July 13th, 2011 admin
Signs and symptoms may be difficult to recognize because they are woven into a background of underlying disease, metabolic abnormalities, psychologic responses, and the effects of other medications.B. Neurologic toxicity may occur with the first course of treat-ment or with subsequent courses.C. Neurotoxicity generally occurs with high-dose therapy andwhen the cumulative dose is high.D. Neurotoxicity may be seen months or years after the com-pletion of chemotherapy.
MONITORING FOR NEUROTOXICITYA. HistoryQuestion the patient and family about numbness, tingling, vertigo, or visual disturbances.Question the patient’s family about changes in personality, affect, or lethargy.Inquire about school and job performance and social and psychological well-being during long-term follow-up visits.B. Physical examinationPhysical examination with serial neurologic examinations is the most useful tool for detecting toxicity.Decreases in deep tendon reflexes, especially in the Achilles tendon, are among the earliest signs of chemotherapy-induced peripheral neuropathy.Loss of proprioception and vibratory sensation also indicate peripheral neuropathy.Changes in gait may indicate neurotoxicity. Observe toe walk, heel walk, and tandem walk. Changes in the ability to perform these tasks may indicate peripheral neuropathy or acute cerebellar syndrome.C. AudiometryObtain audiometric evaluation before beginning cisplatin and before every other course of therapy.D. Monitor cumulative dose calculation for cisplatin and vincristine.
MODIFICATION OF THERAPYA. Treatment ModificationsThe following treatment modifications are only suggestions. Modification of treatment should be based on the child’s diagnosis, stage of therapy, available alternatives, and the judgment of the clinician.B. VincristineDoses >10—15 mg/m2 may lead to neuropathy.Grades 1 and 2 toxicity require no modification.For grades 3 and 4 toxicity, hold the drug until symptoms subside or stabilize. Subsequent doses should be either decreased or omitted.Trigeminal nerve toxicity results in jaw pain.a. Treat with acetaminophen.b. This symptom does not usually recur.c. Do not modify the dose.5. Anticipate autonomic neuropathy resulting in constipation.a. Treat with laxatives such as lactulose, Pericolace, orSenokot S.b. Prevent with Senokot S or increase dietary fiber.6. Treat symptoms of syndrome of inappropriate antidiuret-ic hormone. It is usually not necessary to not modify thevincristine dose unless serum sodium <130 mEq/L.C. CisplatinDo not modify treatment for grade 1 or 2 toxicity.For grade 3 or 4 toxicity, hold the drug until the symptoms subside or stabilize. Either decrease or omit subsequent doses.High-frequency hearing loss occurs at cumulative doses of 270-450 mg/m2.Peripheral neuropathy occurs at cumulative doses of 300-600 mg/m2.May cause Lhermitte sign (sensation of tingling or electric shock in arms and legs when neck is flexed). Do not modify therapy.D. MethotrexateNo modifications are needed for grade 1 or 2 toxicity.For grade 3 or 4 toxicity, hold the drug until symptoms resolve or stabilize. Reduce or omit further doses.Patients receiving high-dose methotrexate may develop acute encephalopathy with the following symptoms.a. Seizuresb. Confusionc. Hemiparesisd. Dysarthria4. High-dose methotrexate may be associated with thedevelopment of leukoencephalopathy.a. Symptoms include:i. Personality changesii. Progressive dementiaiii. Focal seizuresiv. Changes in level of consciousnessb. Follow the patient with serial magnetic resonanceimaging scans.c. Omit further methotrexate treatment.5. Acute encephalopathy sometimes occurs after intrathe-cal therapy.a. Symptoms include:i. Feverii. Nausea and vomitingiii. Headacheiv. Lethargyv. Paresisb. The decision to stop or continue intrathecal therapymust be made on an individual basis.E. Ifosfamide1. Symptoms of toxicity include:a. Hallucinationsb. Confusionc. Cranial nerve dysfunctiond. Cerebellar syndromee. SeizuresNeurotoxicity is more common when serum albumin is low or infusions are rapid.No modifications are needed for grade 1 or 2 toxicityReduce or omit further doses for grade 3 or 4 toxicity.F. L-AsparaginaseL-Asparaginase may cause a mild transient encephalopathy. Also consider intracranial bleeding or clot.G. 5-Fluorouracil5-Fluorouracil may produce the cerebellar syndrome.Reduce or omit further doses.*40\168\2*
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March 7th, 2011 admin
Cancer of the pancreas is a disease in which cancer cells are found in the tissues of the pancreas. The pancreas is an oblong, pear-shaped organ, about six inches long, that lies within a loop of the small intestine behind the stomach. Pancreas produces juices that help break down food, and hormones such as insulin that regulate how the body stores and uses food.
The area of the pancreas that produces digestive juices is called the exocrine pancreas. About 95 per cent of pancreatic cancers begin in this area. The hormone-producing area of the pancreas is called the endocrine pancreas. Only about five per cent of pancreatic cancers start here.
Symptoms
The most common symptoms of pancreatic cancer are nausea, loss of appetite, unexplained loss of weight, pain in the upper or middle of the abdomen, or yellowing of the skin.
Causes
The precise cause of pancreatic cancer is not known. However, smoking has been strongly implicated as a factor because the occurrence among smokers is more than double than that of non smokers. A high meat diet too has been linked to an increased risk of pancreatic cancer. Working with dry cleaning agents, benzene and other chemicals are also believed to cause this cancer. A sudden onset of diabetes is also considered a cause for this cancer. Some studies suggest that diabetic women are at greater risk of developing this disease.
Diagnosis
Ultrasound test may be done to find tumours. A CT scan, a special type of x-ray that uses a computer to make a picture of the inside of the abdomen, may also be done. Another special scan called magnetic resonance imaging (MRI), which uses magnetic waves to make a picture of the inside of the abdomen, may be done as well. A test called an Endoscopic Retrograde Cholangio Pancreatography (ERCP) may also be done. During this test, a flexible tube is put down the throat, through the stomach, and into the small intestine. The doctor can see through the tube and inject dye into the drainage tube (duct) of the pancreas so that the area can be seen more clearly on a X-ray. During ERCP, the doctor may also put a fine needle into the pancreas to take out some cells for biopsy.
Treatment
Medically, three types of treatment are used. These are surgery, radiation therapy and chemotherapy.
Natural Method
Pain and other symptoms of cancer and the after-effects of medical treatment can be relieved through certain natural methods. These methods may include frequent warm water enemas, daily dry friction, cold hip or sitz bath, neutral immersion bath, relaxation methods and meditation. The use of biological therapy (using the body’s immune system to fight cancer) is being tested in clinical trials for treating pancreatic cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body’s natural defenses against the disease.
*69/355/5*
TYPES OF CANCER: PANCREATIC CANCERCancer of the pancreas is a disease in which cancer cells are found in the tissues of the pancreas. The pancreas is an oblong, pear-shaped organ, about six inches long, that lies within a loop of the small intestine behind the stomach. Pancreas produces juices that help break down food, and hormones such as insulin that regulate how the body stores and uses food.The area of the pancreas that produces digestive juices is called the exocrine pancreas. About 95 per cent of pancreatic cancers begin in this area. The hormone-producing area of the pancreas is called the endocrine pancreas. Only about five per cent of pancreatic cancers start here.
SymptomsThe most common symptoms of pancreatic cancer are nausea, loss of appetite, unexplained loss of weight, pain in the upper or middle of the abdomen, or yellowing of the skin.
CausesThe precise cause of pancreatic cancer is not known. However, smoking has been strongly implicated as a factor because the occurrence among smokers is more than double than that of non smokers. A high meat diet too has been linked to an increased risk of pancreatic cancer. Working with dry cleaning agents, benzene and other chemicals are also believed to cause this cancer. A sudden onset of diabetes is also considered a cause for this cancer. Some studies suggest that diabetic women are at greater risk of developing this disease.
DiagnosisUltrasound test may be done to find tumours. A CT scan, a special type of x-ray that uses a computer to make a picture of the inside of the abdomen, may also be done. Another special scan called magnetic resonance imaging (MRI), which uses magnetic waves to make a picture of the inside of the abdomen, may be done as well. A test called an Endoscopic Retrograde Cholangio Pancreatography (ERCP) may also be done. During this test, a flexible tube is put down the throat, through the stomach, and into the small intestine. The doctor can see through the tube and inject dye into the drainage tube (duct) of the pancreas so that the area can be seen more clearly on a X-ray. During ERCP, the doctor may also put a fine needle into the pancreas to take out some cells for biopsy.
TreatmentMedically, three types of treatment are used. These are surgery, radiation therapy and chemotherapy.
Natural MethodPain and other symptoms of cancer and the after-effects of medical treatment can be relieved through certain natural methods. These methods may include frequent warm water enemas, daily dry friction, cold hip or sitz bath, neutral immersion bath, relaxation methods and meditation. The use of biological therapy (using the body’s immune system to fight cancer) is being tested in clinical trials for treating pancreatic cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body’s natural defenses against the disease.*69/355/5*
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May 12th, 2009 admin
There is no single cause for cancer but many different factors which act together. You will remember I said earlier that it is likely that we all develop many cancer cells throughout our lifetime, but that in most cases our immune system destroys them before they have a chance to form a detectable cancer growth. The dangerous cancer cells are the ones which somehow escape the body’s immune system. This escape is made possible by weaknesses in the immune system, strengths in the particular cancer cell, occurrence of a large number of cancer cells or a combination of all three.
You might understand this better if we compare it to the growth of weeds. Imagine weeds as the cancer cells and you, the gardener, as the immune system. If you check on your vegetable patch every day and pull out every tiny weed that is peeping through the soil, no troublesome big weeds will ever have the chance to form. However, if you check your garden less often or less thoroughly, or only pull out part of each weed, you’ll have a problem. This is what can happen if the immune system is not working at full efficiency. Next, you could be unlucky enough to have very aggressive weeds in your garden which very quickly develop an extensive root system. In spite of careful checking and weeding every day, these particularly strong weeds might still overrun your garden. Thirdly, if a great number of new weeds appear every day, it might just be impossible to detect and pull out every one. There is no one simple reason why your garden should get overrun with weeds. It usually takes a combination of factors.
*42/40/1*
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