Fertility problems: like father, like son?

Create new fertility techniques fertility problems? According to recent research would be channeled through ICSI, a specific type of test tube fertilization, infertility are passed from father to son.

In ICSI a single sperm into the egg. The technique is applied to include significantly reduced sperm quality. British-German research would however point out that ICSI sons themselves a greater chance of being less fertile.

"A greatly reduced seed production can indeed be hereditary," said Dr. Benny Verheyden UZA-urologist specializing in male fertility problems. "It is possible that some ICSI boys will inherit their father's problems. But the genetic causes are still poorly known. There is evidence that there are other factors, including the environment and any physical problems such as undescended testicles. "With about 40% of the ICSI fertilization is only the woman fertility problems and there is obviously no problem for the boys.

Strong together

In the Centre for Reproductive Medicine of the ways doctors UZA the couple always the risk of inheritance of fertility problems. "But we certainly should not exaggerate the risk," said Verheyden. "There are too many factors involved. Then I would be very much surprised if we have twenty years were a major problem in male ICSI generation. You should also not forget that many of the dependent partner. A slight man with fertility problems who find a normal fertile woman can perfect the natural way a child. "

New rules for biobanks

In hospitals such as the UZA's a lot of human material stored, used for scientific research. In 2008, a new legislation and both the Flemish and the federal government encourage more efficient use of the material for scientific innovation.

The Law of 19 December 2008 on the human body material body material that provides that a patient is removed and remaining (residual biological material ") may be stored in a biobank and used for scientific research. Against a patient can always lodge an objection. The ethics committee of the hospital monitors the proper use of the material.

Body material, such as a tumor removed, is first and foremost used for the diagnosis and treatment of the patient. Residual tissue is invaluable for researchers. "The available, helping patients, other patients with the same disease," says Elke Smits, scientific project manager in the UZA. Biobanks are especially important for translational research, the results of basic research translates into medical and clinical applications, such as new treatments or
medications.

A large Flemish biobank

The body material is currently spread across different hospitals and research institutes. Not an ideal situation. "For research into a cancer you need quickly some 500 samples," confirms Elke Smits. "Researchers now sometimes lose much time searching for material." The Flemish government wants to combine the existing biobanks therefore a biobank and Flanders has set up the Center for Medical Innovation (CMI) was established. The intention is to the existing activities of research institutions, hospitals and businesses more closely into line and to create the scale needed to be statistically relevant research to do.

The CMI also wants to establish a uniform data structure for the data in different biobanks and uniform procedures to be in the field of data processing, quality assurance and ethical commitments. Elke Smits' new areas covered that physical samples are linked to patient data encrypted. Because you have a large number of patients over a longer time, can cause chronic diseases such as cancer or obesity are followed over time. "

Tumour Bank as a pilot project

In the UZA has launched a project to the storage of human material in the UZA centralize, to create a large biobank to come with blood, tumor tissue and so on. Then the link is made to patient records, although coded and anonymised. The first realization is a tumor bank tumor tissue and serum material. UZA receives a grant under the National Cancer Plan from the federal government.

Lung cancer: small steps

Lung cancer:

it's a hard leg diagnosis. But there is reason for cautious optimism. Thanks to new molecular therapies, some patients with a metastatic tumor is a quality life years. Meanwhile, also sought ways to detect lung cancer earlier.

The treatments have evolved considerably in recent years. It happens rarely that a patient only one surgery. Usually he will also receive chemotherapy because it improves outcomes. Also, new types of chemotherapy and have added more patients with metastatic lung cancer after their first treatment a maintenance therapy.

Cancer cells after four weeks eradicated

The chance of complete cure remains small. Fifteen percent of patients five years after diagnosis is still alive. Yet there is hopeful news. Much is expected from the so-called targeted molecular therapies. These are drugs that, depending on the type of tumor, specific characteristics of the cancer cell targeting. The most important are the EGFR inhibitors, which as yet only be used in patients with metastatic cancer. In a specific subgroup with a specific mutation in the cancer cells - about ten percent of all lung cancer patients - that therapy has a dramatic effect.

"We have seen in end-stage patients whose cancer completely disappeared after four weeks and for many years now have a good quality of life," says Germonpré. "Those people will probably sooner or later relapse, but if you know the prognosis for metastatic lung cancer on average less than one year, means that a tremendous advance." The aim is also to test the therapy in patients with less advanced lung cancer.

Another drug that research is called ALK inhibitor crizotinib would at some three percent of lung cancer patients could have an impact. These are patients with a change in the ALK gene. It is likely that the relatively short term, other targeted drugs added. Also new is a vaccine against lung cancer, which is given to surgical patients. Approximately one third of them have a type of lung cancer that would have some compassion. Research should determine whether such a vaccine reduces the risk of relapse.

Taking the plunge

Compared with roughly ten years ago, patients are given a much more tailored treatment. A multidisciplinary approach is therefore more crucial than ever. Germonpré: "Every week there is a patient in our discussion with the lung-oncologist, the surgeon, radiation oncologist, the pathologist and doctor of nuclear medicine. We discuss new patients and then chop knots. Where we take a piece of tissue for diagnosis? Are we operate or irradiate? And we operate immediately or we give chemotherapy first? "

Patients who undergo surgery is a piece of lung tissue, sometimes even a whole lung is removed. Yet the quality of life after treatment quite well. Germonpré: "We will obviously not happen overnight. If we consider that surgery is the very quality of life would be undermined, we opt for radiotherapy. "

Is a chronic lung disease?

Despite all the treatments is still the greatest progress to expect from early detection. The earlier the cancer is detected, the greater the chance of complete cure. Most patients get symptoms but only when the disease is more advanced. Approximately half the cancer already spread to the diagnosis.

"Also screening is not obvious. The problem is that on a scan difficult to distinguish between an incipient lung cancer and such a benign tumor. And you can hardly operate dozens of patients who only has one lung. An alternative could be to closely follow the gezwelletje so you can intervene immediately if it would grow. "

The time when there was nothing to do with lung cancer, is quite over. "Most patients we can not definitively cured, but we can try to make them as long as possible in a good condition," says Germonpré. "We no longer treat the cancer, but the patient, and will not continue with a therapy such as too many side-effects." "Patients grab every chance of a better prognosis and better quality of life with both hands," says Jones.

Germonpré is cautiously hopeful for the future. "Already there are patients who survive for five years with a metastatic lung tumor. You saw almost never used. I'm not saying lung cancer in the short term to a chronic disease will evolve, but for a small group will probably be so. "