Category: Treatment

Categories
Academic Care and Recovery Personhood Treatment

“I Didn’t Feel Like I Was a Person Anymore”: Realigning Full Adult Personhood after Ostomy Surgery

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  • Long term CRC survivors need temporary or permanent ostomies -> requiring the use of ostomy equipments and stoma bags
    • Parts of their intestines are removed and the remaining part is attached to an opening in abdoment where feces are discharged
    • More documented treatment-related challenges among survivors
  • Ostomies result in complex emotional, social and physical concerns
    • Adjustment to managing uncontrollable bowel movements is compared to second period of toilet training -> compromises adulthood
    • Erosion of adulthood due to physical disability
    • Relationships and sexual concerns
  • Surviving CRC with ostomy disrupts identity and adulthood -> loss of embodied self control
    • ostomy interferes with social roles and ideals
    • Western culture involves self responsibility
  • Narratives enables survivors to create continuity that reconnects them to social and cultural worlds
    • Hence why literature and art produced by cancer patients and survivors are so important
    • Cancer is very isolating and creating narrative is a way to reconnect

I didn’t feel like I was a person any more. I felt more like a non-person, you know, because you’ve got these things on you and then you’ve got this attachment, and not knowing how to care for this. We’d go places and we’d have to come home because I’d like overflow. … I guess that’s all in not knowing how to care for it.

A 62 year old divorced, ethnically mixed Filipina woman, discussing her difficulties and how they relate to personhood degradation.
An example ostomy bag
  • The women interviewed had common themes of technical difficulties, trial and error and the steep learning curve required to get used to living with an ostomy bag
  • Different techniques for regulating bodily functions and gaining control to realign with the ‘normal’ world to fit in and feel ‘normal’
    • Irrigation
    • Regulating timing of foods and dietary modifications
  • Reflections
    • Incorporate research similar to this study into nursing and other spheres of care -> rehabilitation efforts and follow-up efforts with health professionals to support these individuals
    • More interventions could help survivors living with impairments
    • Representations and discussions of ostomy procedures and bag can help make the process visible and negate stigma, such as this photoshoot

Categories
Biology and Research Immunotherapy Treatment

Dendritic Cell Defects in the Colorectal Cancer

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  • Colorectal cancer (CRC) links to accumulation of genetic and epigenetic changes to the genome
    • Accumulated through chromosomal instability, micro satellite instability, CpG island methylator phenotype.
  • Formation of inflammatory milieu -> tumor development/progression
    • Dendritic cells impairments
      • Not recruiting enough activated effector T cells
      • Creation of dominant immune inhibitory mechanisms that usurp T cell effector functions
    • Potential biomarkers for checkpt blockade therapy
      • Biomarkers for therapy would be very helpful in translational research and to evaluate effectiveness of therapy
  • Changes in tumor microenvironment resembles chronic inflammation
  • Dendritic cells as candidates in cancer vaccines of CRC patients -> generate more host immune responses against tumor antigens
    • Challenges: they might lose activity in cancer environment + Interactions with T cell regulators (Treg) actually enhance immunosuppression
    • Is there a way to fully activate dendritic cells (selectively with adjuvants) while keeping Treg from expansion and function?

  • Reflection/questions:
    • Importance of understanding mechanisms behind cancer interactions and immune system -> can reverse dendritic cell as immunosuppressive in cancer to immunostimulatory
    • Will dendritic cell-based therapy be more effectiveness in patients with a specific type of CRC?
Categories
Biology and Research Treatment

UConn Immunology Researcher Unraveling Relationship Between Cytokines and Colorectal Cancer

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  • Cytokines = proteins which play important role in cell signaling (IL-17 cytokines promote inflammation -> drive tumor growth on colon -> colon cancer)
  • Professor Wang discovered removing IL-17 signaling on regulatory T cells (Tregs) increase colon tumor development
    • Tregs = often recruited to tumors, hinder body’s ability to impede tumor growth
    • IL-17 has site specific inhibition
Colon tumor under fluorescent microscopy.

This means IL-17 inhibits Tregs that would otherwise suppress cancer immunosurveillance while also inhibiting the attraction of T cells that would perform this function. These findings illuminate the complicated role of IL-17 in colorectal cancer and showcase the need for further investigation.

https://today.uconn.edu/2021/10/uconn-immunology-researcher-unraveling-relationship-between-cytokines-and-colorectal-cancer/#
  • Reflections/questions:
    • Implications on altered functions of immune system during cancer + microenvironment and site specific inhibition
    • How does this play a role in metastasis?
    • Site specific inhibition may help with more precise treatments
    • Complicated relationships between cytokines and cancer
Categories
Academic Biology and Research Immunotherapy Treatment

Immunotherapy and Colorectal cancer: Where We are and What’s ahead

Resource from here

Example of a T cell
  • Immunotherapy uses immune checkpoint inhibitors, allow immune cells like T cells to target and attack cancerous cells
    • Pembrolizumab + nivolumab
  • Microsatellite instability-high colorectal cancer (MSI cancer)
    • Subtype of colorectal cancer
    • “deficient mismatch repair” (dMMR)
    • Many genetic mutations
    • More likely to be detected by immune system than other cancer cell subtypes
  • 3% are MSI/dMMR, most patients do not have this subtype
    • Require novel ways to overcome lack of immune response
  • Potential outcomes/legacy
    • Molecular subtype classification for more targeted, effective therapies
    • Tumor microenvironment -> critical
    • Other ways to trigger response in immune system -> oncolytic viruses, vaccines, cellular therapies (CAR T cell + CAR NK cell?)
  • Significance
    • Translational research & new avenues of therapies
    • Potential policy or ethical challenges?
      • Ex: genetic manipulations and testing, further funding for vaccines approach, conflicts of interest between different drug manufacturers
    • Is immunotherapy less ‘harsh’?
Categories
Academic Biology and Research Immunotherapy Treatment

Beating Colorectal Cancer’s Immunotherapy Resistance

Resource from here

  • Immune checkpoint inhibitors-> usually unleash immune response against cancer and has been used in cancer treatments (immunotherapy)
  • Many colorectal cancer does not respond to immunotherapy
  • Liver metastases are very resistant to immune checkpoint blockade
    • Lack dendritic cells -> can’t activate cytotoxic T lymphocytes -> can’t activate killing of cancer cells
  • Potential outcomes and legacy
    • Benefits of orthotopic tumor models
    • More research should be done on dendritic cells’ immune functions
      • Unless there already are some?
    • New therapies for resistant colorectal cancer -> clinical trial using immune checkpoint inhibitor + dendritic growth factor Flt3L

When the team augmented the number of dendritic cells within liver metastases…. the treatment led to an increase in cytotoxic T lymphocytes within the tumors and caused the tumors to become sensitive to immune checkpoint inhibitors.

https://news.harvard.edu/gazette/story/2021/10/new-way-to-overcome-colorectal-cancers-resistance-to-immune-response/
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