One of the present issues being addresses in clinical trials is whether anticancer drugs should be used together (cancer combination chemotherapy) or if they should be used as a single agent (sequential chemotherapy). If drugs are combined and share common toxicity such as bone marrow suppression, often the dosage must be reduced, perhaps also reducing its efficacy. Some drugs in combination may be synergistic, wherein the combination of two or more drugs enhances the anticancer effect as compared to when drugs are given alone in sequence.

Based on successful clinical trial results in the treatment of Hodgkin’s disease, breast cancer chemotherapy was traditionally given in combination. Early results did demonstrate a combination of drugs were better than a single agent. As new evidence emerges regarding the presence of potentiation of these drugs and toxicities from interactions, cancer chemotherapy regimens may contain combined drugs, as well as drugs given singularly.

The other major issue for cancer specialists treating breast cancer with chemotherapy is drug dose regimen. The higher the dosage given in a fixed time period, the greater the potential toxicity and risk of adverse effects on the patient. Oftentimes, this is bone marrow toxicity, which involves a suppression of bone marrow stem cells leading to decreased white blood cell production (leucopenia), placing the patient at heightened risk for infection. Research shows that a certain dose intensity must be given to achieve the maximum antineoplastic activity, but going beyond this threshold only increases risk without further benefit.

A majority of anticancer drugs affect all dividing cells in the body. This includes both normal cancer cells. If a woman has microscopic spread of the cancer cells, these cancer cells will be replicating and be more sensitive to chemotherapy than most normal cells. Some of the body’s normal cells that also replicate on a regular basis are the bone marrow cells and the lining cells of the gastrointestinal tract. It is for this reason that these normal cells are also sensitive to the anticancer drugs. Presently, there are several drugs that kill breast cancer cells and there are new agents under investigation. Much progress has been made in how to optimally administer these agents and there are supportive therapies to prevent the adverse events of chemotherapy. Several drug combinations have evolved and have been commonly used to treat women for possible metastatic disease. The standard has been one of two combinations: adriamycin and cyclophosphamide with or without 5 fluorouracil; and cyclophosphamide, methotrexate and 5 fluorouracil.

A new agent, trastuzumab (brand name Herceptin), an antibody directed against Her-2 protein that is abundant on the cancer cell surface. This cancer protein is over expressed in cancer cells and poses as a very good target for anticancer agents. This drug is presently undergoing testing for the use in women with localized breast cancer that demonstrate an abundance of this cancer protein.

It is important for cancer patients to educate themselves about chemotherapy and its adverse effects before making a decision to incorporate certain anticancer drugs in their treatment plan.

Michael Russell
Your Independent guide to breast-cancer.treatment-and-guides.com/ Breast Cancer

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Tags: breast cancer, cancer patient, chemotherapy

It’s a sad fact that most men are into their seventies before prostate cancer is diagnosed, by which time the disease is often well advanced and beyond a cure. This is particularly sad because many men begin to experience enlarged prostate symptoms in their forties and fifties and simply choose to ignore them.

In many cases of course an enlarged prostate is not a problem and, if it does become a problem, then it can be treated without presenting any real threat. In addition, an enlarged prostate is often simply something of an inconvenience which many men feel that they can live with quite happily, so why bother the doctor. The problem of course is that, although not connected, cancer can develop alongside an enlarging prostate and, as a normally very slow growing cancer, it can be easily masked by enlarged prostate symptoms.

One answer, although somewhat controversial, would be to make screening for prostate cancer a routine procedure for men in their forties, or certainly in their fifties.

Prostate screening comes in a variety of different forms but the first line of screening is normally a digital rectal examination, or DRE. This is a simple examination in which the doctor inserts a gloved and lubricated finger into the rectum and feels the prostate gland to gauge its size and to identify any irregularities.

Another less invasive test is the prostate specific antigen, or PSA, test. This is a simple blood test to look for the presence of antigens in the blood which are specific to the prostate. This test will not in itself indicate the presence of cancer but monitoring PSA levels over time will indicate whether or not there is a likelihood of cancer developing and thus whether or not further more specific testing should be undertaken.

To provide a definitive diagnosis of prostate cancer a doctor may typically order a cytoscopy and transrectal ultrasonography in the first instant. A cytoscopy allows the doctor to view the urinary tract as it passes through the prostate gland, by using a thin camera inserted through the penis. A transrectal ultrasonography is carried out by inserting a probe into the rectum and creating a picture of the prostate gland using sound waves.

As a final test, and really the only test to definitely confirm the presence of cancer, the doctor may order a biopsy. A typical biopsy will be carried out through the rectum with a number of needles being inserted into different parts of the prostate gland to remove small pieces of tissue for microscopic examination.

There is considerably controversy surrounding the whole subject of prostate screening, much of it political (or economic) rather than medical, but prostate cancer is a serious condition which kills millions of men every year and an early and definitive diagnosis could certainly reduce the annual death rate very considerably.

For more information on prostatecancerexplained.com/articles/an-outline-of-enlarged-prostate-symptoms.html” target=”_blank enlarged prostate symptoms and prostatecancerexplained.com” target=”_blank prostate cancer cures, please visit ProstateCancerExplained.com

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Prostate brachytherapy (pronounced bray-kee-ther-uh-pee), the implantation of radioactive seeds into the prostate gland, is one of the standard methods of successfully treating prostate cancer. The tiny radioactive seeds are smaller than grains of rice.

A prostate seed implant may be the only type of radiation therapy needed by a man with low-risk prostate cancer or it may be prescribed in addition to external beam radiation therapy in men with intermediate- and high- risk prostate cancer. The goal is to eradicate cancer cells while preserving healthy, surrounding tissue, such as the bladder, the urethra (the tube that connects the bladder to the penis), and the rectum.

The advantages of prostate seed implants are significant. Fist, the procedure requires only minor surgery, usually causing fewer side effects than other treatments. Also, it is generally a same day, outpatient procedure. Men usually are able to return to work within several days, as long as they feel well enough. In addition, recent reports suggest that the procedure, when performed on properly selected men, is at least as effective as surgery to cure prostate cancer. Radiation exposure to other people is minimal, so restrictions do not apply unless the man is returning to a setting where a young child or pregnant woman is present.

Treatment Planning

Men undergo a pre-implant ultrasound study to determine where the radioactive seeds (and the needles to implant them) should be placed. A transrectal ultrasound, wherein an ultrasound probe is carefully positioned in the rectum to view the entire prostate, is performed. Images of the prostate are taken and are transferred to a special treatment planning computer, which evaluates the position of the prostate and generates a three-dimensional plan that dictates the precise placement of the seeds.

Preparation for the Procedure
Most candidates for prostate brachytherapy undergo blood tests, a chest x-ray and an EKG several days prior to the implant, in order to be approved for anesthesia. On the morning of the procedure, men receive an enema to help optimize the quality of the transrectal ultrasound images. In addition, blood thinners are discontinued several days prior to the procedure to help diminish the risk of bleeding.

Day of the Procedure
Typically, men who are scheduled to undergo seed placement arrive early in the morning. Next, the man is taken to the operating room for the procedure, where he undergoes either general or spinal anesthesia. Then, the radiation oncologist and the urologist work as a team to implant the seeds into the prostate, using transrectal ultrasound to guide the placement.

The Implant Process

Using the treatment plan and fluoroscopy (real-time x-ray), the radiation oncologist places the seeds within the prostate. The entire procedure usually takes less than one hour. After the seed placement, the urologist performs a cystoscopy (a procedure in which a slender, flexible, fiber optic scope is inserted from the penis into the bladder), to look for and remove any seeds that dislodged in the bladder or the urethra. Within the few next days, a CT scan is obtained to verify the placement of the seeds.

Prostate Seed Implants: Recovery

Because prostate implants do not involve major surgery, side effects are rarely severe. The most common side effects reported by men after prostate seed implants are:

• Urinary frequency (60-70%)

• Urinary burning (50%)

• Urinary urgency (50%)

• Erectile dysfunction (30%)

• Blood in the urine (20-30%)

• Increased bowel movements and bowel urgency (5%)

• Fatigue (20%)

• Pelvic pain (20%)

• The need for temporary catheter placement (10-15%)

• Urinary incontinence (less than 1%)

In addition, up to 20 percent of men are found to have seed migration into their lungs. However, no detrimental effects have been reported. Infrequently, men have required trans-urethral resection, the “scraping” of the prostate gland via the penis, to relieve urinary obstruction after the seed placement.

Follow-Up

Men who undergo prostate brachytherapy report for follow-up visits four weeks after the procedure and every three months thereafter. A PSA blood test and a physical exam are performed to assess the status of the prostate.

The good news is that prostate seed implants are usually successful at controlling prostate cancer within the gland. Such local control of disease correlates with rendering men free from prostate cancer.

Dr. Kornnmehl is a board certified radiation oncologist and author of the critically acclaimed consumer health book, “The Best News About Radiation Oncology” (M. Evans, 2004). Her website is RTSupportDoc.com RTSupportDoc.com.

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Well, many women in America are diagnosed with pre-ovarian cancer. Pre-ovarian cancer back pain is a common symptom of the disease which is many-a-time treated as a normal back pain mistakenly in the initial stage of cancer. Yes, your doctor can miss it, so you need to be cautious if suffering from chronic and stubborn back pain problem.
Just look at some statistics now. According to a recent study, close to 30,000 women of US will be diagnosed with ovarian cancer in the year 2006. It is also stated that between 15,000 to 16,000 deaths due to ovarian cancer are likely to happen this year. It accounts for 5 % of all the types of cancer deaths.

What encourages this silent killer to go on mercilessly? What are the doctors doing? How is that, that by the time this disease is detected, it is too late! Why it could not be detected at the first stage?

There is dispute among the researchers. British doctors did not make the correct survey when they arrived at the conclusion that symptoms came to the fore at the late stages of the ovarian cancer. So, when they detected the cancer, it was too late.

But, contrary were the findings of the University of California researchers. They concluded that some definite symptoms could be detected four months before and some even before one year. Hence, better treatment was possible.

“The most common symptom is back pain, followed by fatigue, bloating, constipation, abdominal pain and urinary urgency. These symptoms tend to occur very frequently and become more severe with time. Most women with ovarian cancer have at least two of these symptoms.”

-American Cancer Society

Most of the back pain treatments are frustrating. They provide temporary relief here and there. So, you get fed up with the treatment that does not work.

Can Ovarian Cancer be found early? Why ovarian cancer? Every disease tends to cause some symptoms- some specific and some vague. In case of ovarian cancer, it could be abdominal swelling, vaginal bleeding on a high scale, pressure in the pelvic region, leg pain, problems related to digestion—gas trouble, continuous bloating, chronic indigestion and recurring stomach pain and most importantly, the back pain! So, if you take disease by disease treatment, without knowing about the root cause- ovarian cancer will take control slowly, steadily but firmly. After some months, your doctor will find the situation out of control as it is a belated diagnosis!

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