First-ever prostate cancer treatment uses gold nanoparticles to destroy tumorous cells

A small clinical trial using gold nanoparticles that act as tumor-seeking missiles on a mission to remove prostate cancer has begun at The University of Texas Health Science Center at Houston (UTHealth). It is the first trial of its kind in the world.

The nanoparticles, or nanoshells, are made of small layers of silica glass formed into a sphere and wrapped in a thin layer of gold. The shells seek out and saturate cancerous cells, and their advanced vibrational properties are then harnessed to cause the tumorous tissue to pulse with extreme temperature when light is applied through a laser specifically designed to excite the particles. The oscillation kills the cancer cells while preserving the healthy tissue, avoiding the nerves and urinary sphincter. This procedure is the first in the world that is precise enough to potentially avoid negative ramifications like urinary incontinence or sexual impotency.

“This therapy could be life-changing for men diagnosed with prostate cancer and I’m honored to be among the first doctors the U.S. Food and Drug Administration approved to put it to the test,” said Steven Canfield, M.D., chair of the division of urology at McGovern Medical School at UTHealth, who recognized the possibility of the nanoparticles to treat prostate cancer and helped developed the trial to test the theory.

Prostate cancer begins when cells in a man’s prostate gland mutate and start to grow uncontrollably. Other than skin cancer, prostate is the most common cancer in American men, with an estimated 1 out of 9 men diagnosed. The American Cancer Society estimates 29,430 men died from the disease in 2018 alone.

Treatment options have traditionally included radical prostatectomy, which is the removal of the prostate gland and some of the tissue around it, radiation therapy and cryotherapy, among others. These methods carry the potential to have a negative impact on urinary function and sexual performance.

“The side effects of current prostate cancer treatments can be extremely traumatic. This new technology holds the potential to eliminate those life-altering effects, while still removing the cancer tissue and reducing hospital and recovery time,” Canfield said. “In fact, the first patient in the trial was actually riding a bike within a week of his treatment. The fusion of MRI and ultrasound imaging technology that we use to accurately identify and diagnose the cancer, combined with the extreme precision of the gold nanoshells in targeting the diseased cells, allows us to be incredibly accurate at obliterating them. I am excited as we continue tracking the progress of this groundbreaking improvement to prostate cancer care.”

Doug Flewellen, the first patient in Texas to receive the new method of care, says for him, the procedure was a no-brainer.

“No man wants to go through radical removal, and I knew active monitoring could have potentially aggravated the cancer,” Flewellen said. “The side effects of traditional treatment were not worth it to me, and I wasn’t afraid to try the most cutting-edge technology. Looking back, the experience was even better than I was expecting, and I hope to see nanoparticle therapy advance into an option for anyone diagnosed with prostate cancer in the future.”

Source: Read Full Article

Societies publish new guidance for the treatment of slow, irregular heartbeats

The American College of Cardiology, the American Heart Association and the Heart Rhythm Society today released a guideline for the evaluation and treatment of patients with bradycardia, or a slow heartbeat, and cardiac conduction disorders.

In the guideline, bradycardia is defined as a heart rate of less than 50 beats per minute, compared to a normal heart rate of 50-100 beats per minute. A slow heartbeat can limit the amount of blood and oxygen that is pumped to all the organs of the body. Bradycardia is generally classified into three categories—sinus node dysfunction, atrioventricular (AV) block, and conduction disorders. In sinus node dysfunction, the sinoatrial node, the main pacemaker of the heart, cannot maintain an adequate heart rate. In AV block, there is partial or complete interruption of electrical impulse transmission from the atria to the ventricles. Cardiac conduction disorders occur when electrical impulses in the heart that cause it to beat are delayed. Common conduction disorders include right and left bundle branch block. Bradycardia and conduction abnormalities are more often seen in elderly patients.

The writing committee members outline the clinical presentation and approach to clinical evaluation of patients who may have bradycardia or conduction diseases. They reviewed study data and developed recommendations from the evidence. These recommendations include the selection and timing of diagnostic testing tools—including monitoring devices and electrophysiological testing—as well as available treatment options such as lifestyle interventions, pharmacotherapy and external and implanted devices, particularly pacing devices. The authors also address special considerations for different populations based on age, comorbidities or other relevant factors.

Conduction abnormalities are common after transcatheter aortic valve replacement (TAVR). The guideline includes recommendations on post-procedure surveillance and pacemaker implantation. The guideline also addresses ways to approach the discontinuation of pacemaker therapy and end of life considerations.

The writing committee members stress the importance of shared decision-making between the patient and clinicians, as well as patient-centered care.

“Treatment decisions are based not only on the best available evidence but also on the patient’s goals of care and preferences,” said Fred M. Kusumoto, MD, cardiologist at Mayo Clinic Florida in Jacksonville and chair of the writing committee. “Patients should be referred to trusted material to aid in their understanding and awareness of the consequences and risks of any proposed action.”

Yet, according to the authors, there are still knowledge gaps in understanding how to manage bradycardia, especially the evolving role of and developing technology for pacing.

“Identifying patient populations who will benefit the most from emerging pacing technologies, such as His bundle pacing and transcatheter leadless pacing systems, will require further investigation as these modalities are incorporated into clinical practice,” Kusumoto said. “Regardless of technology, for the foreseeable future, pacing therapy requires implantation of a medical device, and future studies are warranted to focus on the long-term implications associated with lifelong therapy.”

Source: Read Full Article