Day: October 21, 2025

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Drug Combo Cuts Risk of Death in Advanced Prostate Cancer by 40%

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Cedars-Sinai Led Clinical trial showed combo treatment reduced deaths in patients with an aggressive form of the disease

Credit: Darryl Leja National Human Genome Research Institute National Institutes Of Health

Men whose prostate cancer returns after surgery or radiation therapy may now benefit from a new drug combination shown in clinical trials to cut the risk of death by more than 40%.

The combination therapy, which adds the drug enzalutamide to commonly prescribed hormone therapy, reduced deaths in patients with recurrent prostate cancer after surgery or radiation for whom other treatments are no longer an option. The trial results were published in The New England Journal of Medicine (NEJM) with simultaneous presentation during the European Society for Medical Oncology Congress (ESMO) Oct. 19 in Berlin.

“After initial treatment, some patients see their prostate cancer come back in an aggressive way and are at risk for their disease to spread quickly,” said Stephen Freedland, MD, director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai Cancer and co-principal investigator of the study. “Hormone therapy, which is what we’ve been offering patients for 30 years, has not improved survival and neither has anything else. That makes these findings a real game changer.”

The trial included more than 1000 patients from 244 sites in 17 countries. All the patients were diagnosed with what is known as high-risk biochemically recurrent prostate cancer. Following the patients’ surgery or radiation therapy, the levels of prostate specific antigen, or PSA, in their blood had risen rapidly. PSA is a protein used to detect prostate cancer, and a rapid rise in PSA levels after treatment indicates a patient’s cancer is likely to return and metastasise, often to the bones or spine.

“We know these patients are at high risk of developing metastatic disease and dying of their cancer unless we offer a meaningful treatment option,” said Freedland, professor of Urology and the Warschaw, Robertson, Law Families Chair in Prostate Cancer.

Patients were randomly selected to receive standard hormone therapy alone, enzalutamide alone, or a combination of the two. After eight years, the risk of death was 40.3% lower in the combination group than in the other two groups, Freedland said.

“This clinical trial, one of many that Cedars-Sinai Cancer has offered to its patients, is an example of the translational work being done by our physician-scientists,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer. “The result will be improved treatment and better outcomes for patients everywhere.”

Freedland noted that, based on previous results published by the team, enzalutamide is approved by the Food and Drug Administration and listed in National Comprehensive Cancer Network treatment guidelines. These latest results, he said, are likely to strengthen the network’s recommendation and solidify this drug combination as the standard of care for patients with high-risk biochemically recurrent prostate cancer.

“These important findings identify a treatment that prolongs survival in men with aggressive prostate cancer,” said Hyung Kim, MD, a urologic oncologist and chair of the Department of Urology at Cedars-Sinai.  “The latest analysis complements previous studies that found enzalutamide significantly improved survival in other prostate cancer settings, and will change how we take care of our patients.”

Source: Cedars-Sinai Medical Center

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Opinion Piece: The Lifetime Toll of Medical Aid Shortfalls

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Photo by Alex Green on Unsplash

By Tony Singleton, CEO at Turnberry Management Risk Solutions

21 October 2025

You plan for retirement, save for your child’s education, and try to build a financial cushion, but what happens when medical co-payments chip away at those plans, year after year? It starts small: a R5,000 co-payment for a scope. Then a few months later, a R12,000 shortfall for a hospital admission. Fast forward five years, and you’ve spent tens of thousands on out-of-pocket medical costs that your medical aid didn’t fully cover.

Medical aids cannot keep pace with the rate of medical inflation while still maintaining affordable premiums, so co-payments grow each year, more sub-limits are introduced, and specialist fees continue to outpace medical aid rates. This means more and more South Africans are finding themselves forced to draw from their retirement funds or take on debt to cover medical aid shortfalls. Medical aid alone is no longer enough to protect your financial future – gap cover has become essential.

How medical expense shortfalls silently accumulate

Medical scheme members, especially those on higher-end plans, often assume they are covered for any medical eventuality – until it is time to actually claim for a significant medical event. Even comprehensive plans can fall short when it comes to specialist charges, hospital procedures, or newer, high-tech treatments. Many specialists charge as much as five or six times the scheme rate, and certain procedures have limits to what medical aid will pay or require an up-front co-payment. While your medical aid might pay a portion, the remainder becomes your responsibility.

This can become a compounding problem. What starts as a few isolated bills adds up. Over time, shortfalls from surgeries, diagnostics, scopes, chronic illness treatment, or specialist consultations can add up to hundreds of thousands of Rands. For example, one Turnberry client managing spinal conditions, lupus, and gastro-oesophageal reflux disease (GERD) claimed R478,000 across 27 incidents in only five years. Another has claimed R450,000 across 54 incidents related to lung disease and spinal conditions, and a third, with multiple chronic issues, has received over R448,000 in gap cover payments over the same period. As the years go by, these amounts continue to add up, and this is becoming an increasingly typical pattern. Many families are forced to pause investments, take out loans, or remove money from their retirement annuities to keep up with these uncovered and unanticipated expenses.

Gap cover has become essential

Gap cover was created precisely to tackle these medical expense shortfalls, with an affordable policy that sits alongside medical aid and offers cover for medical expense shortfalls, co-payments, sub-limit cover, oncology shortfalls, prosthesis costs, and even casualty visits. Where medical aid benefits have tightened to control premiums, gap cover has expanded to fill the void.

Many South Africans still believe gap cover is a nice-to-have or something that is only necessary later in life. The reality, though, is that shortfalls affect people no matter what age they are, from broken bones in their 20s to maternity bills in their 30s or chronic conditions emerging in their 40s and beyond. Joining early also makes a difference, as you are covered from the start and your premiums will remain lower than someone beginning their cover at 65, when age-based premium increases and health exclusions may apply. Gap cover is not just for major surgeries or cancer treatments; it is valuable for more routine procedures as well as accidents and emergencies. And its value increases over time, especially if you remain continuously covered and avoid reintroducing waiting periods.

A long-term strategy, not a short-term fix

By staying on gap cover year after year, members build a stable financial buffer against the cumulative effect of medical costs. We’ve seen clients rely on gap cover for decades of health events, not just one-off emergencies, and the value of continuous cover is evident in our lifetime claims figures. Gap cover is no longer a luxury, it is an essential tool for building long-term financial resilience. Without it, medical aid shortfalls can easily undo years of careful financial planning. Talk to your broker about finding the best gap cover solution to fit your needs.

About Turnberry Management Risk Solutions

Founded in 2001, Turnberry is a registered financial services provider (FSP no. 36571) that specialises in Accident and Health Insurance, Travel Insurance, and Funeral Cover.

With extensive experience across healthcare and insurance industries in South Africa, Turnberry offers unsurpassed service to Brokers and clients. Turnberry’s gap cover products are available to clients on all medical aid schemes, as they are independently provided and are therefore transferable in the event of a change in the client’s medical aid scheme.

Turnberry is well represented nationally, with its Head Office based in Bedfordview, Johannesburg with Business Development Managers in Cape Town and Durban. The Turnberry Team’s focus on outstanding client service comes from having extensive knowledge and experience in the financial services sector and is underwritten by Lombard Insurance Company Limited. Lombard Insurance Company Limited is an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.

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Craters on Surface of Melanoma Cells Serve as Sites for Tumour Killing

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Studying these craters could better assess immunotherapy’s success in treating solid tumours

3D structure of a melanoma cell derived by ion abrasion scanning electron microscopy. Credit: Sriram Subramaniam/ National Cancer Institute

Like the surface of the moon, new research published today in Cell finds the existence of craters on the surface of melanoma cells that serve as immune hubs, becoming major sites for tumour killing. These craters could serve as good markers for immunotherapy success.

This research provides insight into a key function of immune check-point blockade (ICB) cancer therapy that was previously unknown. ICB works by re-activating CD8+ T cells against tumours which shrinks and eventually kills the cancer cells. However, what facilitates local tumour killing by the infiltrating CD8+ T cells has remained a mystery.

Using a zebrafish model, researchers were able to monitor the infiltrating CD8+ T cells for up to 24 hours as they moved through the 3D architecture of endogenous melanoma tumours. Zebrafish provide the only tumour model where continuous live imaging over a 24 hour time period is feasible.  

“We found that rather than patrolling the entire tumour surface, CD8+ T cells aggregated in pockets on the melanoma border, forming prolonged interactions with melanoma cells,” says Leonard Zon, MD, Director of the Stem Cell Program at Boston Children’s Hospital and lead investigator of the study. “We termed these pockets Cancer Regions of Antigen presentation and T cell Engagement and Retention (CRATERs) and saw that, following immune stimulation, the CRATERs expanded and facilitated an effective immune response against the tumour.”

Zon, first author Aya Ludin, and the team also discovered CRATERs in human melanoma samples. Moreover, they saw similar structures in human lung cancer, indicating that CRATERs are likely not limited to melanoma and may form in other solid tumours.

To date, efficacy of therapeutic response to ICB therapy has been assessed mainly by estimating the degree of tumour necrosis and fibrosis. Indicators of CD8+ T cells infiltration has been associated with patient survival and treatment outcome, but direct evidence of effective immune cell-tumour cell interaction has been missing.

“Pending thorough clinical verification and taken together with other measurements, CRATERs may serve to more accurately assess the efficacy of an ongoing treatment and improve treatment outcomes,” said Zon.

The research team is now planning a prospective clinical trial to test if CRATERs are the best marker of ICB success.

Source: Boston Children’s Hospital via EurekAlert!

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Is It Time for the Gloves to Come off?

On By ModernMedia

The indiscriminate use of non-sterile gloves in hospitals and clinics could be doing more harm than good, new research has found.

Photo by Anton on Unsplash

The indiscriminate use of non-sterile gloves in hospitals and clinics is significantly adding to environmental pollution, with little evidence to prove that there are substantial benefits.

New research from Edith Cowan University (ECU) has highlighted the lack of evidenced-based guidelines in the use of non-sterile gloves in healthcare nursing and other medical fields, which could be impacting patient outcomes, healthcare costs, and environmental sustainability in healthcare.

Lead author Dr Natasya Raja Azlan noted while non-sterile gloves are necessary when there is a risk of touching body fluids that could carry viruses or bacteria or hazardous medications, there is no evidence to support the use of gloves for activities like moving patients, feeding, or basic washing or preparing many medications.

In fact, unnecessary glove use can be harmful. Staff are less likely to wash their hands, even though handwashing remains the best way to stop infections spreading. The result can be increased spread of harmful disease between vulnerable patients as well as healthcare staff.

Dr Raja Azlan

Co-author Dr Lesley Andrew added that the abundant use of non-sterile gloves was also contributing to the cost of healthcare, pointing out that one New South Wales hospital’s decision to cut-back on the use of these gloves had saved $155 000 in a single year and reduced medical waste by 8 tonnes.

“The disposal of healthcare products represents 7% of Australia’s national total carbon emissions, only slightly less than the 10% attributed to all road vehicles. Manufacturing these gloves consumes fossil fuels, water, and energy, while their disposal if through incineration can degrade air quality and release harmful chemicals. If sent to landfill, they may leach microparticles and heavy metals into soil and water systems, posing risks to both human health and the environment,” she added.

Dr Raja Azlan noted that, despite non-sterile glove use being a common and routinely taught practice during intravenous antimicrobial preparation and administration, there are currently no evidence-based guidelines or protocols in place to support or standardise this aspect of nursing care.

This lack of evidence-based protocols has resulted in co-author Dr Carol Crevacore calling for a review into this practice.

Source: Edith Cowan University