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Friday, November 21, 2008

Cancer Hospice and Respite Caregivers

When the odds of your loved one surviving the cancer they are suffering from get smaller, it is time to think about hospice care. Family members need to let go of their own wishes for "fighting the good fight" and listen to the desires of the patient.
When odds of survival are minimal, the treatments may in reality impair the quality of life your loved one has left. Yet, hospice care is not equivalent to a death sentence; there have been many who have gone through months of hospice care and emerged renewed while showing no signs of relapse.
Yes, it is a difficult decision. Hope for a miracle turnaround versus the graceful recognition of fate is clashing within you. You must learn to prepare yourself for the end of this process, even as you are still hoping and praying for a miracle. To help you, long term cancer hospice care and respite care is available.
No one is telling you to wear a smiley face when someone close to you is likely to die. Coping with end of life issues and staying present for your loved one are vital parts in letting him or her die at peace. Respite care tied in with hospice care helps you get ready for what is to come when your loved will no longer be there.
You may need to slowly phase yourself out of day to day care and think about picking up the neglected threads of your own life. It is normal to forget about other loved ones who also count on you.
Cancer care with hospice care is for dying with dignity. Respite care is for going on with your life with self-respect and hope.
Article Source: http://EzineArticles.com/?expert=Antoinette_Boulay

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Fundamentals of Cancer Therapy

Treatment of cancer as a whole evolves from surgical oncology through radiation oncology and through medical oncology. Now it is the era of biological oncology. The future oncologist may not be a surgeon or a gist who manipulates the cells in the laboratory and then do the extension of treatment. That is the way the systems go. I am very happy to see that Ayurveda is coming up with plans to establish a medical oncology. Allopathy, Ayurveda and Homeo systems of medicine are not competitors, however those who can do best for a patient, should be able to execute the specialty whatever it may be.
Here are few areas, where we have thoroughly failed in management, like hepato-cellular carcinomas, pancreatic tumors, etc. I think these are the areas where the thrust should be given to all the incoming branches of medicines. In central part of Kerala, hepato-cellular carcinoma, pancreatic tumor etc are very common. The allopathic medicine cannot offer them much relief so they send them to palliative clinics. These are the areas where, other systems of medicines should be able to come up and try to do some thing. But all the experiments should be on scientific basics.
I am starting with some examples (case reports). A girl with acute lymphoblastic leukemia was treated in 1991-92, after treatment; she got married & is now well settled in Dubai. Unlike many other chronic diseases cancer patients can go back to their normal life after treatment. Another case, a lady with acute myeloid leukemia after treatment returned back to the normal life. There is another story of a mother, who had an acute lymphoblastic leukemia, when she was pregnant. The patient was not willing for an abortion and to take the medicines. The pregnancy continued & only chemotherapy was done. The child was born in the oncology ward of RCC & was named as 'Medimon' (because the child was born in the medical oncology ward). The mother & child are now doing well. This is the example of the advancement of oncology where we can select the drugs, which are less toxic.
You should know what cancer is or what actually happens in the body?
Basically in cancer the cells are reasonably immortal. If the cells of the body become immortal, the state of cancer occurs in two ways
1. Uncontrolled multiplication of cells or 2. The cells once attained maturity, but not getting killed.
The natural mechanism of programmed cell death is called Apoptosis. If Apoptosis does not happen, the cells go on multiplying with out any interruption. There will be uncontrolled multiplication of cells, which is the basic problem in a malignancy.
Basics
Let us consider the skin as a model. If injury occurs, there will be a recovery phenomenon. After the repair of the injury, there will be a negative feed back & there is no more repair work that has to be done in a well-balanced state. In malignancy, the cells migrate and they go for an uncontrollable proliferation.
Increased numbers of cells are called hyperplasia, not malignant. But when there is a small change in the nature, (cells doesn't look alike or the arrangement is different), then they are called dysplastic cells. Again, they are not malignant but can progress to a malignancy; but hyperplasia will never progress to a malignancy.
Next we can consider about carcinoma in situ. The cells are showing the features of malignancy, they are still maintained within the basement membrane. When the cells are out of the basement membrane, and shed out, then they are invasive cancer, carcinoma invasive. Dysplasia can reverse to a normal state also. Once they progress in to carcinoma in situ, they can never reverse. They go for a invasive carcinoma.
Problem is not in the local site alone. The cells remain the state for some times is then multiplies and starts then to migration.
Ways of migration:
1. Invasion of the blood vessels or lymphatic - migration 2. Spread by other routes like CSF, implantation and trans coelomic spread.
Terminology:
Cancer is not a single disease. With lot of etiologies and characters cancer exists. That's the problem in identifying the plan of action of cancers. Cancers can occur in anywhere on the body including hair follicles. No area, sex, age, is excluded. Depending of the type of tumors terminology varies. (Lymphoma on the lymph nodes, sarcoma on the connective tissues etc.) The epithelial tumors are called carcinoma; connective tissue tumors are called sarcoma.
Cancers detection & diagnosis:
No patient should be seen or treated as cancers only with a histopathological diagnosis. Basic diagnosis criteria, including fine needle aspiration, biopsy, operative specimen on which we are doing histopathological study etc should be there. But the pathologists should give in black & white, and say that this is a malignancy before you enter into treatment. This should be done in all cases, except in brain tumor, where tumor is in a very vulnerable site. In there cases, you are justified in treating with out a biopsy, but we should have evidence on radiology to say that there is a tumor which is malignant. There are many non-malignant tumors which may mimic malignancy has to be excluded before you treat them as a malignancy.
Features of malignancy.
Normal cells, if any variation in size and shape, you can describe them in two ways.
1. The benign tumors are described as the 'Convert girl appearance' and white or blue & white- Well disciplined going of cells. 2. 2nd type - malignant cells ('College girl appearance' No uniformity) Totally disordered arrangement.
Pathology - Description
1. Morphology- the pattern of cells, low they look like etc. 2. Peoulioe marks- characteristics of certain cells. E.g.:- leukemia, where the cytoplasm on the nucleus can be stained using some special stains. Thus they can be easily diagnosed. 3. Immunized chemistry. The cells do expulse antigens, which can be identified with the use of immunized chemistry. Once the cells are identified, we can label them. 4. Cytogenetics:- There are certain cytogenetic abnormalities, which are specific to some tumors. Thus we can identify the type of tumors.
Combination of these tests helps a clinician to arrive at a correct diagnosis. The pathology, after diagnosing the type of tumors, should predict about the chances of progress of the tumors. The doctor should understand the chances of survival. The chances of survival depends on
1. General condition of the patient 2. Site of tumors. 3. Grade of tumors (Grade 1 tumors - cells have the features almost like normal cells
Grade 2 tumors - in between the G1 and G2xG3.
Grade 3 and 4 tumors - very poorly differentiated.
They don't have the feature of the primary cells).
As a broad statement, poorly differentiated tumors or fast growing tumors have high chance of metastasis and will respond to the chemotherapy and radiotherapy well. But relapse also will be there. Where as the well differentiated & slowly growing tumors have low chance of metastasis. Their response to chemotherapy & radiotherapy is not much effective.
Tumors.
You should do investigations to understand whether metastasis has happened or not. If metastasis occurred, the prognosis is bad. Before doing all the investigations, you should take the natural history of the diseases & then decide the staging. Natural history is the basic study of the oncology. Tumors have got an affinity to certain areas. In each tumor, there is a specific federacy of metastasis to a specific area. The doctors should know that.
Stage I, Stage II, Stage III, Stage IV ® Stages Stage I - well localized Stage II - regional lymph nodes are involved Stage III - Much more lymph nods are involved Stage IV - Distort metastasis
TNM classification is the fundamental classification. Idea of cancer detection is to identify the cancer in the 1st stage itself.
Blood tests to diagnose malignancy: - Tumor markers are certain biochemical products available in the blood, which is secreted by the tumors which when identified, helps in diagnosis.. There is some specificity e.g. if there is prostate cancers the PSA (Prostate specific antigen) will be high in blood. That doesn't mean that, all patients with PSA will have prostate cancers. But there is one tumor marker, by which we can be sure about the diagnosis in the serum. Beta SEG is detected in the clinical set up in gestational trophoblastic tumors. You can go for treatment without doing the histological test. What causes cancer: -
Unknown Postulations
1. Heredity 2. Radiations to a certain extend 3. Chemicals 4. Infections
Concept: - cancers do not develop over night; it is a slowly advancing process, which can be reverted at different stages of progression, by intervention. But it can progress if not intervened. Each part has to contribute in the cancer formation. Molecular aspects: -
Normal cell Gene regulates the cell growth.
When the genes are mutated (in a cancers cell), over activity of the genes (oncogenes) occur. These genes affect the cell growth. The growth is accelerated. Over acceleration of the oncogenes is one cause.
Certain genes can prevent the cancers (Anti oncogenes). Balance between the oncogenes and anti oncogenes maintains the correct growth of the cells. Failure of the working of the anti oncogenes leads to over growth of the cells.
What happens at the cellular level: -
You have got receptors in the cells. The growth factor goes and attach to the receptors. Signal, called transudation signals message to the molecules. Getting the genes activated, out put counting from the genes maintain the cycle. The cell multiplies as a result and uncontrolled proliferation occurs.
Doubling process:-
Time taken for a cell to get doubled is the doubling time. Doubling time will be short for rapidly multiplying tumors. If doubling time remains normal, the curve (combustion growth curve) will be linear. But this doesn't happen. The initial part, multiplication will be slow process; but at the end part the multiplication will be fast process. Till a point, i.e. 109 no of cells are available in the body; it is sub clinical & is not able to detect the cancers grown with any available investigations. By the time, 109 to 1010 no of cell multiplication happen, the patient will be no more.
Importance of early detection in malignancy.
Cancer prevention:-
1. Early displacing cells can have a chance of revision back to normal and we can try to prevent the multiplication process. 2. National cancers convert program (NCKP) In which the thrust be on the tobacco, which is a well established, well-identified cancer causing agent. Even a passive smoker of tobacco has got a 15% higher incidence in developing lung cancers. Smoking in public places should be totally banned. 3. Diet Breast cancers Diet (linked with diet) High fat, high diet- fatty females are the candidates who are more prone to develop breast cancer.
Control measure - Avoid high fatty diets, burn the fat by doing exercises. Vegetables (preferably green leafy vegetables) have anti oxidant property that can reverse the malignant property of the cells. Lot of vegetables should be taken as a part of diet.

Article Source: http://EzineArticles.com/?expert=Dr._Eby_Abraham

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Monday, November 17, 2008

Cancer - Causes and Effects

Cancer has ravaged our western societies for many decades but there was a time not that long ago when cancer was not a part of our lexicon. Cancer is a man made disease caused by the introduction of toxic carcinogens, chemicals, pesticides, food preservatives and a host of additives.
Carcinogens attack the human cells attaching themselves to DNA and either altering cellular metabolism or the damaging the DMA directly. Normal DNA that is damaged and cannot repair itself leads to 'programmed cell death' a process called Biotransformation in which the damaged cells harmlessly become water soluble and are flushed from our body. Sometimes damaged DNA in a cell has no pathway and the cell has no choice but to become cancerous. Cancer tumors are formed when normal biological processes are hindered and the normally aggressive immune system is weak or has been weakened.
Some common carcinogens are tobacco smoke, asbestos (when inhaled), dioxins, radioactive material such as gamma rays, alpha particles (when ingested or inhaled) and x-rays which are highly carcinogenic due their retention in human organs. Also there are many natural carcinogens one being Aflatoxin B. which grows on stored nuts and grains. Another potent carcinogen is formaldehyde, which is used, in embalming and plastic making. In PCV manufacturing vinyl chloride is used which is a strong carcinogen.
Carcinogens are also produced by cooking foods at a very high temperature or by cooking meats until their well done. Some researchers say that the carcinogens present are so minute that they present no health threat. Others especially those in the natural health community say carcinogens in over cooked food do present a significant health threat and do add to cancer growing cells over a period of time.
The human body has a remarkable disposition to ward off disease through our built in immune system but a weakened immune system allows deadly carcinogens to get a foot hold in our cells enabling DNA damage. Acrylamide, a known carcinogen is created in frying or overheating foods such as potato chips, french fries and any other fried foods.
Smoking cigarettes and cigars may cause irreversible damage to human genes. There are over 4,000 chemical compounds, which are toxic to the human body and are carcinogenic. With all the education readily available on how deadly tobacco smoke is one would think smoking related diseases would be eradicated but that is not the case. Smoking still is a serious health problem.
With the advent of processed foods came innumerable additives that are foreign to the human body. Additives that add color or taste to a food and preservatives that unnaturally extend shelf life of processed foods. All man made additives are unnatural and may conflict with natural bodily functions. I won't bore you with long scientific names, which can easily be found, on any processed food ingredient list. Suffice it to say all processed foods lend it to diminish. health.
Our water supply has been tragically compromised with the addition of chemicals added to the water in the name public health. Chlorine in massive amounts has been added to most public water supplies to kill off harmful germs when ironically it is the chlorine that is adding a foreign chemical in to millions of trusting people. Remember anything that is not natural in origin becomes a potentially dangerous ingredient in the 'all-natural human body'. The human body reacts positively to natural wholesome foods and natural supplements and negatively to man made stuff that do not have natural ingredients in them.
In addition to harmful and potentially cancer causing preservatives added to food, pesticides and herbicides are liberally used to kill and deter insects and disease in our produce industry. These chemicals are poisonous to human consumption and studies support an increased cancer risk when consumed. As previously stated, any foreign entity introduced into the human body may potentially be harmful and increase cancer risk.
With that in mind one must place pharmaceutical drugs in the category of foreign material. Pharmaceutical drugs are used like eating candy in a brainwashed society. Every pill taken offers a challenge to our immune system and our naturally created normal bodily functions. Pharmaceutical drugs for the most part are a concoction of man made material created to mask the symptoms of a disease, to temporarily alleviate a medical problem. The pill inevitably is time stamped to 'work' or be effective for a period of time thus the masking effect wears off and you need to take another pill.
Our brave new world with boundless good intentions has opened up a Pandora's box of genetic mutants that have cancer-causing implications. We are self-inflicting ourselves with poisons that immeasurably produce a hostile environment for our wondrously created immune system. Cancer in my opinion is a man made creation and could be eliminated if we all insisted, no demanded, that only all natural ingredients be added to our food, water, products, and medicine. Individually you can create your own 'Cancer Free Zone' by living 'all natural' and allowing your body to function as it was intended; "Free and Clean of Foreign Poisons".

Article Source: http://EzineArticles.com/?expert=Gary_Kenneth_Archer

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Adjuvant Chemotherapy

Adjuvant chemotherapy is the additional treatment along with drugs used to destroy the leftover cancer cells after the removal of tumors by surgery. It helps to prevent cancer from coming back. This treatment is very effective to treat cancers such as testicular cancer, breast cancer, ovarian cancer etc.It is very effective treatment, if the chemotherapy drugs are given immediately after the removal of tumor. The patient who received adjuvant chemotherapy tends to live longer. The patients suggested for adjuvant chemotherapy are considered to be having high risk of reappearance of cancer.For detecting reappearance of cancer the characteristics of tumor are studied. Necessity of adjuvant chemotherapy depends on the size of tumor, proliferation rate and histology. The prognosis is better after the well differentiation of tumor, because the cells look like normal cells.Adjuvant chemotherapy is very important when the cancer is aggressive. Other prognostic factors such as degree of lymph node are based on the type of cancer. For breast cancer, consideration of lymph node degree is very important.Cancer that spreads to lymph nodes can easily spread to other parts of the body and it indicates the high risk of cancer reappearance. If there is high level of estrogen and progesterone present, then your care giver or doctors need to decide about whether to treat patient with adjuvant chemotherapy.Most of the women with primary breast cancer are treated with adjuvant chemotherapy. As within six months after surgery the adjuvant chemotherapy is started, so the preference as well as general health of a patient is important before going to give adjuvant chemotherapy.Adjuvant chemotherapy done after six months of surgery is less useful than the therapy done in three months as overall period for treatment is also reduced. The intensity of adjuvant chemotherapy depends on the total number of doses given in a week.During chemotherapy injections of proteins called growth factors may be needed by some patients and these injections help to produce blood cells. Chemotherapy gives some short term and long term side effects such as omitting, hair loss, lower in blood count, nausea, mouth soreness, diarrhea, neurological toxicity, weight gain, fatigue, memory loss, hot flashes menopause etc. Article Source: http://EzineArticles.com/?expert=Kate_Savage

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