Genetic material shed by tumours can be detected in the bloodstream three years prior to cancer diagnosis, according to a study led by investigators at Johns Hopkins.
The study, partly funded by the National Institutes of Health, was published in Cancer Discovery.
Investigators were surprised they could detect cancer-derived mutations in the blood so much earlier, says lead study author Yuxuan Wang, MD, PhD, an assistant professor of oncology at the Johns Hopkins University School of Medicine. “Three years earlier provides time for intervention. The tumours are likely to be much less advanced and more likely to be curable.”
To determine how early cancers could be detected prior to clinical signs or symptoms, Wang and colleagues assessed plasma samples that were collected for the Atherosclerosis Risk in Communities (ARIC) study, a large National Institutes of Health-funded study to investigate risk factors for heart attack, stroke, heart failure and other cardiovascular diseases. They used highly accurate and sensitive sequencing techniques to analyse blood samples from 26 participants in the ARIC study who were diagnosed with cancer within six months after sample collection, and 26 from similar participants who were not diagnosed with cancer.
At the time of blood sample collection, eight of these 52 participants scored positively on a multicancer early detection (MCED) laboratory test. All eight were diagnosed within four months following blood collection. For six of the eight individuals, investigators also were able to assess additional blood samples collected 3.1–3.5 years prior to diagnosis, and in four of these cases, tumour-derived mutations could also be identified in samples taken at the earlier timepoint.
“This study shows the promise of MCED tests in detecting cancers very early, and sets the benchmark sensitivities required for their success,” says Bert Vogelstein, MD, Clayton Professor of Oncology, co-director of the Ludwig Center at Johns Hopkins and a senior author on the study.
“Detecting cancers years before their clinical diagnosis could help provide management with a more favourable outcome,” adds Nickolas Papadopoulos, PhD, professor of oncology, Ludwig Center investigator and senior author of the study. “Of course, we need to determine the appropriate clinical follow-up after a positive test for such cancers.”
While scientists have long known that different senses activate different parts of the brain, a new Yale-led study indicates that multiple senses all stimulate a critical region deep in the brain that controls consciousness.
The study, published in the journal NeuroImage, sheds new light on how sensory perception works in the brain and may fuel the development of therapies to treat disorders involving attention, arousal, and consciousness.
In the study, a research team led by Yale’s Aya Khalaf focused on the workings of subcortical arousal systems, brain structure networks that play a crucial role in regulating sleep-wake states. Previous studies on patients with disorders of consciousness, such as coma or epilepsy, have confirmed the influence of these systems on states of consciousness.
But prior research has been largely limited to tracking individual senses. For the new study, researchers asked if stimuli from multiple senses share the same subcortical arousal networks. They also looked at how shifts in a subject’s attention might affect these networks.
For the study, researchers analysed fMRI (functional magnetic resonance imaging) datasets collected from 1,561 healthy adult participants as they performed 11 different tasks using four senses: vision, audition, taste, and touch.
They made two important discoveries: that sensory input does make use of shared subcortical systems and, more surprisingly, that all input, regardless of which sense delivered the signal, stimulates activity in two deep brain regions, the midbrain reticular formation and the central thalamus, when a subject is sharply focused on the senses.
The key to stimulating the critical central brain regions, they found, were the sudden shifts in attention demanded by the tasks.
“We were expecting to find activity on shared networks, but when we saw all the senses light up the same central brain regions while a test subject was focusing, it was really astonishing,” said Khalaf, a postdoctoral associate in neurology at Yale School of Medicine and lead author of the study.
The discovery highlighted how key these central brain regions are in regulating not only disorders of consciousness, but also conditions that impact attention and focus, such as attention deficit hyperactivity disorder. This finding could lead to better targeted medications and brain stimulation techniques for patients.
“This has also given us insights into how things work normally in the brain,” said senior author Hal Blumenfeld, the Mark Loughridge and Michele Williams Professor of Neurology who is also a professor in neuroscience and neurosurgery and director of the Yale Clinical Neuroscience Imaging Center. “It’s really a step forward in our understanding of awareness and consciousness.”
Looking across senses, this is the first time researchers have seen a result like this, said Khalaf, who is also part of Blumenfeld’s lab.
“It tells us how important this brain region is and what it could mean in efforts to restore consciousness,” she said.
The potential role of vitamin D in preventing and treating colorectal cancer (CRC) has attracted growing research interest – especially as CRC rates are rising, particularly among younger adults. This isn’t a new area of study. Low vitamin D levels have long been linked to a higher risk of developing colorectal cancer.
One large study involving over 12 000 participants found that people with low blood levels of vitamin D had a 31% greater risk of developing CRC compared to those with higher levels. Similarly, another study reported a 25% lower CRC risk among individuals with high dietary vitamin D intake.
Data from the Nurses’ Health Study – a long-term investigation of American nurses – showed that women with the highest vitamin D intake had a 58% lower risk of developing colorectal cancer compared to those with the lowest intake.
Now, a review highlights vitamin D’s promise in colorectal cancer prevention and treatment – but also underscores the complexity and contradictions in current research.
While observational data, which follow people’s use of vitamin D, and mechanistic studies, to investigate how vitamin D works in the laboratory, suggest protective effects, this isn’t confirmed by larger trials.
In fact, randomised controlled trials (RCTs), in which some people receive vitamin D and others don’t, the gold standard by which treatments are judged, reveal inconsistent outcomes. This highlights the need for a balanced approach to its integration into public health strategies.
Vitamin D is synthesised in the skin in response to sunlight and exerts its biological effects through vitamin D receptors (VDRs) found throughout the body, including in colon tissue. When activated, these receptors help regulate gene activity related to inflammation, immune response and cell growth – processes central to cancer development and progression.
Preclinical studies have shown that the active form of vitamin D (calcitriol) can suppress inflammation, boost immune surveillance (the immune system’s ability to detect abnormal cells), inhibit tumour blood vessel growth and regulate cell division – a key factor in cancer development, as demonstrated in my recent research.
Epidemiological studies, which track health outcomes across large populations over time, consistently find that people with higher blood levels of vitamin D have a lower risk of developing CRC. This paints a hopeful picture, suggesting that something as simple as getting more vitamin D – via sun exposure, diet, or supplements – could lower cancer risk.
But the story gets more complicated.
Mixed results
When it comes to medical decision-making, randomised controlled trials (RCTs) are the gold standard. These studies randomly assign participants to receive either a treatment (like vitamin D) or a placebo, helping eliminate bias and isolate cause-and-effect relationships.
Unfortunately, RCTs on vitamin D and CRC have produced mixed results.
For example, the VITAL trial – a major RCT involving over 25 000 participants – found no significant reduction in overall colorectal cancer incidence with 2000 IU/day of vitamin D supplementation over several years.
However, a meta-analysis of seven RCTs did show a 30% improvement in CRC survival rates with vitamin D supplements, suggesting potential benefits later in the disease course rather than for prevention.
On the other hand, the Vitamin D/Calcium Polyp Prevention Trial found no reduction in the recurrence of adenomas (pre-cancerous growths) with supplementation, raising questions about who benefits most, and at what dosage.
Adding to the uncertainty is the question of causation. Does low vitamin D contribute to cancer development? Or does the onset of cancer reduce vitamin D levels in the body? It’s also possible that the observed benefits are partly due to increased sunlight exposure, which itself may have independent protective effects.
The big picture
These discrepancies highlight the importance of considering the “totality of evidence” – treating each study as one piece of a larger puzzle.
The biologic plausibility is there. Observational and mechanistic studies suggest a meaningful link between vitamin D and lower CRC risk. But the clinical evidence isn’t yet strong enough to recommend vitamin D as a standalone prevention or treatment strategy.
That said, maintaining sufficient vitamin D levels – at least 30ng/mL – is a low-risk, cost-effective health measure. And when combined with other strategies like regular screening, a healthy diet, physical activity, and personalised care, vitamin D could still play a valuable role in overall cancer prevention.
Vitamin D is not a miracle cure – but it is part of a much broader picture. Its role in colorectal cancer is promising but still being defined. While it’s not time to rely on supplements alone, ensuring adequate vitamin D levels – through sun exposure, diet, or supplements – remains a smart choice for your health.
Colorectal cancer is a complex disease, and tackling it requires an equally nuanced approach. For now, that means focusing on evidence-based lifestyle changes, regular screenings, and staying informed as new research unfolds.
New study highlights the importance of preserving fossilised soft tissues
An image of fossilised erythrocyte-like structures. Credit: Anglia Ruskin University
New techniques used to analyse soft tissue in dinosaur fossils may hold the key to new cancer discoveries, according to a new study published in the journal Biology.
Researchers from Anglia Ruskin University (ARU) and Imperial College London analysed dinosaur fossils using advanced paleoproteomic techniques, a method that holds promise for uncovering molecular data from ancient specimens.
The researchers discovered red blood cell-like structures in a fossil while studying a Telmatosaurus transsylvanicus, a duck-billed, plant eating “marsh lizard” that lived between 66-70 million years ago in the Hateg Basin in present-day Romania.
The new study used Scanning Electron Microscopy (SEM) techniques to identify low-density structures resembling erythrocytes, or red blood cells, in the fossilised bone.
The findings raise the possibility that soft tissue and cellular components are more commonly preserved in ancient remains than previously thought.
By identifying preserved proteins and biomarkers, scientists believe they can gain insights into the diseases that affected prehistoric creatures, including cancer, potentially influencing future treatments for humans.
The authors of the new study highlight the necessity of prioritising the collection and preservation of fossilised soft tissue, rather than just dinosaur skeletons, as future advancements in molecular techniques will enable deeper insights into disease evolution.
A separate study had previously identified evidence of cancer in Telmatosaurus transsylvanicus, indicating its deep evolutionary roots.
More precise treatment options with robotic technology
Friday, 20 June 2025:Prostate cancer is a major risk to men’s health, with South African men facing a one in eight chance of developing this most common of male cancers.
Urologists Dr Hannes Brummer and Dr Johan Coetzee, who practise at Netcare Greenacres Hospital, are encouraging men to prioritise prostate cancer screening this Men’s Health Month.
“Usually, men do not feel any symptoms until prostate cancer has progressed significantly, which is why they need to be proactive about booking their routine prostate cancer screenings,” explains Dr Coetzee.
“With the advanced prostate specific antigen [PSA] screening blood test available from GPs these days, there is so much more opportunity for prostate cancer to be detected earlier when it is still at a highly treatable stage.”
“For men who are diagnosed with prostate cancer following a needle biopsy, the treatment options available have improved to such an extent that there is more hope than ever before. Even where surgery is needed, prostate cancer does not necessarily pose a significant disruption to your life,” Dr Brummer adds.
“A prostate cancer diagnosis can be daunting. We have walked this path with so many men, and robotic assisted surgery offers some important advantages for the removal of cancerous tissue in the prostate gland, in particular the precision of this minimally invasive option.”
Over 1 000 robotic assisted procedures have been performed at Netcare Greenacres Hospital since the introduction of this technology in August 2017.
At Netcare Greenacres Hospital, Dr Brummer and Dr Coetzee use the da Vinci X robotic assisted surgical system to operate through tiny punctures in the skin using slender instruments more dexterous than the human hand.
Dr Brummer and Dr Coetzee emphasise that the surgeon remains in control of the robotic system at all times. With magnified 3D imaging capabilities, including a large fixed-focus area at the highest resolution, the nerves, blood vessels and tumour are visible with great clarity for the intricate procedure.
“This robotic system is especially useful for operating on the prostate, as we can more clearly distinguish the nerves controlling erectile function and urinary continence. In most cases, there is less need for blood transfusion and reduced risk of complications,” Dr Brummer explains.
“Another of the advantages of this robotic technology for prostate tumours is that there is much less tissue damage in this sensitive area. Compared with traditional surgery, this means men usually experience much less downtime with less discomfort after the procedure. This translates into shorter hospital stays and faster recovery with robotic assisted prostatectomies overall.”
General manager of Netcare Greenacres Hospital, Reon van Rensburg, joined the urologists in reinforcing the importance of prostate cancer awareness. “Let’s talk to our brothers, fathers, sons and grandsons about health issues, and get to know your family risk for both prostate cancer and breast cancer.”
Van Rensburg thanked Dr Brummer and Dr Coetzee for their continued dedication to making the world-class minimally-invasive robotic assisted surgical option available for patients local to Gqeberha and from as far afield as Knysna, George and East London, inland regions of the Eastern Cape, and parts of the southern Free State, the Northern Cape and the north-eastern region of the Western Cape.
“This Men’s Health Month, let’s pledge to be decisive about booking those routine health checks. Making the time now and every year could help to save your life in future,” Dr Brummer and Dr Coetzee concluded.
