Is it chemo brain or something else?

November 9, 2010 by  
Filed under CANCER

Chemo brain is common complain among cancer survivors who underwent chemotherapy. It is a condition described as “a mental fog and inability to concentrate that persist long after treatment” and has been assumed to be a side effect of chemotherapy.

A few examples of chemo brain manifestation (source: American Cancer Society, ACS) are given below:

But is it really the chemotherapy that causes this problem dubbed by experts as “mild cognitive impairment?”

Researchers at the University of Miami Miller School of Medicine looked at data collected by the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2006. A total of 9819 adults aged 40 and older were studied. Of these, 1305 had a history of cancer. The subjects were asked the following question:

“Are you limited in any way because of difficulty remembering or because you experience periods of confusion?”

Results of the survey showed:

  • 8% of those without cancer history reported some form of memory impairment.
  • 14% of those with cancer history reported similar impairment.
  • After controlling for confounding factors, the likelihood among the cancer survivors to have memory impairment rose to 40%. Yet, some of these people have not undergone chemotherapy.

The researchers believe that this impairment may be due to a lot of things (and not only chemotherapy), such as:

chemotherapy, radiation or hormonal therapy, or to something about the disease itself which can change brain chemistry, or to psychological distress.

In fact, the term “chemo brain” is actually an inaccurate, even misleading term.

According to lead author Dr. Pascal Jean-Pierre, the so-called chemo brain is becoming national problem but can be treated by behavioral interventions and medications (e.g. antidepressants).

The ACS also lists the following factors that can contribute to cognitive impairment of cancer patients:

Cough: the annoying and persistent side effect of ACE inhibitors

November 4, 2010 by  
Filed under HEART AND STROKE

All medications come with side effects, some minor, some severe, some dangerous, some simply annoying. The class of drugs called angiotensin-converting enzyme (ACE) inhibitors are indicated for controlling blood pressure, preventing stroke, and managing heart failure. Some of the most common side effects of ACE inhibitors are

A recent meta-analysis revealed that ACE inhibitor associated coughs are more common than previously thought and are becoming such a nuisance that patients tend to stop taking the drugs. The coughs can range from “just a little scratchy throat to a quite severe hacking cough.” The cough may persist for weeks

Health professionals are complaining that this side effect have been and are still underreported in the labels of these drugs as well as in the clinicians’ reliable source of information, the Physicians’ Desk Reference (PDR). According to study author Dr. Franz Messerli  of St Luke’s Roosevelt Hospital in New York):

“The PDR is supposed to be the most trusted information on which physicians base their therapeutic decisions in the US, so it’s a bit puzzling that for a nuisance side effect such as cough, the information is so unreliable.”

 Furthermore, they believe that the pharmaceutical companies know that the incidence of this type of side effects associated with ACE inhibitors are increasing but are not making the effort to update the labels. These drugs are now available in generic form but the generic labels were not updated as well.

The most common ACE inhibitors approved for marketing in the US are:

If one ACE inhibitor triggers coughing, it is mostly likely that other drugs in the same class will have a similar effect. What should a patient do when the cough becomes too much of a nuisance?

The best option for patients if they feel the cough is too troublesome is to switch to an angiotensin receptor blocker (ARB)…

However, ARBs are generally more expensive than ACE inhibitors, with very few generic options.

In the meantime, health experts are calling for updates on ACE inhibitors labelling.

According to Dr Victor L. Serebruany of Johns Hopkins University

“There is and will be no easy solutions, since pharmaceutical companies are somewhat resisting adequate reporting of adverse reactions, protecting the safety profile image of their products.”

To screen or not to screen: ADHD drugs’ effect on the heart

June 24, 2010 by  
Filed under HEART AND STROKE

In recent years, the number of children diagnosed with attention-deficit/hyperactivity disorder or ADHD has increased. A recent report estimates ADHD prevalence among children and adolescence at 8%.

Pharmacological treatment is most commonly prescribed for ADHD, particularly stimulant medications such as methylphenidate (MPH) and mixed-amphetamine-salt (MAS) formulations. However, there have been concerns on the side effects of these drugs, particularly adverse effects on the heart. However, health experts could not agree about the cardiotoxicity risks involved. As early as 2008, the American Heart Association (AHA) recommends screening pediatric patients for heart problems before starting ADHD treatments. However, the American Academy of Pediatrics was not convinced of the risks and rejected the AHA guidelines.

According to Dr. Raul Silva the New York University Langone Medical Center:

“There has been a big brouhaha about the safety, particularly the cardiovascular safety, of stimulant medications for ADHD in kids, and at one point, the cardiac folks put a very big scare into people.”

This motivated him and his team of researchers to conduct a comprehensive review of data available from clinical trials conducted during the last 10 years on the safety of MPH and MAS.

Their results presented at the National Institute of Mental Health and American Society of Clinical Psychopharmacology New Clinical Drug Evaluation Unit (NCDEU) 2010 Annual Meeting clarified some questions but also brought some reassurances. The findings basically show that ADHD medications, MPH as well as MAS, can increase heart rate, blood pressure, both systolic and diastolic and QT interval of children and adolescents. These increases however are mild to moderate and may not be clinically relevant to ADHD patients without initial cardiovascular problems. However, for those with underlying heart conditions that may not have diagnosed, these side effects can be dangerous. There were no deaths due to cardiovascular problems reported in the studies analyzed. The authors support the recommendations of the AHA to screen patients for heart abnormalities before starting them on these medications – but only if screening is possible. Withholding ADHD treatment from patients without access to an ECG is not warranted, according to the authors.

Dr. Silva believes in erring on the side of caution and performs cardiac screening for all his pediatric patients:

“The parents appreciate my doing this, and I have found some very interesting things, such as arrhythmias. When I go back to the pediatric cardiologist, they often tell me that it’s nothing to worry about. So the take-home message here is monitor when you can, ask baseline questions, but also be reassured, because the data really don’t show a heck of a lot of problems with cardiovascular side effects.”

Many drugs previously thought to be safe turned out to have adverse effects on heart health – rofecixib and rosiglitazone, to name a few. No wonder AHA is being cautious.

Statins, side effects and safety

April 1, 2010 by  
Filed under HEART AND STROKE

Statin therapy is the gold standard in lowering cholesterol levels and preventing cardiovascular events. However, the safety of some statins has been questioned lately. Simvastatin (marketed as Zocor by Merck) is currently under safety review by the US FDA due to a potentially serious side effect. The US FDA is currently reviewing data from the SEARCH trial (Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine) as well as those from other trials.

Statin use can cause muscle myopathy that results in muscle pain and weakness. Higher doses of simvastatin (highest approve is 80 mg) can lead to a serious type of myopathy called rhabdomyolysis which “occurs when a protein (myoglobin) is released as muscle fibers break down. Myoglobin can damage the kidneys. Patients with rhabdomyolysis may have dark or red urine and fatigue, in addition to their muscle symptoms. Damage to the kidneys from rhabdomyolysis can be so severe that patients may develop kidney failure, which can be fatal.” Those at risk are the elderly (older than 65), those with hypothyroidism and impaired kidney function.

There have several reported cases of statin-associated muscle problems, especially among women, leading some experts to question the benefits of statin use (see this article in TIME magazine). The US FDA, however, is quick to point out that rhabdomyolysis is a rare side effect of statins. Patients are advised against statin cessation unless explicitly order by a health care professional.

The American Heart Association (AHA) has issued a statement to react to the FDA advisory and to the TIME magazine article. The statement goes:

Because of the well-documented benefit of cholesterol-lowering with statins, the association advises that patients respect the benefit of statin therapy and only consider discontinuation after a discussion with the appropriate healthcare provider. For the person who experiences myopathy with a statin, other alternatives should be discussed with their physician. Patients who are taking statins and not experiencing any side effects should continue to take their medication unless advised for other reasons to stop by their healthcare provider. Only the very rare side effect of rhabdomyolysis (muscle injury), signaled by dark urine, should lead a patient to stop their statin immediately but then talk promptly with their healthcare provider.

As with all therapies, the decision to use statins for primary or secondary prevention must include careful consideration of the risks and benefits, side-effects and cost. Side effects can vary by dose, by individual, and by the presence of other medical conditions or other medications. Awareness of possible side effects and open communication between patient and provider will allow optimal treatment benefit for each patient.

Aspirin: good for the heart, bad for the tummy

February 4, 2010 by  
Filed under HEART AND STROKE

Aspirin or acetyl salicylic acid has been around for more than 100 years. It has gone from a simple headache and fever remedy to the wonder drug that it is today, used in the treatment and prevention of more serious conditions such as heart disease and even cancer. You can get aspirin everywhere, as an over-the-counter (OTC) drug from your pharmacy or as less than a dollar a bottle from your supermarket.

Yet, despite its wonderful healing powers, aspirin can have some serious side effects just like every drug. Unfortunately, not many of us are aware of these side effects.

A recent New York Times report tackled the issue of “an aspiring a day…” with the expertise of Dr. Neena S. Abraham, a gastroenterologist at the Michael E. DeBakey V.A. Medical Center and associate professor of medicine at the Baylor College of Medicine in Houston.

Dr Abraham warns us of the following:

  • Aspirin can cause damage in the gastrointestinal (GI) tract from mouth to anus. The most common of these side effects are ulcers and bleeding.
  • The risk for GI bleeding is two- to four-fold higher in aspirin users than in non-aspirin users.
  • Aspirin can bring on side effects even at “baby doses” of 81 mg a day.
  • Special formulations such as buffered or enteric coated aspirin do not eliminate the risks.
  • Use of OTC aspirin results in 5 extra cases of ulcer bleeding per 1,000 patients per year.

In addition, we should be aware of the risk factors that make us more susceptible to aspirin-induced GI bleeding:

Dr. Abraham gives the following recommendations to patients:

  • Aspirin, even it is an OTC medication should only be taken after a thorough cardiovascular risk assessment by a qualified health professional.
  • The risks and benefits of aspirin use should be thoroughly assessed. If the benefits exceed the risk of GI bleeding, then aspirin should only be sued at the minimum dose of 81 mg a day.
  • For patients who have high-risk profiles for ulcers and GI bleeding, other alternatives should be looked into. Using stomach-protecting medications such as proton pump inhibitors might minimize the risks.

Photo credit: stock.xchng

Acupuncture improves sex drive, quality of life in breast cancer patients

January 4, 2010 by  
Filed under CANCER

Cancer treatment comes with a lot of side effects, mild and severe, short-term and long-term. In recent years, complementary medicine has become an integral part of the management of the side effects of cancer treatment. The most popular complementary therapies are yoga, transcendental meditation, and acupuncture

In this recent study by researchers at the Henry Ford Hospital, acupuncture has beneficial effects that can reduce two other common side effects of breast cancer treatment – hot flashes and decreased sex drive.

 Acupuncture vs. drug therapy

The study compared venlafaxine (Effexor), a drug commonly used to manage hormone therapy side effects vs. acupuncture in 50 patients undergoing hormone therapy for breast cancer. Although effective, venlafaxine has its own die effects such as dry mouth, decreased appetite, nausea and constipation. The study showed that acupuncture is more effective in improving overall as well as mental health in this group of patients.

 Hot flashes

Night sweats and hot flashes are commonly experienced by breast cancer patients who undergo hormone therapy for breast cancer treatment. Although there are pharmacological agents (e.g. venlafaxine) that help ease these symptoms, acupuncture seems to have a longer-lasting effect compared to drugs.

According to lead author Dr. Eleanor Walker, division director of breast services in the Department of

Radiation Oncology at Henry Ford Hospital:

“Acupuncture offers patients a safe, effective and durable treatment option for hot flashes, something that affects the majority of breast cancer survivors. Compared to drug therapy, acupuncture actually has benefits, as opposed to more side effects.”

 Sex drive

Reduced sex drive is another side effect of cancer treatment. The study observed improved sex drive among patients who underwent acupuncture. Increasing a woman’s sex drive improves her sense of well-being.

 Quality of life

Night sweats and decreased sex drive are vasomotor symptoms caused by long-term hormone therapy. These symptoms lead to decreased quality of life, depression and even discontinuation of cancer treatment. However, patients who underwent acupuncture seemed to be able to cope better with the vasomotor symptoms. These reported a sense of well- being, more energy, and clarity of thought.

 About acupuncture

Acupuncture is a well-known form of traditional Oriental medicine based on the principle of stimulation of certain key body points. Acupuncture has been previously dismissed as “quack” by medical experts. However, its the health benefits is now slowly been recognized by. In a consensus statement in 1997, the National Institute of Health (NIH) stated

 “Acupuncture as a therapeutic intervention is widely practiced in the United States. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.”

Fighting lymphedema with weights

September 15, 2009 by  
Filed under CANCER

Gym2After breast cancer surgery comes lymphedema, a complication that is painful and incurable. Lymphedema is a swelling in the arm that is disabling and painful and can rob breast cancer survivors full use of their arms. About 70% of breast cancer survivors suffer from this condition which can range from mild to severe.

To prevent the occurrence of lymphedema, women who underwent breast cancer surgery are usually advised against performing activities that require arm exercise – including carrying a baby. However, this practice has its downside – it leads to the weakening of muscles and bones of the arm. And a weakened arm can in turn lead to lymphedema. A vicious cycle for the breast cancer survivor. In addition, other conditions can also develop from to lack of exercise, namely loss of bone mass and osteoporosis, and excess weight gain.

A new study published in the latest issue New England Journal of Medicine reported that women actually need not “put their arm in a box.”

By following a carefully designed strength training program of the arm, women can build muscle power while reducing the risk of painful lymphedema flare ups by half.

According to Anna Schwartz, an affiliate professor of nursing at the University of Washington and author of Cancer Fitness

“For many years, we’ve told women not to lift anything heavier than a handbag. This is the first really well-designed study that demonstrates that women can do a lot more than we thought.”

Indeed, this is encouraging for breast cancer survivors. Imagine what you can do with a strong arm – hold your grandchild, play the violin again, even use the vacuum cleaner.

The researchers followed up 141 lymphedema patients with an average age in the mid-50s. Half of the patients underwent structured weight-lifting training, half of the patients had no training. By the end of the course, those who trained were able to bench press an average of 53 pounds, representing a 29% improvement.

After a year, 14% of those who trained had recurrence of lymphedema. This may seem high but this is much lower compared to 29% recurrence rate among those who did not exercise.

It is important however for cancer survivors to work with trained instructors who can guide them the proper way of exercising without overdoing it and getting injured. Just like everything else, too much of a good thing (in this case exercise) can become bad.

How anti-psychotics affect your metabolism

June 4, 2009 by  
Filed under SCHIZOPHRENIA

drugsPatients who present with psychotic symptoms (e.g. as in those with schizophrenia and bipolar disorder) are usually prescribed with anti-psychotic drugs. These drugs are mostly effective in controlling the symptoms. However, they come with side effects that can be detrimental to physical health.

Previous studies have demonstrated that second generation anti-psychotic drugs can affect glucose and lipid metabolism, leading to problems with body weight and cardiovascular disorders. It is not wonder that the American Diabetes Association (ADA) has recommended monitoring of blood sugar and lipid levels in patients on anti-psychotics.

However, a study survey discovered that actual metabolic monitoring only occurs in about 10% of these patients, a clear indication that the guidelines on monitoring are not being followed by psychiatrists.

According to lead author Dr Dan W Haupt of the Washington University School of Medicine, St Louis, MO

“Possibly many psychiatrists do not feel comfortable performing metabolic monitoring, because they were not trained to consider the effects of mental illness and treatment on the whole patient, and many practice in environments that are physically separated from the rest of the healthcare system… However, this represents a missed opportunity for psychiatrists to reduce the impact of medical comorbidities in their patients”

The said guidelines were endorsed by 4 medical organizations in 2004, namely:

  • the ADA
  • the American Psychiatric Association
  • the American Association of Clinical Endocrinologists
  • the North American Association for the Study of Obesity

and strongly recommend that all patients receiving second-generation antipsychotics should have fasting blood glucose and lipid levels determined at baseline and after 12 weeks of treatment.

Unfortunately, the study reveals that there is a general tendency among practitioners not to adapt the guidelines. Furthermore, young psychotic patients are the least likely to be screened and monitored.

This is an issue of major concern, considering the increasing incidence of psychotic disorders in adolescents and young adults. In addition, young American patients tended to be on anti-psychotics than their European counterparts. This increases the risks for cardiovascular disease, type 2 diabetes and obesity among the younger generation.

Dr. Haupt continues:

“While the benefit of these medications likely outweighs the risks in many individuals, psychiatrists cannot discuss informed consent meaningfully with patients and families without monitoring patients for any treatment-emergent metabolic side effects.”

Second generation anti-psychotics are helping people manage mental illness. Without proper metabolic monitoring, we may be treating mental illness at the expense of physical health.

Photo credit: stock.xchng

The price of cancer survivorship

June 3, 2009 by  
Filed under CANCER

national-cancer-survivors-daySunday, June 7, 2009 is the 22nd Annual National Cancer Survivors Day. It is a health observance held annually every first Sunday of June. It is a symbolic event to demonstrate that life after a cancer diagnosis can be a reality. To commemorate this day, let us a look at a very important, yet often taken for granted aspect of life after cancer treatment.

When one is faced with a diagnosis of cancer, then the first thing that comes to mind is get rid of it, no matter what it takes. The main objective of doctors as well as patients, is to beat the disease, drive the cancer out with all the means available to man. Surgery, chemotherapy, radiation therapy – these are some of the treatments currently used against cancer. Nobody dares to think about life beyond cancer treatment.

But surviving cancer comes with a price. The therapies and treatments come with side effects that can cause other health problems. And in many cases, survivors are not prepared for these. Examples of these postcancer treatment problems (aside from hair loss and nausea) are:

According to Dr. James Metz, a Penn radiation oncologist

“These treatments we give are the gifts that keep on giving. Toxicities can happen months, years, decades after treatments were given.”

There is a need for patients to be informed of the long-term health consequences of life-saving treatments. That’s where OncoLink may be able to help, a computerized survivorship program which can create individualized treatment plans for survivors. The platform was set up by the Abramson Cancer Center of the Pennsylvania Medical Center. Patients can type in information about their cancer and treatments. The program generates a report outlining medical tests they should receive, possible side effects of their treatments, and what they can do to keep cancer at bay.

Onoclink is free and user-friendly. It has recently received financial support from the Lance Armstrong Foundation to create an individualized plan of care for those who survived cancer. The plan is based on recommendations of the Institute of Medicine. The site gives invaluable information to patients and survivors about the health risks of the therapy they had or they are on.

There is life after cancer. Know what to expect.

Look what’s in your IV…

May 13, 2009 by  
Filed under HEART AND STROKE

iv_drip_-_intravenous_treatmenHere is another plastic component that seems to have a detrimental effect on our health. And they are to be found in your medical devices like IV bags and tubes, catheters, and even bypass machines. The chemical has been identified as cyclohexanone, an organic compound used as a component in the production of nylon products.

Medical procedures that require blood to be circulated through plastic tubing outside the body (e.g. heart bypass surgery or kidney dialysis) have been associated with side effects such as

  • dysfunction of the sense of taste
  • short term memory loss
  • swelling and fatigue

These side effects are normally temporary and resolve a few weeks or months after the surgery. However, for the heart or the dialysis patients, these side effects can have some consequences on postsurgery quality of life and recovery.

Researchers the Johns Hopkins University School of Medicine searched for the chemical that may cuase these side effects. After isolating and identifying the chemical in question, researchers tested cyclohexanone in laboratory rats.

The researchers then injected rats with either a salt solution or a salt solution containing cyclohexanone and measured heart function. Rats that got only salt solution pumped approximately 200 microliters of blood per heartbeat and had an average heart rate of 358 beats per minute, while rats injected with cyclohexanone pumped only about 150 microliters of blood per heartbeat with an average heart rate of 287 beats per minute.

Aside from causing less blood pumping at a much slower rate, cyclohexanone also induced weaker heart contractions in the test animals – a contraction reduction of about 50%. In addition, the animals exposed to cyclohexanone had

  • less sensitive mechanism that helps control and maintain blood pressure
  • increased fluid retention
  • developed swelling in the rats

It seems that cyclohexanone leaches out from the plastic-made devices and goes into the substances that enter our body. This is not the first plastic component to leach out from plastic-made containers, and devices. Remember bisphenol A (BPA)? The case of BPA as well as this study may have strong implications in plastics manufacturing.

However, it is too early to say how exactly cyclohexanone is causing all this problems. More studies are needed to have in-depth understanding of the mechanisms involved.

According to the researchers

“We would never recommend that patients decline this type of treatment if they need it. On the contrary, such technologies are life-saving medical advances, and their benefits still far outweigh the risks of the associated side effects. As scientists, we are simply trying to understand how the side effects are triggered and what the best method will be to mitigate, and ultimately remedy, these morbidities.”

Acupuncture can ease breast cancer side effects

January 19, 2009 by  
Filed under CANCER

Battling breast cancer is already a painful process for women who are suffering from this deadly disease. While breast cancer treatment can give them a fighting chance to survive, they also have to suffer from its side effects. It has been found that 80% of women who are undergoing chemotherapy and/or taking anti-oetrogen hormones like Tamoxifen and Armidex can suffer from hot flashes. These symptoms can be relieved by hormone replacement therapy but this may increase the risk the cancer coming back. Some patients are given steroids or antidepressant drugs to address this problem but these treatments may also result to weight gain, constipation, nausea and fatigue. The antidepressant, venlafaxine (Effexor) is commonly prescribed to women who are suffering from hot flashes but many are against this because this may cause insomnia, nausea, dizziness and decreased libido or they don’t want to take any more medications.

 A recent research study headed by Dr. Eleanor Walker, a radiation oncologist at the Henry Ford Hospital Department of Radiation Oncology in Detroit, showed that acupuncture may be an alternative to conventional drugs in reducing the side effects of breast cancer treatments. The first of its kind study showed that acupuncture is effective in reducing hot flashes, excessive sweating (vasomotor symptoms) and night sweats caused by breast cancer treatments. The procedure is also longer-lasting and has no treatment side effects compared to conventional drug therapy.

 The clinical trial was conducted on 47 breast cancer patients who were treated with Tamoxifen or Arimidex and were suffering from hot flashes at least 14 times per week. These patients were then treated with acupuncture or venlafixine for 12 weeks to find out if acupuncture is effective in reducing vasomotor symptoms of these patients undergoing hormonal treatment. The results showed that acupuncture can be as effective as venlafixine in reducing hot flashes but has no side effects like the antidepressant drug.

“Our study shows that physicians and patients have an additional therapy for something that affects the majority of breast cancer survivors and actually has benefits, as opposed to more side effects. The effect is more durable than a drug commonly used to treat these vasomotor symptoms and, ultimately, is more cost-effective for insurance companies,” according to Dr. Walker.

 Acupuncture is a well-known form of traditional Oriental medicine based on the principle of stimulation of certain key body points. Acupuncture has been previously dismissed as “quack” by medical experts. However, its the health benefits is now slowly been recognized by. In a consensus statement in 1997, the National Institute of Health (NIH) stated

Acupuncture as a therapeutic intervention is widely practiced in the United States. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.”

Photo credit: wikipedia

New vaccine strategy reduces prostate cancer treatment side effects

November 19, 2008 by  
Filed under CANCER

Therapeutic cancer vaccines can help cure prostate cancer patients. However, the technique comes with side effects such as fatigue and increased blood sugar levels that are not well tolerated by many patients. These adverse effects usually lead to the discontinuation of the treatment. New research, however, developed a new strategy to minimize these side effects and thus giving new hope to prostate cancer patients.

Cancer vaccines were developed when researchers discovered that some cancer cells produce some unique proteins in excessive amount. These proteins are unique in a way that they can trigger the immune system to attack the cancer cells. The cancer vaccines were developed by targeting these proteins and stimulate the immune system to attack cancer cells but not the normal cells.

The vaccine for prostate cancer is designed to trigger the immune system to attack prostate-specific antigen (PSA). PSA is a protein produced by the prostate and is found in the blood of men with prostate cancer and non-cancerous conditions. An immune booster called interleukin-2 (IL-2) is normally administered with the vaccine to further boost the body’s natural defense. IL-2, however, brings about the side effects previously described.

“Developing an alternative method of administering vaccine therapy that is well tolerated by most patients and produces similar immune responses to standard methods may help further the development of vaccine therapies for prostate cancer,” according to James L. Gulley of National Cancer Institute’s Center for Cancer Research.

In earlier studies using the same prostate cancer vaccines, IL-2 was given daily for 5 days to 19 patients in every 28-day vaccine treatment cycle. The majority of the patients, however, experiences severe fatigue so that IL-2 was reduced or discontinued.

In the new study led by National Cancer Institute (NCI) researchers, a method called “metronomic dosing” was tested. In this method, 18 patients were treated with vaccine and radiation therapy. The patients were also given the same total amount of IL-2 but were administered daily for 14 days in smaller doses of each 28-treatment cycle. The metronomic dosing showed that less than 25% of the patients experienced side effects that required the reduction of their IL-2 doses. The strategy was found to be safe with fewer side effects but produces similar immune response to the standard dosing method.

“Based on safety and feasibility, metronomic dosing appears to be superior to standard dosing and administration,” said Gulley.

However, more research is needed to evaluate the efficacy of this dosing method in the treatment prostate cancer.”

 Photo credit: stock.xchng

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.