Notch signaling pathway in cancer: from mechanistic insights to targeted therapies

-



tnm rectal cancer :: Article Creator

Patient With Stage 4 Colon Cancer Receives A Double-lung Transplant At Northwestern, Becomes 'part Of Medical History'

After her colon cancer came back, Mandy Wilk had few options left to stay alive.

The disease had already spread to her liver when she was diagnosed with Stage 4 colorectal cancer in 2017. She tried every available treatment. But after receiving a liver transplant from her younger brother in 2020, the cancer still came back six months later, this time spreading to her lungs.

At that point, "I traveled to almost every major health system across the country, and they all told me there was nothing more they could do," Wilk told reporters during a news conference Wednesday at Northwestern Medicine Prentice Women's Hospital.

That's when the 42-year-old learned about Northwestern's Double Lung Replacement and Multidisciplinary Care program, also called DREAM. The initiative is the only one in the country that offers lung transplants to cancer patients who have run out of treatment options, according to Northwestern Medicine.

Wilk got a new set of lungs June 3 at Northwestern, a first for the hospital and likely the first in the world.

"Mandy's determination has no limits," said Dr. Catherine Myers, one of Wilk's doctors and a lung transplant pulmonologist at Northwestern. "When other hospitals told her there was nothing more that they could do, she really didn't take 'no' for an answer. Instead, she became part of medical history."

Colorectal cancer is the third most common cancer diagnosed in both men and women. Increasingly, patients younger than 50 are being diagnosed with the disease. When colorectal cancer metastasizes, it typically spreads to the liver or the lungs. Cancers that start in or spread to the lungs are the culprit for most cancer-related deaths in the U.S.

Mandy Wilk, a double lung transplant patient listens as Dr. Ankit Bharat, chief of thoracic surgery and director of Northwestern Medicine Canning Thoracic Institute speaks to reporters at Northwestern Medicine Prentice Women's Hospital, Wednesday, Sept. 25, 2024.

Mandy Wilk listens as Dr. Ankit Bharat, chief of thoracic surgery and director of Northwestern Medicine Canning Thoracic Institute, speaks to reporters on Wednesday at Northwestern Medicine Prentice Women's Hospital.

Tyler Pasciak LaRiviere/Sun-Times

Wilk has no signs of cancer in her body and has not needed further cancer treatments. An avid runner, she recently got the go-ahead from her pulmonologist to start running again.

"There isn't another hospital that would have given me an opportunity like this," Wilk said.

"During the surgery, we were able to meticulously remove the cancer-ridden lungs without allowing any cancerous cells to spill into her bloodstream and then put the brand-new lungs in," said Dr. Ankit Bharat, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute.

"I do want to express cautious optimism," Bharat said, adding that Wilk will continue to be closely monitored to determine the long-term impacts of her surgery. "But it does certainly give hope to many patients who don't have any other options."

Wilk has connections to Chicago. She grew up in north suburban Lake Zurich, and her husband is a television producer for the White Sox. Wilk works as an elementary curriculum and instruction specialist. The couple splits their time between Chicago and Minnesota.

Her goal is to eventually complete the Chicago Marathon with her new pair of lungs.

Terrance Jones local artist and administrative assistant with the pulmonology team at Northwestern Medicine hugs Mandy Wilk, a lung transplant patient after unveiling and gifting a piece of art to her during a press conference at Northwestern Medicine Prentice Women's Hospital, Wednesday, Sept. 25, 2024.

Terrance Jones, local artist and administrative assistant with the pulmonology team at Northwestern Medicine, hugs Mandy Wilk after unveiling and gifting a piece of art to her Wednesday during a press conference at Northwestern Medicine Prentice Women's Hospital.

Tyler Pasciak LaRiviere/Sun-Times


Association Between Pathological T1 Colorectal Cancer With Lymphoid Follicular Replacement And Risk Of Lymph Node Metastasis.

Endoscopic resection (ER) is widely performed to treat early colorectal cancer. However, additional surgery for pathological T1 colorectal cancer (pT1CRC) after ER is controversial because of the imprecise prediction of lymph node metastasis (LNM). Recently, several patients of pT1CRC with lymphoid follicular replacement (LFR) without LNM have been reported. This study aimed to investigate the clinicopathological features and risk of LNM in patients with pT1CRC with LFR.We retrospectively analyzed patients who underwent ER or surgical resection and were diagnosed with pT1CRC between January 2010 and December 2020. We defined pT1CRC with LFR as the replacement of a part of the lymphoid follicular component within the submucosal area by adenocarcinoma, with no invasion into other submucosal areas.Among the 600 eligible patients, the incidence rate of pT1CRC with LFR was 6.7% (40/600). Patients with pT1CRC with LFR represented 14.3% (37/258) of the endoscopically treated patients and 0.9% (3/342) of the surgically treated patients. For patients with pT1CRC with LFR, 80.0% (32/40) had flat and depressed lesions, and 35.0% (14/40) had submucosal invasion depth ≥1000 μm. Patients with pT1CRC with LFR had negative lymphovascular invasion, differentiated type, and budding grade 1. In the median follow-up of 61 months, patients with pT1CRC with LFR had no LNM.The presence of LFR in pT1CRC may be associated with a low risk of LNM. In patients with pT1CRC with LFR, follow-up without additional surgery is possible even if the submucosal invasion depth is ≥1000 μm.

© 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.


Restaging MRI Helps Predict Outcomes In Rectal Cancer Treatment

A NEW study highlights the crucial role of MRI in predicting key oncologic outcomes, such as organ preservation and survival, in patients with locally advanced rectal cancer treated with total neoadjuvant therapy (TNT).

The research, a secondary analysis of the Organ Preservation in Rectal Adenocarcinoma (OPRA) trial, evaluated the ability of restaging MRI to predict residual disease and stratify patients into clinical response categories.

The study included 277 participants, with a median age of 58 years, diagnosed with Stage II or III rectal adenocarcinoma from April 2014–March 2020. After receiving TNT, participants underwent restaging MRI approximately 8 weeks after treatment, where radiologists classified them into three clinical response categories: complete, near-complete, and incomplete.

Patients with a complete clinical response demonstrated significantly higher rates of organ preservation compared to those with near-complete response (65.3% versus 41.6%, P<0.001). Additionally, 5-year disease-free survival rates were 81.8% for patients with complete response, 67.6% for patients with near-complete response, and 49.6% for patients with incomplete response (P<0.001). Overall survival, distant recurrence-free survival, and local regrowth rates were also significantly linked to MRI response categories.

The study also identified specific imaging features associated with residual disease. Among 266 participants with at least 2 years of follow-up, 48.5% experienced residual disease. Restricted diffusion on MRI scans (odds ratio: 2.50) and abnormal nodal morphologic features (odds ratio: 5.04) were independently associated with a higher likelihood of residual tumours.

Overall, MRI response category was predictive of organ preservation and survival, highlighting the importance of restaging MRI in guiding treatment decisions and predicting long-term outcomes in patients with rectal cancer.

Ada Enesco, EMJ

Reference

Williams H et al. MRI predicts residual disease and outcomes in watch-and-wait patients with rectal cancer. Radiology. 2024;312(3):e232748.





Comments

Post a Comment

Popular posts from this blog

Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic ...

-
Image
stage 3 lung cancer spread to brain :: Article Creator Tracking Lung Cancer's Path It's common for lung cancer to metastasize, or spread. In fact, 57 percent of lung cancer patients are diagnosed when the cancer has already metastasized, according to an editorial in the Annals of Cancer Epidemiology. [1] Lung cancer also has a preferred path, traveling most often to the bones, brain, adrenal glands, and liver. [2] [3] Why Does Lung Cancer Spread So Easily? Lung cancer may metastasize readily because the lungs are a cellular traffic hub of the body. "The job of the airway is to deliver oxygen to all of your cells, so it's easy for cancer cells to get from the airway lining to the blood and spread to other organs," says Paul Bunn, MD, a professor of medical oncology at the University of Colorado School of Medicine in Aurora. Why Do Lung Cancer Cells Spread to Certain Organs? "Some organs produce a cellular si...
Read more

Respirology | APSR Respiratory Medicine Journal

-
Image
stage 3 pancreatic cancer :: Article Creator Know The Symptoms: Pancreatic Cancer This year, approximately 1,000 Alabama residents will be diagnosed with pancreatic cancer. With a trending increase in cases for patients under the age of 55, experts at the University of Alabama at Birmingham Department of Surgery say it is important for individuals to familiarize themselves with common signs and symptoms associated with pancreatic cancer to reduce their risk and identify key indicators of the disease. "Pancreatic cancer is known for its reputation of being harder to detect in its earliest stages," said J. Bart Rose, M.D., an associate professor in the UAB Division of Surgical Oncology. "Fortunately, there are still several ways you can reduce your chances of pancreatic-related illness and monitor your overall well-being for any sudden changes." Lifestyle changesThe pancreas is a vital organ to both the endocrine and digestive ...
Read more

Free biotech stocks directory, pharma stocks, telemedicine stocks ...

-
Image
stage 4 cervical cancer :: Article Creator Uterine Cancer Stages If you get a diagnosis of uterine cancer, your doctor may tell you what stage it is. It's a way to figure out how advanced your cancer is and what kind of treatment works best. Before your doctor decides your stage, they'll use tests, such as a biopsy and ultrasound, to find what type of uterine cancer you have. Also called the womb, the uterus is a pear-shaped organ where babies grow. There are two kinds of uterine cancer. Endometrial cancer, the most common form, begins in the inner lining of the uterus. Uterine sarcoma is a rare type that starts in the muscles in the uterus or the surrounding tissue. Doctors use two ways to decide the stage of uterine cancer. One is a method created by the International Federation of Gynecology and Obstetrics (FIGO). The other is the American Joint Committee of Cancer TNM staging system. The two methods are almost the same. Both sy...
Read more