cancer treatment edited

8/3/2019 Cancer Treatment Edited

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VISION

A premier university inhistoric Cavite recognized

for excellence in the

development of morallyupright and globally

competitive individuals.

MISSION

Cavite State University shallprovide excellent, equitable and

relevant educational opportunitie

in the arts, science and technologthrough quality instruction and

relevant research and developme

activities. It shall produceprofessional, skilled and morally

upright individuals for global

com etitiveness.

COLLEGE OF NURSING

MEDICAL SURGICAL NURSING

MODERN INNOVATIONS IN TREATMENT OF

VARIOUS TYPES OF CANCER

Submitted by:

Charmaine Joelyn A. Lachica

IV BSN 2

Submitted to:

Normidia A. Quion RN, MAN


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Photodynamic Therapy for Cancer

What is photodynamic therapy?

Photodynamic therapy (PDT) is a treatment that uses a drug, called a photosensitizer or

photosensitizing agent, and a particular type of light. When photosensitizers are exposedto a specific wavelength of light, they produce a form of oxygen that kills nearby cells

Each photosensitizer is activated by light of a specific wavelength .This wavelengthdetermines how far the light can travel into the body .Thus, doctors use specific

photosensitizers and wavelengths of light to treat different areas of the body with PDT.

How is PDT used to treat cancer?

In the first step of PDT for cancer treatment, a photosensitizing agent is injected into the

bloodstream. The agent is absorbed by cells all over the body but stays in cancer cells

longer than it does in normal cells. Approximately 24 to 72 hours after injection , whenmost of the agent has left normal cells but remains in cancer cells, the tumor is exposed tolight. The photosensitizer in the tumor absorbs the light and produces an active form of

oxygen that destroys nearby cancer cells.

In addition to directly killing cancer cells, PDT appears to shrink or destroy tumors intwo other ways . The photosensitizer can damage blood vessels in the tumor, thereby

preventing the cancer from receiving necessary nutrients. In addition, PDT may activatethe immune system to attack the tumor cells.

The light used for PDT can come from a laser or other sources of light .Laser light can be

directed through fiber optic cables (thin fibers that transmit light) to deliver light to areasinside the body. For example, a fiber optic cable can be inserted through an endoscope (athin, lighted tube used to look at tissues inside the body) into the lungs or esophagus to

treat cancer in these organs. Other light sources include light-emitting diodes (LEDs),which may be used for surface tumors, such as skin cancer .

PDT is usually performed as an outpatient procedure .PDT may also be repeated and may

be used with other therapies, such as surgery, radiation, or chemotherapy .

What types of cancer are currently treated with PDT?

To date, the U.S. Food and Drug Administration (FDA) has approved thephotosensitizing agent called porfimer sodium, or Photofrin, for use in PDT to treat orrelieve the symptoms of esophageal cancer and non-small cell lung cancer. Porfimer

sodium is approved to relieve symptoms of esophageal cancer when the cancer obstructsthe esophagus or when the cancer cannot be satisfactorily treated with laser therapy

alone. Porfimer sodium is used to treat non-small cell lung cancer in patients for whomthe usual treatments are not appropriate, and to relieve symptoms in patients with non-

small cell lung cancer that obstructs the airways. In 2003, the FDA approved porfimer


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sodium for the treatment of precancerous lesions in patients with Barrett esophagus (acondition that can lead to esophageal cancer).

What are the limitations of PDT?

The light needed to activate most photosensitizers cannot pass through more than aboutone-third of an inch of tissue (1 centimeter). For this reason, PDT is usually used to treattumors on or just under the skin or on the lining of internal organs or cavities . PDT is

also less effective in treating large tumors, because the light cannot pass far into thesetumors . PDT is a local treatment and generally cannot be used to treat cancer that has

spread (metastasized) .

1. Does PDT have any complications or side effects?

Porfimer sodium makes the skin and eyes sensitive to light for approximately 6 weeks

after treatment . Thus, patients are advised to avoid direct sunlight and bright indoor light

for at least 6 weeks.

Photosensitizers tend to build up in tumors and the activating light is focused on the

tumor. As a result, damage to healthy tissue is minimal. However, PDT can cause burns,swelling, pain, and scarring in nearby healthy tissue . Other side effects of PDT are

related to the area that is treated. They can include coughing, trouble swallowing,stomach pain, painful breathing, or shortness of breath; these side effects are usually

temporary.

What does the future hold for PDT?

Researchers continue to study ways to improve the effectiveness of PDT and expand it toother cancers. Clinical trials (research studies) are under way to evaluate the use of PDTfor cancers of the brain, skin, prostate, cervix, and peritoneal cavity (the space in the

abdomen that contains the intestines, stomach, and liver). Other research is focused onthe development of photosensitizers that are more powerful , more specifically target

cancer cells , and are activated by light that can penetrate tissue and treat deep or largetumors . Researchers are also investigating ways to improve equipment and the delivery

of the activating light .

Reference:

Photodynamic therapy for cancer.Nature Reviews Cancer2009


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Angiogenesis Inhibitors Therapy

What is angiogenesis?

Angiogenesis is the formation of new blood vessels. Angiogenesis is a process controlled by

certain chemicals produced in the body. Some of these chemicals stimulate cells to repairdamaged blood vessels or form new ones. Other chemicals, called angiogenesis inhibitors,signal the process to stop.

Why is angiogenesis important in cancer?

Angiogenesis plays an important role in the growth and spread of cancer. New blood vessels

feed the cancer cells with oxygen and nutrients, allowing these cells to grow, invadenearby tissue, spread to other parts of the body, and form new colonies of cancer cells.

How can angiogenesis be stopped in tumors?

Because tumors cannot grow or spread without the formation of new blood vessels, scientists

are trying to find ways to stop angiogenesis. They are studying natural and syntheticangiogenesis inhibitors, also called antiangiogenic agents, in the hope that these chemicals

will prevent or slow down the growth of cancer by blocking the formation of new bloodvessels.

Are any angiogenesis inhibitors currently being used to treat cancer in humans?

Yes. The U.S. Food and Drug Administration (FDA) has approved bevacizumab (Avastin)for use with other drugs to treat colorectal cancer that has spread to other parts of the body,

some non-small cell lung cancers, and some breast cancers that have spread to other parts ofthe body. Bevacizumab was the first angiogenesis inhibitor proven to delay tumor growth

and, more importantly, extend the lives of patients.

The FDA has also approved other drugs with antiangiogenic activity as cancer therapies formultiple myeloma, mantle cell lymphoma, gastrointestinal stromal tumors (GIST), and

kidney cancer.

Researchers are also exploring the use of these drugs to treat other cancers.

What are the advantages of angiogenesis inhibitors?

Angiogenesis inhibitors usually have only mild side effects and are not toxic to most healthycells. Tumors do not seem to develop a resistance to angiogenesis inhibitors, even when

given over a long period of time, unlike the resistance seen when chemotherapy drugs areused.

Angiogenesis inhibitors seem to help some chemotherapy drugs and radiation therapy work

more effectively when given in combination.


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What are the limitations of angiogenesis inhibitors?

Angiogenesis inhibitor therapy may not necessarily kill tumors, but instead may keep tumorsstable. Therefore, this type of therapy may need to be administered over a long period.

Because angiogenesis is important in wound healing and in reproduction, long-term

treatment with antiangiogenic agents could cause problems with bleeding, blood clotting,heart function, the immune system, and the reproductive system .

Does angiogenesis inhibitor therapy have any complications or side effects?

A patients immune system may be compromised, making the patient more susceptible toinfection and causing wounds to heal poorly, if at all. Patients may experience reproductive

problems, and damage to the fetus is likely if a patient becomes pregnant while taking theantiangiogenic drug. Heart problems and high blood pressure could be made worse, and

bleeding or blood clots could increase .

Since angiogenesis inhibitor therapy is still under investigation, all of the possiblecomplications and side effects are still unknown.

What does the future hold for angiogenesis inhibitor therapy?

Other angiogenesis inhibitors are currently being tested in clinical trials (research studies) but

have not yet been shown to be effective against cancer in humans. If these angiogenesisinhibitors are proven to be both safe and effective in treating human cancer, they may be

approved by the FDA and made available for widespread use.

Reference:

FDA drug approval summary: Bevacizumab plus FOLFOX4 as second-line

treatment of colorectal cancer. The Oncologist2007


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New Treatment for Liver Cancer: Radioactive Microbeads Use Bodys

Pathways to Destroy Tumor Cells

University of Rochester Medical Center physicians recently performed upstate New Yorks first

radioembolization procedure for primary liver cancer. This technique combats the tumor in

patients who cannot be treated with surgery and are awaiting an organ transplant.

The outpatient procedure, called TheraSphere, involves the insertion of millions of microscopic

radioactive glass beads into the vascular system near the tumor. The tiny, glass microspheres,

about one-half the diameter of a human hair, attack cancerous cells while minimizing the impact

on healthy tissue. This procedure is only available at two other sites in New York and 50 select

hospitals in the United States.

This is another option for patients who are waiting for a curative transplant, said David

Waldman, M.D., Ph.D., chair of Imaging Sciences. Medical Center interventional radiologistsand radiation oncologists collaborate to calculate the precise dosage and deliver the microspheres

filled with yttrium-90, the radioactive isotope that destroys the cancer.

Inteventional radiologist Takashi Kitanosono, M.D.,and radiation oncologist Alan Katz, M.D.,

M.P.H., performed the procedure for Thomas Lundgren of Perrysburg, Cattaraugus County. The

61-year-old was diagnosed with hepatocellular carcinoma in March. Physicians at the Veterans

Administration Medical Center in Buffalo referred him to Strong Memorial Hospital for

evaluation for a liver transplant, the only cure for the disease.

About 22,600 cases of primary liver cancer are diagnosed each year in the United States,

according to the American Cancer Society. The most common form of primary liver cancer

is hepatocellular carcinoma, which in the U.S. is commonly caused by the hepatitis B or hepatitis

C viruses or alcohol abuse. It is the fifth most common form of cancer in the world and is

increasing globally due to an increase in the incidence of hepatitis.

However, Lundgrens 7-centimeter tumor was larger than allowable limits for a transplant.

Gastrointestinal oncologist Aram Hezel, M.D., of the James P. Wilmot Cancer Center, suggested

the new treatment to shrink the tumor and allow for him to be placed on the transplant waiting

list.

The Medical Centers Division of Solid Organ Transplantation includes the only liver transplant

program in upstate New York. The transplant team and its four surgeons serves patients from

across New York state and northern Pennsylvania. More than 300 patients are on the URMC list

waiting for a donor organ to become available. Across the state, more than 1,800 people are

waiting.


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On average, about a quarter of the people who received a liver transplant at the Medical Center

had liver cancer. And, more than a third of the people awaiting transplant have liver cancer or

hepatitis C.

The TheraSphere treatment can generally be administered on an outpatient basis and does not

usually require an overnight hospital stay.

The procedure involves extensive imaging to determine the exact location of the tumor and the

arteries and vessels leading into the cancerous lesion. To direct TheraSphere treatment at tumors

in the liver, a physician first makes a small incision in the patients leg and places a long, flexible

plastic tube (a catheter,) into the femoral artery, the major blood vessel in the leg. Guided by X-

ray imaging, the physician then moves the catheter up through the blood vessels to the hepatic

artery, which is one of two blood vessels that feed the liver.

The physician guides the catheter into the branch of the hepatic artery that feeds the cancerous

tumor in the liver and infuses the microscopic glass beads through the catheter into the blood thatsupplies the tumor. This is usually performed in a hospitals radiology suite and patients remain

conscious throughout the procedure.

The Wilmot Cancer Center is the Rochester and Finger Lakes regions leader in cancer care and

research. With a team of more than 400 doctors, nurses, scientists and staff, the center is

dedicated to providing outstanding patient care and finding cures for cancer.

Reference:

http://nanopatentsandinnovations.blogspot.com/2010/05/new-treatment-for-liver-cancer.html


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Cryobiology for Brain Cancer

Cryobiology, study of living things, life processes, and biological material subjected to very lowtemperatures, including preservation at cryogenic temperatures below -150C (-238F)

(cryopreservation). Cold temperatures are also used for medical purposes such as cryogenic

surgery (cryosurgery). The term cryobiology comes from Greek words meaning study of life aticy temperatures.

An important use of cryogenic temperatures is preservation of biological and medical materialfor study and protection, usually in liquid nitrogen in a special container at temperatures below -

150C (-238F). Frozen tissue samples can preserve DNA from living species that might becomeextinct in the future. Frozen embryos, eggs, and semen from endangered species of animals may

be used in the future to save species by adding genetic diversity or by using related animals assurrogate mothers. Plant seeds stored at subfreezing temperatures of -18C (-0.4F) and

germplasm (genetic material) from plants stored at cryogenic temperatures of -170C (-274F)can be resources to preserve genetic diversity and rare species. Frozen tissue from animals or

plants could also be used for cloning or genetic engineering.

A common commercial use for cryopreserved material is artificial insemination of livestock withfrozen sperm, which can be shipped around the world. Other agricultural uses for frozen

biological material include microorganisms used to make cheese, and pollen from certain strainsof plants.

Frozen human sperm, eggs, and embryos can also be cryopreserved for use in vitro fertilizationand other assisted reproduction techniques. Donated sperm and eggs can be cryopreserved in so-

called sperm banks and egg banks for use by other individuals. Men and women undergoingmedical procedures such as radiation treatment or surgery that would damage or remove their

future ability to produce children can also store their own sperm or eggs. Embryos created invitro fertilization procedures can be frozen for future implantation. Multiple embryos created but

not used during such procedures may be frozen and stored as well. Stem cell research and othermedical studies involving such unused or left-over embryos have provoked controversy.

Cryopreservation of human blood and blood products is widely practiced. Human organs,

tissues, and cells are also cryopreserved for medical use. Special cryoprotectant chemicals areoften used with organs preserved for medical transplantation. Cryogenic techniques can also

preserve medical samples of diseased tissues and strains of disease-causing organisms for futurestudy. A commercial market has developed for the cryogenic storage of a babys umbilical cord

to permit future use of the blood stem cells to treat disease in later life.

MEDICAL USES OF COLD TEMPERATURES

Cryogenic surgery, or cryosurgery, involves the selective destruction of tissue by freezing it with

a small cryogenic probe or instrument, usually chilled with liquid nitrogen. The technique is usedto treat Parkinson disease by destroying small areas of tissue in the thalamus or pallidum in the

brain. A similar technique has also been employed to destroy brain tumors and to arrest cervical


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cancer or prostate cancer. Topical cryosurgical procedures can be used to remove warts, minorskin cancers, or hemorrhoids.

Induced hypothermia is another medical use of cold temperatures, but not at cryogenic levels.

The body temperature of a patient is deliberately lowered in a controlled way to slow metabolism

and oxygen use, and to prevent tissue damage, swelling, or bleeding. Induced hypothermia canbe used in surgery on the heart and lungs. It is also used to treat patients who have suffered headinjuries, brain damage, heart attacks, or other trauma. Techniques for inducing hypothermia

include covering a patient with special cooling blankets or infusing the patient with chilled salinesolution.

Reference:

Microsoft Encarta 2010. 1993-2008 Microsoft Corporation. All rights reserved.


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Innovations and Technology

Urology Innovations & Technology at UCLA, Los Angeles, CA

Faculty members of the Department of Urology have been pioneers in developing new

innovations and technologies leading to safer and more effective treatments for patients.

Some of our discoveries have revolutionized the diagnosis and treatment of urologic conditions,while others have improved upon breakthroughs made at other research facilities or academic

medical centers.

Developments from our landmark studies on outcomes and quality of life for prostate

cancer patients have become standards throughout the world. Still other innovations have re-engineered diagnostics or streamlined patient information systems, enabling physicians to devote

more time to patient care. Listed below is a sampling of the innovations and technologicalbreakthroughs that UCLA Department of Urology faculty members have developed.

Minimally Invasive Procedures

Under the direction of Peter Schulam, M.D., Ph.D., the UCLA Department of Urologys

Division of Endourology and Minimally Invasive Surgery is collaborating with other specialistswithin the David Geffen School of Medicine at UCLA to develop new technologies for more

effective treatments for our patients. Among these advances have been new approaches andtechniques in minimally invasive surgery, using miniature instruments inserted via a small tube

(called a laparoscope) through tiny incisions in the body.

Laparoscopic surgery has revolutionized the way patients are treated fora variety of conditions because these minimally invasive procedures

result in less discomfort, quicker recovery times and better outcomes forpatients than traditional open surgery.

Specifically, faculty members of the UCLA Department of Urology are

collaborating with the UCLA Biomechanical Engineering Department todevelop novel biological sensors, instruments, and surgical techniques

for use in minimally invasive surgery.

Urologic conditions for which UCLA currently offers minimally

invasive surgery include kidney stones, live donor nephrectomy, pelvic organ prolapse, prostate

cancer, renal cell carcinoma, renal cysts, transitional cell carcinoma, uretal stricture, anduretopelvic junction obstruction.

While minimally invasive surgery has been used successfully in adults, faculty members atUCLA have successfully refined the use of laparoscopic surgery in children, as well. Some of

these procedures include nephrectomy, which removes malformed or dysfunctional kidneys;pyleloplasty, which removes blockages in the ureter; and treatment of undescended testicles in

infants.


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Robotic Surgery

The UCLA Department of Urology collaborated with the Department of Surgery to open

the Center for Advanced Surgical and Interventional Technology (CASIT) in 2002. TheCenter promotes clinical, educational and research use of surgical robots and digital imaging in

surgery and medicine. Using a robotic surgical system, urologists at UCLA are able to performoperations more precisely than ever before. The system filters the surgeons hand tremors and

allows better range of motion, which ultimately will narrow the deviation in surgical skill amongsurgeons and result in less discomfort and quicker recovery times for patients. Faculty members

in the Department of Urology are also training other surgeons in minimally invasive surgery. TheDepartment is collaborating with several industry partners to refine techniques that will allow

surgeons at remote locations to be trained via teleconferencing and telesurgery.

Outcomes Studies & Quality of Life

The UCLA Prostate Cancer Index, developed by MarkLitwin, M.D., M.P.H., has become the gold standard

worldwide in measuring outcomes and quality of life in

prostate cancer survivors. The UCLA Prostate CancerIndex is now in use in over 200 studies throughout North

America and has been translated into Spanish, Dutch, andJapanese for cross-cultural use. Dr. Litwin 's research

includes medical outcomes assessment, health-related quality of life, urologic oncology, cost-efficacy and resource utilization in urological care, and patient preferences. He published the

first validated instrument to assess disease-targeted health-related quality of life in men treatedfor prostate cancer and has been an international leader in this area. His research is funded by the

National Institute of Diabetes, Digestive and Kidney Diseases, American Cancer Society,California Department of Health Services, and other organizations.

New Advances in Diagnostics

A Bioengineering Research Partnership Project Sponsored by the National Institutes of Health-National Institute of Biomedical Imaging and Bioengineering (NiH-NIBIB), the uropathenogen

detection project at UCLA aims to develop and test a rapid new system that would enable point-of-care diagnosis and treatment of urinary tract infections using clinical urine samples.

Cryosurgery

Although cryosurgery has been used since the 1960s, unique applications are being developed to

make it a desirable treatment option for some patients. New cryosurgical technology for prostatecancer treatment allows the surgeon to precisely map cancerous cells, freezing and killing the

cells that radical prostatectomy would not reach.


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Laparoscopic Prostatectomy

Offered as an option for most patients who would be candidates for an open radical

prostatectomy. Laparoscopic prostatectomy allows the removal of the prostate through anumbilical incision. Patients usually leave the hospital the next day, and the need for pain

medication seems to be reduced. The procedure is as effective as open radical prostatectomy inremoving the cancer.

LaparoscopicNephrectomy

Until recently, nephrectomy, or removal of a kidney, was a major operation requiring open

surgery and up to eight weeks of recovery. The extent of the procedure was often a deterrent for

healthy donors to agree to donate a kidney. But laparoscopic nephrectomy is much lessinvasive, meaning less pain, a shorter recovery period, and a rapid return to normal

activity. Doctors use a miniature video camera and other instruments to perform the procedure.

Cryosurgical Ablation

Roughly half of all prostate cancer patients decline radical surgery, which involves the removal

of the prostate. For many of these patients, cryosurgerywhich uses freezing as a means ofdestroying diseased tissues-- can be effective and is equivalent to radiation therapy in eradicating

the cancer. The newest cryosurgical technique injects the prostate with ultra-thin cryoprobescooled by argon gas. This allows the surgeon to map the placement of ice balls and control

temperatures throughout the procedure. The procedure can be done on an outpatient basis andcan be performed without an incision, resulting in minimal side effects or blood loss. This

procedure is being tested on kidney cancer patients, with encouraging results.

Reference:

http://urology.ucla.edu/body.cfm?id=188


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Prostate Cancer Treatment

There are a variety oftreatment options available to patients who have been diagnosed with

prostate cancer. Here at UCLA, the course of treatment is individualized to each patients

cancer grade and stage as well as current state of health. The management ofprostate cancer

requires extensive collaboration. The Institute of Urologic Oncology at UCLA and theDepartment of Urologys long-standing Prostate Cancer Program have a multi-disciplinary teamthat specializes in prostate cancer treatment and offers a number of innovative options. Bi-

weekly conferences are held and attended by specialists including urologists, medicaloncologists, radiation oncologists, pathologists, radiologists, and clinical trial nurses. This

provides a forum with diverse, specialized perspectives for deciding upon the best option foreach individual patient.

TreatmentOptions for Prostate Cancer

A wide variety oftreatments are used for prostate cancer, depending on the stage of the

disease, the patients age and overall health, and patient preferences or concerns about potentialrisks and side effects such as erectile dysfunction, urinary incontinence, and other bladder or

bowel problems. For early-stage disease when remaining life expectancy is at least 10 years,prostate cancer surgery is often the preferred option. For most men, this means a nerve sparing

radical prostatectomy, in which the prostate is removed while, in most cases, potency ispreserved.

Increasingly, this prostate cancer surgery procedure is now done robotically: This minimally

invasive prostate cancer surgery shortens hospital stay and may shorten recovery time, whileachieving comparable results to traditional open surgery. At UCLA, robotic instruments have

been introduced for prostate cancer surgery to improve surgical precision.

Minimally InvasiveOptions for Prostate Cancer

Robotic Procedure - Minimally Invasive (laparoscopic) Prostatectomy

For many men with early-stage prostate cancer, the robotically assisted minimally invasiveprostatectomy has emerged as an attractive option. UCLA physicians are achieving results that

are equivalent to the traditional open surgical approach to nerve sparing radical prostatectomy interms of eliminating cancer and preserving sexual potency and urinary continence for many

early-stage prostate cancer patients. Surgeons are able to obtain pictures of the surgical site with

15-fold magnification, and insert miniaturized instruments to remove the prostate. Theintroduction of robotic instruments has helped to improve surgical precision. Surgeons are ableto sit in a console with a three-dimensional view inside the patient and move three robotic arms

with the full natural range of motion, while a fourth robotic arm controls the camera. Theinstruments can act like human wrists, giving surgeons greater flexibility as they use the robot to

manipulate the tiny surgical tools inside the body. The minimally invasive approach offers theadvantages of shorter hospital stay and recovery time and less blood loss.


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Treatment: Standard Options

Nerve Sparing Prostatectomy | New Strategies for "Open" Surgeries

For some patients, the nerve-sparing radical prostatectomy continues to be the best option. In

the hands of experienced surgeons, this "open" operation is highly effective in removing thecancer and preserving potency. UCLA's database of the results of more than 1,400 patientstreated with the surgery at UCLA indicates that 80%-90% of patients under the age of 60 regain

their sexual function, with a 5%-10% risk of stress urinary incontinence after one year. Recoverytime has been reduced to one and a half days, with catheterization averaging seven days and

patients returning to regular activities in as little as two to four weeks. UCLA doctors haveadopted new strategies in an effort to improve nerve-sparing abilities for surgical patients.

During the open procedure, patients with bulkier tumors and aggressive cancers receive real-timepathology evaluation by the surgeons who obtain frozen sections when necessary to better

facilitate decisions on preserving the nerves. Medications such as Viagra are being given toprostate cancer patients both pre- and postoperatively to enhance potency rehabilitation.

Non-Surgical / Prostate Radiation TherapyOptions

Early-stage prostate cancer can also be successfully treated with prostate radiation therapy

the use of high-energy rays delivered by external beam, or, more recently, by radioactive seedsimplanted into the prostate under ultrasound guidance, which then emit high doses of radiation

exclusively to the prostate over the course of several months. For patients with early-stageprostate cancer in whom radical prostatectomy or radiation is not a good option, cryoablation is

a minimally invasive procedure that destroys the cancer cells by rapidly freezing and thawing thecancerous tissue. Still others, particularly older patients, choose an active surveillance

approach in which there is no immediate treatment but the tumor continues to be closely

monitored.

Support

Radical prostatectomy is a major surgical procedure and often patients with prostate cancer are in

an age group with other medical problems. At UCLA, we have an excellent support structure to

help patients before, during, and after your surgery. In addition to our surgical team, an internalmedicine hospitalist service routinely follows all our prostate cancer patients following surgery

and is available to see patients before surgery to get acquainted with some of our morecomplicated cases. We have well-trained nurses on the ward and intensive care unit, a pain

service team headed by anesthesiologists, stoma nurses, social workers, physical therapists, andnutritionists.

Reference:

http://urology.ucla.edu/body.cfm?id=188


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Advances in the Treatment of CANCER

Cancer

Finding treatments for rare cancers at specific stages for patients unresponsive to existingtreatment might be the toughestand most gratifyingwork a scientist could ever attempt.

Cancer is a group of diseases in which abnormal cells develop and spread through parts of the

body. Anyone can develop cancer. The National Cancer Institute estimates that 9.8 millionAmericans with a history of cancer were alive in 2001. Some were cancer-free; others were

continuing to undergo treatment.

PHARMACEUTICAL ADVANCES

Disrupting DNA Adds Months for Severe Brain Cancer PatientsIn the two most aggressive forms of astrocytoma, brain tumors grow rapidly and spread to other

parts of the body. Astrocytoma is classified into four grades (Grade I being the least aggressiveand IV most aggressive). Grade III is anaplastic astrocytoma, which affects 2,000-3,000 people

a year with an average survival of two to three years. Grade IV is glioblastoma multiforme,which affects 8,000-10,000 people each year and is usually fatal within one year.

Temozolomide can add an average of two and a half additional monthsan enormous amount

of time in the world of cancer treatmentfor patients with glioblastoma multiforme. "It doesn'tsound like much... but if you can demonstrate that you can extend life for two or three months

for the average patient, that's a significant advance," says Dr. Warren Mason, the co-author of aNew England Journal of Medicine study about the drug. Patients taking temozolomide for

treatment of anaplastic astrocytoma experienced an average survival time of nearly 16 months.

Approved in 1999, temozolomide is the first major new treatment for anaplastic astrocytoma in20 years, and with a second indication approved in 2005, it is the first in over 30 years for

glioblastoma. It works by disrupting DNA to prevent cancer cells from multiplying and prolongssurvival when combined with standard radiation. Additionally, it is a more convenient therapy

for patients; it is an oral treatment allowing patients to take their medication in the comfort oftheir own homes rather than having to receive intravenous treatments at a physician's office or

hospital.

Dual-Action Therapy Initiates Immune Response and Attacks

Tumor Cells Directly

Non-Hodgkin's lymphoma is a cancer of lymphatic tissues, such as lymph nodes, spleen, andother immune system organs. There are several different types of non-Hodgkin's lymphomas.

One of those types, follicular lymphoma, makes up 22 percent of all non-Hodgkin's lymphomas.Follicular lymphoma is not curable, but due to its slow growth, 60 to 70 percent of patients live

at least five years; it occurs mainly in adults, with an average age of 60. People with follicularnon-Hodgkin's lymphoma usually have lymphoma in many parts of the body. According to the

FDA Office of Orphan Products, the condition affects 193,500 people in the United States.


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With the 2003 approval oftositumomab and Iodine-131 tositumomab, patients with a subset offollicular non-Hodgkin's lymphomaCD20 positive follicular non-Hodgkin's lymphoma

gained a new treatment option with an innovative therapeutic twist. The drug is made up of animmune system protein, called an antibody, attached to radioactive Iodine-131. Combined, they

form a "radiolabeled" monoclonal antibody that is able to bind to a protein found only on the

cancer cells, thus targeting the radioactivity directly to the cancer cell, killing it.

This new medicine is used for patients with CD20 positive follicular non-Hodgkin's lymphoma

who have not responded to other treatments or whose cancer has returned after chemotherapy.For more than two years, on average, two-thirds of patients who took this medication during

clinical trials experienced either improved condition or full remission of the disease.

First Ray of Hope for Asbestos-Related Lung CancerWhen someone first experiences symptoms and is diagnosed with malignant pleural

mesothelioma, the fatal cancer is often already in advanced stages, and doctors expect them tolive just nine to 13 months. Malignant pleural mesothelioma is a cancer of the lining of the lung

and chest cavity, called the pleura. This is a very rare type of cancer affecting only 2,000 newpeople each year, and it is associated with exposure to asbestos.

Now the first drug approved for this rare cancer, pemetrexed, combined with other treatments,

gives patients 40 percent longer survival time compared with current treatment alone. "Before[pemetrexed] was available, patients suffering from mesothelioma had no hoperarely living a

year after diagnosis," said Nicholas J. Vogelzang, MD, Director of the Nevada Cancer Institutein Las Vegas. "At 18 months, there is still a statistically significant difference in survival, which

demonstrates patients are living longer when treated with this [pemetrexed] combination,"Volgelzang said.

Approved in 2004, pemetrexed is a novel antifolate, a class of drugs that targets the folic acid

metabolic pathway, which affects availability of certain B complex vitamins. It is indicated forpatients with the advanced form of the disease who have already had chemotherapy. Pemetrexed

was found in clinical trials to be as effective as other cancer drugs, but with fewer side effects,such as hair loss and subsequent infections.

Reference:

American Cancer Society, Inc., Cancer Facts and Figures 2005


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Ketoconazole: Not Just an Anti Fungal

Ketoconazole, prescription drug used to treat fungal infections. It works by weakening fungal

cell walls, thereby either killing the fungus or stopping its growth. Ketoconazole is also used totreat prostate cancer because it suppresses the production of testosterone, a hormone necessary

for prostate cancer cell survival.

Ketoconazole is available as a tablet, cream, or shampoo. Patients using the drug in tablet formtake 200 to 400 mg once a day for fungal infections and 400 mg three times a day for prostate

cancer. The drug should be taken with food for better absorption and to avoid stomach irritation.It must be taken for two to four weeks before a physician can evaluate its effectiveness as an

antifungal agent. A cure may require many months of treatment.

Common side effects of ketoconazole include reduced testosterone production (which mayimpair sexual function in males), skin irritation and rash, headache, nausea, diarrhea, and liver

problems. Pregnant and nursing women, patients with active liver disease, and patients who have

previously had an allergic reaction to the drug should not take ketoconazole. Patients shouldexercise caution in taking the drug if they are allergic to related antifungal drugs, take any otherdrugs, have liver disease or reduced liver function, have a history of alcoholism, or have low

levels of hydrochloric acid in their stomachs.

Ketoconazole enhances the blood-thinning effects of warfarin and minimizes the effects of

theophylline. Antacids may lessen ketoconazoles effectiveness. Patients who consume alcoholwhile taking this drug may experience dizziness, headaches, and nausea. Alcohol in combination

with ketoconazole can also contribute to liver problems.

Brand Name:Nizoral

Reference:

Microsoft Encarta 2010. 1993-2008 Microsoft Corporation. All rights reserved.


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SUMMARY OF ARTICLES




y Photodynamic therapy (PDT) combines a drug (called a photosensitizer orphotosensitizing agent) with a specific type of light to kill cancer cells.

y There is specific wavelength for every light emission at a therapy.y Two ways on how PDT can kill cancer cells, 1. It destroys the blood vessel in the tumor.

2. It activates the immune system to release needed leukocytes to fight the cancer cells.y PDT is used to treat or relieve the symptoms of esophageal cancer and non-small cell

lung cancer.y PDT is usually used to treat tumors on or just under the skin or on the lining of internal

organs or cavities .y The U.S. Food and Drug Administration has approved the photosensitizing agent called

porfimer sodium, or Photofrin, for use in PDT to treat or relieve the symptoms ofcertain cancers .

y Patients treated with porfimer sodium should avoid direct sunlight and bright indoor lightfor at least 6 weeks after treatment.

y Researchers continue to study ways to improve the effectiveness of PDT and expand itsuse to other cancers .


y Angiogenesis is the formation of new blood vessels and is controlled by chemicals in thebody .

y Tumors need blood vessels to grow and spread.

y Angiogenesis inhibitors prevent the formation of new blood vessels so that the tumorcannot grow.

y The U.S. Food and Drug Administration (FDA) has approved some angiogenesisinhibitors for the treatment of cancer . Bevacizumab was the first angiogenesis inhibitor

proven to delay tumor growth and, more importantly, extend the lives of patients.y Angiogenesis inhibitors have fewer side effects than many other cancer treatments, but

they may only limit the growth of the cancer, not cure it . Angiogenesis inhibitortherapy may not necessarily kill tumors, but instead may keep tumors stable. Therefore,

this type of therapy may need to be administered over a long period.y Researchers continue to test new angiogenesis inhibitors and to investigate the way these

drugs or chemicals work against different cancers .


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New Treatment for Liver Cancer: Radioactive Microbeads Use Bodys

Pathways to Destroy Tumor Cells

y TheraSphere, an outpatient procedure, involves the insertion of millions of microscopic

radioactive glass beads into the vascular system near the tumor. The TheraSphere

treatment can generally be administered on an outpatient basis and does not usually

require an overnight hospital stay.

y This technique combats the tumor in patients who cannot be treated with surgery and are

awaiting an organ transplant.

y The tiny, glass microspheres, about one-half the diameter of a human hair, attack

cancerous cells while minimizing the impact on healthy tissue.

y This procedure places a long, flexible plastic tube (a catheter,) into the femoral artery, the

major blood vessel in the leg. Guided by X-ray imaging, the physician then moves the

catheter up through the blood vessels to the hepatic artery. The branch of hepatic arterythat supply the tumor cell with blood is where the infusion of microscopic glass beads

happen.

y This is usually performed in a hospitals radiology suite and patients remain conscious

throughout the procedure.


y Cold temperatures are also used for medical purposes such as cryogenic surgery(cryosurgery). The term cryobiology comes from Greek words meaning study of life at

icy temperatures.

y Cryogenic surgery, or cryosurgery, involves the selective destruction of tissue by freezingit with a small cryogenic probe or instrument, usually chilled with liquid nitrogen.

y A similar technique has also been employed to destroy brain tumors.

y The body temperature of a patient is deliberately lowered in a controlled way to slowmetabolism and oxygen use, and to prevent tissue damage, swelling, or bleeding.

y It is also used to treat patients who have suffered head injuries, brain damage, heartattacks, or other trauma. Techniques for inducing hypothermia include covering a patient

with special cooling blankets or infusing the patient with chilled saline solution.


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Innovations and Technology


y

UCLA considered laparoscopic procedure as a minimally invasive procedure wherein itis applicable not only in treating cancer but also kidney stones, live donor nephrectomy,pelvic organ prolapse, renal cysts, transitional cell carcinoma, uretal stricture, anduretopelvic junction obstruction.

y Use of surgical robots and digital imaging in surgery and medicine. Using a roboticsurgical system, urologists at UCLA are able to perform operations more precisely thanever before.

y New innovations in diagnostic testing. The uropathenogen detection project at UCLAaims to develop and test a rapid new system that would enable point-of-care diagnosisand treatment of urinary tract infections using clinical urine samples.

y New cryosurgical technology for prostate cancer treatment allows the surgeon to

precisely map cancerous cells, freezing and killing the cells that radical prostatectomywould not reach.

y Instead of open radical mastectomy, patients were then advised to undergo laparoscopicprostatectomy-it allows the removal of the prostate through an umbilical incision.

y The newest cryosurgical technique injects the prostate with ultra-thin cryoprobes cooledby argon gas. This allows the surgeon to map the placement of ice balls and controltemperatures throughout the procedure.

Prostate Cancer Treatment

y For some patients, the nerve-sparing radical prostatectomy continues to be the best option. In

the hands of experienced surgeons, this "open" operation is highly effective in removing the

cancer and preserving potency.

y During the open procedure, patients with bulkier tumors and aggressive cancers receivereal-time pathology evaluation by the surgeons who obtain frozen sections whennecessary to better facilitate decisions on preserving the nerves. Medications such as

Viagra are being given to prostate cancer patients both pre- and postoperatively toenhance potency rehabilitation.


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y Temozolomide can add an average of two and a half additional monthsan enormous amount oftime in the world of cancer treatmentfor patients with glioblastoma multiforme.

y Patients taking temozolomide for treatment of anaplastic astrocytoma experienced an average

survival time of nearly 16 months.

y It works by disrupting DNA to prevent cancer cells from multiplying and prolongs survival whencombined with standard radiation. Additionally, it is a more convenient therapy for patients; it is

an oral treatment allowing patients to take their medication in the comfort of their own homesrather than having to receive intravenous treatments at a physician's office or hospital.

y Tositumomab and Iodine-131 tositumomab, patients with a subset of follicular non-Hodgkin'slymphomaCD20 positive follicular non-Hodgkin's lymphomagained a new treatmentoption with an innovative therapeutic twist. The drug is made up of an immune system protein,

called an antibody, attached to radioactive Iodine-131. Combined, they form a "radiolabeled"

monoclonal antibody that is able to bind to a protein found only on the cancer cells, thus targetingthe radioactivity directly to the cancer cell, killing it.

y

Pemetrexed, combined with other treatments, gives patients 40 percent longer survival timecompared with current treatment alone.

y Pemetrexed is a novel antifolate, a class of drugs that targets the folic acid metabolic pathway,which affects availability of certain B complex vitamins. It is indicated for patients with the

advanced form of the disease who have already had chemotherapy.


y Ketoconazole is also used to treat prostate cancer because it suppresses the production

of testosterone, a hormone necessary for prostate cancer cell survival.y 400 mg three times a day for prostate cancer. The drug should be taken with food for better

absorption and to avoid stomach irritation.

y Common side effects of ketoconazole include reduced testosterone production (which may impairsexual function in males).


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Reaction:



Cancer ,any of more than 100 diseases characterized by excessive, uncontrolled growth of

abnormal cells, which invade and destroy other tissues. Cancer develops in almost any organ or

tissue of the body, but certain types of cancer are more life-threatening than others.

Oncologists select from a number of options when treating cancer, depending on the type and

stage of the tumor involved. The major treatments currently available are surgery, radiationtherapy, chemotherapy, hormone therapy, and immunotherapy. Often, targeting cancerous

tumors requires the artful combination of more than one type of cancer therapy.

First article:


Photodynamic therapy is a noninvasive medical procedure suitable for patients who cant

undergo surgery. It works by destroying the blood vessel in tumor and it activates the immune

system to fight further the disease. The only contraindicated for this patient is to avoid exposure

to sunlight to not counteract with the treatment.

Second article:


Angiogenesis inhibitor therapy is not an all out cure for cancer. It is just a modality treatmentused to disrupt blood vessel growth that supple tumors with blood. It can prolong the life of

tumor cell but not killing it.


23/24

Third article:

New Treatment for Liver Cancer: Radioactive Microbeads Use

Bodys Pathways to Destroy Tumor Cells

Just like angiogenesis inhibitor therapy, it is a modality treatment to help other procedures for the

success of tumor elimination and destruction. It involved the insertion of microbeads to the site

of tumor growth for it to shrink the tumor. It is done because some patient cant undergo surgery

if the tumor had a big size and is at risk of metastasizing.

Fourth article:


Though cryosurgery is already used in the field of cancer treatment, its effectiveness when it

comes to brain is just recently clinically tested and proven effective. Freezing of the brain is very

crucial in the part of the treatment. It may give undesired effects after the surgery. Good thing is

that this treatment came with devices that helps the brain throughout the procedure.

Fifth and sixth article:

y Innovations and Technology


y Prostate Cancer Treatment

Both this article had focused on cancers involving the urinary tract and the prostate. If in the past

doctors are the one to handle the procedure, now robots are specifically made to replace them.The surgeons were the only one to operate the robots. It is proven more effective because it

lessen the tremors and hesitancy that the surgeons do made. The next one is the improvement of

diagnostic testing in detecting the early signs of these cancers. Another is instead of a radical

prostatectomy, an option which is laparoscopic prostatectomy is most used now. Less

complication and lesser days in the hospital due to quick healing.


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Seventh article:


This article shows the importance of a treatment to add another month or two in a patients life.

Still if its only months, patient are still lucky to extent their live with the use of innovations

researchers made. Both Tositumomab and Pemetrexed, medications for brain cancer can

extend the patients life for as long as two months to 40% longer for a typical course of survival

for brain cancer patients.

Eighth article:


Such a shocking effect coming from an antifungal medicine. Though not always prescribed, its

effects were just recently known to be an adjunct therapy for prostate cancer. It suppresses the

production of testosterone, which is necessary for prostate specific tumor survival.

cancer treatment edited

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