Game changer in cancer treatment in Switzerland.

BACKGROUND: It is time for a game-changer in the cancer pathway in Switzerland and around the world. COVID-19 has made this more evident than ever. The prevalence, complexity, and cost of cancer care are increasing in Switzerland. Losses in efficiency, resources, and inappropriate attribution hinder health outcomes. This study examined opportunities for improvement across the cancer path, with a focus on patient-provider communication, effective policies and approaches to strengthen interprofessional collaboration. METHODS: A qualitative study was undertaken. Key stakeholders, selected on the basis of their expertise in different areas of the cancer pathway, were assessed through interviews. The need to develop and implement innovative strategies to prevent and treat cancer was investigated, and key recommendations were identified for discussion with politicians and policy makers. Inductive content analysis was conducted. RESULTS: There is a prominent need for collaboration and cross-sectoral action in cancer, encompassing clinical disciplines, communication strategies, and professional attitudes. The need and demand for collaboration responds to a highly fragmented cancer landscape in Switzerland, with a hierarchical organization of medical care entities and much competition. COVID-19 made these gaps more visible and highlighted the need to develop a new systematic approach and contingency plan to protect the most vulnerable. CONCLUSION: Pressing developments are occurring in the health care system given the increasing prevalence of some cancers, the demographics of the Swiss population, the growing number of cancer survivors, and the consequences of the COVID-19 pandemic. POLICY SUMMARY: More fundamental solutions and policies should be developed and implemented to meet patient needs and increase health outcomes: are providers and patients taking responsibility for change? Will business interests and the power play boycott policy development? Change must start now, with policymakers, patients, providers and insurers joining forces.

The sugar tax - An opportunity to advance oral health.

The new sugar tax was recently announced by Government, aiming to combat obesity through investment in school sports. Dental professionals should seize this rare opportunity to raise awareness of the other adverse effects of sugar; young children continue to suffer alarmingly high rates of dental cavities in the UK. A significant amount of money raised through the levy must be reinvested into ensuring fluoride toothpaste is more affordable. Since daily use of fluoride toothpaste is the most effective evidence-based oral health preventative measure that is widely used, this should receive tax exemption status from the government as a means of universal oral health prevention. There must also be a re-investment in innovative oral health education so that the next generation of children will alter their mind set about sugar. Oral health prevention advice must be tightly integrated into general health messages.

Patients' experiences following breast cancer treatment: an exploratory survey of personal and work experiences of breast cancer patients from three European countries.

Improved treatments for early breast cancer have led to a significant increase in overall survival. While evidence regarding potential long-term sequelae of adjuvant treatments exists, relatively little research reports patients' own perceptions of change before and after adjuvant chemotherapy (AC). This study aimed to identify key ongoing issues associated with AC in daily life. An online survey developed for this study was completed by 198 women (mean age 49.7 years) in the UK, France and Germany who had AC 1-5 years previously for oestrogen receptor positive, HER2 negative early breast cancer. Women without AC and endocrine therapy, those treated with Trastuzumab or who had recurrent disease were excluded. A third of women who responded were currently unable to perform their former family role. The majority had needed support, particularly with child care, during treatment. While 54% were in full-time employment before diagnosis this had reduced to 32% following AC. Of those women still working, over half reported difficulties with tiredness or concentration. Most (85.8%) were satisfied with healthcare professionals' treatment information, but only 29.7% received information about returning to work. This exploratory survey highlights areas of women's lives affected 1-5 years following AC for early breast cancer. The impact on returning to work and issues surrounding childcare particularly, require further study.

Calcium and calmodulin are essential for Ras-GRF1-mediated activation of the Ras pathway by lysophosphatidic acid.

The exchange factor Ras-GRF1, also called CDC25Mm, couples calcium signaling and G-protein-coupled receptors to Ras and downstream effectors. Here we show that when expressed in different cell lines Ras-GRF1 strongly enhances the level of active Ras (Ras-GTP) and the activity of mitogen-activated protein kinases (MAPK). Moreover, in NIH 3T3 fibroblasts it potentiates the effect of lysophosphatidic acid (LPA) on Ras protein and MAPK activity. Calmodulin and cytosolic free calcium are essential for Ras and MAPK activation induced by LPA and mediated by Ras-GRF1, as shown by the finding that BAPTA-AM, an intracellular calcium chelator, and calmodulin inhibitors completely abolished this effect. This report demonstrates the relevance of calmodulin in addition to calcium for the response of Ras-GRF1 to LPA.