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Health News

Study reveals how patients’ smoking history changes evolution of lung cancer (EMBARGOED)

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Study reveals how patients’ smoking history changes evolution of lung cancer (EMBARGOED)

Understanding the differences in the evolution of lung cancer between smokers and non-smokers could be the key to unlocking new treatments.

Researchers evaluated lung cancer progression in smokers, compared with people who had never smoked, and found substantial changes in the way the body responds.

The study helps explain why immunotherapy isn’t always effective in treating the disease.

At a glance

  • Researchers observed very different inflammatory environments in the lungs of smokers compared to those who had never smoked.
  •  A specific subset of T cells, called TRM, were highly enriched in smoker lungs, forcing any arising tumours to evolve and evade immunotherapy.
  • The results highlight the importance of tailoring treatment for lung cancer patients, depending on their smoking history.

Of the 13,000 Australians diagnosed with lung cancer every year, 10% of men and 35% of women have no history of smoking.

The new research, published in Cancer Cell, was co-led by WEHI Associate Professor Marie-Liesse Asselin-Labat and Professor Daniel Gray.

Associate Professor Asselin-Labat said differences in the immune reactions between smokers and non-smokers may explain why only 20% of patients with lung cancer responded to immunotherapy treatment.

“It shows that we need to take a different approach to treating smoker and non-smoker patients with lung cancer,”she said.

“In smokers, we need to make the tumours visible to the immune system for immunotherapy to be effective, whereas in non-smoker patients we need to activate a dormant immune system to enable it to fight the tumour.”

Professor Gray said the research teams had made interesting observations about the environment in which tumours grow and the difference in disease progression between smokers and non-smokers.

“There’s a very different inflammatory environment in the lungs of smokers compared to those who had never smoked,” he said.

“We found a specific subset of T cells, called TRM, that are highly enriched in smokers. In these patients, the TRM apply pressure on the tumour to evade the body’s immune response.

“Immunotherapy is less effective against tumours that acquire this property.”

Identifying new targets for lung cancer treatment

 Researchers are now keen to investigate ways of increasing the visibility of the tumour cells to the immune system in lung cancer patients who have been smokers.

“We are using genomic screening to look for epigenetic silencing that might occur so we can then focus on those targets,” Associate Professor Asselin-Labat said.

“This is the first step in developing precision, tailored therapies for specific patients depending on their smoking history.”

Another of the study’s lead researchers, Dr Clare Weeden, said lung cancer did not only affect smokers, and understanding the differences in tumour evolution was vital to improving treatment.

“Our work shows the importance of the environment a tumour develops in. If we can understand the nature of the pre-existing tissue, we can better work out how tumours evolve over time and develop precision therapy for individuals based on their smoking history,” she said.

The research was a collaboration between WEHI, the Peter Doherty Institute for Infection and Immunity, the Royal Melbourne Hospital, the University of Melbourne, Austin Health and the Francis Crick Institute in London.

The research was supported by funding from the National Health and Medical Research Council, Australian Cancer Research Foundation (ACRF), the Lung Foundation Australia, Cure Cancer/Cancer Australia, the Harry Secomb Trust, the Jenny Tatchell Fund and the Victorian Cancer Agency

The study, ‘Early immune pressure initiated by tissue-resident memory T cells sculpts tumor evolution in non-small cell lung cancer’, is published in Cancer Cell (DOI: 10.1016/j.ccell.2023.03.019).

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Vape Laws Spark Opposition

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Vape Laws Spark Opposition

 

Queuing at local pharmacies is expected to become longer and more complex due to new laws permitting pharmacies to sell e-cigarettes, commonly known as vapes.

As of 1 July, pharmacies are the sole legal dispensers of nicotine-containing vapes. Initially, customers will need a prescription to purchase these products, but starting 1 October, adults will be able to buy them after a consultation with the pharmacist.

However, the new legislation has sparked significant opposition from many pharmacy chains and independent chemists. The Pharmacy Guild of Australia has strongly criticised the move, describing the expectation for pharmacists to retail vapes as “insulting.”

“Pharmacists are healthcare professionals, and community pharmacies do not want to supply this potentially harmful, highly addictive product without a prescription,” stated Anthony Tassone, the guild’s national vice-president. Tassone also emphasised that vaping products have not been approved by the Therapeutic Goods Administration (TGA) and no nicotine-containing vape is listed on the Australian Register of Therapeutic Goods.

The controversial laws were passed by Parliament following a compromise between Labor and the Greens. Beginning 1 October, pharmacists who opt to sell vapes will be able to provide them to customers aged 18 or over with proper ID but without requiring a prescription, as nicotine vapes will be reclassified from schedule 4 to schedule 3 of the poison’s standard. However, individuals under 18 will still need a prescription to purchase nicotine vapes.

The intent behind the new laws is to regulate the sale of nicotine vapes more strictly while making them accessible for adults who choose to use them. Despite this, the Pharmacy Guild remains critical, highlighting the health risks associated with vaping and the added responsibility placed on pharmacists to manage these products safely.

As the implementation date approaches, the debate within the healthcare community and among the public is likely to intensify, raising questions about the balance between accessibility and safety in the regulation of nicotine vapes.

 

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Onsite Pharmacists – Just What the Doctor Ordered

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Onsite Pharmacists – Just What the Doctor Ordered

 

The Aged Care Onsite Pharmacist (ACOP) program aims to revolutionise medication delivery in residential facilities by placing trained professionals directly on-site.

Addressing Medication Mismanagement

The mismanagement of medications, inconsistent safety procedures, and low vaccination rates in aged care homes have long been controversial. Health authorities are urging providers to increase vaccine rates, as the lives of residents and communities are at risk. Despite these pleas, the Royal Australian College of General Practitioners reported that 97 aged care facilities had COVID-19 vaccination rates below 10%. Additionally, 706 facilities reported less than 50% of their residents vaccinated against COVID, with the lowest coverage in various states including New South Wales, Queensland, South Australia, Tasmania, Victoria, and Western Australia.

The Role of Onsite Pharmacists

The Aged Care Royal Commission identified medication delivery as a crucial area for improvement in aged care homes, recommending the employment of allied health practitioners, including pharmacists. Responding to this, the Federal Government has allocated $333.7 million to fund the ACOP program. This initiative enables residential aged care providers to engage pharmacists through local pharmacies or direct employment. These pharmacists will deliver personalised medications, manage frequent medication reviews, and administer antipsychotic drugs and vaccinations.

Goals of the ACOP Program

The ACOP aims to:

  • Improve medication use and safety in aged care homes, particularly the use of high-risk medications.
  • Ensure continuity in medication management through regular reviews and prompt issue resolution.
  • Provide easy access to pharmaceutical advice for residents and staff.
  • Integrate on-site pharmacists with the healthcare team, including local GPs, nurses, and community pharmacies.
  • Enhance understanding and response to individual resident needs.

Support from the Pharmacy Guild of Australia

The initiative has garnered support from the Pharmacy Guild of Australia, recognising the potential to elevate the role of pharmacies. This program enables pharmacists not only to deliver medications and dose administration aids but also to provide quality use of medicines within the facility. A Pharmacy Guild spokesperson highlighted the additional services pharmacists can offer, such as vaccinations, as they begin to practice to their full scope. This will create further opportunities for community pharmacies to become significant providers of healthcare services to aged care facilities.

Funding Model

The ACOP funding model is divided into two tiers:

  • Tier 1: Community pharmacies receive payments to engage with specific residential aged care facilities.
  • Tier 2: Residential aged care facilities can claim up to $138,282 per year for the full-time equivalent employment of an on-site pharmacist.

This government-funded initiative promises to improve medication management and overall healthcare in aged care facilities, ensuring better health outcomes for residents.

 

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Foods That Can Help Reduce or Prevent Joint Pain

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Minimally processed, whole foods That Can Help Reduce or Prevent Joint Pain
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Foods That Can Help Reduce or Prevent Joint Pain

 

Minimally processed, whole foods — including brightly coloured fruits and vegetables, healthy fats, and lean proteins — may help relieve inflammation and other symptoms that lead to joint pain. Inflammation is a common cause of joint pain, often associated with arthritis and other joint conditions. Eating foods that help reduce inflammation may improve joint pain and offer additional health benefits, such as improved heart health.

Can Diet Help Reduce Joint Pain?

Research indicates that diet can significantly impact joint health. A survey of 217 people with rheumatoid arthritis (RA) found that 24% reported their diet affected their symptoms. A 2023 study on osteoarthritis supports the idea that certain diet patterns can improve joint symptoms. Diets high in nuts, legumes, fruits, vegetables, and seafood, which contain anti-inflammatory properties like antioxidants and phytochemicals, may help reduce joint pain.

Beneficial Foods for Joint Pain

Incorporating anti-inflammatory foods into your diet can help reduce joint pain and slow disease activity. Beneficial foods include:

  • Nuts: Rich in healthy fats and antioxidants.
  • Legumes: High in fibre and protein, reducing inflammation.
  • Fruits and Vegetables: Packed with vitamins, minerals, and antioxidants.
  • Seafood: Especially fatty fish like salmon and mackerel, high in omega-3 fatty acids.

Foods to Avoid

To manage joint pain, limit or avoid processed foods, trans fats, and added sugars. A nutrient-rich diet can also help maintain a moderate weight, reducing strain on the joints.

Popular Diets for Joint Pain

The Mediterranean Diet

Emphasises fruits, vegetables, whole grains, legumes, and healthy fats, with moderate seafood and poultry, and limited dairy and red meat. Associated with reduced inflammation and improved joint health.

The DASH Diet

Includes fruits, vegetables, fish, poultry, nuts, whole grains, and low-fat dairy while restricting salt, sugar, fats, and red meat. May help improve and reduce the risk of gout, a type of arthritis that causes joint pain.

Conclusion

Incorporating a variety of nutrient-rich, anti-inflammatory foods into your diet can help manage and prevent joint pain. Following dietary patterns like the Mediterranean or DASH diets may offer comprehensive benefits for joint health and overall well-being.

 

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