CLUELESS! doctors are confused of each others responsibility in cancer treatment, study found

When it comes to their respective responsibilities in patient care with breast cancer, doctors may be as clueless as the next person, according to a study conducted on Metro Manila doctors.

Researchers underlined the need for multidisciplinary guidelines for patient care in breast cancer .

The study surveyed doctors from tertiary hospital in Metro Manila with regards to division of labor among health practitioners in various aspects of Human Epidermal Growth Factor Receptor-2 (HER2) Testing, an important diagnostic exam for breast cancer.

HER-2 testing is widely recommended diagnostic procedure for all primary breast cancers. From patient education, to collection of specimen, and and overall patient care, the procedure involved a team of medical practitioners with with varying tasks and responsibilities.

The study, done in collaborations between researchers at the University of the Philippines – College of Medicine and Cardinal Santos Medical Center,   revealed that more than half (54%) of the surveyed answered that surgeons and staff at the operating room are responsible for the breast tissue collection, while 23% answered it is the pathologist’s responsibility. Varying answers include staff at the operating room only (13%), medical technicians (7%), medical oncologist (1%), and  whomever was in charge of the patient (1%).

As for the primary responsibility of requesting for HER-2 testing, 69% answered the medical oncologist or whomever the patient saw first, 13% answered surgeons, 12% medical oncologist only, 4% pathologists, and 1% said it should be the patient.

With regard to patient education, 59% of the surveyed answered the responsibility is in the hands of medical oncologists or whomever sees the patient first. Other answered medical oncologists only (28%), surgeons (9%), nurses (1%), and any oncologist or practicing physician (15).

With the varying answers, researchers lamented, “Though the differences are minor, these may reveal a lack of interdisciplinary awareness.”

Researchers explained that the awareness of interdisciplinary roles played by members of the medical team is essential for the well-being of both the patient and the medical practitioners. Patients get more efficient service while the medical team increase morale and work satisfaction.

The lack of interdisciplinary awareness can only be sufficiently addressed through strong compliance to international accepted guidelines with patient care. The researchers discussed that guidelines on HER-2 testing has been set up by the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP). However, the Philippines currently have no central body that will help with the adoption of a similar guidelines for HER-2 testing in the country. Until the Philippines has find away to successfully set up guidelines for HER-2 testing, cohesive and efficient medical service for Filipino breast cancer patient will remain a challenge.

Urban slums report the highest death rates for children under five

Children in world’s urban slums are twice as likely to die before they reach the age of five than their richer counterpart, according to the State of the World’s Mothers 2015 report released by the Save the Children Foundation last 5 May 2015.

The first-ever assessment of disparities in health among the the rich and the poor in cities worldwide, the report warned of the widening gaps in child survival rates among the rich and poor in almost half of the 40 developing nations surveyed.

Death among newborns in cities is common, the report revealed. However, in some cities, such as in Brazil and India, death rates among newborns could be 50% higher in urban slums than in the richer neighborhoods.

Malnutrition increases susceptibility of children in slum areas to diarrheal diseases and respiratory infections, further increasing chances of  dying among children in slums. For instance, in Bangladesh, 50% of children living slums under the age of five are stunted, while 43% are underweight. The figures are 33% and 26% respectively in wealthier areas in the country.

Lack of access to medical and health services was cited as a major factor in the skewed death rates among rich and poor children in cities worldwide.

For instance, mothers giving births at home without the attendance of trained medical personnel can result to late recognition of newborn illnesses, inadequate newborn care, and delay in appropriate medical interventions.

“While urbanization in and of itself not inherently problematic, the pace and the sheer scale of urbanization has, in many places, far exceeded local government’s ability to provide essential services, including water, sanitation, and health care,” the report discussed.

Amidst the grim statistics, Dr. Carolyn Miles, President and CEO of Save the Children, found hope in cities such as Addis Ababa and Manila. “There is no simple solution to creating more equitable cities, but a number of cities cited in the report – such as Addis Ababa in Ethiopia and Manila in the Philippines – have been successful in addressing the health needs of the poorest families, and these examples could serve as models for other cities to follow,” she said.

Manila and Addis Ababa were among the major cities that were found to be making significant gains for the poorest children, which also includes Cairo, Guatemala City, Kampala and Phnom Penh. Dr. Miles explained that while these cities have conducted various programs to address the inequity in access to health care services, three major strategies were found to be consistent. These are 1) better care for mothers and babies before, during and after childbirth; 2) increased use of modern contraception to prevent or postpone pregnancy; and 3) effective strategies to provide free or subsidized quality health services for the poor.

Dr. Miles stressed that cities have the advantage of technology, highly skilled partners, and presence of health care services to address the growing divide in survivability of children in cities of the world. What must be done is to provide enough resources to fuel life saving programs to make health services accessible to everyone.


Nutrition experts recommend inclusion of nutrition interventions in disaster response

Nutrition experts pushed for the inclusion of nutrition interventions in times of disasters during the 2014 Dr. Juan Salcedo Memorial Lecture on October 9, 2014.

“Food and nutrition must be part of our initial response during disasters,” said Ms. Florinda Panlilio, Nutrition Program Coordinator of the National Nutrition Council – Region III (NCC-Region III). Highlighting the importance of prioritizing victims’ nutritional status in times of calamities, she warned that malnutrition increases susceptibility of victims of disasters to communicable diseases.

Traditionally, patients with malnutrition are sent to hospitals or health centers for treatment. However, the approach can be disadvantageous to hospitals with limited resources or space. Especially in times of emergencies, Ms. Panlilio said that the approach can cause overcrowding of hospitals.

Dr. Martin Parreño, National Program Officer of the United Nations (UN) World Food Programme (WFP) – Philippines, recommended the integration of community management of acute malnutrition (CMAM) to national program on health, especially during emergencies.

CMAM is a strategic community-based intervention wherein children with acute malnutrition are treated at home, as opposed to the hospitals or medical clinics. It allows health workers to target children most vulnerable to acute malnutrition, conduct in depth screening, and provide selective feeding.

At the moment, the WFP recommends CMAM to countries that has 10% to 14% burden on malnutrition. Despite the country’s 7.9% burden, Dr. Parreño explained that the frequency of disasters makes the CMAM an ideal program for the Philippines.

With over one million young Filipinos suffer from acute malnutrition, Dr. Parreño said that the children are especially vulnerable during disasters. The integration of CMAM in disaster program will help save lives.

The 2014 Dr. Juan Salcedo Memorial Lecture, a nutrition forum annually hosted by the Nutrition Foundation of the Philippine, Inc. (NFP) and supported by the Philippine Council for Health Research and Development of the Department of Science and Technology (PCHRD-DOST).

MD-PhD program lauded as model for human resource development

Prof. Fortunato Dela Peña, Department of Science and Technology (DOST) Undersecretary for Scientific and Technological Services, lauded the MD-PhD Molecular Medicine Scholarship Program as good model for human resource development programs in science and technology during the signing of Memorandum of Understanding (MOU) at the University of the Philippines (UP) College of Medicine on October 8, 2014.

MD-PhD in Molecular Medicine Scholarship Program is a joint initiative of UPM and the DOST, through the Philippine Council for Health Research and Development (PCHRD), that aims to train aspiring physician-scientists for careers in basic and applied biomedical research towards the advancement of health from individual to global levels. It is the first and pioneering degree program in the Philippines that combines the MD and PhD courses in one.

Usec. Dela Peña explained that the MD-PhD Program is part of an ongoing effort to capacitate the S&T sector with highly trained and skilled human resource by providing scholarship grants in almost all educational Levels. Aside from scholars at the Philippine Science High School (PSHS) System, the Department also supports more than 4,000 undergraduate and more than 1,000 MS and PhD scholars.

Describing the program as “very innovative” and a “breakthrough in graduate education,” Usec. Dela Peña discussed DOST may follow the dual-career concept of MD-PhD in Molecular Science program in developing future scholarship grants in other fields of science and technology. He said, “I was just thinking in the future, with the people who conceptualized this, we can also develop similar PhD programs for other S&T tracks.”

ASEAN network to address global threats of infectious and tropical diseases

Dr. Jaime C. Montoya, Executive Director of the Philippine Council for Health Research and Development of the Department of Science and Technology (PCHRD-DOST), discussed the importance of building and sustaining a regional network for health research and innovation in Southeast Asia at the 12th Taro Takemi Memorial Oration at the Marriott Hotel, Pasay City on October 2014.

The Oration is held every two years since 1990 to honor the late Dr. Taro Takemi, former President of Confederation of Medical Associations in Asia and Oceania (CMAAO) and the Japan Medical Association, for his contributions to the Confederation and his achievements in global health care as a physician, researcher, and inventor.

The first Filipino to deliver the Oration, Dr. Montoya highlighted the ongoing network between member states of the Association of Southeast Asian Nations (ASEAN) to address the escalating cost of and poor access to modern medicine in the region. Featuring ASEAN – Network for Drugs, Diagnostics, Vaccines, and Traditional Medicine Innovation (ASEAN-NDI), he discussed that the collaboration supports health research on emerging and the re-emerging health concerns in Southeast Asia.

Dr. Montoya explained that difference in economic capacity affects the health systems and programs among ASEAN member states. Linking wealth to health status, Dr. Montoya mentioned that poorer nations suffer more from communicable and non-communicable diseases. Through ASEAN-NDI, ASEAN member states enhance their research capacity, minimize duplication of work for the same diseases and products, and address concerns on lack of infrastructure and resources, sharing of expertise, and intellectual property by implementing working arrangement between ASEAN states and the international community.

Dr. Montoya said that the establishment of a Southeast Asian center for fundamental and translational research is one way to address global threats of infectious and tropical diseases. As a catalyst of regional and global research collaborations, he stressed that the ASEAN-NDI will be significant in finding solutions to emerging and re-emerging health concerns worldwide.

The 12th Taro Takemi Memorial Oration was hosted by the Philippine Medical Association (PMA) in line with the 29th General Assembly and 50th Council Meeting of CMAAO.

Banana may prevent kidney stones, study says

Banana stalk may be the next alternative herbal remedy against kidney stones according to a study done on mice by Pharmacy students at the San Pedro College in Davao City.

Student researchers recommended further studies to test the effectiveness of banana stalk in prevention of kidney stones in humans.

Kidney stones or renal calculi are hard masses developed from the crystalized substances from the urine. Factors attributed to the formation of the kidney stones include low fluid intake, acidic urine, and high intake of foods rich in protein (meat and beans), salt (canned and processed foods), and oxalate (spinach, tea, nuts, and cocoa).

During the study, laboratory mice were drug-induced to develop kidney stones and were given banana stalks that were processed into capsules for 10 days.
Laboratory examinations showed that mice fed with banana capsules did not show signs of developing kidney stones. Blood and urine examination conducted on the mice revealed healthy functioning kidneys.

Researchers attributed to the high magnesium and potassium content of the plant for its ability to prevent the formation of kidney stones. They explained that magnesium combines readily with the oxalates in the food we eat, inhibiting the growth of a type of kidney stone known as calcium oxalate crystals. Potassium on the other hand balances the acidity of the urine preventing increase in urine acidity and development of calcium oxalate crystals.

While treatments for kidney stones are available, the student researchers argued that prevention is still better. The cost of treatment for removal of kidney stones can be exorbitant and may be beyond the reach the poor, the researchers expressed that the study will help with the development of affordable remedy against kidney stones. “This study will provide economical alternative maintenance herbal plant for the prevention of formation of kidney stones,” they said.

The research, entitled, “The Anti-Urolithiatic Activity of the Tundan Saging (Musa paradisiaca Linn.) Pseudo-Stem Capsule in Ethylene Glycol-Induced Albino Rats (Rattus norvegicus): A Potential Preventng Agent for Kidney Stone Formation,” was recently awarded second prize at the Gruppo Medica award during the Philippine National Health Research System week Celebration in Cebu on August 12, 2014.

Davao students win first prize for research on antidengue property of papaya and tawa-tawa

Student-researchers bagged first prize at the Gruppo Medica Award for their research on the anti-dengue property of papaya (Carica papaya) and tawa-tawa (Euphorbia hirta) during the 8th Philippine National Health Research System (PNHRS) Week celebration in Cebu City on 12-14 August 2014.

Topping 21 research entries from all regions in the Philippines, the research done by Pharmacy students at the San Pedro College in Davao City revealed that tea concoction from tawa-tawa can increase blood platelet counts in rabbits by 194% in just 24 hours, whereas tea concoctions from papaya leaves only and mixture of papaya leaves and tawa-tawa plant yielded 85.74% and 83.44% increased in platelet counts respectively in rabbits within 24 hours.

Further laboratory tests on papaya and tawa-tawa revealed that both plants contain quercetin, a plant pigment known to naturally increase the platelet counts.

Recommending the continuation of the research, especially with the isolation of quercetin, the students stressed that the study is significant in the effort to develop treatment for the management of dengue. They said, “This research can benefit the society because it will pave the way to the development of new drug that is affordable, accessible, and effective against dengue.”

The Gruppo Medica Award is conferred annually by the Philippine Council for Health Research and Development of the Department of Science and Technology (PCHRD-DOST) to give recognition to undergraduate researches on the practical or commercial application of herbal plants for health.

Malunggay demonstrates potential anticancer property in an award-winning study

Award-winning research eyed malunggay (Moringa oleifera) for its potential anticancer properties, after laboratory tests showed extracts from the seeds and leaves to be toxic to colorectal cancer cells.

The study, done by researchers at the De La Salle University and supported by the Philippine Council for the Department of Science and Technology (PCHRD-DOST), won the recently concluded Poster Exhibit Contest during the 8th Philippine National Health Research System (PNHRS) Week celebration in Cebu City on 12-14 August 2014.

Through an in vitro test, researchers found that extract from malunggay can destroy colorectal cancer cells lines, while remaining safe and non-toxic on normal and healthy human cells. The ability was attributed to a bioactive compound that the researchers found in malunggay called, isothiocyanates. The compound has been previously reported to induce cell death in some human cancer cell lines.

Further test comparing malunggay extract to colchicine, a common anti-cancer drug, found that malunggay extract is less toxic to normal human cells than the commercial drug. Researchers explained that while colchicine is effective in destroying cancer cells, its toxic effect on healthy human cells is a huge disadvantage in using the drug. Therefore, the discovery of malunggay’s relative safety on normal human cell is very promising in search for effective and safe drug for cancer.

Researchers are hopeful that the research can establish strong foundation for further investigations of malunggay’s anticancer property. They said, “This study will provide solid scientific basis for at least one of the most important medicinal benefits that could be attributed to the plant – its anticancer property.”

Database set to protect Philippine cultural heritage on health

Patents on indigenous healing practices being wrongly granted to private companies endanger indigenous people’s rights to their own traditional knowledge and practices on health and healing.

To protect indigenous peoples’ claim to their cultural heritage, the University of the Philippines Manila (UPM) developed the Philippine Traditional Knowledge Digital Library on Health (TKDL-Health), a digital library of the country’s traditional knowledge and practices on health, healing and diseases.

In an email interview, Dr. Isidro C. Sia, Institute of Herbal Medicine (IHM) Director, University of the Philippines Manila – National Institutes of Health (UPM-NIH) and head of the Philippine TKDL-Health program, discussed that the TKDL-Health website helps prevent private entities from laying exclusive claim to the therapeutic practices or medicinal products of indigenous groups by creating proof of ownership for the traditional knowledge.

Dr. Sia cited India’s successful use of their own TKDL website to revoke a US patent on turmeric as a great example on how TKDL can be used as evidence for indigenous groups’ ownership of their healing practices.

The TKDL is consisted of databases of information regarding traditional knowledge on health, illness, and healing gathered from the documentary studies done among indigenous peoples and other cultural communities. At the moment, it supports information on 13,900 medicinal plants. Through the program, researchers and community members can work together as partners to catalogue the folk traditions in health, and in the process, advocate for the protection of the cultural legacy of the Filipinos. Go to to visit the site.

The TKDL-Health is a project supported by the Philippine Council for Health Research and Development of the Department of Science and Technology (PCHRD-DOST), the Philippine Institute of Traditional and Alternative Health Care (PITAHC), and the IHM, UPM-NIH.