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The nail toxicities related to chemotherapy reduced by wearing a cooling glove
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A cooling glove preventing nail and skin toxicities associated with certain
chemotherapy drugs is used successfully in the oncology department of the
hospital group HEGP-Broussais in Paris.
Presented at the
American ASCO, the study led by Dr. Florian Scotté (oncology department
Professor Andrieu in HEGP-Broussais hospital group) gave excellent results in
the prevention of discoloration, the separation and loss of the nail cancer patients
treated with chemotherapy.
The cooling
glove is based on the same principle as the cooling helmet, which has been
proven in the prevention of hair loss caused by chemotherapy, told Reuters
Health Dr. Scotté. Causing unevasoconstriction, the application of cold glove
reduces contact between the hair root or the base of the nail and the drug
administered, thereby limiting the risk of side effects.
These can be
purely aesthetic and are known as Grade 1 (discoloration, ie color of the
nail), or they can cause pain, and are said to grade 2 (or fall detachment of
the nail).
The so-called
case-control study examined fifty patients. All wore the glove on one hand and
kept the other free. Half (51%) patients showed an discoloration (29%), a
mycolyse (22%) at the glove without hand, against 11% at the hand and glove
with only grade 1 says Dr. Scotté.
The gloves have
also proven effective in the prevention of dry skin, reducing its incidence
from 53% to 24%, he added.
According to
him, "This is a real breakthrough in comfort to provide patients during
chemotherapy." Evidenced by the level of satisfaction, which reached 86%
of patients. The only cons-indications are cold intolerance, Raynaud's syndrome
and distal metastases.
Since the end of
the study, these gloves are used when necessary in the cancer ward of the
hospital group HEGP-Broussais. The distribution company, Acromed, is
responsible for expanding their use to other institutions.
Relatively
expensive (95 euros glove at 2 pairs chemotherapy), however they can be used
for several years in a row, the coolant after use at -20 ° C about 12 hours
before treatment.
In addition, a
prototype for the feet is under construction and should be a future study on
the prevention of harm to nail this level of the body.
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cancer de la prostate
Glioblastoma multiforme: immunotherapy followed by chemotherapy prolongs survival in patients
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Immunotherapy
combined with chemotherapy significantly slows tumor progression and prolongs
survival in patients with glioblastoma multiforme, a highly aggressive and
incurable form of brain tumor, according to a study published in the journal
"Clinical Cancer Research ".
Although the
exact mechanism of this therapeutic approach has not been clearly identified,
the team of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical
Center in Los Angeles, assumes that the tumor vaccine carries a first blow to
cells tumor, which has the effect of increasing their susceptibility to
anti-tumor drugs.
Before coming to
such assumptions, the researchers followed 36 patients aged 32-78 years, who
had prior to entering the study underwent surgical removal of their tumor,
followed by radiotherapy. Divided into three groups, some patients then
received only treatment for chemotherapy, other immunotherapy, others
immunotherapy followed by chemotherapy.
Participants who
received the vaccine, either alone or in combination with chemotherapy, were
included in the study between 1998 and 2001 at the Institute of immunotherapy
with dendritic cells, say the authors. This therapeutic approach is to
introduce proteins taken from tumors in dendritic cells harvested from the
patient's blood and then inject all as a vaccine to stimulate the immune system
of patients, particularly T lymphocytes
Patients in the
second and third groups received a total of three injections, two weeks apart.
Some more received a fourth injection six weeks later. Then all were subjected
to MRI every 2-3 months as part of their monitoring.
The median
survival was 26 months for patients who were vaccinated and who received
chemotherapy, against 18 months for those who received the immunotherapy
treatment alone and 16 months for those who had not been treated by
chemotherapy.
In addition, of the
12 patients who received dual therapy approach, five survived more than two
years (41.7%), against only one of 12 patients under immunotherapy alone and 12
patients received chemotherapy alone, report the authors.
They conclude
that "the acts synergistically with chemotherapy prior vaccination to
generate a single effective treatment that slows the progression of
glioblastoma multiforme and significantly extends patient survival compared to
single therapies.
"If these
results are reproducible, it would be extremely gratifying to see such an
increase in survival in such a devastating disease," comments Keith L.
Black, director of the institute and one of five researchers behind the study.
According to his
colleague Christopher J. Wheeler, "the fact that the tumors treated with
immunotherapy to be highly sensitive to chemotherapy successor dendritic cells
suggests that the vaccine 'ready' machinery of cell death, or that alters the
genetic or structural constitution of tumor cells . From there, it seems that
this weakness is exploited by the administration of drugs that attack the DNA
of the tumor. "
The authors are
preparing now to conduct a Phase 3 clinical trial in collaboration with other
institutions in order to confirm that the combination of immunotherapy and
chemotherapy actually extends survival for patients with glioblastoma.
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cancer de la prostate
Oncologists blame the general not to proceed with manual screening
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Cancer screening
is insufficient in people 70-80 years, denouncing the oncologists, who partly
blame the GPs, according to them guilty of not practicing enough manual
screening.
Routine
screening?
Today, the taboo
associated with the nakedness of older people is deeply rooted in our society.
Number of GPs are uncomfortable when it do a strip-old patient and in addition
an old woman and perform a manual review, and passing by small tumors easily detectable.
Therefore,
screening for breast cancer in women over 70 years is very low, resulting in
delayed diagnosis, while its incidence increases with age, it is a rapid and
Early diagnosis of halting its progression, lamented Dr. Francois Pein,
Institut Gustave Roussy (Villejuif), during a session on cancer after 70 years,
organized under Eurocancer.
For the
oncologist, "GPs must undress their patients, especially if they are
older." Deliberately provocative, he called his general practitioners to
"reach into the bra" their elderly patients and conduct a pat of
their breasts.
Same for
prostate cancer, whose incidence increases with age, but for which there are no
recommendations for mass screening in over 70 years. For Professor Jean-Pierre
Droz, oncologist at the Centre Léon Bérard in Lyon, a man aged 70-75 years,
diagnosed with prostate cancer, which also presents no criteria for frailty,
may well undergo prostatectomy.
A very
heterogeneous population
In general,
older people do not benefit from the multidisciplinary consultation enjoyed by
younger patients, and for them, the recommendations are poorly monitored,
confirmed Professor Dominique Maraninchi, oncologist at the Institut Paoli
Calmettes in Marseille .
However, with
the increase in life expectancy, the average age of cancer patients will soon
reach or exceed 70 years against 60-65. Those 70 years have 19 more years to
live, and those aged 80 7.7. It should therefore not neglect this population
and make sure to give them the means to a good quality of life during their
last years of life.
"From a
certain age, it is not the quantity of survival he must aim, but the
quality," rightly pointed out by Pein, activist compliance and maintaining
autonomy elderly patients.
The specialist
also denounced three ideas that explain the delay or absence of screening,
diagnosis and treatment, relief or sometimes "irrational" of it: the
cancer progresses slower in the elderly, these are fragile, making it less
effective and more toxic chemotherapy, and finally they do not want their
cancer is treated. "This is all wrong!" Is he exclaimed.
In contrast, the
geriatrician population is very heterogeneous, it recommends to classify
elderly patients into subgroups according to their degree of autonomy, and
customize the treatment plan for each. Indeed, autonomous patients without
comorbidities can quite successfully support healing therapies, while the frail
elderly and other diseases dependent may receive only palliative care.
"Chronological
age is not a relevant factor in the decision," added Professor Claude
Jeandel, a geriatrician at the University Hospital of Montpellier, for whom the
only issue that the doctor must ask is to what category is his patient.
Therefore
plebiscite approach based on the concept of functional reserve, "what
matters is the ability of a person to cope with a stressful event" ... but
still recognizes the lack of tools to measure this ability.
Oncologists
present finally denounced the lack of representation of older patients in
clinical trials, as they are ultimately the main users of developed drugs. With
"too much risk of complications," the "orphans of the
system," as he called Dr. Pein, "could penalize an authorization file
on the market."
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Labels:
cancer de la prostate
Heredity and cancer: the brochure CRA reminds when to consult
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The brochure of
the Association for Research on Cancer (ARC) is devoted to the link between
genetics and cancer, and emphasizes family situations that motivate a cancer
genetics consultation.
Some people may
be from birth mutations predisposing to cancer. This is known as a genetic
predisposition, transmitted by heredity, said the CRA in the brochure.
For example,
there are two genes, BRCA1 and BRCA2, associated with an increased risk of
developing breast cancer. A person with a mutation in one of these two genes
may be seen from 10% (the level of risk of the general population) to 50% to
80%.
In case of
suspicion of risk for a given cancer, a person may be directed by an oncologist
or his attending physician, to a cancer genetics consultation. The
oncogénéticien, specialist in both cancer and genetics, is responsible in the
first instance to assess the patient's risk restoring family history of the
disease.
It is able to
offer, if any, monitoring or even appropriate care. When the risk is
particularly high, genetic tests can be used to search for genetic mutations.
"Making a
genetic test is not a trivial process," insists the CRA. The booklet
therefore recalls that "some situations particularly motivate the use of a
specialized genetic counseling"
- When three
cancer cases are found in the same location related in the same parental branch
people;
- When two
cancer cases are found in first-degree relatives of people, as soon as one of
them occurred at an early age (before age 50) or when one of them was a cancer
Breast Hit both breasts at once or having taken a multifocal form;
- When a single
case of cancer occurred before age 35, even in the absence of family history;
- When several
cases of cancer have occurred in the same person of the family;
- When
associated with cancer predisposing disease (familial adenomatous polyposis,
ataxia telangiectasia ...) are in the family.
Thus, 5% to 10%
of breast and / or ovarian cancer are linked to a genetic predisposition, as
about 3% of cancers of the colon and rectum, and 10% of prostate cancers arise
in the context family.
Sometimes the
transmission for diseases at risk of cancer development. This is the case of
family polyposis coli, which can progress to colorectal cancer if polyps are
not removed surgically. Similarly, ataxia telangiectasia, hereditary disease
causing problems with balance and coordination of movement is associated with
an increased risk of leukemia and brain cancer risk.
Read More »
Labels:
cancer de la prostate
Heredity and cancer: what is the good time to visit?
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The brochure of the Association for Research on Cancer (ARC) is devoted to the link between genetics and cancer, and emphasizes family situations may motivate some people to cancer genetics consultation. Can carry from birth mutations favoring the development of cancer. This is known as a genetic predisposition, transmitted by heredity, said the CRA in the brochure.
For example, there are two genes, BRCA1 and BRCA2, associated with an increased risk of developing breast cancer. A person with a mutation in one of these two genes sees its risk from 10% (the level of risk of the general population) to 50% to 80%.
In case of suspicion of risk for a given cancer, a person may be directed by an oncologist or his attending physician, to a cancer genetics consultation. The oncogénéticien, specialist in both cancer and genetics, is responsible in the first instance to assess the patient's risk restoring family history of the disease.
It is able to offer, if any, monitoring or even appropriate care. When the risk is particularly high, genetic tests can be used to search for genetic mutations.
"Making a genetic test is not a trivial process," insists the CRA. The booklet therefore recalls that "some situations particularly motivate the use of a specialized genetic counseling"
- When three cancer cases are found in the same location related in the same parental branch people;
- When two cancer cases are found in first-degree relatives of people, as soon as one of them occurred at an early age (before age 50) or when one of them was a cancer Breast Hit both breasts at once or having taken a multifocal form;
- When a single case of cancer occurred before age 35, even in the absence of family history;
- When several cases of cancer have occurred in the same person of the family;
- When associated with cancer predisposing disease (familial adenomatous polyposis, ataxia telangiectasia ...) are in the family.
Thus, 5% to 10% of breast and / or ovarian cancer are linked to a genetic predisposition, as about 3% of cancers of the colon and rectum, and 10% of prostate cancers arise in the context family.
Sometimes the transmission for diseases at risk of cancer development. This is the case of family polyposis coli, which can progress to colorectal cancer if polyps are not removed surgically. Similarly, ataxia telangiectasia, hereditary disease causing problems with balance and coordination of movement is associated with an increased risk of leukemia and brain cancer risk.
Read More »
Labels:
cancer de la prostate
Americans believe in the value of cancer screening tests, despite the medical supplies?
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The vast majority of Americans are convinced of the importance of cancer screening, so much so that she would be willing to ignore the advice of the doctor suggest to space tests, shows a survey published in the "Journal of the American Medical Association."
Much debate exists regarding the benefit of cancer screening. From these discussions emerged the idea that consensus, "to allow the public to make the right decision, it must have access to all information regarding the benefits and risks," the researchers said at the Veterans Medical Center White River Junction.
The work undertaken by the U.S. health authorities for many years to persuade the people of the United States of the importance of cancer screening seems to bear fruit, they point out, however, denouncing advertising more "aggressive" to sing the praises of new screening techniques, yet not prouvés.Les researchers conducted a telephone survey of 500 adults over 40 years for women and 50 years for men to express their attitude to -vis the testing in general, and particularly in the case of false positives, and their enthusiasm for a new method of screening, aided tomography whole body ordinateur.La almost all of the women interviewed had suffered a smear (99%) and a mammogram (89%), 71% of men had meanwhile been tested for PSA assay, to indicate the existence of prostate cancer, and nearly half of the participating persons, men and women, had undergone colonoscopie.Une vast majority (87%) believed that cancer screening is "almost always a good idea," three-quarters believe that early tests save lives "mostly" or "all the time," the authors report. Half also thought that screening reduces the amount of enthusiasm nécessaires.Cet treatments for cancer screening primarily reflects the desire of the people whether or not they are sick, and not an interest in the implications comment on auteurs.En addition, more than half of the women said she was ready to go against the advice of their doctor if it is advised to recommend smear them further apart in time. Similarly, three-quarters of men continue to be screened for prostate cancer, and a similar proportion of men and women suffer a colonoscopy, despite recommendations contraires.D Moreover, if there was a question the cost of each of these tests, some of the respondents said they would increase the frequency of screening, due to a review every six months.The risk of false-positive results are, however, (38% of participants), requiring new medical board exams, with the psychological consequences that pending the final outcome may result. While describing this scary waiting time, some remembering even as "the most terrifying moment of their lives," nearly half of those who lived it does not however regretted having passed the first test . asked about their interest vis-à-vis the whole body positron desktop, only a quarter of them have raised the risk of side effects, the authors report. "Our study shows that screening is not considered as an option but an obligation "towards the close but professional, they comment, involving" the campaigns of incitement to screening have passed a misleading message and biased, discouraging any discussion on the use framed these tests when the recommendations are poorly defined (screening at an earlier age, old age or for patients with several diseases, for example). "
Now, "the challenge is to adjust these messages and reduce the risk of 'over-testing' and 'over-treatment' of the public," they conclude.
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cancer de la prostate
the dermatologist?
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We have it all wrong when we say that the dermatologist is the specialist in skin diseases. It is also involved in diseases of the mucous membranes, hair and nails. Most dermatologists are themselves connoisseurs sexually transmitted diseases ..
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cancer de la prostate
What is a glioblastoma?
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Glioblastoma is an aggressive brain
tumor, his prognosis is very dark and the protocol established pretreatment is
still considered palliative. However, the change varies from one subject to
another. Age, neurological deficits, aggressiveness and tumor progression have
to keep in mind ...
Glioblastoma is a cancerous brain
tumor that develops at the expense of the central nervous system cells called
astrocytes. This tumor usually sits in the cerebral hemispheres, and
development quickly become a very large tumor.
This type of brain cancer affects
more frequently between the ages of 45 and 70 people (one peak to the sixties),
and certainly remains the most serious.
It differs essentially:
- The primary glioblastoma
- The secondary glioblastoma, which
usually develops from the evolution of a benign tumor into a malignant tumor.
The evolution is slower in a transformation of a glioblastoma astrocytoma.
Signs presented by patients are
highly variable and depend on the particular location of the tumor, its
evolution. In general, a glioblastoma begins with neurological deficits, but
are nevertheless not specific to the tumor:
- Headaches
- Disturbances of vision
- Difficulties with concentration and
memory, personality disorders
- Seizures simulating seizures
These signs are usually signs of
compression, inflammation and irritation of the brain due to the development
and extension of the tumor. The tumor may also develop without specific
symptoms.
The diagnosis of glioblastoma is
usually established after a CT scan and MRI. The tumor can not be accessible to
biopsy. However, pathological examination of confirmation can be made after surgical
resection of the tumor.
The treatment is based on a protocol
of care pre established:
- The surgery is performed in the
first time, a total excision of the tumor is often impossible because of its
location and volume
- Radiation therapy is then
performed after surgery
- Chemotherapy uses temozolomide (a
newly authorized and listed since 2000 in France molecule)
- Several sessions of
radio-chemotherapy are then recommended
- In case of recidivism, the
resumption of chemotherapy with Avastin-Campto can be proposed.
In these treatments may involve
supportive medical treatments such as anticonvulsants / antiepileptics, or
corticosteroids.
The management of glioblastoma is
very delicate and requires the intervention of a multidisciplinary team.
Glioblastoma is a malignant tumor
with a poor prognosis, often associated with high mortality. This type of tumor
often gives local metastases (and rarely distant metastases), in the brain
itself (including infiltration in the gray matter). Indeed, cancer cells of
glioblastoma are not particularly stable, and genetic specificity varies
considerably from one patient to another. Where ineffective treatments
currently available.
Treatments are generally considered
palliative and even surgical resection combined with chemotherapy does not
guarantee a cure. Recurrence is common, but a new surgery with chemotherapy is
not necessarily curative either. In addition, surgical reoperation depends
primarily on the condition of the patient, age, as well as any associated
diseases. The prognosis is also all the more reserved when it comes to a
person, or a patient with signs of severe neurological deficits.
In addition, chemotherapy is a
therapeutic technique that the side effects are sometimes not tolerated in the
elderly: fatigue, weight loss, anemia, immune deficiency, hair loss, nausea,
...
Glioblastoma is an aggressive brain
tumor. The survival rate at five is very low (less than 10%) and without
treatment, the survival rate is estimated at 3-4 months on average.
The treatment increases the survival
rate of a few months, which is estimated between 1-2 years on average. Patients
exceeding this period often have abnormalities such as hydrocephalus. The tumor
also causes cerebral edema causing an increase in intracranial pressure. These
are conditions that usually result in death.
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cancer de la prostate
Vitamin D Deficiency: Know the causes to prevent the consequences!
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Vitamin D is a very important
substance and plays a leading role in the proper functioning of the body. A
vitamin D deficiency is common both in adults than in children. What are the
causes, what can be the consequences? Here are the answers.
Vitamin D is a vitamin mainly
manufactured by the body from cholesterol, with the effect of ultra-violet rays
of the sun. Thus, vitamin D is also considered a hormone because it is
primarily synthesized in the skin with several stages of processing in the
liver and kidneys. However, a small portion is provided by food (meat, salmon,
egg, cow's milk, soy milk ...). For food intake and drug intake, vitamin D is
stored in the liver and used as needed by the body.
We're talking about a vitamin D
deficiency when the blood levels below 75 nmol / l. Of the fact that over 80%
of vitamin D in the body involves the action of sunlight, the primary cause of
vitamin D deficiency is the absence or lack of sun exposure. This is
particularly
- People with darker skin
- Guests staying in a country with a
high latitude and low intensity of sunlight
- Persons whose exposure to the sun
is impossible because of the existence of a disease (cancer of the skin) or
disability.
However, there are other causes that
can lead to vitamin D deficiency:
- A diet low in meat, fish, dairy
products (milk, butter, cheese ...)
- Diseases resulting from improper
use or decrease the absorption of vitamin D such as celiac disease, intestinal
malabsorption, cystic fibrosis, liver disease, pancreatic disease, renal
failure, hyperparathyroidism
- The body of the elderly have
difficulty synthesizing vitamin D, and these people are at risk
- Obesity increases the risk of
deficiency because the body, in this state requires a surplus of vitamin D in
relation to a person of normal weight
The main function of vitamin D is to
regulate calcium levels in the body, it controls the absorption (in the
intestines) and elimination (the kidneys) of calcium, according to the needs of
the body. Through the action of calcium, vitamin D is involved in the health of
an individual bone by helping to bind the calcium in the bones. Thus, the main
condition linked to vitamin D deficiency is the absence or deficiency of bone
calcification. It is rickets in children and osteomalacia in adults. These
conditions are the cause of bone fragility, facilitating the occurrence of
fractures and bone diseases such as osteoporosis or osteoarthritis. The vitamin
D deficiency also affects dental health. The occurrence of these disorders is
usually determined by a lower threshold of 25 nmol / l. exclusive breastfeeding
because breast milk contains very little vitamin D.
In addition, vitamin D is involved
in several other functions such as muscle function, metabolism, kidney
function, immune system and its deficiency causes many diseases and increases
the risk of
- Cardiovascular diseases including
hypertension
- Cancers: breast cancer, colorectal
cancer, prostate cancer
- Diabetes
- Autoimmune Diseases
The role of vitamin D in these
diseases and conditions are still unclear, but the admission of these diseases
as the consequences of vitamin A deficiency was determined after numerous
research and clinical trials.
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cancer de la prostate
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