Q: How would a cancer vaccine work, and how close are we to getting one? — Phyllis J., San Diego
A: Much of the work that's going on with cancer vaccines now involves personalized medicine. Scientists tailor each vaccine to YOUR immune system and train it to kill cell mutations (that's the cancer) that are unique to YOU.
In the U.S., a small clinical trial of what's called a neoantigen vaccine focused on folks with melanoma. It targeted 20 predicted personal tumor neoantigens in the participants; neoantigens are a peptide — two or more amino acids — that arise from tumors. Four of six vaccinated patients had no recurrence of the disease 25 months after vaccination. Two who had recurrence were then treated with anti-PD-1 (anti-programmed cell death-1) therapy and had complete tumor regression.
Another study, in Germany, used what are called personalized RNA mutanome vaccines to effectively mobilize immunity against cancer mutations in melanoma. The approach used in the German vaccine trial was to do very thorough genetic sequencing of a person's tumor and compare that to a genetic sequencing of healthy cells in that person. The researchers then identified parts of the "healthy" genome that they thought would activate immune system T cells to efficiently kill tumor cells. From that information, they made a vaccine and injected it into the person's lymph nodes.
The results? The German study included 13 people with melanoma; all had experienced multiple relapses of the disease, but eight of the 13 were tumor-free when they got the personalized vaccine. Over the 23-month follow-up, all eight remained tumor-free. The other five patients had relapses before they received the personalized vaccines, but one of them saw measurable tumor shrinkage and another became tumor-free after receiving the vaccination.
Many other approaches are being considered as well, and you can bet cancer vaccines will become a powerfully precise way to beat cancer in the future. Some researchers are even testing vaccines that prevent the disease! Stay tuned.
Q: My uncle, an aunt and my dad all suffered dementia at the end of their lives. What are my chances of dodging this family curse? — Harriett S., Seneca Falls, N.Y.
A: You definitely can increase your chances of good cognitive health as you get older! A study in The Lancet shows that one in three cases of dementia could be prevented by adopting a healthy lifestyle and being aware of some of the early warning signs, such as midlife hearing loss, that you might not usually associate with cognitive decline.
Yes, many of the modifiable risk factors for dementia that the study highlights are the ones we talk about every week: having Type 2 diabetes; being obese or overweight; having high blood pressure; smoking; and a lack of physical activity. But they also mention some risk factors you might be less aware of: social isolation; failing to seek early treatment for depression; and failing to complete a secondary education.
The good news: We think 80 percent of cases of cognitive decline are preventable, if you add in our nutritional advice found in "YOU on a Diet"; practice stress management and do mental speed-of-processing games; and avoid toxins. For the 16 million people in the U.S. living with cognitive impairment, that means 12 million could have dodged the decline.
Your smart steps are to get to a healthy weight and have good blood glucose numbers. You can do that by avoiding highly processed foods and kicking added sugar and syrups, any grain that isn't 100 percent whole, all trans fats and most sat fats off your plate. Also get in your 10,000 steps a day, and seek treatment for high blood pressure, if needed. Also essential: If you're depressed, seek help; if you smoke, try Dr. Mike's quit plan (just Google "Dr. Michael Roizen's Smoke-free Plan for Successful Quitters"); get your hearing tested; practice mindful meditation; volunteer in your neighborhood; and continue your education, which builds cognitive reserve.
Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Dr. Mike Roizen is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to email@example.com.