Monthly Archives: October 2021

The link between alcohol consumption and breast cancer progression

by Mbalentle Madolo

It is not a novel concept that the consumption of alcohol is linked to negative side effects- and not just trivial ones like a bad hangover. It carries other significant issues such as how alcohol consumption has been shown to be linked to the progression of breast cancer. In South Africa, it has been estimated that female drinkers consume around 16% of pure alcohol per year which is 80% above the world average (8.9 litres) (1). And with 19,4 million women over the age of 15 being at risk of being diagnosed with breast cancer- what do these statistics mean for South African women? (2) Does the devil really live in a bottle? Alcohol is not only a risk factor for breast cancer and other diseases, but with recent studies showing that alcohol might enhance the progression of breast cancer in breast cancer patients- South African women need to be wary of the detrimental effects alcohol has.

In a recent study, Yongchao Wang and colleagues investigated the cellular and molecular mechanisms underlying alcohol-induced aggressiveness of breast cancer (3). Using a MMTV-neu mouse model, the researchers of this study were able to gather multiple potential mechanisms that are involved in alcohol-stimulated breast cancer progression.

Alcohol is said to induce the mobility of cancer cells through the degradation and re-structuring of the extracellular matrix leading to further cancer cell invasion. Using Boyden chamber, wound healing assays and a 3-dimension (3-D) Matrigel system, it was shown that alcohol induces the spread of breast cancer cells to the lungs and colon and even more shockingly, chronic exposure to alcohol lead to less aggressive cancer cells transforming into a more aggressive form. Additional evidence show that Matrix metalloproteinases (MMPs) have a crucial role in the degradation of ECM, and it has been demonstrated that alcohol induces the actions of certain MMPs on ECM therefore increasing mammary tumour malignancy. The disruption of endothelial integrity is also a possible mechanism of alcohol induced cancer metastasis through damaged adherens junctions by decreasing the electric resistance across the endothelial layer and which facilitates intercellular gaps between the endothelial cells. This study highlighted how mammary epithelial cells as well as breast cancer cells, have the capacity to metabolize alcohol through the presence of various alcohol-metabolizing enzymes.

The accumulation of reactive oxygen species is said to play a crucial role in mammary carcinogenesis and aggressiveness by inducing oxidative stress. ROS is found to increase cancer metastasis and promote tumour angiogenesis. The researchers have hypothesised that alcohol induced ROS and oxidative stress is mediated by the metabolism of alcohol as well as other factors. With the aid of electron spin resonance, It is demonstrated that alcohol has the capacity to generate a variety of ROS in breast cancer cells and in epithelial cells of mammary tissue. Additionally, the study highlighted the positive correlation between ErbB2, an epidermal growth factor receptor part of the epidermal growth factor receptor family (EGFR) and the promotion of tumour growth and spread due to alcohol consumption. Breast cancer cells and mammary epithelial cells that over express EGFR/ErbB2 are more susceptible to alcohol-induced tumour growth through the phosphorylation of EGFR. Additionally, this study concluded that the chronic exposure to alcohol in mammary tumours of MMTV-neu mice increased levels of the population of cancer stem cells (CSC).

The results indicate that alcohol consumption could indeed play a role in promoting breast cancer aggressiveness when observing at a cellular and molecular perspective. Even though the mechanisms by which this happens seem to be vast and complex, the researchers were able to shed more light onto the subject and further propose potential therapeutic targets for breast cancer patients that still consume alcohol.


1.         Women & Cancer. CANSA – The Cancer Association of South Africa. 2016. Available from:

2.         The Demand for Alcohol in South Africa during the National Lockdown. Available from:

3.         Wang Y, Xu M, Ke Z, Luo J. Cellular and molecular mechanisms underlying alcohol-induced aggressiveness of breast cancer. Pharmacological Research. 2017 Jan 1;115:299–308.

Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant

by Marlu McLean

The recent surge in SARS-CoV2 which cause COVID-19 cases worldwide which was driven by the delta variant.  The effectiveness of the new emerging vaccines is still unknown and researchers in the United Kingdom decided to investigate the effectiveness of the vaccines (Gower et al., 2021).

Since November 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has infected nearly 197 000 000 people and caused the death of 4 200 000 people.  This has not only burdened our healthcare systems, but economies worldwide have been shaken.  Due to the mutagenic potential of the virus, it has been able to change and adapt to overcome barriers to spreading the infection.  The delta variant was first detected in December 2020 in India, where it caused the largest wave of infections yet seen after the discovery of SARS-CoV2.  Scientists has been working on vaccines worldwide, but the efficiency of these vaccines are still uncertain and causes a lot of hesitancy among people.

A group of scientists in the United Kingdom decided to look at the effectiveness of the vaccines currently approved in the United Kingdom on the delta variant.  They looked at the effectiveness of BNT162b2 (Phizer-BioNTech) and ChAdOx1 nCoV-19(Novavax) vaccines after one and two doses. They also compared the effectiveness of the vaccine to the alpha variant.  The scientists accounted for possible confounders by looking at health seeking behaviour of the vaccinated and unvaccinated groups and looked at the effect of any vaccine compared with these two.  They used data acquired in England and used PCR tests to test for SARS-CoV2 and whole genome sequencing to determine which variant according to the spike protein, nucleocapsid and open reading frame 1ab.  The data was analysed and they also compared the results with previous studies on the alpha and delta variant which confirmed that the alpha variant control group was accurate. 

They determined that in the any vaccine group, Phizer-BioNTech and Novavax groups the effectiveness of the vaccine was more after the second dose than the first.  People who received any vaccine had an 87,5% effectiveness with the alpha and 79,6% with the delta variant.  The Phizer-BioNTech vaccine had 93,7% with the alpha and 88,0% with the delta variant.  The Novavax vaccine had an effectiveness of 74,5% effectiveness against the alpha variant and 67,0% with the delta variant.  In all three groups was there a very small difference between the alpha and delta strains. 

Ultimately was the effectiveness against the delta strain better in the group who received the two doses of the Phizer-BioNTech than the Novavax vaccine.  These results are also consistent with other studies.  This paper shows that the two vaccines studied in England had high levels of effectiveness against symptomatic disease caused by the delta variant.  The emergence of effective vaccines is a light at the end of the dark COVID-tunnel and brings hope that we would be able to win the fight against this pandemic.


Gower, C., Phil, D., Gallagher, E., Ph, D., Simmons, R., Ph, D., Thelwall, S., Ph, D., Stowe, J., Ph, D., Tessier, E., Sc, M., Groves, N., Sc, M., Dabrera, G., Myers, R., Ph, D., Campbell, C. N. J., & Amirthalingam, G. (2021). Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. 1–10.


by Mbalentle Madolo

If someone would have told 23-year-old Mbali, a young budding scientist that had just been accepted into the honours programme of her dreams, that her honours year would leave her feeling emotionally drained, she would have told you that you are lying, but sadly it is absolutely true. Now don’t get me wrong, Clinical Anatomy still remains my passion and the fact that I was selected amongst many who applied to be a part of this honours cohort is something I don’t take lightly, but it can’t be escaped that this year has been one of my toughest years to date.

The academic content covered so far has been extremely interesting but also difficult to grasp. The challenges that I have faced so far this year go beyond handling academic stress and delve into the emotional turmoil that this year induced. As a black woman, I can’t say that I have been able to look around and see a lot of people who look like me in this field, something that has always bothered me when looking at the sciences as a discipline overall (in my opinion of course). It was this year where my imposter syndrome truly kicked in, and this left me feeling as though I was not fit to do this honors programme, like I was not intellectual enough, like I was too old etc. Granted, these feelings were fueled by academic stress and the fact that we are still living through a world-wide pandemic, but they were mostly exacerbated by how I felt that I could not speak to anyone about how I was struggling to adjust or ask for assistance as I felt that no one would understand.

On the bright side, the support that I have received from my mother and classmates has been absolutely amazing, hence why I find myself happier. I find myself going back to that 23-year-old Mbali who was ready to take on the world and, as cliché as it sounds, cement myself in the science community as a force to be reckoned with! This change came about because I decided to reach out to those around me, that included calling my family whenever I was overwhelmed instead of bottling up my emotions. It also included talking to my classmates about my anxiety, or even asking for assistance with understanding course material if needed. Because of that I will be eternally grateful to the Clinical Anatomy Honours Class of 2021. The friendship and support they have given me is unmatched, I discovered that I was not the only one feeling emotionally drained and overwhelmed, I discovered that I was not the only one having difficulty adjusting…. I discovered that I was not alone.

The first 6 months of my honours degree were extremely challenging for me, but I still recognize how much I have grown not only as a student, but as a person. It’s because of this growth that I am so excited for the next 6 months of this year. The rest of this year will be filled with academic success, further growth and blessings…I can feel it in my bones!


by Luxolo Mdolo

This year has been long. Students have literally seen flames. Many times, I find myself trying to exist in isolation from the world we live in because the show must go on. There have been wars raging in the streets on which I walk. Severe taxi violence incidents have left us fearing for our parents who commute to put food on the table. Strikes and looting have turned the country upside down to reveal a side that we have all been trying so hard to hide in the name of freedom. The COVID 19 pandemic just keeps coming at us in waves – meanwhile the people are so fatigued from trying to keep afloat. I personally do not know how other students do this thing of living each day as though these things do not concern them. I even pay attention to my colleagues in MBChB as they continuously talk about the lives lost to COVID in the wards they work in. I reflect at times and just wonder what form of normality is left to go back to when we have finally overcome this pandemic? How do we mourn the lives lost when we could not even attend their burials or night vigils? It has stripped so much from our understanding of what is important to society. Schools were closed and education of children did not mean anything to anyone. The churches were closed, and religion became an afterthought. Businesses were closed and the economy did what it does best. My grandmother said that the last time she saw so many restrictions was during apartheid. It is interesting how this life never ceases to amaze us.

Anyway, on a lighter note, this year in Honours has given me the greatest gift that medicine (MBChB) continuously failed to offer. Time. I have had time to sit, think and reflect. It gave me the time to do things that I always thought I would do immediately when I got to university. I joined the gym. I found some work to make extra income. I do spur waffle Mondays with my friends. I play soccer with other friends at 4pm twice a week. I go on double dates and baecations. I do educational talks. I run a YouTube channel of 500 subscribers. I love it here. The most amazing thing about this year though is doing an amazing research project with a Supervisor who cares.

One of the biggest fears among the people who are in the intercalated programme like me is the fear of detachment from your classmates in the MBChB class and having to integrate with a new group of students. It is more like a fear of the unknown really because you can easily assume the worst of what could possibly happen. However, I have met the most amazing, easy and outgoing people that just fill up your day with smiles and laughter. I never even thought I would be doing study sessions in coffee shops and building solid friendships with my Honours colleagues. This has been such a holistic experience. The hardship and the joy in my life are at such a wonderful reversible potential. I was even going to make a joke about allostatic load, but I realized that it was too soon. Thank you for reading though.


by Koketso Mwale

Euthanasia and Physician assisted suicide (EAS) are becoming one of the most common ways to die in the 21st century. Euthanasia is a death process in which a physician is allowed by law to end a patient’s life upon requested by the patient. Physician assisted suicide is when a physician assists a patient to end their life by providing them with lethal pharmaceutical drugs. EAS constitutes 0% -4,6 % of all deaths in countries where it is legalized, and it is mostly undertaken in extreme medical conditions. Although it allows people to have a say over their lives and when they want to die, some people argue that it is trying to ‘play’ God.

A recent study by Sigrid Dierickx et al (2019) evaluates EAS practice in three countries i.e., Belgium, The Netherlands, and Switzerland. In the study, they evaluated data for the three jurisdictions and observe the commonalities and differences between the countries in terms of: socio-demographic characteristics, legalisation and ethicality and physician, decision-making and clinical characteristics of death by EAS.

The Medico-legal aspects of EAS differ between the countries as euthanasia is permitted in Belgium and The Netherlands and not Switzerland, whereas physician assisted suicide is permitted in all three countries. Although the laws are different in all countries, they all share the same underlying principles, which are consent, incurability of the disease and voluntary request with no action bias. The different years of legalization between the countries indicate the increasing awareness and conceding of the government regarding the practice.

The total number of deaths studied were 3751 for Belgium,7761 for The Netherlands and 5239 for Switzerland. Deaths by EAS were 349 in Belgium,851 in The Netherlands and 65 in Switzerland. The patient’s characteristics data indicate the individuals who died by EAS were mostly males, 51% in Belgium, 53.8 % in The Netherlands and 42.5% in Switzerland. Moreover, most individuals who died by EAS were 65-79 years old and the most prominent underlying condition for all the studies was cancer.

Additionally, the study indicates the type of physician who performed EAS was a general practitioner for all three countries and an oral and written request was mostly done. The overall shortening of life was estimated to 1-7 weeks for both Belgium and The Netherlands but more than 4 weeks in Switzerland. The person who administered the lethal drugs was only the physician in Belgium (71.4%) and The Netherlands (87.3%), whereas in Switzerland (73.3%) it was the patient (with or without another person).

In conclusion, the above-mentioned data indicated the vast preference of EAS as a method of death and how most individuals suffering from life terminal diseases would like to eradicate their pain by dying in this way. As much as the physician’s role is to prolong life, the question arises as to why should it not also be to help individuals shorten their lives in excruciating circumstances? In the future, the legalization of EAS will most likely occur in more countries and people will not only have a say on how they want to live their lives, but also how they want to die.


Dierickx, S., Onwuteaka-Philipsen, B., Penders, Y. et al. Commonalities and differences in legal euthanasia and physician-assisted suicide in three countries: a population-level comparison. Int J Public Health 65, 65–73 (2020).


by Marlu Mclean

When I started Med School in 2018, I was intrigued by the intercalated program they offer at UCT.  I immediately knew I wanted to do it and that it would require me to do well to continue with honours.  Going through the first three years of Medicine, I really enjoyed and gained so much from the interactive learning activities.  I would love to go to campus and spend my days from 8 to 5 running from the lecture theaters to Groote Schuur hospital and back to the anatomy labs.  Coming from a class with 250 students, I looked forward to the 10-student class to build connections, friendships and life-long relationships.  Little did I know how this year will turn out.

From an online open day to registration, introduction and techniques course, I only met the people in my class after 4 weeks of online teaching.  The first week together was amazing, I got to know the people a little bit and got to experience the “real-university life” for the first time this year.  But we soon returned to the “real-COVID-life” again with more online classes, tutorials and a handful of in-person lectures and presentations.  Instead of spending most of my time on campus and in the library, it was now spent in my bedroom, also known as my study and also known as my workout space.  It was just me and my laptop.  The space got smaller and smaller.  I escaped to run trails on the mountain.  I would come back and work without any motivation.  I would leave once a week to see patients in the hospital.  I tried figuring out how to do things in the lab with countless fails.  I got sick and was in bed doing lectures and studying because I didn’t want to fall behind.  It was scary, lonely and hard. 

It was different from what I expected.  Many days I wanted to give up, but through prayer, I was able to fight, learned how to step out of my comfort zone and most how to be resilient in ways I never thought I would have to be.  But today I am grateful for the hard times.  Grateful that I have this amazing opportunity to do something I wanted to do from the start.  I learned that if it wasn’t for the trail running, church, friends, family and their support I wouldn’t have been able to pull through.  I was able to believe God has a bigger plan with this year, even if I can’t see it yet.  I have slowly adjusted to this new “normal” and I am excited that the second semester is here, and I am able to focus on my research without running to class and studying for tests.  Let’s hope this will be the best one yet!

Far, far beyond

by Vennesa Subbiah

In my short life, there are many experiences that could qualify as metamorphic. At one time or another, every new experience was the first experience and for good or bad, each instance has altered the trajectory of my life. But none have been as daunting and transformative as the day I walked into my Honors year.

My Honors year is something I like to refer to as a happy accident. You could liken it to the first encounter with your best friend – you don’t exactly like each other but give it a few months and you’re as thick as thieves! Don’t get me wrong! This is not to say I’ve mastered my course work because that would be a blatant lie, but more of an appreciation of how I have come to fall in love with the lessons I have learnt from the pressure and challenges of this year.

Unlike most people, my first day of school wasn’t at all exciting. For starters, I was late to my lecture so that was not a good impression at all. Half the time while I was in that lecture, I was daydreaming because my mind was still on ‘holiday-mode’. I was completely unprepared so naturally I was out of place. I felt this way for the first few weeks of the Honors year and waking up early for lectures was not helping me in any way. I have never been a morning person so you must imagine my pain. I was also not eating properly or taking care of myself because I ‘had’ to keep pushing to meet my deadlines and make sure I was prepared for all my classes. Let’s face it, no one likes to be the student who’s constantly behind. I, for one, aim to always be on top of things. So, when I found myself not having a certain level of control over things, everything seemed to stir into a wild frenzy. For someone who’s always organizing almost every aspect of her life, I found it difficult not being able to manage my time properly. I struggled with this, and I still am but I am also learning to take it easy on myself and try my best without punishing myself for not being able to achieve more than I can at that moment.

In between lectures and reading journal articles and attending meetings, I found myself constantly exhausted. I went from having absolutely all the time in the world to having none at all. Most of the time I had, I spent reading through mandatory journal articles. I enjoyed most of them, but I was often lost in the process which meant I had to go over paragraphs multiple times. I have never despised reading so much in my life until I had to read a journal article. But there was an upside to this because I gained certain critical thinking and analytical skills which enabled me to differentiate between excellent pieces of work to those that aren’t. Having Journal Clubs also enabled me to engage with scientific pieces of work in a thorough manner whilst simultaneously improving my competence in formal presentations and public speaking. So, you see, a challenge presented was a lesson I needed to encounter and learn from.

Overall, I haven’t really been too excited about this year. When we started with General Techniques, I was the most miserable person you could find. Many times, I was not finding the purpose of the lectures or why I had to learn the information in front of me. This isn’t quite what I imagined this degree would be like and I absolutely detested every single moment. I contemplated a lot – whether I had made the right decision to come back to school, whether this degree was the right one for me or if I was doing enough. I was not motivated to learn or engage with the material coupled with the hurdle of not having any people around to actively challenge me. Before the pandemic, I saw my colleagues and friends almost daily and we could exchange ideas on how best to study or what better resources were available to help us excel in our work. Now it’s only me. At first it was unusual, but it was a life-changing moment too because it taught me to be more independent and confident in myself and what I am capable of producing. I am deeply grateful for this moment because in the quiet and absence of the world, I found a great power within myself – the power to believe in myself.

With an adjustment in attitude and the start of the actual modules, I found myself falling back in love with the idea of being in a class and learning. It wasn’t a gradual process as some might expect. I just woke up one morning and realized that this is what I was meant to do. It’s crazy when I think about it because it literally boils down to timing. Timing is so important for any person because when you give yourself room to experience life as it is, you find your passion even in the smallest moments. I was so focused on how well I needed to be performing and how hardworking I should have been from the beginning instead of letting time tell me what to do. Ms. Oprah Winfrey always says one should listen to the whispers of the universe. Sometimes the universe is trying to tell us something, whether it is to slow down, to make an adjustment, to change a habit or to work harder at something. My mistake was not listening to the whispers when the universe told me to be patient with myself and the process. I was quick to rush myself and expect certain things out of the year when it had hardly begun. I learnt the hard way through multiple encountered failures, and I can safely say that it is one thing to have goals and aspirations and another to rush those goals based on where you think you need to be instead of where you are meant to be.

It turns out that life isn’t always what it presents itself as. One moment you have things all figured out then the next it’s all shambles and you’re left to pick up the pieces. But no matter how rocky or rough the path may be, it shouldn’t take away from the splendor and beauty that awaits us at each and every step along the way. Because with each and every challenge we’re faced with, we come out stronger and with a greater set of skills to help us face even bigger challenges in future. Not only that but we acquire a heightened knowledge of ourselves and our abilities and how much more we can reach towards.

I walked into this year feeling quite small and afraid at what lay ahead. I’ve been handed jabs, hooks, uppercuts, you name it. But I’ve learnt to fight back too and stand a little taller. Whatever position and path life may place you in, allow yourself to be present in that moment, taking in everything as it comes and appreciating that knowledge is something we can never fully acquire. So yes, there are times where you will be clueless about everything and that’s perfectly okay. But an inquisitive mind that is willing to learn will take you far, far beyond.

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