With the onset of the COVID-19 pandemic last year and now its resurgence in the second wave we have been left unprepared in true sense to fight this biggest threat to human race in recent times. There are different aspects that need to be seen which in general can help us understand and plan better for future as this disease is here to stay and may not be gone so soon.
Issues with COVID Pandemic
COVID infection has posed a recent threat to mankind especially considering its intensity of spread and also severity and increased mortality in cases with comorbidities or older age. The best of the countries too have failed in providing adequate attention to ailing cases because of a simple reason of sudden rise in total number of cases in society surpassing limits that healthcare infrastructure can accommodate at any given time. Secondly, being totally new viral disease, assured and complete treatment and prevention will take time to develop by researchers. So to limit the spread and halt the rate of spread is the best way forward as of date.
COVID and Cancer
In the last one year, we have seen COVID infecting mostly older age group, but now even the young and children are getting infected in the second wave probably due to the new mutant variant. Although complications can arise in almost any case, mostly people with co-morbidities and immune-compromised state have been found to be infected earlier and also have more complicated clinical course with mortalities. Cancer being a known immuno-compromised state thus poses a risk factor. Moreover, issue with cancer is unawareness, late presentation and lack of timely treatment which has made cancer as one of the most dreaded diseases. With COVID scare in public - restrictions due to lockdown and prevention protocols, it has posed as a major roadblock in active management in needy cancer patients. This has left common public and also the care giver confused about the right approach in cancer care in this pandemic era.
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Effect of Covid on Cancer Management
Cancer is a disease that is known of stage progression if left untreated. Also, cure from cancer treatment largely depends on the stage that the patient presents. Thus cancer is a disease where we cannot hold treatment fearing a possible infection which may or may not affect the individual depending on exposure risk and on the contrary may also not be symptomatic or life threating even if infected, in all cases. At the same time in an already infected case, individual's capacity to fight infection in immune-compromised state created with cancer therapy and the risk of cancer progression outcome on survival if treatment delayed , is something that has to be weighed with caution.
Effect on Infrastructure and Care Givers
Apart from effect of COVID on individuals, the effect on infrastructure and care givers also decides the management in cancer cases. With sudden rise of Covid cases, as per government policies a big share of infrastructure (beds, ICUs, oxygen, medications, staff) is being diverted to COVID emergencies, which is logical too. However, this poses a serious threat to our capabilities of providing adequate care to non Covid oncological emergencies and timely intervention in needy patients. Although the priority between a COVID or an oncological malignancy is something that cannot be decided so easily, at least treatment related known morbidities and emergencies in cancer cases ï¿½is something that really needs to be looked into.
Lessons Learnt and Precautions for Future
To summarise, it should be known that COVID is here to stay. State, care givers and individuals in public have their own important role to play. First and the foremost role is of an individual to take all steps to avoid spread of Covid infection by social distancing, face masks and frequent hand-washing. Specific to cancer patients do understand that cancer growth will not stop so we cannot neglect this disease, be it a pandemic or no pandemic. Timely detection of symptoms, consultation by specialists be it physical with all Covid precautions or better by a virtual mode can atleast help detect urgency, stage and then prioritize treatment to see if it can be delayed or needs urgent start. Once diagnosed, care givers take all due precaution to decide appropriate treatments where routine management can be slightly modified with non invasive and less toxic therapies given priority.
Truncated iso-effective therapies needing lesser visits and monitoring if possible are preferred. More emphasis of preparing the patient for treatment with adequate nutrition, timely immunization prevention and preventive treatments to spare cases landing into severe treatment related complications and admission are advocated. Understanding limited resources especially as seen in this second wave, it will be prudent to choose alternatives where chances of medical emergencies and need of special care like oxygen and ICUs are reduced as far as possible.
Lastly there is a huge demand and need for the authorities from state health departments to understand the ardent need of expansion of our health care system, timely pre-planning of improving infrastructure and establish disaster management protocols where we are well prepared to fight such unpredicted emergencies and we have ample preparedness to support our ailing population in the time of need and none of them suffer due to lack of healthcare facilities at least. It's a ongoing battle, which we sure are going to win with patience, understanding, cooperation and collaboration.
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New Delhi, June 14 (IANS) The Union Ministry of Science & Technology said on Monday that a study conducted by Indian scientists have recently found that cancer-causing Epstein-Barr Virus (EBV) affects the glial cells or the non-neural cells in the central nervous system (CNS) and alters molecules like phospho-inositols (PIP) when the virus infects the brain cells.
The findings could pave the way towards understanding the probable role of the virus in neurodegenerative pathologies, especially given the fact that the virus has been detected in the brain tissue of the patients suffering from neurological disorders such as Alzheimer's, Parkinson's disease and multiple Sclerosis.
The EBV can cause cancers like nasopharyngeal carcinoma (a type of head and neck cancer), B-cell (a type of white blood cells) cancer, stomach cancer, Burkett's lymphoma, Hodgkin's lymphoma, post-transplant lymphoid disorders, and so on.
However, the infection is mostly asymptomatic, and very little is known about the factors which trigger the development of such a disease. It was the detection of the virus in patients with neurodegenerative diseases that triggered the search for the mechanism of propagation of the virus.
Scientists' teams from the Departments of Physics nd Biosciences and Biomedical Engineering at IIT Indore along with their collaborator, Fouzia Siraj, at the National Institute of Pathology (ICMR), New Delhi, used the Raman Spectroscopy System supported by the Fund for Improvement of S&T Infrastructure (FIST), a scheme of the Department of Science and Technology, to trace the propagation mechanism of the virus.
The study, based on spatial and temporal changes in the Raman signal, was helpful in advancing the application of Raman Scattering as a technique for rapid and non-invasive detection of virus infection in clinical settings.
New Delhi, June 14 (IANS) The Union Ministry of Science & Technology said on Monday that a study conducted by Indian scientists have recently found that cancer-causing Epstein-Barr Virus (EBV) affects the glial cells or the non-neural cells in the central nervous system (CNS) and alters molecules like phospho-inositols (PIP) when the virus infects the brain cells.The findings could pave the way towards understanding the probable role of the virus in neurodegenerative pathologies, especially given the fact that the virus has been detected in the brain tissue of the patients suffering from neurological disorders such as Alzheimer's, Parkinson's disease and multiple Sclerosis.The EBV can cause cancers like nasopharyngeal carcinoma (a type of head and neck cancer), B-cell (a type of white blood cells) cancer, stomach cancer, Burkett's lymphoma, Hodgkin's lymphoma, post-transplant lymphoid disorders, and so on. However, the infection is mostly asymptomatic, and very little is known about the factors which trigger the development of such a disease. It was the detection of the virus in patients with neurodegenerative diseases that triggered the search for the mechanism of propagation of the virus.Scientists' teams from the Departments of Physics nd Biosciences and Biomedical Engineering at IIT Indore along with their collaborator, Fouzia Siraj, at the National Institute of Pathology (ICMR), New Delhi, used the Raman Spectroscopy System supported by the Fund for Improvement of S&T Infrastructure (FIST), a scheme of the Department of Science and Technology, to trace the propagation mechanism of the virus.The study, based on spatial and temporal changes in the Raman signal, was helpful in advancing the application of Raman Scattering as a technique for rapid and non-invasive detection of virus infection in clinical settings.--IANSmiz/arm
New Delhi, June 8 (IANS) The Chimeric Antigen Receptor T-cell (CAR-T) therapy has emerged as a breakthrough in cancer treatment. Clinical trials conducted globally have shown promising results in end stage patients, especially in patients suffering from Acute Lymphocytic Leukemia -- a type of blood and bone marrow cancer in children.The development of CAR-T cell technology for diseases including acute lymphocytic leukemia, multiple myeloma, glioblastoma, hepatocellular carcinoma and type-2 diabetes.On June 4, TMH, IIT Bombay team and cancer care in India as the first CAR-T cell therapy (a type of gene therapy) was done at the Bone Marrow Transplant unit at ACTREC, Tata Memorial Centre in Mumbai. The CAR-T cells were designed and manufactured at Bioscience and Bioengineering (BSBE) department of IIT Bombay.This work is partly supported by BIRAC-PACE scheme. The TMC-IIT Bombay team are further supported to extend this project for conducting Phase I/II trial of their CAR-T product by DBT/BIRAC, through National Biopharma Mission.Department of Biotechnology has supported First CAR-T cell therapy conducted at ACTREC, Tata Hospital in Mumbai.This is a "first in India" gene therapy in early phase pilot clinical trial and the dedicated efforts and excellent collaboration between IIT Bombay and Tata Memorial Hospital, Mumbai. The Central government's National Biopharma Mission-BIRAC has approved Rs 19.15 crore to the team for conducting a first-in-human phase-1/2 clinical trial of the CAR-T cells.The clinical trials are being done by Gaurav Narula, Professor of Paediatric Oncology and Health Sciences, and his team from TMC, Mumbai, and the novel CAR-T cells that will act as drugs that were manufactured by Prof. Rahul Purwar, Bioscience and Bioengineering (BSBE) department and his team at IIT Bombay. The design, development, and extensive pre-clinical testing was carried out by IIT-B as a collaborative project with Tata Memorial Centre, Mumbai by the two Investigators.IIT-B director Subhasis Chaudhuri said this was a significant feat for the institute as well as the country. "We at IIT-B are delighted that our scientists along with Tata Memorial Hospital have come out with the most sophisticated therapy in cancer treatment. If the trials are successful, it may save millions of lives by making the treatment available in India at an affordable cost. It is a research of IIT-B that is expected to touch the lives of all," said Chaudhuri.National Biopharma Mission is also supporting the development of Lentiviral vector manufacturing facility for packaging plasmids used to transfer the modified T cell inside the body, cGMP facility for T-cell transduction and expansion for CAR T-cell manufacturing to two other organisations.Though this technology has a remarkable therapeutic potential for cancer patients, at present this technology is not available in India. Each patient's CAR-T cell therapy costs 3-4 crore (INR). The challenge therefore is to develop this technology in cost-effective manner and make it available for the patients.The manufacturing complexity is a major reason for the therapy cost. In order to promote and support development of CAR-T cell technology against cancer and other diseases, BIRAC and DBT have taken initiatives and launched specialised calls to invite proposals in the last 2 years.--IANSmiz/pgh
Mumbai, May 29 (IANS) In a unique gesture, the Sir H. N. Reliance Foundation Hospital (HNRFH) will provide free vaccination to the families of children undergoing cancer treatment at the hospital, an official spokesperson said here on Saturday.For this, the HNRFH has tied up with Access Life Assistance Foundation, an NGO that provides multi-disciplinary supportive care to families of cancer-afflicted children who come to Mumbai for treatment.The NGO also runs five childhood cancer care centres in Mumbai which accommodate at least 60 families of children suffering from cancers at any given time.The children face the harsh realities of life but still venture out regularly encountering risks for their chemotherapy and other follow-up cancer treatment.They are accompanied by their family members to the hospital for the ongoing treatment and are at risk of contracting the Covid-19 virus whenever they step outside.Accordingly, the families of all such cancer-hit kids shall be given free Covid-19 vaccination jabs to ensure their safety, said the HNRFH official. --IANS qn/ash
New York, May 28 (IANS) Antibodies aren't the only immune cells needed to fight off Covid-19, T cells are equally important and can step up to do the job when antibodies are depleted, suggests a new study of blood cancer patients with coronavirus.Researchers at the University of Pennsylvania, US, found that blood cancer patients with Covid-19 who had higher CD8 T cells, many of whom had depleted antibodies from cancer treatments, were more than three times more likely to survive than patients with lower levels of CD8 T cells."It's clear T cells are critical in terms of the early infection and to help control the virus, but we also showed that they can compensate for B cell and antibody responses, which blood cancer patients are likely missing because of the drugs," said Alexander C. Huang, Assistant Professor of Hematology-Oncology at the varsity's Perelman School of Medicine."This is important when we think about how to improve the care of cancer patients with Covid. We need to maximise all the arms of the immune system, especially if we know that one particular arm of the immune system is down," Huang added.Additionally, because the current Covid-19 mRNA vaccinations induce both antibody and T cell responses, the findings, published in Nature Medicine, suggest that vaccination of blood cancer patients could provide protection through T cell immunity, despite the absence of antibodies.The team found that patients with blood cancer were more likely to die from Covid-19 than patients with solid tumours or without cancer.Further, immune profiling of 214 patient blood samples revealed that patients with blood cancers, in particular patients treated with anti-CD20 antibodies, had decreased B cells and antibodies compared to patients with solid cancers and patients without cancer.Additional analyses also revealed that among patients with blood cancers, including patients treated with chemotherapy and anti-CD20 antibodies, those with higher CD8 T cell counts had a 3.6 fold greater likelihood of survival compared to those with lower counts.Thus, the researchers concluded, CD8 T cells may influence recovery from Covid-19 when B cells and antibodies are deficient.--IANSrvt/vd