A chemotherapy alternative called immunotherapy is showing promise in treating cancer — and a new artificial intelligence tool could help ensure that patients have the best possible experience.

Immunotherapy, first approved in 2011, uses the cancer patient’s own immune system to target and fight cancer. 

While it doesn’t work for everyone, for the 15% to 20% who do see results, it can be life-saving.

WHAT IS ARTIFICIAL INTELLIGENCE (AI)?

Like any medication, immunotherapy has the potential for adverse side effects — which can be severe for some. 

Studies show that some 10% to 15% of patients develop "significant toxicities."

Headquartered in Chicago, GE HealthCare — working in tandem with Vanderbilt University Medical Center (VUMC) in Nashville, Tennessee — has created an AI model that's designed to help remove some of the uncertainties surrounding immunotherapy.

Over the five years it’s been in development, the AI model was trained on thousands of patients’ electronic health records (EHRs) to recognize patterns in how they responded to immunotherapy, focusing on safety and effectiveness.

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"The model predicts which patients are likely to derive the benefit from immunotherapy versus those patients who may not," said Jan Wolber, global digital product leader at GE HealthCare’s pharmaceutical diagnostics segment, in an interview with Fox News Digital.

"It also predicts which patients have a likelihood of developing one or more significant toxicities."

When pulling data from the patient’s health record, the model looks at demographic information, preexisting diagnoses, lifestyle habits (such as smoking), medication history and more.

"All of these data are already being collected by the patient’s oncologist, or they’re filling out a form in the waiting room ahead of time," said Travis Osterman, a medical oncologist and associate chief medical information officer at Vanderbilt University Medical Center, in an interview with Fox News Digital.

(Osterman is working with Wolber on the development of the AI model.)

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"We're not asking for additional blood samples or complex imaging. These are all data points that we're already collecting — vital signs, diagnoses, lab values, those sorts of things."

In a study, the AI model showed 70% to 80% accuracy in predicting patients’ responses to immunotherapies, according to an article published in the Journal of Clinical Oncology Clinical Cancer Informatics.

"While the models are not perfect, this is actually a very good result," Wolber said. "We can implement those models with very little additional effort because there are no additional measurements required in the clinic."

This type of technology is "a natural progression of what we've been doing in medicine for a very long time," Osterman said.

"The only difference is, instead of surveying patients, we're taking the entirety of the medical record and looking for risk factors that contribute to an outcome," he said in an interview with Fox News Digital.

With immunotherapy, there is generally a lower response rate than with chemotherapy, Osterman noted — but some patients have "incredible responses" and ultimately become cancer-free.

"I would be horrified to know that one of my patients that I didn't give immunotherapy to could have been one of the tremendous responders," he told Fox News Digital. 

Conversely, Osterman noted that in rare cases, immunotherapy can have some serious side effects.

"I would say about half of patients don't have any side effects, but for those who do, some of them are really life-altering," he said. 

"We don't want to miss anyone, but we also don't want to harm anyone."

At the core of the AI project, Osterman said, is the ability to "put all the information into the exam room," so the oncologist can counsel the patient about the risks and benefits of this particular therapy and make the best, most informed decision about their care. 

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the AI model’s development but commented on its potential.

"AI models are emerging that are helping to manage responses to cancer treatments," he told Fox News Digital. 

"These can allow for more treatment options and be more predictive of outcome."

AI models like this one are an example of "the essential future of personalized medicine," Siegel said, "where each patient is approached differently and their cancer is analyzed and treated with precision using genetic and protein analysis."

As long as physicians and scientists remain in charge — "not a computer or robot" — Siegel said that "there is no downside."

The AI model does carry some degree of limitations, the experts acknowledged.

"The models obviously do not return 100% accuracy," Wolber told Fox News Digital. "So there are some so-called false positives or false negatives." 

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The tool is not a "black box" that will provide a surefire answer, he noted. Rather, it's a tool that provides data points to the clinician and informs them as they make patient management decisions.

Osterman pointed out that the AI model uses a "relatively small dataset."

"We would love to be able to refine our predictions by learning on bigger data sets," he said.

The team is currently looking for partnerships that will enable them to test the AI model in new settings and achieve even higher accuracy in its predictions. 

Another challenge, Osterman said, is the need to integrate these AI recommendations into the workflow.

"This is pretty new for us as a health care community, and I think we're all going to be wrestling with that question," he said. 

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Looking ahead, once the AI model has achieved the necessary regulatory approvals, GE HealthCare plans to make the technology available for widespread use by clinicians — perhaps even expanding to other care areas, such as neurology or cardiology.

There is also the potential to incorporate it into drug development.

"One of the things that drug makers struggle with is that some of the agents that may be really useful for some patients could be really toxic for others," Osterman said.

"If they were able to pick which patients could go into a trial and exclude patients with the highest risk of toxicity, that could mean the difference between that drug being made available or not."

He added, "If this means that we're able to help tailor that precision risk to patients, I'm in favor of that."

Ultimately, Osterman said, "it's a really exciting time to be in medicine … I think we're going to look back and regard this as the golden age of AI recommendations. I think they're probably here to stay."

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An Air Europa passenger jet — en route from Lima, Peru to Madrid, Spain — made an emergency landing at the Cheddi Jagan International Airport (CJIA) on Monday afternoon because one of the passengers fell ill, officials confirmed. “The aircraft declared a medical emergency on board and as such, an emergency landing was instituted. The airport’s ...

Santo Domingo.- The Dr. Ney Arias Lora Traumatological University Teaching Hospital and the Dominican Medical College (CMD) have filed an Appeal for Constitutional Review against Sentence SCJ-TS-24-0126, issued by the Third Chamber of the Supreme Court of Justice, regarding a case dating back to 2016.

The appeal aims to review the sentence issued by the high court, as the health center was not allowed to present expert evidence, review management protocols, or examine international treatment guidelines for clinical cases, thus impeding its right to defend itself.

In a statement, the health center expressed confidence that the Constitutional Court judges will uphold fundamental rights and ensure fair application of the law for all parties, maintaining the rule of law in the Dominican Republic.

The sentence from the Third Chamber of the Supreme Court of Justice condemns the health center to pay 10 million pesos for the amputation of a patient’s leg, a procedure conducted in 2018 following an admission in 2016.

Dr. Julio Landrón, the hospital’s general director, noted that upon assuming office in August 2020, he inherited several legal challenges stemming from past administrations, including the case of Félix Julián Encarnación. Encarnación was admitted to the hospital in January 2016 following a traffic accident and underwent surgery again in November 2017 for another accident, resulting in the amputation of his leg.

Despite ongoing legal proceedings, Landrón expressed surprise at the timing of the sentence’s issuance, emphasizing the state of the health center inherited from the previous administration. He emphasized the hospital’s commitment to transparency and accountability in addressing legal challenges inherited from past administrations.

View the full post Caribbean Family Planning Affiliation announces new Board of Directors on NOW Grenada.

Barbados has a low immunisation rate making thousands of residents susceptible to many vaccine-preventable diseases, says senior health sister Hazel Forde.

She said this was a major concern, especially in the wake of the island hosting the International Cricket Council Men’s T20 World Cup in June, which is expected to attract more than 20 000 visitors to the island.

She was speaking to Barbados TODAY on Saturday during a health fair and exhibition organised by the Ministry of Health, held at Massy Supermarket in Warrens.

“Herd immunity means that enough people are vaccinated to protect the unvaccinated and the vulnerable — the ones that could not be vaccinated for one reason or another, either because of their age or because of their immune system. For that to occur, you need 95 per cent coverage for most diseases. And based on our current coverage, we are in the high 80s.

“So, we are facing challenges with low immunisation coverage, which means that we are susceptible to vaccine-preventable diseases like measles and whooping cough, things that we thought were gone a long time ago; and they are re-emerging in our tourism source markets — the United States, Canada and Europe. We have the World Cup coming up and we are going to have a lot more tourists, so there is increased risk,” she said, adding that the Ministry of Health was putting measures in place, such as the health fair, to help stave off those vaccine preventable diseases.

At the health fair, interested people also got the opportunity to get their blood sugar and pressure taken and blood work done to test cholesterol levels and kidney and liver health. (Photo by Sheria Brathwaite)

Forde explained that since the advent of COVID-19 there was a surge in the anti-vaccination movement and this was the main reason the island’s immunisation rate was low.

“During COVID-19, we did have a lot of anti-vaccine sentiment and that has transferred from the COVID-19 vaccine to vaccines in general and the childhood vaccines. The anti vaxxers are much more prominent.

They are very vocal, and people, before looking into all the facts, are hooking on to their words. Plus, there’s a lot of distrust as well for health care, so that has contributed to the low coverage.”

At the health fair, there were several adult vaccines on offer such as hepatitis B and the flu shot. All of the children’s vaccines were also available such as measles, mumps and rubella, tetanus and polio.

Interested people also got the opportunity to get their blood sugar and pressure taken and blood work done to test cholesterol levels and kidney and liver health.

There was also a sexual education and reproductive system booth, where men and women got the opportunity to learn more about their reproductive organs and how to practise safe sex. (SZB)

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The Vector Control Unit will focus on the parish of Christ Church when it carries out its fogging exercise this week.

The districts of Maxwell Hill Road, Cane Vale Road, Maxwell Terrace, Maxwell Gardens, Mahogany Gardens, Moravian Gardens, Fair Holmes Gardens, Hythe Gardens, and Ashby Avenue will be fogged on Monday, April 22.

The next day, Tuesday, April 23, the team will spray Graeme Hall Terrace, Graeme Hall Park Road, and Goodwood Drive.

On Wednesday, April 24, St Lawrence Gap, Paradise Village Road, Bath Village Road, Dover Avenues, Dover Gardens, Maxwell Coast Road, Oistins, and surrounding areas will be targeted.

The fogging team will visit Scarborough, Pegwell Road, Church Hill Main Road, Church Road, Evergreen Road, and Windy Ridge on Thursday, April 25.

The fogging exercise for the week will conclude on Friday, April 26, in Windy Ridge, Thornbury Hill, and neighbouring districts.

Fogging takes place from 4:30 to 8:30 p.m. daily. Householders are reminded to open their windows and doors to allow the spray to enter. Children should not be allowed to play in the spray.

Members of the public are advised that the completion of scheduled fogging activities may be affected by events beyond the Unit’s control. In such circumstances, the Unit will return to communities affected in the soonest possible time.

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The Ministry of Health on Saturday denied an allegation by opposition APNU+AFC parliamentarian, Christopher Jones that several nurses of the Campbellville Health Centre fell ill. “At the time of discovery, no staff reported any adverse health effects,” the Health Ministry said in response to Mr Jones’ claim on Facebook that ten nurses from the Campbellville ...

Health officials in the United States have raised alarms about a sharp rise in cases of measles, a highly infectious viral illness that spreads through the air and can cause serious complications or even death. During the first quarter of this year alone, there have already been approximately 30 per cent of the total measles cases reported since 2020. Medical experts view this sudden surge as a significant setback to efforts aimed at eliminating measles from the US.

But in a bid to console residents here, Deputy Chief Medical Officer Dr Arthur Phillips said on Thursday that Barbados has maintained its measles elimination status up to 2023.

“There have been no confirmed cases of measles in Barbados in the 21st century thus far. The last confirmed case of measles in Barbados was in 1991,” Dr Phillips told Barbados TODAY.

“There is an annual verification process to certify the elimination of measles in countries, and this includes the ability of the country to demonstrate that there is a strong epidemiological surveillance system in place, which Barbados has consistently demonstrated.”

Turning his attention to measles prevention, he said Barbados, like other countries, had seen a decline in measles, mumps and rubella (MMR) vaccine coverage in 2020, associated with the COVID-19 pandemic. But he said the trend had rebounded, although not to the ideal levels.

Dr Phillips said: “In 2022 and 2023, there was a steady reversal of the declining trend in coverage. For 2022, the MMR coverage for the first dose was 85 per cent and the MMR coverage for the second dose was 73 per cent. At the end of 2023, the MMR coverage for the first dose was 90 per cent and the MMR coverage for the second dose was 76 per cent,” he revealed. “Two doses of MMR vaccine are needed to ensure maximum protection against measles and overall, the coverage is well below the targeted 95 per cent.”

Dr Phillips explained that one dose of MMR vaccine is 93 per cent effective at preventing measles, and two doses are 97 per cent effective. The MMR vaccine’s first dose is usually administered at age one and the second dose at 18 months.

The senior medical official pointed out that the immunisation programme has historically performed “very well” and has maintained routine vaccination, including MMR vaccine coverage at “reasonably high levels”.

“This success,” Dr Phillips contended, “has led to good population immunity and now unfortunately to some complacency within the population.”

He said that interventions aimed at improving MMR coverage include new and ongoing activities supervised by the Senior Health Sisters in the various polyclinics.

These activities include reviewing vaccine registers to identify children that have defaulted from vaccination so that their parents can be called, and appointments scheduled for vaccination at the polyclinic. They also involve visits to nurseries and daycare facilities by public health nurses to check vaccination cards and alert parents of children who are missing vaccines through written notices. That activity was started in February and is ongoing, Dr Phillips said.

MMR vaccine coverage was also tackled by the opening of several clinics on Saturdays during March and is aimed at continuing throughout the year.

Dr Phillips announced that MMR immunisation was also being taken to the community to vaccinate eligible children who missed their shots in 2020 through 2023.

“This includes introduction of the new mobile bus recently commenced to facilitate the delivery of health interventions more directly within communities around Barbados,” he said.

Barbados will also be taking part in Vaccine Week of the Americas which runs from April 20-27, and features health fairs and exhibitions and open days at polyclinics. The week begins with two health fairs on Saturday the Emerald City Complex, Six Roads St Philip, and Massy Supermarket and Shopping Complex, Warrens, St Michael.

In the US, from 2020 through 2023, there was an average of five measles cases in the first quarter of each year. Those low numbers were due, in part, to the COVID pandemic, when fewer people were interacting in person. By contrast, this year’s first-quarter tally was 97, according to a report the Centers for Disease Control and Prevention released Thursday.

“The rapid increase in the number of reported measles cases during the first quarter of 2024 represents a renewed threat to elimination,” the authors wrote.

Measles has been considered eliminated in the US since 2000, meaning the disease is no longer constantly present, though there are still occasional outbreaks there.

emmanueljoseph@barbadostoday.bb

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Dr Jeremy Farrar, Chief Scientist at the World Health Organization (WHO), said that the avian influenza virus – which is also known as H5N1 – has had an “extremely high” mortality rate among the several hundred people known to have been infected with it to date.

To date, no human-to-human H5N1 transmission has been recorded.

“H5N1 is (an) influenza infection, predominantly started in poultry and ducks and has spread effectively over the course of the last one or two years to become a global zoonotic – animal – pandemic,” he said. 

“The great concern, of course, is that in doing so and infecting ducks and chickens – but now increasingly mammals – that that virus now evolves and develops the ability to infect humans. And then critically, the ability to go from human-to-human transmission.”

Cattle mystery

Commenting on an ongoing outbreak of H5N1 virus among dairy cows in the United States, the WHO senior official urged further close monitoring and investigation by public health authorities, “because it may evolve into transmitting in different ways”.

He added: “Do the milking structures of cows create aerosols? Is it the environment which they’re living in? Is it the transport system that is spreading this around the country? This is a huge concern and I think we have to … make sure that if H5N1 did come across to humans with human-to-human transmission, that we were in a position to immediately respond with access equitably to vaccines, therapeutics and diagnostics.”

SOURCE: United Nations 

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Heart disease is part of a larger grouping called cardiovascular diseases, which include strokes and heart attacks; cardiovascular diseases, cancers and even mental illnesses are normally included in the NCDs.

These NCDs are generally caused by lack of physical activity, unhealthy eating, alcohol overuse, and inappropriate habits like smoking tobacco and marijuana, and can lead to heart disease, stroke, obesity, diabetes and some cancers. These are called disease risk factors.

Some risk factors, such as gender, age and genetics (family history) cannot be changed by individual activity: these are called non-modifiable risk factors.

The modifiable risk factors include obesity, unhealthy diet, high blood pressure (hypertension); high blood sugar (diabetes); high cholesterol; smoking (nicotine/marijuana), including exposure to smoke – sidestream smoking; alcohol overuse, and inactivity.

Present medical knowledge suggests we can prevent about 80 per cent of the suffering and death from NCDs if we adopt healthy habits.

Some of the ways to avoid any of the NCDs include:

• Maintain a healthy weight. Avoid overweight and obesity if possible. While the pharmaceutical industry has developed quite a few potent medications for promoting weight loss, at this time it seems that this set of medications can only be afforded by high-income countries. Thus for low and middle-income countries, obesity prevention programmes, as opposed to weight reduction, should be the focus, particularly targeting the paediatric population. Persons who are obese are also more likely to develop the other major cardiovascular risk factors diabetes, hypertension and high cholesterol (called dyslipidemia).

• Limit unhealthy foods and eat healthy meals. Generally speaking, the consumption of fresh fruits and vegetables are healthier options, while processed foods, in boxes and tins, tend to have too much salt, sugars, unhealthy fats and preservatives, and are not good for long-term health. It is hoped that the front-of-package labelling will soon become a reality here, and encourage individuals to consider ‘health’ when purchasing food.

• Drink lots of water and stay well hydrated. This is especially important in our already hot climate, and the experts predict even hotter days ahead.

• Limit sugar-sweetened Beverages (SSBs), strongly implicated in our alarming Childhood Obesity Statistics, and mindful that an obese child is very likely to become an obese adult. An ounce of ‘preventing obesity’ is better than a pound of ‘curing obesity’.

• Exercise regularly and be physically active. It is recognised that inactivity (‘laziness’) may be even more dangerous than smoking as a contributor to poor health. Reduce sitting and screen time, as these discourage individuals from being physically active.

• Get enough good sleep. Sleep medicine is an emerging specialty area of medicine, as it is recognised that the quality and quantity of your sleep cycle affects what happens during your waking hours. Adults should aim for five to seven hours of sleep every night.

• Go easy on alcohol and stay sober. Moderation is key.

• [The 11th Commandment of Health]: Thou shalt not smoke. Even exposure to the smoke from someone else – second-hand smoke or side-stream smoking- is dangerous, and can be deadly.

• Know your numbers. Family medicine is evolving to include more of what is termed ‘patient-centred care’: part of this involves the individual taking control of large portions of their health. Thus individuals are encouraged to monitor their blood pressure and blood sugars and to know what these numbers should be.

Perhaps before too long this may be expanded to include blood cholesterol levels. Of the three ‘medical disease’ risk factors hypertension, diabetes and high cholesterol, the order of potency is hypertension (least potent), diabetes, and high cholesterol (most potent). However when any two appear together, e.g. diabetes and hypertension, hypertension and high cholesterol, the potency of the combination rises markedly. The risk of a major cardiac event or stroke rises significantly if all three: diabetes, hypertension and high cholesterol, appear in the same individual, and the term ‘metabolic syndrome’, a condition associated with high risk for sudden death, heart attacks, strokes and a variety of severe medical problems, is used when obesity appears with the other three risk factors. Unfortunately, in some Caribbean populations with high rates of obesity, many patients have metabolic syndrome which contributes to the 80 per cent of people who die from cardiovascular disease.

All adults must avail themselves of the appropriate screening for breast, uterine, prostate and colon cancers. Thus mammograms, pap smears, PSA tests and colon cancer screening should be fitted into the schedule of all adults who treasure good health.

All adults should schedule their periodic health examinations, also called the annual checkup, with their family physicians. Those with established disease need to be monitored more frequently. Apart from prevention, the next step is early detection, in an effort to prevent severe or even life-threatening illnesses. We are witnessing our single public tertiary institution crumble under the load of patients who flock to the Emergency Department. You should not postpone seeing about your health until an accident or emergency develops.

Some, perhaps many, people feel that they only need to go to the doctor when they are unwell. In our population, the profile of illnesses suggests that this is unwise. Diseases like diabetes, hypertension and high cholesterol are all considered ‘silent killers’: they slowly ‘wear you down’ from the inside while you are totally unaware as, in most cases, there are no or very few symptoms. Thus ‘little’ symptoms like fatigue, poor concentration, deteriorating vision, disturbed sleep and many others are often attributed to getting old, needing a tonic, or under stress from too much work/too little pay/too little sexual activity or following WI cricket. When evaluated by a medical professional, any ‘warning signs’ can be detected early, and preventive action taken. On the other hand, when specific symptoms develop, this may signify advanced disease, and even emergency treatment (in the rare scenario that it can be quickly assessed) may not change poor outcomes in the immediate-to-long term.

Staying healthy does not require the same luck as winning the lottery, where only one or two people win. You don’t have to take a chance and hope you too can be a winner. Following a few sensible options, living a life of moderation, having an annual evaluation of your health status, and listening to the advice of your family physician, can go a long way to living well past three score and ten.

Dr Colin V Alert MBBS DM is a family physician.

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