Black Cohosh vs The Menopause
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Black Cohosh, By Any Other Name…
Black cohosh is a flowering plant whose extracts are popularly used to relieve menopausal (and postmenopausal) symptoms.
Note on terms: we’ll use “black cohosh” in this article, but if you see the botanical names in studies, the reason it sometimes appears as Actaea racemosa and sometimes as Cimicfuga racemosa, is because it got changed and changed back on account of some disagreements between botanists. It’s the same plant, in any case!
Read: Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae)
Does it work?
In few words: it works for physical symptoms, but not emotional ones, based on this large (n=2,310) meta-analysis of studies:
❝Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges’ g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges’ g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges’ g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo.
However, black cohosh did not significantly improve anxiety (Hedges’ g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges’ g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131)❞
~ Dr. Ryochi Sadahiro et al., 2023
Source: Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
Here’s an even larger (n=43,759) one that found similarly, and also noted on safety:
❝Treatment with iCR/iCR+HP was well tolerated with few minor adverse events, with a frequency comparable to placebo. The clinical data did not reveal any evidence of hepatotoxicity.
Hormone levels remained unchanged and estrogen-sensitive tissues (e.g. breast, endometrium) were unaffected by iCR treatment.
As benefits clearly outweigh risks, iCR/iCR+HP should be recommended as an evidence-based treatment option for natural climacteric symptoms.
With its good safety profile in general and at estrogen-sensitive organs, iCR as a non-hormonal herbal therapy can also be used in patients with hormone-dependent diseases who suffer from iatrogenic climacteric symptoms.❞
~ Dr. Castelo-Branco et al., 2020
(iCR = isopropanolic Cimicifuga racemosa)
So, is this estrogenic or not?
This is the question many scientists were asking, about 20 or so years ago. There are many papers from around 2000–2005, but here’s a good one that’s quite representative:
❝These new data dispute the estrogenic theory and demonstrate that extracts of black cohosh do not bind to the estrogen receptor in vitro, up-regulate estrogen-dependent genes, or stimulate the growth of estrogen-dependent tumors❞
Source: Is Black Cohosh Estrogenic?
(the abstract is a little vague, but if you click on the PDF icon, you can read the full paper, which is a lot clearer and more detailed)
The short answer: no, black cohosh is not estrogenic
Is it safe?
As ever, check with your doctor as everyone’s situation can vary, but broadly speaking, yes, it has a very good safety profile—including for breast cancer patients, at that. See for example:
- Black cohosh efficacy and safety for menopausal symptoms: the Spanish Menopause Society statement
- Black cohosh (Cimicifuga racemosa): safety and efficacy for cancer patients
- The safety of black cohosh (Actaea racemosa, Cimicifuga racemosa)
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
What should I do if I can’t see a psychiatrist?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
People presenting at emergency with mental health concerns are experiencing the longest wait times in Australia for admission to a ward, according to a new report from the Australasian College of Emergency Medicine.
But with half of New South Wales’ public psychiatrists set to resign next week after ongoing pay disputes – and amid national shortages in the mental health workforce – Australians who rely on psychiatry support may be wondering where else to go.
If you can’t get in to see a psychiatrist and you need help, there are some other options. However in an emergency, you should call 000.
Why do people see a psychiatrist?
Psychiatrists are doctors who specialise in mental health and can prescribe medication.
People seek or require psychiatry support for many reasons. These may include:
- severe depression, including suicidal thoughts or behaviours
- severe anxiety, panic attacks or phobias
- post-traumatic stress disorder (PTSD)
- eating disorders, such as anorexia or bulimia
- attention deficit hyperactivity disorder (ADHD).
Psychiatrists complement other mental health clinicians by prescribing certain medications and making decisions about hospital admission. But when psychiatry support is not available a range of team members can contribute to a person’s mental health care.
Can my GP help?
Depending on your mental health concerns, your GP may be able to offer alternatives while you await formal psychiatry care.
GPs provide support for a range of mental health concerns, regardless of formal diagnosis. They can help address the causes and impact of issues including mental distress, changes in sleep, thinking, mood or behaviour.
The GP Psychiatry Support Line also provides doctors advice on care, prescription medication and how support can work.
It’s a good idea to book a long consult and consider taking a trusted person. Be explicit about how you’ve been feeling and what previous supports or medication you’ve accessed.
What about psychologists, counsellors or community services?
Your GP should also be aware of supports available locally and online.
For example, Head to Health is a government initiative, including information, a nationwide phone line, and in-person clinics in Victoria. It aims to improve mental health advice, assessment and access to treatment.
Medicare Mental Health Centres provide in-person care and are expanding across Australia.
There are also virtual care services in some areas. This includes advice on individualised assessment including whether to go to hospital.
Some community groups are led by peers rather than clinicians, such as Alternatives to Suicide.
How about if I’m rural or regional?
Accessing support in rural or regional areas is particularly tough.
Beyond helplines and formal supports, other options include local Suicide Prevention Networks and community initiatives such as ifarmwell and Men’s sheds.
Should I go to emergency?
As the new report shows, people who present at hospital emergency departments for mental health should expect long wait times before being admitted to a ward.
But going to a hospital emergency department will be essential for some who are experiencing a physical or mental health crisis.
Managing suicide-related distress
With the mass resignation of NSW psychiatrists looming, and amid shortages and blown-out emergency waiting times, people in suicide-related distress must receive the best available care and support.
Roughly nine Australians die by suicide each day. One in six have had thoughts of suicide at some point in their lives.
Suicidal thoughts can pass. There are evidence-based strategies people can immediately turn to when distressed and in need of ongoing care.
Safety planning is a popular suicide prevention strategy to help you stay safe.
What is a safety plan?
This is a personalised, step-by-step plan to remain safe during the onset or worsening of suicidal urges.
You can develop a safety plan collaboratively with a clinician and/or peer worker, or with loved ones. You can also make one on your own – many people like to use the Beyond Now app.
Safety plans usually include:
- recognising personal warning signs of a crisis (for example, feeling like a burden)
- identifying and using internal coping strategies (such as distracting yourself by listening to favourite music)
- seeking social supports for distraction (for example, visiting your local library)
- letting trusted family or friends know how you’re feeling – ideally, they should know they’re in your safety plan
- knowing contact details of specific mental health services (your GP, mental health supports, local hospital)
- making the environment safer by removing or limiting access to lethal means
- identifying specific and personalised reasons for living.
Our research shows safety planning is linked to reduced suicidal thoughts and behaviour, as well as feelings of depression and hopelessness, among adults.
Evidence from people with lived experience shows safety planning helps people to understand their warning signs and practice coping strategies.
Sharing your safety plan with loved ones may help understand warning signs of a crisis. Dragana Gordic/Shutterstock Are there helplines I can call?
There are people ready to listen, by phone or online chat, Australia-wide. You can try any of the following (most are available 24 hours a day, seven days a week):
Suicide helplines:
- Lifeline 13 11 14
- Suicide Call Back Service 1300 659 467
There is also specialised support:
- for men: MensLine Australia 1300 78 99 78
- children and young people: Kids’ Helpline 1800 55 1800
- Aboriginal and Torres Strait Islander people: 13YARN 13 92 76
- veterans and their families: Open Arms 1800 011 046
- LGBTQIA+ community: QLife 1300 184 527
- new and expecting parents: PANDA 1300 726 306
- people experiencing eating disorders: Butterfly Foundation 1800 33 4673.
Additionally, each state and territory will have its own list of mental health resources.
With uncertain access to services, it’s helpful to remember that there are people who care. You don’t have to go it alone.
Monika Ferguson, Senior Lecturer in Mental Health, University of South Australia and Nicholas Procter, Professor and Chair: Mental Health Nursing, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Share This Post
-
Macadamia Nuts vs Brazil Nuts – Which is Healthier?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our Verdict
When comparing macadamia nuts to Brazil nuts, we picked the Brazil nuts.
Why?
They’re a lot more nutrient dense! But watch out…
First, to do due diligence in terms of macros: Brazil nuts have twice as much protein and less fat, as well as being a little higher in fiber and slightly lower in carbs.
In terms of vitamins, Brazil nuts are about 10x higher in vitamin E, while macadamias are somewhat higher in several B-vitamins.
The category of minerals is where it gets interesting. Macadamia nuts are a little higher in iron and considerably higher in Manganese. But… Brazil nuts are a lot higher in calcium, copper, magnesium, phosphorus, potassium, selenium, and zinc.
About that selenium… Specifically, it’s more than 5,000x higher, and a cup of Brazil nuts would give nearly 10,000x the recommended daily amount of selenium. Now, selenium is an essential mineral (needed for thyroid hormone production, for example), and at the RDA it’s good for good health. Your hair will be luscious and shiny. However, go much above that, and selenium toxicity becomes a thing, you may get sick, and it can cause your (luscious and shiny) hair to fall out. For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.
In short… Brazil nuts are much more nutrient dense in general, and thus come out on top here. But, they’re so nutrient dense in the case of selenium, that careful moderation is advised.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
Share This Post
-
The Problem With Sweeteners
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
The WHO’s view on sugar-free sweeteners
The WHO has released a report offering guidance regards the use of sugar-free sweeteners as part of a weight-loss effort.
In a nutshell, the guidance is: don’t
- Here’s the report itself: Use of non-sugar sweeteners: WHO guideline
- Here’s the WHO’s own press release about it: WHO advises not to use non-sugar sweeteners for weight control in newly released guideline
- And it was based on this huge systematic review: Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis
They make for interesting reading, so if you don’t have time now, you might want to just quickly open and bookmark them for later!
Some salient bits and pieces:
Besides that some sweeteners can cause gastro-intestinal problems, a big problem is desensitization:
Because many sugar substitutes are many times (in some cases, hundreds of times) sweeter than sugar, this leads to other sweet foods tasting more bland, causing people to crave sweeter and sweeter foods for the same satisfaction level.
You can imagine how that’s not a spiral that’s good for the health!
The WHO recommendation applies to artificial and naturally-occurring non-sugar sweeteners, including:
- Acesulfame K
- Advantame
- Aspartame
- Cyclamates
- Neotame
- Saccharin
- Stevia
Sucralose and erythritol, by the way, technically are sugars, just not “that kind of sugar” so they didn’t make the list of non-sugar sweeteners.
That said, a recent study did find that erythritol was linked to a higher risk of heart attack, stroke, and early death, so it may not be an amazing sweetener either:
Read: The artificial sweetener erythritol and cardiovascular event risk
Want to know a good way of staying healthy in the context of sweeteners?
Just get used to using less. Your taste buds will adapt, and you’ll get just as much pleasure as before, from progressively less sweetening agent.
Share This Post
Related Posts
-
Unprocessed – by Kimberly Wilson
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
First, what this is not: hundreds of pages to say “eat less processed food”. That is, of course, also advisable (and indeed, is advised in the book too), but there’s a lot more going on here too.
Though not a doctor, the author is a psychologist who brings a lot of data to the table, especially when it comes to the neurophysiology at hand, what forgotten micronutrients many people are lacking, and what trends in society worsen these deficiencies in the population at large.
If you only care about the broadest of take-away advice, it is: eat a diet that’s mostly minimally processed plants and some oily fish, watch out for certain deficiencies in particular, and increase dietary intake of them where necessary (with taking supplements as a respectable next-best remedy).
On which note, a point of criticism is that there’s some incorrect information about veganism and brain health; she mentions that DHA is only found in fish (in fact, fish get it from algae, which has it, and is the basis of many vegan omega-3 supplements), and the B12 is found only in animals (also found in yeast, which is not an animal, as well as various bacteria in soil, and farm animals get their B12 from supplements these days anyway, so it is arguable that we could keep things simpler by just cutting out the middlecow).
However, the strength of this book really is in the delivery of understanding about why certain things matter. If you’re told “such-and-such is good for the brain”, you’ll up your intake for 1–60 days, depending on whether you bought a supermarket item or ordered a batch of supplements. And then you’ll forget, until 6–12 months later, and you’ll do it again. On the other hand, if you understand how something is good or bad for the brain, what it does (for good or ill) on a cellular level, the chemistry and neurophysiology at hand, you’ll make new habits for life.
The style is middle-range pop-science; by this we mean there are tables of data and some long words that are difficult to pronounce, but also it’s not just hard science throughout—there’s (as one might expect from an author who is a psychologist) a lot about the psychology and sociology of why many people make poor dietary decisions, and the things governments often do (or omit doing) that affect this adversely—and how we can avoid those traps as individuals (unless we be incarcerated or such).
As an aside, the author is British, so governmental examples are mostly UK-based, but it doesn’t take a lot to mentally measure that against what the governments of, for example, the US or Canada do the same or differently.
Bottom line: there’s a lot of great information about brain health here; the strongest parts are whether the author stays within her field (psychology encompasses such diverse topics as neurophysiology and aspects of sociology, but not microbiology, for example). If you want to learn about the physiology of brain health and enjoy quite a sociopolitical ride along the way, this one’s a good one for that.
Click here to check out Unprocessed, and make the best choices for you!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Professional-Style Dental Cleaning At Home?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
You know the scene: your dentist is rummaging around inside your mouth with an implement that looks like a medieval torture device; you wince at a sudden sharp pain, only to be told “if you flossed, you wouldn’t be bleeding now”.
For most of us, going to the dentist isn’t near the top of our “favorite things to do” list, but it is of course a necessity of (healthy) life.
So, what can we do to minimize suffering in the dentist’s chair?
First, the basics
Of course, good oral hygiene is the absolute baseline, but with so many choices out there, which is best? We examined an array of options in this three-part series:
- Toothpastes & Mouthwashes: Which Help And Which Harm?
- Flossing Without Flossing?
- Less Common Oral Hygiene Options ← we recommend the miswak! Not only does it clean the teeth as well as or better than traditional brushing, but also it changes the composition of saliva to improve the oral microbiome, effectively turning your saliva into a biological mouthwash that kills unwanted microbes and is comfortable for the ones that should be there.
In fact, caring for the composition of one’s saliva, and thus one’s oral microbiome, is so important that we did a main feature on that, a little later:
Make Your Saliva Better For Your Teeth ← this is especially important if you take any meds that affect the composition of your saliva (scroll down to the table of meds). Your medications’ leaflets won’t tell you that it does that directly, but they will list “dry mouth” as one of the potential side effects (and you’ll probably know if you have a medication that gives you a dry mouth).
Next, level up
For this one, we’ll drop some links to some videos we’ve featured (for those who prefer text, worry not, your faithful writer has added text-based overviews):
- How To Regrow Receding Gums
- Tooth Remineralization: How To Heal Your Teeth Naturally
- Tartar Removal At Home & How To Prevent Tartar
Now, that last one sounds slightly more exciting than it is—it is about using chemical processes to gradually lessen the tartar over time, with a six-month timeframe.
So, what if you want to do one better than that?
Finally… Buckle up, this one’s fun
Ok, so “fun” and “dental care” don’t usually go hand-in-hand, and maybe your sense of fun differs from this writer’s, but hey. The thing is, we’re going to get hands-on with dental tools.
Specifically, these dental tools:
👆 these are literally the tools this writer has; if you look in the specula (the round mirror bits), you can see the reflection of the fluffy gray bathrobe I was wearing when I took the picture!
You can get tools like these easily online; here’s an example product on Amazon; do also shop around of course, and we recommend checking the reviews to ensure good quality.
Writer’s story on why I have these: once upon a time, a wisdom tooth came through at 45°, ploughing through the molar next to it, which then needed removing.
However, my teeth have the interesting anatomical quirk that I have hooked/barbed roots, which does not make tooth extraction easy; it had to come out sidewise, and the process was somewhat bungled by an inexperienced dental surgeon.
When the anesthetic wore off, it was the most pain I’ve ever been in in my life.
After that, I wasn’t a very regular returner to the dentist, and in 2013, I fell into a very deep depression for unrelated reasons, and during that period, I got some plaque/tartar buildup on some of my teeth due to lack of care, that then just stayed until I decided to take care of it more recently, which I am happy to say, I’ve now done (my teeth are the happiest and healthiest they’ve ever been), and I’m going to share how, with you.
So, here’s how to do it… First, you’ll need those tools, of course.
You will also want a good quality backlit magnifying mirror. Again, here’s an example product on Amazon ← this is the exact kind this writer has, and it’s very good.
You may be thinking: “wait a minute, this is scary, those are dangerous and I’m not a dentist!”
If so, then a few quick things to bear in mind:
- If you’re not comfortable doing it, don’t do it. As ever, our medical/legal disclaimer applies, and we share information for your interest only, and not as an exhortation to take any particular action. By all means confer with your dentist, too, and see whether they support the idea.
- These things do look scarier than they are once you get used to them. Do you use metal silverware when eating? Technically you could stab yourself with a fork any time, or damage your teeth with it, but when was the last time you did that?
- With regard to manual dexterity, if you have the manual dexterity required to paint your nails, floss your teeth, sew by hand, or write with a pen, then you have the manual dexterity to do this, too.
Now, about the tools:
- Speculum / magnifying speculum: the one with the mirror. This is useful for looking at the backs of teeth.
- Tweezers: the one with the gold grip in the photo above. You probably won’t need to use these, but we’re sure you know how to use tweezers in general.
- Dental explorer: the one with the big wicked-looking hook on one end, and a tiny (almost invisible in the photo) hook on the other end. This is for examining cavities, not for manipulating things. Best leave that to your dentist if you have cavities.
- Dental pick: this is the one to the right of the dental explorer, and it is for cleaning in the crevices between teeth. One end is quite blunt; the other is pointier, and you can choose which end to use depending on what fits into the shape of the crevice between your teeth.
- Dental scraper: this is the one with chisel ends. One end curves very slightly to the left, the other, very slightly to the right. This is for ergonomics depending on which hand you’re using, and which side you’re scraping (you’ll become very aware that your teeth, even if they look straight, curve very slightly at the edges.
You’ll be using these last two for the actual tartar removal, selecting the tool appropriate to cleaning the flat surface of a tooth, or the crevice where the teeth meet (not like flossing! That part, yes, but under no circumstances is this thing going all the way through to the other side, it’s just for getting into to nook that the scraper can’t so easily clean, that’s all).
A word on using metal against your teeth: a scary prospect, initially! However…
While steel is indeed harder than the enamel of your teeth, the enamel of your teeth is much harder than the plaque/tartar/calculus that you will be removing. Therefore, the technique to use is very gently scrape, starting as gently as humanly possible until you get a feel for it.
Unlike the dentist, you will have an advantage here in that you have biofeedback, and bone conduction of the sounds in your mouth, so you can exercise much more restraint than your dentist can. With the correct minimum of pressure, the tool should glide smoothly down enamel, but when it’s scraping tartar, it should make a very fine sandpapery noise.
This is why “or write with a pen” was one of the skills we mentioned earlier; it’s the same thing; you don’t press with a pen so hard that it goes through the paper, so don’t press so hard with the tool that it damages your enamel, that’s all.
Because of the differential in hardness between the tartar and the enamel, it’s really very easy to remove the tartar without harming the enamel, provided one is gentle.
Final word of warning; we’ll repeat: If you’re not comfortable doing it, don’t do it. As ever, our medical/legal disclaimer applies, and we share information for your interest only, and not as an exhortation to take any particular action. By all means confer with your dentist, too, and see whether they support the idea.
Also, while this kind of cleaning can be done safely at home, we recommend against doing anything more complicated than that.
See for example: Can You Repair Your Own Teeth At Home? ← the short answer is “no”, or not beyond tooth remineralization, anyway, and kits that say otherwise are potentially misleading, or stop-gap solutions at best.
One last time: always consult with a professional and get their advice (ours is not advice; it’s just information).
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
From immunotherapy to mRNA vaccines – the latest science on melanoma treatment explained
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
More than 16,000 Australians will be diagnosed with melanoma each year. Most of these will be caught early, and can be cured by surgery.
However, for patients with advanced or metastatic melanoma, which has spread from the skin to other organs, the outlook was bleak until the advent of targeted therapies (that attack specific cancer traits) and immune therapies (that leverage the immune system). Over the past decade, these treatments have seen a significant climb in the number of advanced melanoma patients surviving for at least five years after diagnosis, from less than 10% in 2011 to around 50% in 2021.
While this is great news, there are still many melanoma patients who cannot be treated effectively with current therapies. Researchers have developed two exciting new therapies that are being evaluated in clinical trials for advanced melanoma patients. Both involve the use of immunotherapy at different times and in different ways.
The first results from these trials are now being shared publicly, offering insight into the future of melanoma treatment.
Svitlana Hulko/Shutterstock Immunotherapy before surgery
Immunotherapy works by boosting the power of a patient’s immune system to help kill cancer cells. One type of immunotherapy uses something called “immune checkpoint inhibitors”.
Immune cells carry “immune checkpoint” proteins, which control their activity. Cancer cells can interact with these checkpoints to turn off immune cells and hide from the immune system. Immune checkpoint inhibitors block this interaction and help keep the immune system activated to fight the cancer.
Results from an ongoing phase 3 trial using immune checkpoint inhibitors were recently published in the New England Journal of Medicine.
This trial used two types of immune checkpoint inhibitors: nivolumab, which blocks an immune checkpoint called PD-1, and ipilimumab, which blocks CTLA-4.
More than 16,000 Australians are diagnosed with melanoma each year. Delovely Pics/Shutterstock Some 423 patients (including many from Australia) were enrolled in the trial, and participants were randomly assigned to one of two groups.
The first group had surgery to remove their melanoma, and were then given immunotherapy (nivolumab) to help kill any remaining cancer cells. Giving a systemic (whole body) therapy such as immunotherapy after surgery is a standard way of treating melanoma. The second group received immunotherapy first (nivolumab plus ipilimumab) and then underwent surgery. This is a new approach to treating these cancers.
Based on previous observations, the researchers had predicted that giving patients immunotherapy while the whole tumour was still present would activate the tumour-fighting abilities of the patient’s immune system much better than giving it once the tumour had been removed.
Sure enough, 12 months after starting therapy, 83.7% of patients who received immunotherapy before surgery remained cancer-free, compared to 57.2% in the control group who received immunotherapy after surgery.
Based on these results, Australian of the year Georgina Long – who co-led the trial with Christian Blank from The Netherlands Cancer Institute – has suggested this method of immunotherapy before surgery should be considered a new standard of treatment for higher risk stage 3 melanoma. She also said a similar strategy should be evaluated for other cancers.
The promising results of this phase 3 trial suggest we might see this combination treatment being used in Australian hospitals within the next few years.
mRNA vaccines
Another emerging form of melanoma therapy is the post-surgery combination of a different checkpoint inhibitor (pembrolizumab, which blocks PD-1), with a messenger RNA vaccine (mRNA-4157).
While checkpoint inhibitors like pembrolizumab have been around for more than a decade, mRNA vaccines like mRNA-4157 are a newer phenomenon. You might be familiar with mRNA vaccines though, as the biotechnology companies Pfizer-BioNTech and Moderna released COVID vaccines based on mRNA technology.
mRNA-4157 works basically the same way – the mRNA is injected into the patient and produces antigens, which are small proteins that train the body’s immune system to attack a disease (in this case, cancer, and for COVID, the virus).
However, mRNA-4157 is unique – literally. It’s a type of personalised medicine, where the mRNA is created specifically to match a patient’s cancer. First, the patient’s tumour is genetically sequenced to figure out what antigens will best help the immune system to recognise their cancer. Then a patient-specific version of mRNA-4157 is created that produces those antigens.
The latest results of a three-year, phase 2 clinical trial which combined pembrolizumab and mRNA-4157 were announced this past week. Overall, 2.5 years after starting the trial, 74.8% of patients treated with immunotherapy combined with mRNA-4157 post-surgery remained cancer-free, compared to 55.6% of those treated with immunotherapy alone. These were patients who were suffering from high-risk, late-stage forms of melanoma, who generally have poor outcomes.
It’s worth noting these results have not yet been published in peer-reviewed journals. They’re available as company announcements, and were also presented at some cancer conferences in the United States.
Based on the results of this trial, the combination of pembrolizumab and the vaccine progressed to a phase 3 trial in 2023, with the first patients being enrolled in Australia. But the final results of this trial are not expected until 2029.
It is hoped this mRNA-based anti-cancer vaccine will blaze a trail for vaccines targeting other types of cancer, not just melanoma, particularly in combination with checkpoint inhibitors to help stimulate the immune system.
Despite these ongoing advances in melanoma treatment, the best way to fight cancer is still prevention which, in the case of melanoma, means protecting yourself from UV exposure wherever possible.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research) and John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: