Vaccines for Cancer!

 BOOK REVIEW ON “TOP 5 NATURAL CANCER VACCINES” BY PROFESSOR DR NOR HAYATI OTHMAN

 

I was expecting a long queue while waiting for my first dose of COVID-19 vaccine and brought another type of “vaccine”, i.e. a compact book written by my university mate, Yati.  

 

What is a vaccine?  As a pathologist and a urologist, we probably look at things from the other end, the results!  It is amazing that such simple valuable information on cancer prevention is not widely practised.  Professor Dr Nor Hayati Othman has clearly illustrated that cancer can be prevented by the simple strategies of such as reducing the risks from smoking and  obesity. Diabetes is not only the top non-communicable disease in Malaysia but a risk factor for cancer. Exercise, having a balanced diet with less processed food and more fresh vegetables/fruits are important in cancer prevention.  In the book, evidence is also presented that taking daily doses of natural honey as well as daily doses of curcumin (found in turmeric which we use for cooking frequently) reduces cancer.

 

Throughout the book, Professor Dr Nor Hayati Othman has presented data from research including many of her own research in Universiti Sains Malaysia.  However, at my age, I do find that the fonts of the many illustrations  small for comfortable reading!  The book is a small one that can fit into the pocket and it is only 41 pages.  Even without looking at the figures and tables, reading the headings and the last paragraph would convey the important messages.  Patients in the waiting room can easily read  this wonderful little book.

 

Dr Clarence Lei Chang Moh,

Consultant Urologist

 

 

Undescended Testis "Basic to Clinical Practice" updated on 15 February 2021

 Undescended Testis “Basic to Clinical Practice” 

@ Asian Congress of  Urology / Thai Urological Association 23 Aug 2012

 

By Dr Clarence Lei Chang Moh, FRCS (Urol), FEBU, Consultant Urologist

clarencelei@gmail.com; WA: +60128199880; kuchingurology.com

 

Undescended testis (UDT) is defined as a testis which has failed to descend to the scrotum and is retained at some point along its path of descent.  The gonads first appear in intra-uterine life around the 2^nd month at the lumbar area and descends under the influence of androgens and shortening of the gubernaculum.  The cause of UDT is thought to be due to hormonal or genetic defects.  Nevertheless, hormonal manipulation after delivery is of limited value in UDT.  The incidence of UDT at birth is estimated to be about 4% and 1% at 1 year of age.  Therefore, surgical treatment is recommended around 1 year of age.

 

The management of UDT depends on the following factors: unilateral or bilateral, whether ectopic, the location and size of the testis.  80% of UDT are palpable. Retractile testis may be observed. If the testis is not palpable in an obese groin, a good quality ultrasound of the groin may help to locate the testis in the groin or just at deep ring; sensitivity in identifying inguinal testis is 95%. MRI  & CT may not be useful to locate the intraabdominal position. The definitive  investigation is a laparoscopy and if only a nubbin is found, it is not necessary to excise it.  

 

Almost all bilateral intraabdominal testes would be infertile, if not operated.  Germ cell depletion is noted in 55% of testicular biopsies of intra-abdominal testes at 12 months (AbouZeid). On the other end of spectrum, fertility is almost normal if there is a unilateral descended normal  testis. 93% of UDT have absent germ cells on biopsy. There is an increased relative risk of malignancy in the UDT, 2.75 to 8 times, with an absolute risk of  1%. The risk of cancer would be when the patient is 15 to 30 years old. The peritoneal invagination of the processes vaginalis follows the course of the gubernaculum and when patent,  increases the UDT to torsion, trauma and hernia formation.  These are additional reasons for surgical treatment. Surgery is usually a one-stage orchidopexy, performed under magnification, Prentiss manoeuvre if necessary.  After orchidopexy, malignant risk is  still present, with more cases of non-seminoma.  If it is not possible to bring intraabdominal testis to the scrotum, one can do a two-stage procedure by performing a high ligation of the spermatic vessels during the first stage (Fowler Stephen). The 2^ndstage operation may be performed 6 to 12 months later, doing one side at a time.

 

Updated 14 February 2021

 

References: 

AbouZeid et al Intraabdo testes Biopsy J Urol 2011, 185- 269-274

Fowler Stephen J Urol 1996, 156:802

Jack Elder J Urol 2009, 181: 452-461

Prentiss, J  Pediat Urol 2012 (8): 488