What are Colony Stimulating Factors (CSFs)?
White cells, red cells and platelets are produced in the bone marrow in a constant production line, to replace the cells that are old and dying. The life expectancy of each of these cell lines ranges from 10 days to 3 months. The bone marrow is a busy place.
Are tanning beds safe?
The short answer is NO. There are an incredible number of women who want to “look healthy”, and subject their skin to UV radiation in tanning beds.
A study has just been published in the Journal of Clinical Oncology (the journal published by the American Society of Clinical Oncology), which substantiates this position.
It is better to eat a balanced, natural diet, than to take pills, which contain an extract. I always tell my patients that nothing natural comes in a pill, and it is better to incorporate beneficial foods into your diet.
But, if you do take them, it is important to inform your physician about any supplements. You may need to stop them before a surgical procedure, as they may interfere with the normal clotting process, and cause bleeding.
Which foods are good for cancer risk?
Mushrooms, it turns out. A number of them, including shitake and white button mushrooms have been shown to have beneficial effect, when used in addition to conventional chemotherapy.
Turmeric has shown to increase cancer cell death in laboratory experiments, and in animal models. It has shown cancer preventive properties. Unfortunately, as used as a food additive, it has very little gastrointestinal absorption, and very little oral bioavailability. It is likely that the Indian style of cooking with turmeric, tempering it in hot oil extracts the active principles, making the medicinal chemical more available for absorption.
Green tea may decrease progression of pre cancer cells to prostate cancer. It may also have activity against the HPV virus in cervical dysplasia, and may enhance the anticancer activity of some chemotherapy drugs (adriamycin). However, it may activity of other anticancer drug activity in other cancer cell lines (Bortezomib, in multiple myeloma cells).
Omega 3 Fatty acids (found in fish) have laboratory evidence of decreasing cancer cell proliferation, and improving chemotherapy activity. They have been shown to increase drug accumulation in some cancer cells.
Lycopene (found in tomatoes) can delay or prevent progression to prostate cancer. It may eventually be used in preparation for a radical prostatectomy, to shrink prostate tissue.
Vitamin D (with Calcium) supplementation in postmenopausal women has shown decreased cancer risk of any kind. Another study has shown that higher Vitamin D levels have been shown to be associated with decreased cancer risk and cancer mortality. We have to keep in mind that these studies were done in mostly cold weather countries, where sun exposure is limited for half the year, and the body’s Vitamin D production is sub optimal. We don’t know whether there is a universal deficiency in Vitamin D, and whether supplementation is necessary in all populations.
Calcium supplementation (with Vitamin D) helps reduce recurrence of colon polyps, which would eventually turn in colon cancer.
Should I check my PSA?
The purpose of all screening tests is to catch the cancer early, treat it early, and allow you to live longer, as a direct result of the screening. The PSA is a measure of the amount of antigen or protein the prostate cell sheds. It can go up with an inflammation or infection of the prostate gland, or any manipulation, as a digital rectal examination. There is a number beyond, which it is more suspicious of cancer than otherwise, but the borderline elevations are not clearly related to cancer.
What is hospice care?
In every patient with Stage 4 metastatic disease, the risk of treatment needs to be balanced against the potential benefit. Eventually, sooner or later, there is no real benefit to continuing treatment, and we decide to stop it. But the disease doesn’t stop, and we still need to treat the ill effects it causes.
Hospice is a service that helps us take care of end stage symptoms. The goal shifts from treatment to comfort and symptom management
What are advance directives? What is a health care proxy?
In the United States, medical intervention is the norm. It has become an expectation on the part of both the consumer of health care, as well as the medical community. It is never a question that, whatever the cost, every blocked coronary artery needs to be stented, every malfunctioning cardiac valve needs replacement, every cardiac arrest needs resuscitation, every respiratory failure needs intubation, every abnormal shadow on an X-ray needs a CT scan, and every mass needs a biopsy. And so on…
Unlike the commonly used term and badge of honor of “surviving” your cancer, it is dealing with the aftermath of the cure. We have started diagnosing and treating and thankfully curing a lot of cancers in younger and younger patients. What happens in the treatments’ aftermath? The patients are now living a long lifespan, and dealing with long-term side effects of the treatment.
For decades, during the months that they were being treated with chemotherapy, women complained of feeling foggy brained, not being able to process information, or think at their usual levels. Often, this fogginess lasted for a few months, and a recovery process could take up to a year. This was not understood to be a real “brain-related” condition, as most chemotherapy drugs do not cross the blood-brain-barrier. This was often attributed to depression, fatigue, poor nutrition and lack of exercise.
DCIS is the pre-invasive form of Breast Cancer, which has been diagnosed in increasing numbers due to screening mammograms. It is confined to the inside of the ductal lining, and has no access to the lymphatics and blood vessels that drain away from the breast, so it cannot travel outside of the breast. It requires complete removal, and patients are offered radiation therapy after the lumpectomy, and Tamoxifen for 5 years, as a risk reduction strategy. However, absolute numbers of recurrences are small, probably mostly colored by the fact that most DCIS is of low risk. Till now, there was no quantitative way of differentiating risk, and we probably have over-treated most women with DCIS.
What is an Oncotype Dx score?
It is a new way of assessing recurrence risk in Breast Cancer, and selecting patients for whom chemotherapy would be useful to decrease that risk, after curative surgery. Previously, we were recommending postoperative chemotherapy in most sizes of tumors larger than 1 cm, or whose estrogen or progesterone receptors were low, or grade was high. Some fraction of those didn’t really need it. We didn’t have a tool to tease out those who would truly benefit vs. those who would not.
All cells need glucose (a form of sugar) for their metabolism. They get their glucose from circulating glucose, which is maintained in a safe range by the body’s sensors. The sugar you eat pushes up the circulating glucose, which is then brought back to normal by Insulin. No extra sugar reaches the cancer cell.
Starving the body of glucose can hurt other cells. To avoid low blood sugars with the complications that follow, the body breaks down storage form of glucose, e.g. glucagon, to maintain normal circulating levels.
Starving the Cancer Patient of sugar containing foods does them no good, and deprives them of much needed calories. Often they are running a calorie deficit, and cannot afford to go on no sugar diet.
Everything in moderation!
What is Hormonal Therapy?
Some cancer cells are driven by hormone stimulation. The body’s normal hormones interact with receptors on the surface of the cell membrane and send signals to the interior nucleus, telling it to divide and grow. Hormone therapy is actually Anti-Hormone therapy, which decreases that signaling pathway.
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