Tag: Chemotherapy

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Hi-tech ‘Trojan Horse’ Can Kill Cancer Cells

Australian researchers are set to begin human trials of a tiny nano-cell that acts as a “Trojan horse” against cancer cells; a breakthrough they say may curb the need for debilitating chemotherapy.

The technology could eventually allow cancer sufferers to receive treatment as outpatients, rather than being hospitalised for lengthy bouts of chemotherapy, according to the researchers.

Himanshu Brahmbhatt from Sydney-based biotechnology company EnGeneIC said the research — outlined in the journal Nature Biotechnology — had the potential to reduce the side-effects of cancer treatment and make it cheaper.

Brahmbhatt said the technology allowed medics to target cancer cells without damaging healthy tissue, a major problem with existing chemotherapy treatments.

“Essentially you need to get the drug directly inside the cancer cell and not slug the body,” he told the Australian Broadcasting Corporation.

While researchers have been working on using nano-cells against cancer for at least five years, Brahmbhatt said the latest version had proved 100% effective treating cancers in mice which were resistant to conventional chemotherapy.

The cells were loaded with anti-cancer medications and deployed in “waves” to combat cancers, he said.

“The first wave of Trojan horses goes in there and disables the resistance mechanisms inside the cancer cell,” he said.

“Interestingly, these cancer cells are totally receptive to repeated waves of these Trojan horses.

“We can send in these nano-cells again and again and each time we can load them up with different types of armaments against cancer.”

The cells will be tested on long-term cancer patients at three Melbourne hospitals later this year.

Brahmbhatt said the nano-cells used less drugs than conventional treatments, making them cheaper to administer.

The targeted treatment also means they have less side-effects than chemotherapy, he said.

“(Cancer treatment) effectively can change to literally an outpatient therapy, where the patient simply comes in once or twice a week,” Brahmbhatt said.

“You can receive the treatment in a very short period of time and you can go about your normal life and not have any of these horrific toxic side effects.”

Source: The Times Of India

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Ailmemts & Remedies

Cytopenia

DEFINITION:

Cytopenia is a reduction in the number of blood cells. It takes a number of forms:
*Low red blood cell count: anemia.
*Low white blood cell count: leukopenia or neutropenia (because neutrophils make up at least half of all white cells, they are almost always low in leukopenia).
*Low platelet count: thrombocytopenia.
*Low granulocyte count: granulocytopenia
*Low red blood cell, white blood cell, and platelet counts: pancytopenia..

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Blood cell development. A blood stem cell goes through several steps to become a red blood cell, platelet, or white blood cell.

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Cancer patients may frequently develop cytopenia, a disorder in which the production of one or more blood cell types ceases or is greatly reduced. Cancer and chemotherapy used to treat cancer, and sometimes radiation therapy, may sometimes cause cytopenia.

TYPES:
A deficiency of red blood cells which  is called anemia; a deficiency of white blood cells, or leukocytes, leukopenia or neutropenia (neutrophils make up over half of all white blood cells); and deficiency of platelets is called  thrombocytopenia.

Pancytopenia is the deficiency of all three blood cell types and is characteristic of aplastic anemia, a potentially life-threatening disorder that requires a stem cell transplant.

Blood Cells
The blood consists of three different  types of cells: red blood cells (erythrocytes), white blood cells (leukocytes), and platelets. Erythrocytes contain hemoglobin, the protein that carries oxygen from the lungs to all cells in the body. Proper cell function depends on an adequate oxygen supply. When cells are oxygen deprived, organ function can be seriously impaired.

Leukocytes (white blood cells) protect the body against viral, bacterial, and parasitic infection and detect and remove damaged, dying, or dead tissues. Someone with a deficiency of white blood cells is extremely vulnerable to infection.

The term “leukocyte” refers to all six types of white blood cells; each plays a unique role in the immune system:

1. Basophils circulate in the blood and initiate the inflammatory response.
2.Eosinophils kill infecting parasites and produce allergic reactions.
3.Lymphocytes produce antibodies and regulate immune responses.
4. Mast cells are fixed in tissues and initiate the inflammatory response.
5. Monocytes capture infecting organisms for identification, ingest infecting organisms, and remove damaged or dying cells and cell debris. When monocytes become fixed in tissue, they are called macrophages.
6.Neutrophils identify and kill infecting organisms, and remove dead tissue.

Platelets are essential factors for blood clotting. Sudden blood loss triggers platelet activity at the site of the wound. Exposure to oxygen in the air causes platelets to break apart and combine with a substance called fibrinogen to form fibrin. Fibrin has a thread-like structure and forms a scab, or external clot, as it dries. Platelet deficiency causes one to bruise and bleed easily. Blood does not clot at an open wound, and there is greater risk for internal bleeding.

All blood cells have a lifespan: erythrocytes have a lifespan of about 120 days; leukocytes, 1 to 3 days; and platelets, approximately 10 days. The body continually replenishes the blood supply through a process called hematopoiesis.

Blood Cell Formation—Hematopoiesis, the formation and development of blood cells, occurs in bone marrow. Bone marrow is a nutrient-rich spongy tissue located mainly in the central portions of long flat bones (e.g., sternum, pelvic bones) in adults and all bones in infants.

All blood cells derive from blood-forming stem cells that reside in bone marrow. Stem cells replicate indefinitely and develop into mature, specialized cells. A hormone produced in the kidneys, erythropoietin, stimulates blood stem cells to produce all three types of blood cells.

CAUSES & RISK FACTORS:-

Chemotherapy and radiation therapy both reduce the number of blood-forming stem cells in cancer patients, but chemotherapeutic agents have a greater adverse effect because they suppress bone marrow function in several ways.The degree of damage is related to the particular drug(s) and the dose.

Chemotherapeutic agents can produce deficiencies in all blood cell types by

* damaging blood-forming stem cells,
* suppressing the kidneys? production of erythropoietin (hormone that stimulates blood cell production), and
* triggering red cell destruction (hemolysis) by inducing an immune response that causes the body to mistakenly identify erythrocytes as foreign bodies and destroy them.

Malignant tumors can cause anemia and other cytopenias when they directly invade bone marrow and suppress marrow function. Malignant cells also can migrate from tumors in other parts of the body to bone marrow. Tumors also can replace normal blood-forming stem cells with abnormal clones.

SIGN & SYMPTOMS:-

Anemia
A deficiency in erythrocytes reduces the amount of oxygen reaching all cells in the body, thus impairing all tissue and organ function. Severe fatigue is the most common symptom of anemia and is experienced by approximately 75% of chemotherapy patients. Patients find it more disabling than other treatment side effects, including nausea and depression.

Anemia also produces these symptoms:

* Confusion
* Dizziness
* Headache
* Lightheadedness
* Loss of concentration
* Pallor (pale skin, nail beds, gums, linings of eyelids)
* Rapid heart rate (tachycardia)
* Shortness of breath (dyspnea)

Neutropenia
Patients with a white blood cell deficiency experience frequent and/or severe bacterial, viral, and/or fungal infections; fever; and mouth and throat ulcers.

Complications—Bacteremia, the form of sepsis characterized by the presence of bacteria in the blood, can develop in immunocompromised patients who have neutropenia. Fever, rapid heart rate, and quick shallow breathing are signs of early sepsis, usually a reversible condition.

Untreated bacteremia can lead to severe sepsis, in which one or more organs become dysfunctional. Septic shock is severe sepsis with low blood pressure. The risk for death increases with the development of septic shock. Even aggressive treatment can fail to reverse the condition.

Thrombocytopenia
Platelet deficiency causes patients to bruise and bleed easily. Bleeding occurs most often in the mucous membranes lining the mouth, nose, colon, and vagina. Tiny reddish-purple skin lesions (petechiae), evidence of pinpoint hemorrhages, may appear on the skin or in the mouth.

Pancytopenia
Patients who are deficient in all blood cell types experience signs and symptoms associated with each, but bleeding from the nose and gums, and easy bruising usually appear first. Symptoms of anemia (e.g., fatigue, shortness of breath) are also common. Patients may look and feel well, otherwise, despite the seriousness of their condition.

Anemia
People with anemia (reduced red cell production) are advised to rest and eat foods high in iron (meat, fish, poultry, lentils, legumes, iron-enriched grains and flours).

If immediate remedy is necessary, treatment may include medication that helps restore the red blood supply and a transfusion of packed red blood cells.

Epoetin alpha (Epogen®, Procrit®)is a synthetic erythropoietin (normally produced by the kidneys) that stimulates stem cells to produce red blood cells. Restoration of the red blood cell supply with medication is gradual.

Darbepoetin alfa (Aranesp®) also stimulates red blood cell production but requires fewer doses and less disruption of daily living.

In March 2007, the Food and Drug Administration (FDA) issued a warning about these medications in response to studies indicating that they may increase the risk for blood clots, strokes, and heart attacks in some patients (e.g., patients who have kidney disease).

Thrombocytopenia
People with an abnormally low platelet count should avoid bruising or breaking the skin, and should carefully brush their teeth. A persistently decreased platelet count may be treated with a transfusion of platelets.

Neutropenia
The patient with a low white blood cell count is advised to  do the following:

*Avoid contact with people who are ill,
*Monitor closely for signs of infection (e.g., fever), and
*Take antibiotics when appropriate.

Medication, a colony-stimulating factor (CSF), may be prescribed to speed the development of white blood cells and shorten the period of susceptibility to infection.

Growth Factors
Growth factors are synthetic versions of substances involved in stimulating red and white blood cell production. Physicians exercise caution when prescribing these medications for people with tumors that involve the bone marrow, because growth factors might stimulate malignant cell growth.

These medications include the following:

Epoetin alpha (Procrit®, Epogen®; stimulates red blood cell production)
G-CSF (granulocyte colony-stimulating factor; e.g., filgrastim [Neupogen®]; stimulates neutrophil production)
GM-CSF (granulocyte-macrophage colony-stimulating factor; stimulates production of several white blood cells, including macrophages)

Leukocytes and other cells that contain granules are also called granulocytes.

Side effects
Fever, fatigue, dizziness, diarrhea, nausea, vomiting, weakness, and paresthesia (prickling sensation) are side effects associated with epoetin alpha.

Bone pain, malaise, headache, flu-like symptoms, muscle ache, redness at the injection site, and skin rash may occur with GM-CSF.

G-CSF commonly produces bone pain.

MEDICATIONS:-

Medications used to treat bacterial infection and other illnesses also can contribute to immune system suppression.

Some of these are :

* Antacids: cimetidine (Tagamet®)
* Antibiotics: chloramphenical (Chloromycetin®), sulfonamide (Thiosulfil®, Gantanol®); cephalosporin (Cephalaxin®), vancomycin (Vancocin®)
* Anticonvulsants: phenytoin/hydantoin (Dilantin®), felbamate (Felbatol®), carbamazepine (Tegretol®)
* Antimalarials: chloroquine (Aralin®)
* Antivirals: ganciclovir (Vitrasert®), zidovudine (AZT®)
* Cardiac drugs: diltiazem (Cardizem®), nifedipine (Procardia®), verapamil (Calan®)
* Diabetes drugs: glipizide (Glucotrol®), glyburide (Micronase®)
* Hyperthyroid drug: propylthiouracil
* NSAIDs (nonsteroidal anti-inflammatory drugs): phenylbutazone (Butazolidine®), indomethacin (Indocin®, Indochron E-R®)—Due to potentially severe gastrointestinal and cardiovascular side effects, NSAIDs should only be used as instructed.
* Rheumatoid arthritis drugs: auranofin (Ridaura®), aurothioglucose (Solganal®), gold sodium thiomalate (Myochrisine®)

Bone Marrow and Stem Cell Transplantation:-
The treatment of choice for the pancytopenic patient with a matched bone marrow donor is stem cell transplantation. The goal of transplantation is to restore blood-forming stem cells to the marrow.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.oncologychannel.com/cytopenia/index.shtml
http://en.wikipedia.org/wiki/Cytopenia
http://www.cancer.umn.edu/cancerinfo/NCI/CDR378089.html

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News on Health & Science

New Methods for Curbing Nausea of Chemotherapy

Ginger, a home remedy for helping an upset stomach, and a cocktail of anti-nausea drugs both reduced vomiting and sickness in cancer patients.

Chemotherapy could soon become less grueling.

Simply adding about half a teaspoon of ginger to food in the days before, during and after chemotherapy can reduce the often-debilitating side effects of nausea and vomiting, a large, randomized clinical trial has found. And a newer type of anti-nausea drug, when added to standard medications, can help prevent such side effects as well.

The ginger results will be presented this month at the American Society of Clinical Oncology annual meeting; the drug study was published this week in the Lancet Oncology journal.

The findings are significant, cancer experts say, because about 70% of chemotherapy patients experience nausea and vomiting — often severe — during treatment.

“Chemotherapy has come to be the thing cancer patients fear the most,” said Dr. Steven Grunberg, a professor of medicine at the University of Vermont and lead author of the study in the Lancet Oncology. “We’ve made a huge amount of progress, but we haven’t completely solved the problem.”

In the ginger study, 644 patients, most of them female, from 23 oncology practices nationwide received two standard anti-emetic medications at the time of chemotherapy. They also were given a capsule containing either 0.5 gram, 1 gram or 1.5 grams of ginger, or a placebo capsule. The patients took the capsules containing the placebo or ginger for three days before chemotherapy and three days after the treatment.

All of the patients receiving ginger experienced less nausea for four days after chemotherapy, said lead study author Julie L. Ryan of the University of Rochester Medical Center. Doses of 0.5 gram and 1 gram were most effective, reducing nausea by 40% compared with the patients on the placebo.

The study is the largest to examine the effect of ginger, already widely used as a home remedy for an upset stomach. One gram of ground ginger is equivalent to about 1/2 teaspoon. Ryan cautioned that some foods labeled as ginger, such as ginger ale or ginger cookies, may contain only ginger flavoring.

Researchers don’t know why ginger seems to help, Ryan said. But, she added: “There is other research showing it has a potent anti-inflammatory effect in the gut.”

In the study led by Grunberg, 810 patients were given two standard anti-nausea drugs, dexamethasone and ondansetron, that work by blocking a neural pathway in the brain that controls nausea. This two-drug regimen is most effective in preventing nausea and vomiting in the first 24 hours after chemotherapy.

One-third of the patients also received a one-day dose of the new drug, casopitant mesylate, while one-third received a three-day dose and one-third received a placebo.

Adding casopitant mesylate, the authors found, helped control symptoms in the so-called delayed phase of nausea that occurs beyond the first day after chemotherapy. Of patients receiving the standard two-drug regimen, 66% experienced no nausea or vomiting in the five days after chemotherapy, compared with 86% of patients taking a single dose of casopitant mesylate.

Casopitant mesylate probably adds extra relief from nausea because it acts on different nerve systems than the standard drugs, Grunberg said. Dexamethasone and ondansetron are in a class of drugs known as serotonin receptor antagonists; casopitant mesylate blocks the so-called NK1 pathway in the brain.

“NK1 antagonists work better for that later period,” Grunberg said. “This study reinforces the value of this family of anti-nausea agents.”

It also appears that the three-drug combination can be given on the day of chemotherapy without the need for additional doses, he said.

“That is a huge convenience for the patient, if we can give them all the drugs they will need for this period on the day they come to the clinic for chemotherapy,” Grunberg said. “Our whole goal is maintain the highest quality of life during chemotherapy.”

Sources: Los Angeles Times

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Fatty Fish-oil May Help Reduce Tumour

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An omega 3 fatty acid found in fish oils reduced the size of tumours in mice and made a chemotherapy drug more potent while limiting its  harmful effects, Egyptian researchers reported.

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The findings, published in publisher BioMed Central‘s peer-reviewed Cell Division journal, add to evidence showing a range of health benefits from eating the fatty acids found in foods such as salmon. A.M. El-Mowafy and colleagues from Mansoura University in Egypt looked at how an omega 3 fatty acid called docosahexanoic acid, or DHA, affected solid tumours growing in mice and how well it interacted with the chemotherapy drug cisplatin.

“Our results suggest a new, fruitful drug regimen in the management of solid tumours based on combining cisplatin and possibly other chemotherapeutics with DHA,” El-Mowafy said in a statement. “DHA elicited prominent chemo-preventative effects on its own, and appreciably augmented those of cisplatin as well.” In March, U.S. researchers showed that a diet high in omega 3 fatty acids– the kind found in fish such as salmon, mackerel, herring and sardines- protected against advanced prostate cancer even in men more at risk of the disease.

The fatty acids, also found in foods such as walnuts and leafy greens, have been shown to provide an anti-inflammatory effect and have been linked to a lower risk of heart disease. In their study, El-Mowafy’s team found that, at the molecular level, DHA reduces the accumulation of white blood cells, systemic inflammation, and a harmful condition marked by decreased antioxidant levels- all of which have been linked to tumour growth. Their experiment also showed that the fatty acid reduced toxicity and injury to kidney tissue caused by the chemotherapy drug, the researchers said.

Sources:The Times Of India

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Diagnonistic Test Health Problems & Solutions

Cardiac Catheterization

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Alternative Name: Catheterization – cardiac; Heart catheterization

Definition:
Cardiac catheterization with coronary angiogram takes pictures of the blood vessels in your heart, to evaluate the health of your heart and detect any narrowing of the blood vessels or other problems. The catheterization is performed by a cardiologist (or sometimes a radiologist) who is a specialist in doing this type of test.
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This process involves passing a catheter (a thin flexible tube) into the right or left side of the heart. In general, this procedure is performed to obtain diagnostic information about the heart or its blood vessels or to provide treatment in certain types of heart conditions.

Cardiac catheterization can be used to determine pressure and blood flow in the heart’s chambers, collect blood samples from the heart, and examine the arteries of the heart with an x-ray technique called fluoroscopy. Fluoroscopy provides immediate (“real-time”) visualization of the x-ray images on a screen and provides a permanent record of the procedure.
Why the Test is Performed ?
Cardiac catheterization is usually performed to evaluate heart valves, heart function and blood supply, or heart abnormalities in newborns. It may also be used to determine the need for heart surgery.

Therapeutic catheterization may be used to repair certain types of heart defects, open a stenotic heart valve, and open blocked arteries or grafts in the heart.
How the Test is Performed:
You lie on your back as a medical technician connects you to a heart monitor. An intravenous (IV) line is inserted into one of the blood vessels in your arm, neck, or groin after the site has been cleansed and numbed with a local anesthetic.. You may be given a sedative through the IV so that you are relaxed during the test.

First, the doctor injects a local anesthetic into the skin. This might sting momentarily. After the skin is numb, the cardiologist inserts a catheter (a thin, hollow plastic tube) into a large artery-usually in your groin but possibly in your arm or wrist.

Using live x-rays displayed on a video monitor as a guide, your doctor moves the catheter along the artery until it reaches your aorta (the large blood vessel that carries blood from your heart to the rest of your body). The tip of the catheter is pushed up the aorta until it reaches the heart and then gently pushed into the coronary arteries that supply blood directly to your heart muscle.When the tip of the catheter reaches one of the coronary arteries, the doctor injects contrast dye through the catheter. The dye illuminates the artery, allowing the doctor to see if it is blocked or narrowed. The procedure is repeated to visualize the other coronary arteries.

X-ray pictures are taken while the dye travels down the arteries. The arteries look like thick lines on the x-ray; a narrowing or blockage in an artery appears as a thinner line (see Figure 1). Your doctor might also inject some contrast medium into the left ventricle of your heart to show how forcefully your heart is pumping. The entire procedure usually takes from one to several hours.

How you Prepare for the Test:
Food and fluid are restricted 6 to 8 hours before the test. The procedure takes place in the hospital and you will be asked to wear a hospital gown. Sometimes, admission the night before the test is required. Otherwise, you will be admitted as an outpatient or an inpatient the morning of the procedure.

Your health care provider should explain the procedure and its risks. A witnessed, signed consent for the procedure is required.

Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.

During this procedure, local anesthetics (numbing agents) are used to minimize pain. Tell the cardiologist if you have ever had an allergic reaction to a local anesthetic or to contrast dyes. Also let your doctor know if you could be pregnant, since the x-rays used during this procedure can damage a fetus.

. Tell the cardiologist if you’re taking a nonsteroidal anti-inflammatory drug (NSAID) or other medicines that affect blood clotting and could increase the chance of bleeding from the procedure. You should also tell your doctor if you take insulin shots or blood sugar-lowering pills so that you can take steps to avoid dangerously low blood sugar, or hypoglycemia.

How the Test Will Feel?
The study is carried out in a laboratory by a trained cardiologist or radiologist and technicians or nurses.

You will be awake and able to follow instructions during the catheterization. A mild sedative is usually given 30 minutes before the procedure to help you relax. The procedure may last from 1 to several hours.

You may feel some discomfort at the site where the IV is placed. Local anesthesia will be used to numb the site, so the only sensation should be one of pressure at the site. You may experience some discomfort from having to remain still for a long time.

After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the IV is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.

Risk Factors:
There are several potential risks. First, the catheter can irritate the heart, in rare cases causing a disturbance in the heart rhythm. Should this happen, the doctor can immediately use devices and medicines to restore a normal heart rhythm. The catheter occasionally can cause the coronary artery to go into spasm, temporarily reducing the blood flow and causing chest pain. For this reason, alert the doctors and nurses if you develop any chest discomfort, trouble breathing, or any other problem during the test.

In addition, the contrast medium can sometimes impair kidney function. This effect is almost always temporary, but some people have permanent damage. Another possible complication is bleeding at the place where the catheter was inserted. If blood collects under the skin, it can form a large painful bruise called a hematoma. This usually resolves on its own, without requiring additional treatment. Occasionally, people are allergic to the contrast dye and develop a rash, hives, or difficulty breathing after the dye is injected. If this should occur, the medical staff in the catheterization laboratory have medicines available to treat the allergic reaction.

The amount of radiation from this test is too small to be likely to cause harm.
Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.

Generally, the risk of serious complications ranges from 1 in 1,000 to 1 in 500. The risks include the following:
*Cardiac arrhythmias
*Cardiac tamponade
*Trauma to the artery caused by hematoma
*Low blood pressure
*Reaction to contrast medium
*Hemorrhage
*Stroke
*Heart attack
Must you do anything special after the test is over?
You should lie flat for a few hours after this procedure. Often, a small plug or stitch is used to prevent bleeding from the artery that was entered to perform the catheterization. If you received a sedative, you might feel sleepy and shouldn’t drive or drink alcohol for one day after the catheterization.

What Abnormal Results Mean
The procedure can identify heart defects or disease, such as coronary artery disease, valve problems, ventricular aneurysms, or heart enlargement.

The procedure also may be performed for the following:
*Primary pulmonary hypertension
*Pulmonary valve stenosis
*Pulmonary embolism
*Tetralogy of Fallot
*Transposition of the great vessels
*Tricuspid regurgitation
*Ventricular septal defect

How long is it before the result of the test is known?
Your doctor will have your results as soon as the test is completed. In particular, the doctor can tell you if you have any blockages in the coronary arteries, how many and how severe they are, and the best way to treat them. In some cases, your doctor is even able to remove any blockages immediately by performing an intervention known as a coronary angioplasty, a procedure that uses a tiny inflatable balloon to reopen the artery.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/cardiac-catheterization.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/003419.htm

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