reste du corps des effets secondaires. Les patients reçoivent une chimiothérapie dirigée par PPAH en plus de la chimiothérapie intraveineuse (IV) régulière (chimiothérapie systémique), afin de réduire le nombre et la taille des tumeurs. Drs. Paul Karanicolas and Michael Raphael are the program leads and happy to see patients who may be eligible for the therapy.
Maintenant au centre de cancérologie Odette, le PPAH est utilisé chez les patients atteints d'un cancer colorectal qui s'est propagé au foie et qui ne peut être enlevé chirurgicalement et ne s'est pas propagé à d'autres parties du corps. Les patients qui ont peu (1-5) et de très petites tumeurs dans les poumons peuvent être pris en considération si la maladie pulmonaire est jugée traitable avant le PPAH. Si vous pensez pouvoir bénéficier de cette thérapie et/ou si vous souhaitez en savoir plus sur l'essai clinique, votre oncologue médical ou votre chirurgien peut vous adresser par télécopie au 416-480-6179. Pour plus d'informations sur l'essai clinique PPAH, veuillez cliquer sur le lien fourni ci-dessous
http://sunnybrook.ca/content/?page=colorectal-colon-bowel-haip-chemotherapy
7. Living Donor Liver Transplantation for Unresectable CRC Liver Metastases (May1/22)
Environ la moitié des patients atteints de cancer colorectal (CCR) développent des métastases, généralement au niveau du foie et des poumons. L'ablation chirurgicale des métastases hépatiques (MH) est la seule option de traitement, bien que seulement 20 à 40 % des patients soient candidats à un traitement chirurgical. La thérapie chirurgicale apporte un avantage significatif en termes de survie, avec une survie à 5 ans après résection du foie de 40 à 50 % pour les MH, contre 10 à 20 % pour la chimiothérapie seule. La transplantation du foie (TF) permettrait d'éliminer toute maladie évidente dans les cas où les métastases colorectales sont isolées au foie mais considérées comme non résécables.
Source de l'image : 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.
https://clinicaltrials.gov/ct2/show/NCT02864485
LES RADIOTHÉRAPIES/RADIOLOGIE INTERVENTIONNELLE
8. Study Offered at the Odette Cancer Centre to Treat Recurrent Rectal Cancer (May 1/22)
Magnetic resonance-guided focused ultrasound (MRg-FU) is a less invasive; 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:
DÉPISTAGE
9. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age (May 1/22)
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. Researchers calculated the 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.
10. Guardant Debuts its First Cancer Screening Blood Test for Catching Colorectal Tumors (May 2/22)
The blood-testing company Guardant Health aims to offer a simpler option to people who may have missed their recommended appointments to be checked out for colorectal cancer (CRC)—such as a colonoscopy—with the launch of its first cancer screening test. Guardant estimates that one in three adults have not completed the recommended set of screening tests for CRC, which include colonoscopies every 10 years and annual stool-based tests starting at age 45 (in the U.S.) and 50 in Canada.
The test searches for early signs of CRC from pieces of tumor DNA found floating in the bloodstream. In a clinical study of about 300 samples, the assay showed 91% sensitivity in detecting positive cases, including 90% for people with early, stage I cancers, 97% for stage II and 86% for stage III. Shield also demonstrated a low rate of false positives, at 8%, but the company said that a negative result does not fully rule out the presence of cancer. People who have a signal detected by the test should be referred to a colonoscopy for confirmation, and Guardant said its blood test is intended to complement, not replace, current screening methods.
11. Empirical Evidence Points to Benefit of Earlier Colon Cancer Screening (May.5/22)
According to an analysis of the Nurses’ Health Study II, screening for colorectal cancer (CRC) in women before the age of 50 can significantly reduce the risk of CRC compared to those who have no endoscopic screening or decide to initiate testing at age 50. Researchers found a 50-60% lower risk of CRC among women who started endoscopy screening at age 45 compared to those who had not undergone screening at all. In addition, they learned that starting screening at ages 45 to 49 resulted in a significant reduction in the population’s actual cases of CRC diagnosed through age 60, compared to a strategy in which women began screening at ages 50 to 54. While the study was focused on women, Andrew Chan, a gastroenterologist and epidemiologist at MGH, and senior author of the study, suggests the same benefits likely accrue to men, though he adds further studies are needed. The findings support guidelines from the past 4 years that recommend screening for CRC at 45 years of age and provide empirical evidence for patients, physicians, and policy makers to consider when making decisions about CRC screening in a younger population.
https://www.medpagetoday.com/gastroenterology/coloncancer/98565
AUTRE
12. Young Adult CRC Clinic Available at Sunnybrook (May 2/22)
A recent study led by the University of Toronto doctors has observed a rise in colorectal cancer (CRC) rates in patients under the age of 50. The study mirrors findings from the U.S., Australia and Europe. The growing CRC rates in young people come after decades of declining rates in people over 50, which have occurred most likely due to increased use of CRC 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. Le Dr Shady Ashamalla (oncologue chirurgien spécialisé dans le cancer colorectal) et son équipe du Centre des sciences de la santé Sunnybrook comprennent les besoins de cette population de patients.
Le Dr Ashamalla fait partie d'une équipe multidisciplinaire d'experts de La Clinique Du Cancer Colorectal Des Jeunes Adultes who will work with young CRC 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
L'équipe d'experts est composée de :
• Oncologists (medical, surgical, radiation)
• Social workers
• Psychologists
• Geneticists
• Nurse navigator
Si un patient souhaite être orienté vers Sunnybrook, il peut demander à son médecin traitant ou à son spécialiste de l'orienter vers Sunnybrook via le formulaire d'orientation électronique, accessible via le lien figurant ci-dessous. Une fois l'orientation reçue La Clinique Du Cancer Colorectal Des Jeunes Adultes sera informée si le patient a moins de 50 ans. Un rendez-vous sera alors fixé, au cours duquel le patient rencontrera différents membres de l'équipe afin de répondre à leurs préoccupations spécifiques.
http://sunnybrook.ca/content/?page=young-adult-colorectal-cancer-clinic
13. Updates from The Colorectal Cancer Project (Apr.20/22)
CCRAN is proud to partner with Count Me In, a nonprofit research initiative, on The Colorectal Cancer Project. This new project is open to anyone in the United States or Canada who has ever been diagnosed with colorectal cancer (CRC). Patients can find out more and join at JoinCountMeIn.org/Colorectal.
Over 250 patients have joined the Colorectal Cancer Project since the launch in fall 2021. Every patient that joins the Colorectal Cancer Project enables us to learn more about colorectal cancer. Pts diagnosed at any age, whether newly diagnosed or years from their diagnosis, can enroll. If you have ever been diagnosed with colorectal cancer, you can visit JoinCountMeIn.org/Colorectal to enroll and have a direct impact on research and future treatment strategies.
14. Early-Age-Onset CRC in Canada: Evidence, Issues and Calls to Action (Apr.29/22)
In light of the rapidly rising rates of early-age-onset colorectal cancer (EAO-CRC) among Canadians under the age of 50 and the impactful outcomes associated with this disease, CCRAN convened the inaugural Early-Age-Onset Colorectal Cancer Symposium in June 2021. Bringing together a cross-section of patients, clinicians and researchers, the virtual symposium discussed the implications of the current evidence on EAO-CRC and to offer directions for research and clinical practice. A total of 170 people registered for the symposium. Of the participants, 42% identified as patients or belonged to a patient group, and 33% were healthcare professionals or researchers. The table below summarizes key actions of the symposium, identified as being important for improving outcomes in EAO-CRC.
Much more can be found about CCRAN’s first EAOCRC Symposium by vising the publication found in Current Oncology: https://www.mdpi.com/1718-7729/29/5/256/pdf
Stay tuned as CCRAN hosts its second EAOCRC Symposium on October 27-28th, 2022, whose first scheduled day will target patients and caregivers and the second day will target clinicians, policy makers and other experts across the continuum of colorectal cancer care.
15. Colon Cancer Survivors Suffer Less Recurrence and Live Longer with Healthy Lifestyle (Apr.18/22)
A new paper that focuses on predicting survival outcomes for stage 3 colon cancer patients found that colon cancer patients who have a healthier diet and lifestyle are predicted to live longer and have a lower risk of recurrence compared to patients with unhealthier habits, regardless of tumor characteristics. After a median follow up of slightly more than 7 years from approximately 1,000 colon cancer patients’ data, 311 people had died and 350 had experienced recurrences. The researchers first used the standard prediction model based on clinical and other medical characteristics, such as tumor location. Then they repeated the analysis with patients’ diet and lifestyle factors incorporated into the model.
The paper found that when incorporating lifestyle into the model, patients who maintained a healthy diet and lifestyle were predicted to live longer and have reduced risk of cancer recurrence. By adding healthy lifestyle habits to the established model, researchers were able to improve the accuracy of the prediction models. Then the authors devised hypothetical scenarios that would separate patients into high, average and poor risk categories depending upon their risk for five-year survival after treatment. Incorporating diet and lifestyle factors into the model made a difference in health outcomes among all groups, with those having the worse prognosis seeing the strongest effects. Among patients at poor risk for survival, those having the most favourable diet and lifestyle habits had a 45% reduced risk of predicted death and recurrence over 5 years compared to a 2% reduced risk based on clinical factors alone. Conversely, having the unhealthiest diet and other lifestyle factors increased predicted death and recurrence at each risk level. A patient at average risk with the least healthy habits would increase their 5-year risk of death and recurrence over 50% compared to those with the healthiest habits, according to the model. Both patients and providers could utilize these models for diet and lifestyle modifications that could meaningfully improve patient outcomes.
16. Increasing Incidence of Early-Onset CRC (Apr.21/22)
An alarming increase in cases of early-onset colorectal cancer (CRC), defined as diagnosis in patients younger than 50 years of age, has occurred in the United States and other high-income countries over the past few decades. Early-onset CRC now accounts for approximately 10% of all new diagnoses of this cancer, and an accompanying increase in CRC–related mortality during the past decade has also been observed among younger patients.
Although patients with early-onset CRC are more likely to have a hereditary syndrome than those who have later-onset disease, most cases are sporadic, with no identifiable cause. A lot of the symptoms of CRCs can be vague – like stomach pain or cramping. It’s important to be aware of what to look out for, and consult a doctor if you notice any of these symptoms:
1. Change in bowel habits (like diarrhea, constipation, narrowing of stools) that is persistent.
2. Rectal bleeding.
3. Anemia (low red blood cell counts).
4. Cramping or abdominal pain.
5. Weakness or fatigue.
6. Unintentional weight loss.
People with a family history of cancer should speak to their physician about being screened earlier. If you have a first-degree relative with a history of CRC, it is best to starting screening 10 years before the age they were diagnosed. For example, if a family member was diagnosed at 45, that would mean you may want to consider screening at 35. At the latest, those with a family history of colon cancer should start screening at age 40. People who have other risk factors like inflammatory bowel disease or hereditary syndromes (like Lynch syndrome), should discuss what age to begin screening with their doctor.
https://www.stamfordhealth.org/healthflash-blog/cancer/colorectal-cancer-30s-40s-what-to-know/
17. Wireless Device to Provide New Options for CRC Treatment (Apr.25/22)
For those diagnosed with colorectal cancer (CRC), surgery has been the only option that offers a solution. Unfortunately, surgery is frequently complicated by disease recurrence at the site of the original cancer when microscopic cancer cells are left behind at the time of surgery. Chemotherapy is a treatment option that is often given in conjunction with surgery, although it can lead to toxic side effects. Researchers at Texas A&M University are working to develop a low cost, minimally invasive wireless device that offers precise, safe treatment options for cancers. They will utilize photodynamic therapy (PDT) during surgery by using a photosensitizer — a drug activated by light — to kill the cancer cells. During this process, surgeons will be able to remove the bulk of the tumor, then fully irradiate the tumor bed when the photosensitizer is activated by the light. This combination would result in a complete treatment in a safe and effective way with no toxic side effects.
In the long term, the work will result in a platform that has the potential to provide clinical-quality health monitoring capabilities for continuous use beyond the confines of traditional hospital or laboratory facilities. It will also allow for treatment options to prevent the development of additional malignancy and therefore significantly improve the quality of life for people with cancer.
https://www.sciencedaily.com/releases/2022/04/220425144205.htm
18. Payer Targets Health Equity in CRC Prevention (May.5/22)
Independence Blue Cross (Independence) is partnering with a nonprofit dedicated to colorectal cancer (CRC) awareness and research in order to improve preventive care and health equity for CRC. Along with Colorectal Cancer Alliance (the Alliance), Independence will work toward bringing CRC screenings to more Philadelphians, specifically more Black residents, through a program called Cycles of Impact. This is a pilot program that aims to screen at least 2,400 people in Philadelphia. The goal is to prevent 60 or more cancer diagnoses, particularly among Black Philadelphians, who are known to be disproportionately impacted by CRC.
A third of all adults who should receive a CRC screening do not get screened, thus lowering the screening age could expand the number of individuals who receive the screening. Screening is an important way to prevent colorectal cancer, but it is not the only step that payers can take in order to support members who are at risk for CRC. Payers can educate members on colorectal cancer, identify and close gaps in care, and offer telehealth and home healthcare methods of support. Home testing kits have become a popular way to overcome barriers to screenings.
https://healthpayerintelligence.com/news/payer-targets-health-equity-in-colorectal-cancer-prevention
NUTRITION/MODE DE VIE SAIN
19. “Keto” Molecule May Be Useful in Preventing and Treating CRC (Apr.27/22)
A study conducted at Perelman School of Medicine at the University of Pennsylvania found that beta-hydroxybutyrate (BHB), a natural molecule produced in the liver in response to keto diets or starvation, strongly suppresses the growth of colorectal tumors and could potentially be used as a preventive measure and treatment against colorectal cancer (CRC).
The study examined whether different types of diet could hinder CRC development and growth. Six groups of mice were put on diets with varying fat-to-carb ratios and were given a chemical technique that normally induces colorectal tumors. They found that the 2 diets with 90% fat-to-carb ratios one using lard (pig fat) and the other Crisco (mostly soybean oil) prevented colorectal tumor development in most of the animals on those diets. Conversely those on low-fat, high-carb diets developed tumors. Even in the case where mice started the diet after colorectal tumors started growing, the diets showed a “treatment effect” by significantly slowing further tumor growth and spread.
In later experiments, scientists concluded that tumor suppression is linked to a slower production, by stem cells, of new epithelial cells lining the colon. This slowdown of gut-cell growth was traced to BHB – normally produced by the liver as a “starvation response” triggered in this case by low-carb keto diets. BHB is an alternate fuel source for key organs in low-carb conditions as well as a powerful growth-slowing signal for gut-lining cells. Scientists were able to reproduce the tumor-suppressing effects of the diet by giving the mice BHB, either in their water or via an infusion copying the liver’s natural secretion of the molecule. They showed that BHB applies its gut-cell growth effect by activating a surface receptor called Hcar2 which in turn stimulates the expression of a growth-slowing gene, Hopx. BHB had the same growth-slowing effects on human gut lining cells via the human versions of Hcar2 and Hopx. Clinical trials of BHB supplementation are needed before any recommendation can be made about its use in prevention or treatment of CRC.
20. Mixed Messaging on Red Wine (Apr.19/22)
While many choices you make to lower the risk of cancer also lowers the risk of heart disease, trying to make a smart choice about alcohol can be confusing. Alcohol – especially wine – has an image as a heart-healthy choice, and fewer than 4 in 10 people are aware that alcohol poses a cancer risk.
The evidence is stronger than ever linking alcohol to increased risk of breast cancer. Just 10 grams of pure alcohol consumed daily raises the risk of premenopausal breast cancer 5%, and the risk of postmenopausal breast cancer 9%. While the risk of breast and esophageal cancers increases at even low levels of consumption, alcohol beyond moderation also raises the risk of cancers of the colorectum, stomach, liver, mouth, pharynx, and larynx. DNA damage can occur from the free radicals formed as alcohol is metabolized, forming acetaldehyde, a recognized carcinogen. Alcohol may also act as a solvent, increasing other carcinogens’ ability to damage cells. At the same time observational studies following large groups of people for many years, found that those who drink moderate amounts of alcohol have a lower risk of heart disease compared to people who drink large amounts and compared to those who don’t drink alcohol. However, in studies like these, which can’t establish cause-and-effect, some of the people with little or no alcohol consumption are people who have health problems that led them to avoid alcohol. A closer look shows that alcohol stands on a thin line when it comes to heart health: Blood triglyceride levels can rise with too much alcohol and in turn raise heart disease risk.
Despite some differences in how alcohol affects the risk of heart disease and cancer, there is agreement about a commonsense approach. Recommendations agree that for those who choose to drink, it is best if women limit themselves to no more than one alcoholic drink per day, and men to no more than two. Additionally, guidelines focused on heart health emphasize that you should not drink alcohol specifically in hopes of cardiovascular benefits.
Mixed Messaging on Red Wine: Separating Myth from Fact
MISES À JOUR COVID-19
21. Moderna Asks FDA to OK Its COVID-19 Vaccine for Kids Under 5 (Apr.29/22)
Moderna has put forward a request to the Food and Drug Administration (FDA) for emergency authorization of its mRNA COVID-19 vaccine for children 6 months to 5 years of age. The vaccine is a two-dose regimen, given at one-quarter the strength of the adult vaccine. No COVID_19 vaccines have been approved in the U.S. for children under 5.
While cases are currently low in many parts of the US, Dr. Diego Hijano, an infectious disease specialist at St. Jude Children’s Research Hospital in Memphis, Tenn stated it makes sense to have a vaccine available to younger children before the next surge. “It takes time for children to be fully protected,” he said, “because it’s two doses separated by several weeks, in the case of this vaccine, and then you have to wait two weeks after the second dose for full protection.” In addition, he said there is a need to have vaccines available to protect younger children from coronavirus infection. “We know they can get severe disease and they can be hospitalized, even if they don’t have a co-morbidity,” he said. “We also have very few options to treat [this age group] because most of the treatment options are for adults or children over 12 years of age.” Dr. Hijano recommends that parents of young children continue to take steps to protect them by avoiding large indoor gatherings and those two years or older wearing masks in indoor public settings. Tentative dates of June 8, 21 and 22 have been scheduled by the FDA to review applications.
Source de l'image : https://www.istockphoto.com/illustrations/covid-19-vaccine-kids
22. People with Long COVID Benefit from Rehab Therapy (Apr.29/22)
It is estimated that up to 30% of people who contracted COVID-19 will experience some type of long-term health problems with fatigue as the most common symptom. A study conducted in Ireland found that occupational therapy can improve the overall wellbeing and quality of life among people with long-haul COVID who are living with chronic fatigue. Researchers found that an occupational therapy fatigue management program resulted in positive changes to those with post-COVID symptoms who said their tiredness was affecting their work, leisure activities, and self-care. Occupational therapy helps people get back to their everyday activities by teaching them techniques to manage their fatigue. The program spanned a four-week period with three 1.5 hours of group therapy covering self-management techniques to address fatigue, brain fog, sleep hygiene, energy conservation and pacing of activities by taking breaks before reaching the point of exhaustion.
23. National COVID-19 Guidelines (May.11/22)
The following COVID-19 guidelines are specific to Ontario. To view guidelines for the other provinces, visit the link below.
24.Foire Aux Questions Pour 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.
https://www.who.int/news-room/q-a-detail/q-acoronaviruses
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
1. 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.
2. 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.
3. Avoid touching your eyes, nose and mouth. If the virus is on your hands, it can enter the body through these areas.
4. 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.
5. 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.
6. Please wear a face covering or mask in public when physical distancing is not possible.
https://www.who.int/news-room/q-adetail/q-a-coronaviruses
Y a-t-il des précautions particulières que les personnes atteintes d'un cancer peuvent prendre ?
R : Les personnes atteintes de cancer (et d'autres maladies chroniques telles que les maladies cardiaques, le diabète, l'hypertension et les maladies pulmonaires) sont plus exposées à une maladie grave en raison de la COVID-19, le cancer étant considéré comme un problème de santé préexistant. Certains traitements contre le cancer, notamment la chimiothérapie, les radiations et la chirurgie, peuvent affaiblir le système immunitaire, ce qui rend l'organisme plus difficile à combattre les infections et les virus, comme le Coronavirus. Il est important de suivre avec diligence les recommandations de l'Organisation mondiale de la santé ci-dessus pour réduire le risque de contracter le COVID-19. Si vous avez des inquiétudes quant à votre risque, il est préférable de contacter votre médecin ou votre équipe de soins.
Y a-t-il des changements en ce qui concerne mes visites médicales liées au cancer ? Chaque patient et chaque plan de traitement étant uniques, il est toujours préférable de contacter votre prestataire de soins de santé pour obtenir des informations actualisées sur votre plan de traitement. Dans certains cas, il est possible de retarder le traitement du cancer jusqu'à ce que le risque de pandémie ait diminué. Dans d'autres cas, il peut être sûr de se rendre dans une clinique distincte de celle où sont traités les patients COVID-19. Les options de traitement oral pourraient être prescrites par votre prestataire de soins de manière virtuelle, sans qu'il soit nécessaire de se rendre à la clinique. Enfin, certains rendez-vous ou discussions de suivi pourraient être organisés virtuellement (via skype ou zoom par exemple) ou par téléphone pour minimiser votre risque. Comme nous le savons, les conditions et les protocoles changent quotidiennement en raison de la nature de l'épidémie de COVID-19 et varient en fonction du lieu, par conséquent, la meilleure première étape consiste à demander conseil à votre prestataire de soins.
https://www.cancer.gov/contact/emergencypreparedness/coronavirus
Si vous souhaitez contacter votre agence locale de santé publique, veuillez voir ci-dessous.
Alberta
Informations COVID-19 pour Alberta
Les médias sociaux : Instagram @albertahealthservices, Facebook @albertahealthservices, Twitter @GoAHealth
Numéro de téléphone : 811
Colombie-Britannique
Informations COVID-19 pour Colombie-Britannique
Les médias sociaux : Facebook @ImmunizeBC, Twitter @CDCofBC
Numéro de téléphone : 811
Manitoba
Informations COVID-19 pour Manitoba
Les médias sociaux : Facebook @manitobagovernment, Twitter @mbgov
Numéro de téléphone : 1-888-315-9257
Nouveau Brunswick
Informations COVID-19 pour Nouveau-Brunswick
Les médias sociaux : Facebook @GovNB, Twitter @Gov_NB, Instagram @gnbca
Numéro de téléphone : 811
Terre-Neuve et Labrador
Informations COVID-19 pour Terre-Neuve-et-Labrador
Les médias sociaux : Facebook @GovNL, Twitter @GovNL, Instagram @govnlsocial
Numéro de téléphone : 811 ou 1-888-709-2929
Territoires du Nord-Ouest
Informations COVID-19 pour Territoires du Nord-Ouest
Les médias sociaux : Facebook @NTHSSA
Numéro de téléphone : 811
Nouvelle-Écosse
Informations COVID-19 pour Nouvelle-Écosse
Les médias sociaux : Facebook @NovaScotiaHealthAuthority , Twitter @healthns, Instagram @novascotiahealthauthority
Numéro de téléphone : 811
Nunavut
Informations COVID-19 pour Nunavut
Les médias sociaux : Facebook @GovofNunavut , Twitter @GovofNunavut, Instagram @gouvernement du Nunavut
Numéro de téléphone : 1-888-975-8601
Ontario
Informations COVID-19 pour Ontario
Les médias sociaux : Facebook @ONThealth, Twitter @ONThealth , Instagram @ongov
Numéro de téléphone : 1-866-797-0000
Île-du-Prince-Édouard
Informations COVID-19 pour Île-du-Prince-Édouard
Social media: Facebook @GovPe, Twitter @InfoPEI, 16
Québec
Informations COVID-19 pour Québec
Les médias sociaux : Facebook @GouvQc, Twitter @sante_qc
Numéro de téléphone : 1-877-644-4545
Saskatchewan
Informations COVID-19 pour Saskatchewan
Les médias sociaux : Facebook @SKGov, Twitter @SKGov
Numéro de téléphone : 811
Yukon
Informations COVID-19 pour Yukon
Les médias sociaux : Facebook @yukonhss, Twitter @hssyukon
Numéro de téléphone : 811
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