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Letters to the Editor Issue 289

by Letters(more info)

listed in letters to the editor, originally published in issue 289 - September 2023

Why Do I Listen at Length to Complete Strangers?

Richard Millard – My Story

Originally Published on:

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As a volunteer Listener for the Samaritans, I often find myself listening to someone for well over an hour with little interruption from me. While my role involves creating some empathy with the caller, including the occasional question or comment, so that they feel safe to talk freely about whatever distress they are feeling, the crucial part of the call is simply to listen without judgment. What Samaritans offer is not an advice line or counselling, but an open-hearted willingness to allow an unknown stranger to rediscover that kindness and patience are still the most basic traits of us humans, despite the harsher elements of the modern world that they may have been encountering.

If I think about the “why” on a deeper level, the answer to the question “why do I do it?” probably starts with my own feelings of appreciation for the gift of life. I’m not a religious person, but this recent quotation from Prem Rawat sums it up for me: “In its purest and most potent form, my gratitude for this life is for the gift itself; not what it enables me to do, just the experience of existing in this world right now.” [my emphasis added]

When you feel grateful, there’s a natural motivation to give something back.

In turn I feel a deep sense of privilege at being able to provide a listening ear for strangers in distress – because of course the reason people feel safe to call the Samaritans is the reputation that has been built up over decades of providing this safe space where every call is treated with kindness and in strict confidence.

There is no doubt that there are many unpleasant things happening in the world today, whether it be on the level of politics, economics, ecology, society, family or personal. So many of the apparently well-meaning commentators in the media seem to spend most of their time looking for someone to blame. They don’t seem to have much inspiration to offer.

So it’s wonderful to be part of a team that has this one common thread – the recognition that every human being deserves to be treated with dignity and compassion whatever they are going though, even where they have reached a point where suicide seems the only option. And though we don’t tend to talk about it as a group, I believe every Samaritan Listener has a store of gratitude that gives them the patience to keep picking up the phone, no matter how taxing the last call might have been.

There are about 60 volunteers at my local branch – an amazingly varied group from all walks of life and age groups Some of us are participating in this month’s Samarathon – 26.2 miles over the course of July (so no big sweat…!).  

This is the Samarathon message to our supporters:

Samaritans know that life can sometimes be incredibly tough. Each year, our 20,000 volunteers answer more than 5 million calls for help by phone, email, SMS, letter, and face to face at one of our local branches or in local communities right across the UK and Republic of Ireland. We're here 24/7, before, during and after a crisis for anyone struggling to cope. This life-saving work wouldn’t be possible without the generosity of our amazing supporters. Thank you.

So if you’d like to donate – anything from £1 to £100 as a thumbs up for the Samaritans will be wonderful – please click here

Best wishes
Richard Millard
Tel: 08456 120129;
Tel: 01934 257066 [direct line]

Tel: +44 1934 257066 [international]

Mobile: 07732 212 945 [mobile]

Acknowledgement Citation

Originally Published on:

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Korea University Medicine Team Explores Ways to Overcome Cisplatin Resistance and Alleviate Pain in Cancer Treatment

Researchers elucidate the biological pathways leading to cisplatin resistance in patients with cervical cancer. 

Cisplatin is a widely used chemotherapy drug for various types of cancers. However, frequent usage can lead to the development of drug resistance and neuropathic pain, eventually resulting in treatment failure. In a new study, researchers from South Korea investigated the underlying pathways contributing to this resistance and identified potential therapeutic targets that can be modulated to overcome this. By understanding and targeting these mechanisms, effective treatment strategies can be developed and implemented.

Cisplatin is a potent chemotherapeutic agent used to treat various cancers, including cervical cancer. But the continued use of cisplatin can lead to the development of cisplatin resistance and other side effects, like chemotherapy-induced neuropathic pain. Overcoming these issues is a critical concern in cervical cancer treatment.

Now, in a new study, Prof. Tae Woo Kim from Korea University Medicine and his team have explored the pathways leading to cisplatin resistance. Their study was published online on 10 May 2023 in Nature Communications.[1]

The team analyzed the transcriptome of patients with cervical cancer who had undergone surgery and found that elevated epidermal growth factor receptor (EGFR) activity scores were associated with poor overall survival in cisplatin-treated patients.

"EGFR is a protein involved in cell signalling and its dysregulation leads to uncontrolled cell growth and tumor formation. We conducted experiments on EGFR signalling using cervical cancer cell lines and observed that the cisplatin-resistant cell line exhibited hyperactivated EGFR signalling compared to the cisplatin-susceptible cells. This led us to conclude that hyperactive EGFR triggers resistance mechanisms, leading to decreased drug effectiveness in tumor cells," explains Prof. Kim.

The team further identified NANOG, a transcription factor associated with resistance, metastasis, and stem cell-like properties in cancer cells, to be involved in the regulation of the EGFR pathway. They discovered that NANOG activates the transient receptor potential vanilloid 1 (TRPV1), which is responsible for causing neuropathic pain. TRPV1 further promotes a process called secretory autophagy, which leads epidermal growth factor (EGF) secretion. EGF, in turn, activates the EGFR signalling pathway, contributing to cisplatin resistance.

“Most noteworthy, in our study, inhibiting TRPV1 using AMG9810, a potential pain-relieving agent, rendered the resistant tumours vulnerable to cisplatin,” says Prof. Kim.

This study serves as valuable proof-of-concept for TRPV1 as a therapeutic target to combat cisplatin resistance and neuropathic pain, thereby improving the outlook for patients with cervical cancer.


  1. Oh, S.J., Lim, J.Y., Son, M.K. et al. TRPV1 inhibition overcomes cisplatin resistance by blocking autophagy-mediated hyperactivation of EGFR signaling pathway. Nature Communications 14, 2691. . 2023.

About the Korea University Medicine

Korea University (KU), located in Seoul, South Korea, is a leading university established in 1905, renowned for its academic excellence and contributions to higher education. Within KU, Korea University Medicine (KU Medicine) is a top-ranked medical institution, comprising campuses like Anam Hospital, Guro Hospital, Ansan Hospital, Cheongdam Goyeong Campus, and Jeongneung Mediscience Park. KU Medicine also has educational institutions affiliated to it, including the College of Medicine, Graduate School of Public Health, and Graduate School of Clinical Dentistry, driving remarkable advancements in medical treatment, education, research, and social contributions.

About the Author

Prof. Tae Woo Kim received his PhD from Korea University, Seoul, Republic of Korea, in 2000 and then trained at Johns Hopkins University, School of Medicine, Baltimore, MD, USA during his postdoctoral course. Then he joined Graduate School of Medicine, Korea University, Seoul, Republic of Korea in 2005, where he is currently a professor. His laboratory has focused on the elucidation of the mechanism of tumour immune escape and the understanding of malignant evolution of tumor cells after cancer treatment. Based on those, he has tried to develop a novel modality for the control of immune-refractory tumours.


New Alzheimer’s Drug Accelerates Rate of Brain Shrinkage By 20%

by Patrick Holford

Don’t be fooled by the rhetoric promoting the new Alzheimer’s anti-amyloid drug. The results – increased brain shrinkage, a third getting brain bleeding or swelling and no clinically meaningful benefit – are not good.

However, reading this week’s headlines claiming a ‘turning point’ in the fight against Alzheimer’s you’d be mistaken in thinking something new has occurred since Eli Lilly’s press release regarding their new drug, donanemab, a month ago.

What stimulated this week’s front pages was publication of the actual study in the Journal of the American Medical Association[1] giving more details of the results. This was reported positively in every major newspaper. Yet not one reported the fact that the drug treatment accelerated the rate of brain shrinkage by over 20% compared to placebo. This is clearly stated in the paper as

“At 76 weeks, MRI [scans] showed a greater decrease in whole brain volume”.

This is consistent with a meta-analysis of all anti-amyloid treatments including donanemab, in the journal Neurology[2] earlier this year, which concluded that

"Mild cognitively impaired participants treated with anti-amyloid drugs were projected to have a material regression toward brain volumes typical of Alzheimer dementia approximately eight months earlier than if they were untreated.”

In stark contrast, treatment with homocysteine-lowering B vitamins, given to those with sufficient omega-3, ‘the rate of atrophy was significantly slowed by circa 70%’.[3] B vitamins and omega-3 are but two out of eight established prevention steps you can take yourself.

Alzheimer’s is characterised by brain shrinkage, and particularly in the ‘hippocampus’ which is part of the medial temporal lobe at the centre of the brain. The new drug treatment was not associated with accelerated shrinkage of the hippocampus, just the whole brain. In fact, there was a very small reduction, of about one per cent, in the rate of shrinkage in this area of the brain compared to the placebo. In the B vitamin study there was an 80% reduction in shrinkage in the medial temporal lobe. While it is theoretically possible that, having selected people with lots of plaques, then targeting them with an aggressive drug, the brain may have shrunk as part of the process of amyloid destruction, this is not yet known and therefore this increased brain shrinkage is worrying.

The other main measure of Alzheimer’s and dementia, made by a health professional, is the Clinical Dementia Rating (CDR). This includes interviewing the patient’s carer or partner, and thus is potentially subject to ‘hopeful’ bias.

The new drug treatment results do show a statistically significant improvement, showing just over half a point  (0.67) less worsening, compared to placebo, on the 18 point CDR scale. But is this small change meaningful? A study in the Lancet suggests that minimum changes of 0.98 in mild cognitive impairment and 1.63 in mild Alzheimer’s disease are meaningful.[4] This study was on those with early Alzheimer’s.

In contrast, a trial giving omega-3 fish oils to those with adequate B vitamin status, showed more than double this beneficial clinical effect.[5] In another, giving homocysteine lowering B vitamins to those with adequate omega-3, almost two thirds of the trial participants ended the trial with an overall Clinical Dementia Rating of zero.[6] This means they were no longer diagnostically labelled as having cognitive impairment. In other words, not less worse, but actually better.

Serious Adverse Effects Including Deaths

More details in the recent donanemab paper were given on the adverse effects and trial deaths.

‘Treatment-emergent adverse events’ were reported by 759 of 853 participants (89%) receiving donanemab’ and ‘Either amyloid-related imaging abnormalities of oedema/effusion [swelling] or micro haemorrhages [bleeding] occurred in 314 participants (37%) receiving donanemab’.

Also, in the donanemab group,

‘3 participants with serious amyloid-related imaging abnormalities subsequently died.’

This means that more than a third had brain bleeding or swelling and 1 in 287 died. This compares to no adverse events in the B vitamin and omega-3 trials, or other prevention approaches. If any nutritional supplement had anything like these adverse effects it would be banned, not licenced.

According to the Financial Times, this new treatment will cost $26,000 a year (in addition to medical costs including numerous scans). In the UK this would be paid by the taxpayer. In contrast, taking homocysteine-lowering B vitamins, eating fish and/or having fish oil supplements would cost perhaps 20p or cents a day – less than £100 a year.

So, the question is would you rather take a treatment that markedly slows both whole brain and medial temporal lobe shrinkage than a treatment that is associated with a greater loss of brain volume, a high risk of adverse effects and high costs?

The big push is now on to get approval of the UK’s NICE  (National Institute for Health & Care Excellence) and the drug licensed in Europe. NICE has previously refused to consider the evidence for homocysteine-lowering B vitamins and omega-3, which is now overwhelmingly positive when both these nutrients are combined.

That is why we, at Food for the Brain, aim to make sure as many people as possible know that the real ‘turning point’ for Alzheimer’s is prevention through diet, nutrition and lifestyle improvements, not expensive drugs with dangerous side-effects. You can take the free Cognitive Function Test yourself at and we encourage everyone to do so and take control of their brain health for the future.

Further Information

Patrick Holford, Director of the Alzheimer’s Prevention Project and founder of the Food for the Brain Foundation, and many of the experts on the Scientific Advisory Board ( ) are available for interview and comment.

Journalists are invited to take the test at

For media enquiries please contact Sophie at Panpathic Communications –  / 01323440998 / 07815 860 082


The Food for the Brain Foundation is a UK based charitable foundation that developed a fully validated Cognitive Function Test in 2012 and has so far tested 380,000 people. The test is available at

Social Media

Social media images and 1 minute animations showing ‘how to build the brain’ ‘how to fuel your brain’ and ‘how to protect your brain’ are available for use on request. A short animation explaining COGNITION is viewable here:


  1. Simms J., et al JAMA July 17, 2023.
  2. Alves, F., et al Neurology 2023 May 16;100(20):e2114-e2124.
  3. Jernerén F., et al. Am J Clin Nutr. 2015 Jul;102(1):215-21.
  4. Liu KY., et al Lancet Psychiatry 2021;8:-6.
  5. Jernerén F., et al J Alzheimers Dis. 2019;69(1):189-197. doi: 10.3233/JAD-181148. PMID: 30958356
  6. de Jager C et al Int. J. Geriatr. Psychiatry 27:592–600 2012



Don’t be a Golden Oldie – Baby Boomers’ Attitude To Suntans Must Change

Cases of skin cancer among over 55s have soared by 195% since the 1990s. A leading testing expert says it’s partly down to the legacy of foreign holidays in the 1960s and 70s, but baby boomers must also rethink the view that a tanned body is a healthy body.

Cases of melanoma skin cancer have boomed among baby boomers – the generation born between 1946 and 1964 and now aged between 57-75 years old. Melanoma skin cancers in people aged 50-59 have increased by 102%, in 60-69 year-olds by 158% and 70-79 year-olds by a shocking 236%.

While some researchers have pointed the blame at the legacy of cheap package holiday suntans during the 1960s and 70s, a leading testing expert says it’s also the case that many over 55s have never stopped believing a tanned body is a healthy body.

Leading testing expert, Dr Avinash Hari Narayanan (MBChB), Clinical Lead at London Medical Laboratory, says: 

‘The number of people aged over 55 developing skin cancer has almost tripled since the 1990s, Cancer Research UK has revealed. It’s not just the consequence of sunbathing when they were young that puts many baby boomers at risk; some have never changed their attitudes to tanning.

‘Back in the 1960s and 70s, many young people would hit the beach hoping to get a great tan; that was seen as a healthy or attractive look. Today, thanks to greater awareness, skin cancer rates, while soaring for older people, are decreasing for young people below the age of 24. Since the early 1990s, this age group has seen a decline in melanoma cases of 18%. While younger people are getting the message, greater awareness is needed in older adults.

‘The US Center for Disease Control and Prevention says less than half of older adults protect their skin when outside for an hour or more on a warm, sunny day. Furthermore, nearly 18% of older adults don’t use any kind of sun protection regularly and more than 1 in 10 older adults (13%) have been sunburned in the past year. It is very likely that we would get comparably similar figures in the UK.

‘A study of women aged over 71 published in the journal “Health and Illness” highlights typical attitudes towards sunbathing. It reveals most participants “felt pale skin was unsightly and undesirable while lightly suntanned skin was beautiful, in part because it was perceived to be indicative of health and vibrancy.”

‘The attitude among older adults is that it’s too late to start taking precautions. Since the publication of flawed data in 1986, it’s been widely believed that people get about 80% of their lifetime ultraviolet (UV) dose by the age of 18. That story prompted fears of a melanoma time bomb, but it was based on flawed calculations. Later research reveals that most people across the world (including Brits) get less than 25% of their lifetime UV dose by the age of 18, meaning it’s worth taking protective measures against cancer.

‘Even if you were regularly sunbathing in the 60s and 70s without any sun creams, the most recent studies reveal that protecting your skin today can still make a big difference. Research from the US Skin Cancer Foundation has shown that it’s not too late for older people to take preventive action. Damage from UV exposure is cumulative and increases your skin cancer risk over time.

‘So how can we identify potential melanomas? Some develop from existing moles. Others grow on what was previously normal skin. Not all skin cancers are melanomas; unprotected sun exposure can also result in squamous cell and basal cell carcinomas. If you notice a new mole or skin lesion that you are worried about, show it to your doctor. It’s important to be eagle-eyed. Some melanomas may look like a bruise under a nail. Even more rarely, they can present in the coloured portion of the eye (iris).

‘While skin cancers can often be easily observed, other cancers that may affect older people are not so readily detected. That’s why a general health profile blood test may be a good idea for baby boomers (and indeed any generation) concerned about their health.

‘For example, London Medical Laboratory’s Premier Health Profile blood test can detect blood cancers such as leukaemia, which becomes more common in older age groups. It also monitors kidney and liver functions and can identify abnormal biomarker levels that may prompt further investigation into potential cancer risks. It can be taken at one of the many drop-in clinics that offer these tests across London and nationwide in over 95 selected pharmacies and health stores. The same test minus the full blood count is also available as a home test. It can be taken at home through the post. For full details, see:

Further Information

London Medical Laboratory’s Clinical Lead, Dr Avinash Hari Narayanan, is available to supply exclusive written comment or for interview. To contact Dr Hari Narayanan, or for more information, please email London Medical Laboratory’s Head of Public Relations, David Jinks M.I.L.T., at


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