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Removal of testicles can save men with fourth-stage prostate cancer

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New Delhi, Feb 27 

Initially, 62-year-old Ram Mathur did not feel any symptoms. When he started feeling some difficulty during urination, he chose to ignore it. The problem took an extreme turn when he started noticing swellings in the pelvic region, followed by blood in semen, decreased

Initially, 62-year-old Ram Mathur did not feel any symptoms. When he started feeling some difficulty during urination, he chose to ignore it. The problem took an extreme turn when he started noticing swellings in the pelvic region, followed by blood in semen, decreased flow of urine and loss of bladder control. Mathur was shattered to know he had fourth stage prostate cancer.

His urologist told him that he had ignored the symptoms for too long, and his condition was likely to deteriorate as his testicles were secreting testosterone – which fuels growth of the prostate.

According to the Health Ministry, late detection and ignorance about the disease are the sole reason that prostate cancer has affected 1.7 million people around the globe, with 2,88,000 cases in India alone.

Doctors gave Mathur the option of getting his testicles removed through surgery, to permanently stop the prostate from growing further.

The prostate gland — part of the male reproductive system — lies below the urinary bladder and in front of the rectum. The gland surrounds the first part of the urethra that carries urine from the bladder to the penis.

Mathur was initially reluctant to get his testicles removed, feeling it would affect his sex life. But he underwent the surgery, fearing the spreading of the disease. Mathur’s prostate cancer, which had spread to a great extent, is now nil.

“Prostate cancer is hormone dependent and testicles are responsible for secretion of hormones. Therefore, once it is removed the cancer is cured,” S.P. Yadav, Urologist and Managing Director of Gurgaon-based Pushpanjali Hospital, told IANS.

“Prostate cancer forms in the cells of the prostate. It is usually a very slow growing cancer and most patients do not have significant symptoms until cancer reaches an advanced stage. Most men with prostate cancer die, and many never know that they have the disease. But once prostate cancer begins to grow quickly or spreads outside the prostate, it is dangerous,” Yadav said.

Explaining the surgical procedure, Kapil Kumar, head of Surgical Oncology at Delhi-based BLK Cancer Centre, said that an orchiectomy — surgical procedure in which one or both testicles are removed – is done to treat cancer, or for other reasons, to lower the level of testosterone.

“Surgical removal of a testicle is the usual treatment if a tumour is found within the gland itself, but an orchiectomy may also be performed to treat prostate cancer or cancer of the male breast, as testosterone causes these cancers to grow and metastasize (spread to other parts of the body),” Kumar told IANS.

On the precautions to be observed post-surgery, Akash Jain, Consultant General Laparoscopic Surgery at Delhi-based Saroj Super Speciality Hospital, said that the patient should wear a scrotal support for at least 48 hours so that it holds the dressing in place and provides support.

“Ice may help with the swelling and bruising post surgery. Patient should not strain when there is bowel movement. More liquids, foods with fiber should be taken,” said Jain told IANS.

Doctors say though such surgeries don’t cost much, they should beAundertaken when there is no other option available.

“The cost of orchiectomy is 40 to 50 thousand rupees but orchiectomy is not required in all the cases; we strongly suggest to take injection instead of surgery,” Vikas Goswami, Senior Consultant Oncologist at city-based Fortis Hospital, told IANS.

According to medical data, the incidence rate of prostate cancer in Delhi is 10.66 per 100,000, which is higher than Southeast Asia (8.3) and north Africa (8.1).

Doctors say late diagnosis is the main culprit for the rising cases of prostate cancer, and recommend going for Digital Rectal Examination (DRE) for detection.

“Prostate-specific antigen, or PSA, is a protein produced by the prostate gland, which can be tested with a simple blood test. Rise in PSA value can be associated with prostate cancer. Early detection of prostate cancer can be done with this test and the state of the prostate glands with Digital Rectal Examination (DRE),” Atul Goswami, Chief of Urology at city-based Action Cancer Hospital, told IANS.

(IANS)

By Rupesh Dutta 
(Rupesh Dutta can be contacted at [email protected])

Health

Moderna Says Vaccine 100% Effective Against Severe Covid, Seeks Clearance

COVID-19 Vaccine: Moderna said it expects to have approximately 20 million doses of the vaccine, called mRNA-1273, available in the US by the end of the year.

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Washington: Moderna Inc will apply for US and European emergency authorization for its COVID-19 vaccine on Monday after full results from a late-stage study showed it was 94.1% effective with no serious safety concerns, the company said. Moderna also reported that the vaccine’s efficacy rate was consistent across age, race, ethnicity and gender demographics as well as having a 100% success rate in preventing severe cases of a disease that has killed nearly 1.5 million people.

The filing sets Moderna’s product up to be the second vaccine likely to receive US emergency use authorization this year following a shot developed by Pfizer and BioNTech which had a 95% efficacy rate in trials. “We believe that we have a vaccine that is very highly efficacious. We now have the data to prove it,” Moderna Chief Medical Officer Tal Zaks said.

“We expect to be playing a major part in turning around this pandemic.”

Of the 196 volunteers who contracted COVID-19 in the trial with more than 30,000 people, 185 received a placebo while 11 got the vaccine.

Moderna reported 30 severe cases — all in the placebo group — which means the vaccine was 100% effective in preventing severe cases.

“As the numbers of cases reported grows, confidence grows that this amazing protection will be maintained in a product that can be rolled out to protect the public,” said Alexander Edwards, associate professor in biomedical technology at Britain’s University of Reading.

In addition to filing its US application, Moderna said it would seek conditional approval from the European Medicines Agency, which has already begun a rolling review of its data, and would continue to talk with other regulators.

Pfizer has already applied for emergency use authorization in the United States and Europe, putting it about a week ahead of Moderna.

Moderna said it was on track to have about 20 million doses of its vaccine ready to ship in the United States by the end of 2020, enough to inoculate 10 million people.

Both of the vaccines use a new technology called synthetic messenger RNA (mRNA) whereas others, such as Britain’s AstraZeneca, are using more traditional methods to develop their vaccines.

AstraZeneca has announced an average efficacy rate of 70% for its shot and as much as 90% for a subgroup of trial participants who got a half dose, followed by a full dose.

But some scientists have expressed doubts about the robustness of the 90% efficacy figure for the smaller group.

Moderna’s latest efficacy result is slightly lower than an interim analysis released on Nov 16 of 94.5% effectiveness, a difference that Mr Zaks said was not statistically significant.

“At this level of effectiveness, when you just do the math of what it means for the pandemic that’s raging around us, it’s just overwhelming,” said Zaks, who said he cried when he saw the final results over the weekend.

Both the Moderna and Pfizer vaccines proved more effective than anticipated and were far superior to the 50% benchmark set by the US Food and Drug Administration (FDA).

The past few weeks of positive vaccine results have ignited hopes for an end to a pandemic that has battered economies and comes as new infections and COVID-19 hospitalizations are at record levels across the United States.

Independent advisers to the FDA are scheduled to meet on December 17 to review Moderna’s trial data and make a recommendation to the FDA.

They will meet on December 10 to review Pfizer’s data. Shortly after gaining emergency use authorization, Moderna expects the vaccine to be shipped to distribution points throughout the United States by the government’s Operation Warp Speed program and McKesson Corp, a drug distributor contracted by the US government.

Its distribution is expected to be easier than Pfizer’s because while it needs to be stored in a freezer, it does not require the ultra-cold temperature needed by Pfizer’s vaccine.

Moderna said the 196 COVID-19 cases in its trial included 33 adults over 65 years old and 42 volunteers from racially diverse groups, including 29 Latinos, 6 Blacks, 4 Asian Americans and 3 multiracial participants. There was one death related to COVID-19 in the placebo group.

Azra Ghani, chair in infectious disease epidemiology at Imperial College London, said Monday’s details from Moderna confirmed the vaccine was highly efficient, including against severe cases. “Whilst this does not exclude some risk of severe disease after vaccination given the relatively small number of severe cases, these results suggest very high efficacy,” she said.

Zaks said the vaccine has been developed during a period of “political acrimony” and having a highly effective vaccine may go a long way toward erasing some of that distrust. “This is as black and white as an effect on a population will be. Your chances of actually being sick if you’ve been vaccinated are decreased 20-fold,” he said.

Moderna reported no new side effects since its interim analysis. Based on that analysis, the most common side effects were fatigue, injection site redness and pain, headache and body aches, which rose after the second dose and were short-lived.

Zaks said the vaccine caused significant flu-like symptoms in some participants, which, he said, “goes hand-in-hand with having such a potent vaccine.” But it has not caused any significant safety concerns so far.

Moderna plans to start a new trial to test the vaccine in adolescents before the end of the year, followed by another in even younger volunteers early in 2021.

It hopes to have the vaccine available for adolescents by September, Zaks said.

Other vaccine makers have said they are studying their vaccines in young people as well.

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Modi interacts with 3 teams developing corona vaccines

The Prime Minister also asked the companies to come out with their suggestions and ideas regarding the regulatory processes and related matters.

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Narendra Modi

New Delhi, Nov 30: Prime Minister Narendra Modi on Monday held virtual meetings with three teams working on the development and manufacture of vaccines against Covid-19, and discussed the potential of various platforms for vaccine development.

The teams are from Gennova Biopharmaceuticals Ltd at Pune, and Biological E Ltd and Dr Reddy’s Laboratories Ltd at Hyderabad.

Their potential vaccines are in different stages of trials and detailed data and results are expected from early next year onwards, a Prime Minister’s Office (PMO) statement said on Monday.

“The potential of various platforms for vaccine development was also discussed,” the statement said.

The Prime Minister also asked the companies to come out with their suggestions and ideas regarding the regulatory processes and related matters.

He also suggested that they should make extra efforts to inform the general public in simple language about the vaccine and related matters such as its efficacy.

Matters relating to logistics, transport and cold chains in respect of delivery of the vaccines were also discussed.

The Prime Minister advised all departments concerned to engage with the manufacturers and seek to resolve matters so that the efforts by these companies bear fruit in order to serve the needs of the country and the entire world.

The Prime Minister praised the efforts made by scientists and researchers in these companies to come out with a vaccine solution to tackle the ongoing coronavirus pandemic, which so far has infected 94,31,692 people across the country, and led to deaths of 1,37,139 patients.

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With 38k new Covid-19 cases, India’s tally tops 94.3 lakhs

The recovery rate stands at 93.81 per cent, and the fatality rate is 1.45 as per cent, the Ministry said.

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New Delhi, Nov 30: With 38,772 new coronavirus cases and 443 deaths in the past 24 hours, India’s overall tally stood at 94,31,692 on Monday, as the fatality toll touched 1,37,139, the Ministry of Health and Family Welfare said.

Currently, there are 4,46,952 active cases, whereas 8,84,76,00 patients have been cured and discharged so far.

The recovery rate stands at 93.81 per cent, and the fatality rate is 1.45 as per cent, the Ministry said.

“India continues to have one of the lowest deaths per million population globally (presently 99). Focussed measures to ensure a low and manageable fatality rate have resulted in daily mortality figures of less than 500,” it added.

Maharashtra continued to be the worst-hit state with 1,820,059 cases till date. There are 92,062 active cases and 47,071 Covid-19 deaths.

According to the Ministry, over 70 per cent of the daily new cases are contributed by eight States and UT i.e. Maharashtra, Delhi, Kerala, West Bengal, Rajasthan, Uttar Pradesh, Haryana, and Chhattisgarh.

The overall number of global coronavirus cases has topped 62.6 million, while the deaths have surged to more than 1.45 million, according to the Johns Hopkins University.

In its latest update on Monday, the University’s Center for Systems Science and Engineering (CSSE) revealed that the current global caseload and death toll stood at 62,670,153 and 1,458,360, respectively.

The US is the worst-hit country with the world’s highest number of cases and deaths at 13,374,162 and 266,838, respectively, according to the CSSE.

India comes in second place in terms of cases.

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