Download this Blogger Template by Clicking Here!

Ad 468 X 60

Showing posts with label cancer de la prostate. Show all posts

The nail toxicities related to chemotherapy reduced by wearing a cooling glove

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.

Read More »

Glioblastoma multiforme: immunotherapy followed by chemotherapy prolongs survival in patients

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.

Read More »

Oncologists blame the general not to proceed with manual screening

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."

Read More »

Heredity and cancer: the brochure CRA reminds when to consult

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 »

Heredity and cancer: what is the good time to visit?


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 »

Americans believe in the value of cancer screening tests, despite the medical supplies?


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.

Read More »

the dermatologist?


   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 ..

Read More »

What is a glioblastoma?

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.

Read More »

Vitamin D Deficiency: Know the causes to prevent the consequences!

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.

Read More »