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Mithuruwela’s Latest Initiative: Establishing Molecular Testing for Breast Cancer at Anuradhapura Teaching Hospital
In June 2022, Mithuruwela the Cancer Support Network moved away from its customary activities which included awareness- raising and caregiver support, a news release from the organzation said.
“Inspired by an appeal from Dr Nuradh Joseph, Oncologist, the organization helped to support the establishment of molecular testing at the Anuradhapura Teaching Hospital. This initiative marks the first time molecular testing for breast cancer has been instituted in a state hospital and Mithuruwela is proud to be part of this endeavor,” it said.
Breast Cancer and Molecular Testing Of all the cancers affecting females in Sri Lanka, Breast Cancer is the commonest. Records of cancer in the island are maintained annually and according to data from the National Cancer Registry nearly 4,000 new cases are diagnosed each year.
The diagnosis of breast cancer is a complex process which includes findings from clinical examination and imaging such as ultrasound and CT scanning. If cancer is suspected, oncologists then seek confirmation. This confirmation requires a biopsy whereby a core of tissue from a suspicious lump is analysed in the laboratory by histopathologists.
Explaining the process of diagnosis and treatment, Dr Joseph comments that if the diagnosis of cancer is confirmed, histopathologists then perform additional tests called immunohistochemistry which look to see if the cancer cells express certain proteins (called receptors) that may influence treatment.
Routinely immunohistochemistry is performed for hormone receptors (Oestrogen and Progesterone) as well as another protein called HER2/neu. If the hormone receptors are expressed oncologists will offer anti-oestrogen hormonal treatment while if the HER2/neu protein is over-expressed, patients will be treated with novel agents which specially target cancer cells. These drugs reduce the risk of cancer recurrence by 50% in tumours over-expressing the HER2/neu protein.
However, in some instances (approximately 10%) it is not possible to confirm whether the HER2/neu protein is abnormally expressed or not based on immunohistochemistry alone. When this happens the histopathologist reports it as an “equivocal” expression of the HER2/neu protein. It is uncertain if these patients will benefit from the novel targeted drugs mentioned previously and further molecular testing is needed for confirmation.
For these patients, one needs to check if the HER2/neu gene is present in abnormal amounts in the cancer cells. This is known as gene amplification. Testing for gene amplification is done by special techniques called in situ hybridization (ISH). About 50% of patients with equivocal expression of HER2/neu on immunohistochemistry will have gene amplification confirmed by molecular testing thus making them suitable for treatment with the novel targeted drugs.
Currently these molecular tests are available at a few private hospitals but not in the histopathology laboratories of government hospitals. As many patients cannot afford funding for these tests in the private sector, they miss out on potentially life- saving treatment.Molecular testing for HER2/Neu at the Teaching Hospital , Anuradhapura In recent times, molecular testing for HER2/neu gene amplification using available equipment has been established in certain government sector hospitals in the country.
The histopathology department of the Teaching Hospital of Anuradhapura is one such department which has the equipment and also staff that has been trained to perform the required tests. The problem however is the cost of the consumables that are required. According to Dr Joseph, to commence testing at Anuradhapura, the hospital would require a sum of US dollars 5,839 just to purchase the minimum quantities of reagents needed. It was this consideration that led Dr Joseph to reach out to Mithuruwela to request help in getting these funds.
In spite of the current challenging climate, Mithuruwela together with Dr Joseph and his contacts were able to collect the required funds, thanks to the generosity of donors such as the Tissa De Silva Trust, the Students Association of Edith Cowan University in Australia, well-wishers in Australia and New Zealand and a number of generous individuals in Sri Lanka. JL Morisons, the agents for the reagents also supported the cause by ensuring that the reagents reached Anuradhapura safely under refrigerated conditions.
The Anuradhapura Teaching Hospital is now in a position to commence molecular testing for HER2/neu. The tests will be carried out by Dr Jayanjana Ashanthi and Dr Sanjeewanie Jayawardena, Consultants to the histopathology laboratory at the Anuradhapura hospital.
Establishing testing for HER2/neu gene amplification at the Teaching Hospital of Anuradhapura will not only benefit patients with breast cancer, but will blaze a new trail for cancer diagnostics in Sri Lanka as it would be the first time ever that any form of molecular testing is performed in a laboratory attached to the Ministry of Health. Mithuruwela expressed its gratitude to all those who made this initiative a reality.
Opp. lashes out at Justice Minister for disparaging remarks about CLA
By Shamindra Ferdinando
The Joint Opposition yesterday (09) tore into Justice and National Integration Minister Harsha Nanayakkara over some disparaging remarks about the Commonwealth Lawyers Association (CLA) in Parliament on Tuesday (08).
The Convenor of the Opposition grouping, former Law Professor Peiris questioned Minister Nanayakkara’s declaration that the CLA was a private club that granted membership on payments received. Emphasising that the CLA consisted of those in the legal profession in Commonwealth countries, Prof. Peiris told the weekly media briefing at the Flower Road Office of former President Ranil Wickremesinghe that the views expressed by the organisation couldn’t be discarded under any circumstances.
Prof. Peiris dealt with Nanayakkara’s response to the CLA’S concerns about several issues, including the composition of the five-member panel of judges. “How could Minister Nanayakkara dismiss concerns raised by CLA on the basis of the paid-membership of the organisation?” Prof. Peiris asked. If membership became an issue, the government would have to reconsider Sri Lanka’s UN membership, the ex-External Affairs Minister said, pointing out that the country had to make regular payments to retain membership of other UN agencies, as well.
Prof. Peiris said that indefensible attacks on international organisations could cause irreparable damage to the country. Appreciating the CLA’s report on the Supreme Court proceedings on the 01 and 02 September, Prof. Peiris stressed the importance of what he called total transparency in the judicial process. He said that whatever the outcome of a particular legal process, it couldn’t be done behind the backs of the public.
Referring to legal processes regarding the 6th Amendment and 13th Amendment, in 1983 and 1987, respectively, Prof. Peiris said, on both occasions the then Chief Justices Neville Samarakoon and S. Sharvananda constituted benches consisting of all Supreme Court judges.
But, the incumbent CJ Preethi Padman Surasena, in spite of the majority of petitioners demanding all available 13 justices to hear the case, decided to leave out those on the seniority list from second position to fourth position.
The government got offended because the CLA pointed that out for the whole world to take notice, Prof. Peiris said. The former parliamentarian noted that the CJ hadn’t even give a reason for declining the widespread call to involve all available 13 judges. According to him, there had been instances where CJ’s appointed seven justices to hear a particular case. Prof. Peiris cited the 2018 bench of seven judges that heard the petitions against President Maithripala Sirisena over the dissolution of Parliament and a panel constituted in 2023 to hear the 2019 Easter Sunday carnage that claimed the lives of 270 people.
The issue at hand is that the five-member panel of judges hadn’t been selected on the basis of seniority, Prof. Peiris said, once the SC determination was sent and released through the Speaker, they would meticulously examine that to make their position known to the people. Prof. Peiris said that what they really wanted to know was that if seniority hadn’t been the basis for selection what the criterion was.
News
Sri Lanka reiterates its territory won’t be used against India
The Indian Defence Ministry in a statement issued yesterday (09) quoted President Anura Kumara Dissanayake as having assured visiting Defence Minister Rajnath Singh that Sri Lanka would never allow its territory to be used for activities inimical to India’s security interests.
The text of the Indian press release: “Visiting Indian Defence Minister Rajnath Singh called on President Anura Kumara Dissanayake in Colombo on September 09, 2026. The two leaders held substantive discussions on issues covering the entire spectrum of the multi-faceted partnership between the two nations, characterised by traditionally warm relations and mutual trust.
The two sides reaffirmed that as civilisational twins, close neighbours and maritime partners, India and Sri Lanka would continue to work together for their development and welfare of the people while working jointly to ensure the safety, security, peace and prosperity of the region. The senior Indian Minister conveyed greetings on behalf of Prime Minister Narendra Modi and underlined that the citizens of the two countries share deep friendship based on strong historical & civilisational links and people-to-people exchanges.
Extending a warm welcome to Mr. Singh, President Dissanayake recalled his interactions with PM Modi and reiterated that Sri Lanka would never allow its territory to be used for any activities inimical to India’s security interests.
President Dissanayake expressed his gratitude for the relief assistance provided by India as part of Operation Sagar Bandhu during Cyclone Ditwah and the comprehensive rehabilitation package extended by New Delhi to facilitate reconstruction and rehabilitation work across different parts of the island. The powerful Indian Defence Minister emphasised that as a closest friend and neighbour of Sri Lanka, India considered it not a favour, but a responsibility to provide assistance as the first responder and would continue to do so in the future as well.
Both leaders virtually inaugurated three Bailey Bridges constructed by the Indian Defence Forces. The two sides also exchanged MoUs on upgradation of L70 Guns for the Sri Lankan Air Force, and cooperation between National Cadet Corps (NCC) & National Defence Colleges (NDC) of both the countries. The MoU on Upgradation of six L70 guns for the Sri Lankan Air Force falls under a Government of India grant. The upgradation of these air defence guns will significantly strengthen the air defence architecture of critical assets in Sri Lanka. These air defence guns were earlier provided to the Sri Lanka Air Force by India.
The MoU on academic cooperation between NDC, India and NDC, Sri Lanka will facilitate knowledge sharing which will be a significant step in further strengthening the academic bonds between both the sister institutes. The MoU on NCC cooperation will formalise the NCC youth exchange programme between India and Sri Lanka. This exchange programme provides a valuable opportunity for NCC cadets from multiple countries across the world to come to New Delhi every year and participate in NCC events.”
News
UK-led Core Group calls Jaffna mass graves a ‘stark reminder’ but stops short of calling for international accountability
Mass grave excavations in Sri Lanka are a stark reminder that thousands of cases of enforced disappearance remain unresolved, the Sri Lanka Core Group has told the UN Human Rights Council, urging Colombo to translate its stated commitment to reform into concrete progress, while again stopping short of calling for the international accountability that Tamils have long demanded.
The statement, delivered in Geneva, on Tuesday (08), during the Council’s 63rd session by the United Kingdom’s Human Rights Ambassador Eleanor Sanders on behalf of Canada, Malawi, Montenegro, North Macedonia and the UK, welcomed, what it called, the High Commissioner’s balanced assessment of the human rights situation on the island.
The group acknowledged that Sri Lanka had faced considerable challenges recently, including severe weather events and global energy shocks, and welcomed positive developments, including the ratification of the ILO Convention 190 and engagement on the Convention on the Rights of Persons with Disabilities.
“However, much further action is needed to build confidence in accountability and reconciliation efforts,” Sanders said. “Progress in several emblematic cases has not yet been accompanied by a comprehensive,
victim-centred accountability process to address past violations. Mass grave excavations are a stark reminder that thousands of cases of enforced disappearances remain unresolved. And reports of intimidation, harassment, and restrictions affecting civil society, journalists and victims’ groups, including in the North and East, still raise concerns.”
The group urged progress on democratic governance, including advancing legal and institutional reforms, resolving land-related issues, ensuring respect for human rights in detention institutions and strengthening independent institutions.
The statement follows a familiar pattern. In June, the group acknowledged “developments in certain mass grave investigations” and urged that excavations meet international standards, and in March it called for the repeal of the Prevention of Terrorism Act. At the 58th session it welcomed a series of measures Tamils regarded as superficial. Neither this statement, nor its predecessors, names Chemmani, calls for international oversight of the excavation, or addresses the demand for a referral to the International Criminal Court.
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