Aadautech

Cancer Drug Discovery & Therapeutics Blog

Conventional and Unconventional Therapies for Cancer Survivors

clock October 31, 2009 17:04 by author Dr. Nagaraj

Cancer survivors are people who are living with a diagnosis of cancer, including those who have recovered. Awareness of cancer survival has increased greatly since the 1990s. So has the number of people living with a diagnosis of cancer. The total number of recovered cancer survivors in the world in 2002 was estimated to be just under 25 million, and by 2050 may approach 70 million.

The term ‘cancer survivor’ covers a very wide variety of circumstances. Thus, the needs of people currently undergoing therapy are likely to be different from those of people whose metabolic functions have been altered as a result of therapy and from those of people who are evidently fully recovered and whose functions are intact.

Conventional medicine is also known as modern or Western medicine. It is allopathic, meaning that it relies on diagnosis of disease, by examinations and tests, and treatment. With cancer, treatment includes surgery, chemotherapy, and radiotherapy. Conventional medicine is based on investigation of the biology (including anatomy, physiology and biochemistry) of body organs, tissues and cells. It includes an understanding of the pathological processes that lead to disease, and testing of interventions for efficacy and safety. Conventional practitioners undergo externally validated and structured education and training programs, and continuing professional development, and they are subject to statutory regulation.

Complementary and alternative medicine includes many diverse medical and healthcare systems, practices, and products- some traditional, some modern. Training and regulation of providers exist, but often vary between therapies and nations. Some orthodox scientific evidence is available regarding some of these therapies, although the efficacy of many remains unclear and often controversial.

These therapies include mind-body interventions, such as meditation; biologically based treatments, such as radical nutritional regimens, micronutrient supplements, and herbal products; manipulative and body-based techniques, such as massage and osteopathy; ‘energy therapies’, such as the use of magnets or therapeutic touch; and alternative medical systems, such as traditional Chinese and Ayurvedic medicine.

Integrative medicine’ is a recent approach that uses some complementary and alternative therapies within conventional medicine. Physical activity programs and dietary interventions are commonly used in integrative medicine, together with counseling.

Cancer survivors should consult their physician or qualified health professional before initiating any therapies that are alternative or complementary to conventional therapies. Cancer survivors should keep all of the health professionals involved in providing any treatment fully informed of their choices in these areas.

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Lung cancer metastasis: new drugs in the market?

clock May 17, 2009 14:45 by author Dr. Nagaraj

Lung cancer:

The lungs are a pair of cone-shaped breathing organs in the chest. The lungs bring oxygen into the body as you breathe in. They release carbon dioxide, a waste product of the body’s cells, as you breathe out. Each lung has sections called lobes. The left lung has two lobes. The right lung is slightly larger and has three lobes. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Tiny air sacs called alveoli and small tubes called bronchioles make up the inside of the lungs.Eighty% of lung cancers are due to tobacco smoke. There are over 2,000 known cancer-causing chemicals in tobacco smoke. Normal human cells change into cancer cells when exposed to carcinogens (chemicals which cause cancer). Other well established carcinogens of the lung include radon, asbestos, bischolomethylether, nickel, chromates, coal tar, copper radioactive materials and arsenic.

Lung cancer types:

Lung cancers are broadly classified into small cell or non-small cell. Non-small cell cancers are further divided into adenocarcinomas, squamous cell and large cell carcinomas. Approximately, 75-85% of lung cancers are non-small cell cancers and 15-25% are small cell cancers of the lung.

  • Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. This is also called epidermoid carcinoma.
  • Large cell carcinoma: Cancer that may begin in several types of large cells.
  • Adenocarcinoma: Cancer that begins in the cells that line the alveoli and make substances such as mucus.

1.     Persistent cough and bloody sputum can be symptoms of lung cancer.

2.     Lung cancer can be diagnosed based on examination of sputum, or tissue examination with biopsy using bronchoscopy, needle through the chest wall, or surgical excision.

3.     The treatment of lung cancer depends on the type of cancer, its location and size as well as the age and health of the patient.

Lung metastasis:

Metastasis of lung cancer is present in over 50% of patients at the time of the diagnosis of the lung cancer. The type of screening for metastatic disease depends on the patient’s cancer type, potential for complete surgical removal, the extent of cancer in the chest, and the planned therapy.

Mediastinoscopy, or looking into the central portion of the chest through a small incision made just below the collar line, is used to sample the lymph nodes in the central portion of the chest (mediastinum). This helps evaluate the extent of the tumor. If the cancer has spread to these lymph nodes, the chance of surgically curing the lung cancer is eliminated. Bone metastasis is suggested by bone pain or abnormal blood tests (elevated serum calcium, or elevated alkaline phosphatase).

 X-rays or bone scans are used to evaluate the areas suspected of being cancerous. Liver metastasis may result in pain in the upper right portion of the abdomen, swelling of the abdomen, or abnormal blood tests of the liver.

The diagnosis can be made by liver scan, CAT scan or liver biopsy. Brain and spinal cord metastasis can occur with or without neurological symptoms. CAT and MRI scans of the brain and spinal cord will usually reveal these metastastic tumor sites.




Figures adapted from: 

http://www.qeok.com/lung-cancer/large-cell-carcinoma-picture.jpg,

http://www.elekta.com/assets/content/patient/abcancer.gif

 

Treatment:

Treatment choices and chances of long term survival in lung cancer depend on the type of cancer, its location and size, lymph node involvement, and whether there is evidence of cancer spread to other parts of the body outside of the lungs.

Stage

Common options
I Surgery
II Surgery, chemotherapy, radiation
IIIA Combined chemotherapy and radiation, sometimes surgery based on results of treatment
IIIB Chemotherapy, sometimes radiation
IV Chemotherapy, targeted drug therapy, clinical trials, supportive care

Above figure shows Stage IV non-small cell lung cancer. The cancer has spread to another lobe of the same lung, to the other lung, and/or to one or more other parts of the body such as brain, liver, adrenal glands, kidneys and bone.

Radiation therapy is the local treatment of cancer using various types of radioactive x-ray beams. These treatments prolong life in some patients, and improve the quality of life while relieving pain in others. It rarely cures patients of lung cancer. The major role of radiation therapy is to relieve symptoms.

Chemotherapy is called a systemic treatment because the medicines enter your bloodstream, travel through your body, and kill cancer cells both inside and outside the lung area. Some chemotherapy drugs are taken by mouth (orally), while others are injected into a vein (intravenous, or IV). Chemotherapy is widely accepted as the primary treatment for small cell cancers. In early small cell cancers of the lung, there is a higher success rate with chemotherapy, especially if the cancer is only in the chest.

Extensive research and clinical trials have studied the different chemotherapy medicines used to treat lung cancer. Some medicines are used for most people with lung cancer. Some are used in combination with others to be more effective. Some may be used before surgery or after surgery. Your oncologist will discuss and recommend chemotherapy treatment specific to your condition. Several of the more common chemotherapy medicines include the following:

·         Carboplatin

·         Cisplatin

·         Docetaxel

·         Erlotinib

·         Etoposide

·         Gemcitabine

·         Irinotecan

·         Paclitaxel

·         Pemetrexed

·         Topotecan

·         Vinorelbine  

In cases of non-small cell cancers of the lung, chemotherapy can be used alone or in combination with radiation therapy.

Clinical trials tested:

Chemoprevention is the use of drugs, vitamins, or other substances to reduce the risk of developing cancer or to reduce the risk cancer will recur (come back).

Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

New combinations: New combinations of treatments are being studied in clinical trials.

 

Lung Cancer Statistics and Surgery: Videos

http://www.youtube.com/watch?v=dd2jYSTi9NM

http://www.youtube.com/watch?v=QBht72_PA-4

http://www.youtube.com/watch?v=Kvmoj_xEeUs

http://www.youtube.com/watch?v=MlAL7YuuQIM

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Aadautech

The Cancer Drug Discovery & Therapeutics Blog was started in January 2009. It updates therapeutic targets and drug discovery in the area of cancer. Most of what you read here are updates of recent and new research in cancer therapeutics. Got a cancer news story you think belongs here? Lets discuss. So if you have an interest in cancer and cancer related discovery, please register and join others like you in an ongoing, vibrant dialog.

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