Past Issues

Issue 12 | December 2017

What did we learn about cancer in 2017?

Welcome to the last edition of myStrand of the year 2017! We hope you found our articles informative and we look forward to your continued readership in 2018! To bring out the old year, we’ve looked back at some of the key findings on what causes cancer, how we can prevent it, and how we are going to treat it in the coming years. And last but not least a “Happy and Healthy New Year” from everyone in the myStrand Team!

What causes cancer? – Here’s what we learned in 2017

Cancer has been at the forefront of health news this year! Liquid biopsy for monitoring cancer left research labs and entered the clinic abroad as well as here in India. Yet, at the same time the race to a cure slowed into an effort to manage the disease and increase sufferers’ life spans and quality of life, as research and doctors began to realize the genomic complexity and reality of the origin and progression of cancer. One of the key revelations of 2017 was that “cancer is unavoidable two-thirds of the time”, the reason being that when our cells try to make copies of themselves little mistakes occur all the time. Those ‘mistakes’ are part of the reason for the great diversity of life, but unfortunately also do harm some of the time, like when they lead to cancer. However, that means we can still actively influence the remaining third in order to minimize our overall risk by:

  1. Improving our lifestyle to include exercise and a healthy diet.
  2. Knowing our genetic status for hereditary predisposition for cancer, especially if there are cases of cancer in the family.

Why obesity increases cancer risk

We have known for a long time that being overweight is bad for our health on many counts. Yet, how obesity specifically increases cancer risk was only unraveled by researchers this year. Using a mouse model, they found that belly fat (or visceral fat) produces a protein that encourages normal cells to turn cancerous. And when they took the mice’s fat cells and exposed human cells (in a petri dish of course) to it, those cells sure enough started turning cancerous, too. So, how does that knowledge translate into cancer risk? Another study tried to figure out the same thing and concluded that an increase of 11 centimeters at the waist increases your cancer risk by 13 percent. Yet more data crunching conducted by the Center for Disease Control and Prevention (CDC) in the United States (US) revealed that around 40% of all cancer cases registered in the US in 2014 could be linked to obesity and concluded that those obesity-linked cancers could be one of the reasons why cancer incidence is increasing world-wide (just like our waistlines) despite the efforts to prevent cancer and advances in early cancer detection.

And what about alcohol and tobacco?

Well, we all know by now that tobacco is bad for us in whatever form it is consumed and many countries have by now forced tobacco companies to splash pictures and stark messages of what the health consequences are on packaging and even ads, where they are still allowed. However, when it comes to alcohol, the jury was still out and many of us had settled for moderate drinking as being ok, at least when it came to our overall health. This assumption was somewhat unraveled by the results of a study on the effects of alcohol consumption on cancer risk published in October 2017. The study established a firm link between daily consumption of even moderate amounts of alcohol and an increased risk of getting certain types of cancer. Obviously, top of the list are tissues that come directly in touch with alcohol and researchers found that even a single alcoholic

drink a day increased the risk for mouth and throat cancer by 17% and esophageal cancer by 30%. Surprisingly, cancer risk even increased for seemingly untouched tissues, like in breast cancer for example, where they found that cancer risk increased by 5%. This is in line with the findings of another study from 2016 that linked increased breast cancer risk in women with drinking alcohol regularly even in moderate quantities. Other types of cancers linked to alcohol consumption are skin, liver, pancreatic, as well as head and neck cancers.

So we know more about the effect our own habits and lifestyles can have on our cancer risk, but what did we learn in 2017 about how we can prevent and treat cancer? Read more about those revelations in the second article of this issue of myStrand.

Disclaimer: The information provided in this article is in no way intended to replace expert medical advice. Always discuss any concerns with your doctor.

What is Non-invasive Prenatal Screening (NIPT)?

2017 is also the year NIPT screening tests have started to become available here in India. NIPT screening tests are a safe and non-invasive option to determine whether a pregnant woman is at an increased risk of giving birth to a baby with one of three chromosomal disorders. They are:

NIPT looks at cfDNA from mother and baby

  • Trisomy 21 (Down’s Syndrome)
  • Trisomy 18 (Edwards Syndrome)
  • Trisomy 13 (Patau Syndrome)

All that is required is a blood sample and the technicians at the lab can then separate baby’s cell-free DNA (cfDNA) that was passed from the placenta into the mother’s blood stream from mother’s cfDNA and detect any anomalies. Your doctor will use the results in combination with other screening techniques like the first trimester ultrasound and nuchal translucency screening to determine whether any one of the invasive techniques, like chorionic villus sampling (CVS) or amniocentesis are required to confirm a prenatal diagnosis of one of these trisomies. NIPT is highly accurate ranging from 97-99% for the three trisomies listed here. Some tests are able to detect other anomalies, too. Always discuss the best option for you with your doctor!

News about cancer prevention and treatment? – No dearth of new findings here either!

Cancer remains one of the top priorities for pharmaceutical companies and research alike. However, while new knowledge about just how complex a disease cancer is has also somewhat complicated the search for effective treatments the emergence of personalized or targeted therapy has still made its presence felt in 2017. One key moment was the approval of a cancer drug by the US Food and Drug Administration (FDA) solely based on the presence of a certain genetic marker in a tumor (of any tissue type) rather than based on the affected tissue (like breast, colon, or skin for example) as had so far been the case. Spurred on by this ground-breaking development, clinical researchers and genetic diagnostics companies continue to investigate and develop new information and methods which will help match cancer drugs to genetic mutations and cellular markers often found across various cancer types for more effective treatments.

Similarly, we learnt that the presence of inherited mutations in the BRCA1 and BRCA2 genes, found in up to 10% of ovarian cancer patients, makes drugs called PARP inhibitors a good treatment option. Since their approval by the FDA and also here in India to treat this patient group, they have helped extend survival periods with minimal side effects compared to conventional chemotherapy. So far, these drugs have only been approved for BRCA1 and BRCA2 positive ovarian cancer patients if their cancer recurred and is resistant to chemotherapy. However, early results from ongoing trials and research indicate that the drugs might also be beneficial for BRCA1 and BRCA2 positive breast cancer patients.

These are just two of the examples of new avenues being explored to bring more effective treatments to cancer patients in the hope of managing the disease better while the hunt for a cure continues.

Prevention is better than cure

Meanwhile, new insight into how we ourselves can try and prevent cancer also hit the news this year. Especially colorectal cancer (a term that refers to both colon cancer and rectal cancer) made the headlines when it comes to how our diet can make a difference. One big report covering data from 99 studies (covering some 29 million people) published by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) in September this year concluded that eating at least three servings of whole grains (like whole wheat products and brown rice for example) every day reduced the risk for colon cancer by 17%. The report also noted that the more fiber and grains were included in the diet, the lower the overall cancer risk became. Another finding closer to home concluded that eating sambar, the South Indian dish made from a concoction of spices, dals, and vegetables, also reduces the risk for developing colon cancer.

Make that 8 a day, please!

Last but not least, the sentence many of us would have heard from doctors and nutritionists again and again – “Eat more fruits and vegetables and reduce intake of processed foods” – was backed up by yet another major study conducted by a research team in Norway bringing together data from 142 publications across 95 different populations covering several hundreds of thousands of people. The study didn’t just look at cancer, but a whole range of conditions including heart disease, stroke, and premature death. The results suggested that close to 8 million deaths could be prevented worldwide if people changed their diets to included just 800 grams of fresh fruits and vegetables in their diets every day. This is quite a bit more than the recommended “Five-a-Day” mantra widespread in the West, which equates to around 500 grams. And what makes those fruits and veggies so beneficial for our health? Well, they’re choc-a-bloc full of nutrients, phytochemicals, and fiber – all the things our bodies need to operate at their best and ward off the damage caused by so-called ‘free radicals’ in our environments and occurring naturally as part of the sugar metabolism.

So will your New Year’s resolution include a healthier diet and less of those vices to ensure you are doing all you can to “keep the doctor away”?
Disclaimer: The information provided in this article is in no way intended to replace expert medical advice. Always discuss the best possible course of action for your situation with your doctor.

Impacting Lives with Precision Medicine

Quality Counts

Strand Center for Genomics and Personalized Medicine (Strand Center) is India’s first Next-Generation Sequencing (NGS) laboratory to receive the College of American Pathologists (CAP) accreditation in 2015 and was re-accredited in November 2017. The CAP accreditation is awarded to diagnostic laboratories that follow stringent quality and process control norms at every stage. Adoption of these quality control measures enhance the accuracy of the results obtained from the analytical processes. In keeping with this vision, the Strand Center participates in blind, comparative exercises wherein unknown samples are sent to us and Strand is re-accredited by CAPthe results are validated against those provided by other NGS laboratories, worldwide. Results provided by the Strand Center have been consistently found to be at par with those obtained from other renowned laboratories.

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