Tuesday , September 21 2021

and can the micro-organisms present in our stools help patients to heal?



Between 1980 and 2012, the number of new cases of skin cancer more than tripled in France. The disease now affects nearly 80,000 new people each year. In 10% of cases, people are diagnosed with melanoma. If this form of skin cancer is the rarest, it is also the most aggressive. With 15,404 new cases of cutaneous melanoma estimated in 2017 in metropolitan France (8,061 men and 7,343 women) and 1,783 deaths (1,036 men and 747 women), this disease represents nearly 4% of all cancers and 1.2 % of cancer deaths.

Skin melanoma is well predicted if it is detected early enough, hence the importance of early diagnosis, explains the National Cancer Institute. Treatment is based on surgical excision. On the other hand, diagnosed later, the patient is much less likely to escape. In fact, this cancer has high metastatic potential: it can spread rapidly to ganglion relays and other organs. Doctors then try additional treatments such as ganglion dissection, radiation, chemotherapy, excision of metastases or immunotherapy.

The latter aims to stimulate a patient's immune system to attack and destroy cancer. Although these treatments can significantly improve the survival of patients with melanoma, they are effective in only 40 to 50% of them. For this reason, researchers at the Lawson Health Research Institute in Canada are studying the impact of fecal implants on the longevity of immunotherapy-treated skin melanoma patients. They are preparing to launch a clinical trial as outlined in a press release published on August 16 on their official website.

Preliminary studies show that the human microbiome, various collections of germs in our body, may play a role in a patient's response to immunotherapy. "The gut microbiome helps build the immune system at an early age, so it makes sense that healthy gut can improve the response to immunotherapy," says Dr. Jeremy Burton, a scientist specializing in immune system research. microbiome. "It made us look at the potential of fecal transplants," he continues. The goal is to transplant the donor microbiome so that healthy bacteria colonize the patient's gut.

"Our institute is able to move forward"

In a first phase of the clinical trial, researchers examined the use of fecal transplants to alter patients' microbiome and improve their response to immunotherapy. From now on, after the collection of faeces from healthy donors, researchers will transplant them to 20 Britons with skin melanoma. In detail, patients will swallow oral capsules specially prepared for their attention. Over time, researchers will evaluate the evolution of their cancer, microbiome, immune system and general health.

"Melanoma is the least common skin cancer, but the most lethal and fatal cases are rising," says Dr. John Lenehan, who will participate in the study. "Anti-PD1 immunotherapy drugs can be extremely effective, but we want to help more patients respond, which is our goal."

If researchers now focus on skin melanoma, they see the potential for other cancers as well. "We are one of the first teams in the world to research fecal transplants in cancer patients, the most up-to-date study of potential applications for many types of diseases," said Dr. Saman Maleki, a Lawson research fellow specializing in cancer immunology. "With specialists in microbiology, infectious diseases, cancer and immunology, our institute is able to move forward," he says.

Potential for the treatment of other diseases

"Faecal transplants have saved the lives of countless patients with recurrent colitis Clostridium difficile," says Dr. Michael Silverman, a pioneer in stool transplants. "We're starting to see his potential for treating other ailments," he explains. Today, Lawson's researchers are planning fecal transplant studies for many other ailments, including non-alcoholic fatty liver disease, multiple sclerosis (MS), and toxicity for cancer treatment. "But to do this research, we need donors of stool," says Dr. Silverman.

Remember that melanoma can occur on healthy skin in 70 to 80% of cases or can be the result the malignant transformation of the molHence the importance of having your suspected moles checked regularly by a dermatologist. It is also possible to refer to the ABCDE rule (for asymmetric, edges, color, diameter and evolution), a self-discovery technique developed by specialists. According to the latter task, a mole with any of the following characteristics may be suspicious: asymmetry, irregular edges, uneven color, increasing diameter, or rapidly developing.

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