Health Watch - Cancer News
July 07/2012 - Multiple Myeloma (MM) is a highly treatable but rarely curable disease. It is a hematological malignant neoplasm (tumor) of plasma cells that accumulate and proliferate in the bone marrow, leading to painful bone destruction, bone lesions, skeletal related events (SLE), bone marrow failure and renal dysfunction.
I like to refer to it as CRAB -- Calcium elevation, Renal complications, Anemia and Bone disease.
About 25-30% of patients will experience renal impairment during their disease course and 30-40% will have elevated serum creatinine at presentation. Renal insufficiency or failure maybe reversible with high dose glucocorticoids.
The majority of patients with MM will develop bone disease.
The presentation of MM can range from asymptomatic to severely symptomatic with complications requiring emergent treatment. Systemic ailments include bleeding, infection and renal failure, local catastrophes include pathological fractures and spinal cord compression.
Although patients benefit from treatment (that is longer life, less pain) currently no cure exists. Recent advances in therapy have helped to lessen the severity of adverse events. Significant survival gains have been reported because of new drugs such as Bortezomib, Thalidomide, Lenalidomide, Dexamethasone and biphosphonates and opioids like hydrocordone (vicodin) are used to mitigate pain. Newer agents and combination regimens are leading to higher response rates and improve patients outcomes.
Some of these combinations are associated with a higher incidence of certain toxicities such as peripheral neuropathy (nerve damage in fingers and toes) and you will need to talk to your doctor and oncologist to discuss proper treatment strategies.
Hope yuu find this useful. Remember Cancer is nature (genetics), cancer is nuture (environment). Please give a Dominican brother with cancer a helping hand.
Dr J. Celaire, (Hem/Onc)
July 07/2012 - Nearly 90% of patients experience cancer - related pain during or after treatment. Pain can be caused by cancer or its treatment, but it can be relieved with its own array of treatment strategies. Surgery can cause nerve damage or a buildup of scar tissue pressing on the nerve.
A tumor can compress or damage nerves, causing pain that may persist even when the tumor is no longer present. Surgical removal of lymph nodes can lead to lymphedema, a buildup of lymphatic fluid that sometimes puts a painful pressure on nearby nerves.
Radiation sometimes damages axons (long projections from nerve cells) as well as there protective sheath. And chemotherapy can damage the axons,interfering with the transmission of nerve impulses.
Every person undergoing treatment is unique.In addition to the ones explained here, other possible side effects include rash,cognitive dysfunction (also called chemobrain),oral mucositis (mouth sores), insomnia and thrombocytopenia (low platelets), which can result in life - threatening bleeding.
Talk to your doctor about any side effects that you believe are associated with your treatment. Hope you find this useful.
Dr J. Celaire, (Hem/Onc)
June 27/2012 - Nausea and Vomiting in Chemotherapy treatment: Cancer related nausea and vomiting can develop at any time during treatment. The body releases a chemical called serotonin in response to several types of chemotherapy.When serotonin binds to certain receptors in the brain, it can result in nausea.Many anti-nausea drugs (antiemetics) work by blocking and shutting down these serotonin receptors.
Aloxi (palonosetron) prevents short-term as well as prolonged nausea. Other medications that prevent the acute nausea that occurs within the first day after therapy and are somewhat effective with long-term nausea include Anzemet (dolasetron) and Zofran (ondansetron)
Steroids,such as Decadron (dexamethasone) are also used to prevent nausea.Side effects can include jitteriness. Dosages used to prevent nausea typically do not cause the effects of long-term steroids, such as swelling and immune response.
Dr J. Celaire, (Hem/Onc)
June 27/2012- Pain treatments are available to those who experience cancer related pain during and after treatment.
Many cancer centers now have pain specialists and palliative care departments to help with this. With a doctor or pain specialist, patients can develop a personal pain management plan that may include relief strategies for long term (chronic) and short term (acute) pain, as well as the brief, severe flare ups called breakthrough pain.
Patients with chronic pain may need drugs to prevent pain rather than waiting to relieve it ounce it occurs. Although morphine, one of the most commonly prescribed opioids, has side effects that can include drowsiness, itching, urinary retention and nausea, it continues to be the standard for chronic pain relief.
Medications are also available to relieve symptoms caused by opioids. Constipation is a common side effect of opioids;stool softeners and laxatives should be taken regularly and should be started prior to medication.
Pain relief patches, which can be applied to the skin for continuous release of pain meds over several days, may be more convenient than oral medication, especially if a patient have difficulty swallowing.
The fentanyl patch (duragesic), used for chronic pain, delivers opioids continuously thru the skin for up to 72 hrs. Fentanyl is also used for breakthru pain and comes in various formulations: a swab that can be sucked (actiq), an effervescent tablet that is held between the cheek and gum (fentora), and a dissolvable film that is put on the inner cheek (onsolis).
In the past yr, the FDA approved two new fentanyl products: a nasal spray (lazandra) and a tongue spray (subsys)
Hope u find this info useful;please give a helping hand to a Dominican friend who has cancer. Remember, cancer is nature (genetics), cancer is nurture (environment), medicine is an art based on science,When study results are disappointing, healing words can help patients draw strength and nourish hope from both the science and the mystery of healing.
Dr J. Celaire, (Hem/Onc)
June 27/2012 - Neutropenia: Patients may be prone to infection if they develop neutropenia,a shortage of white blood cells (neutrophils). Fast growing neutrophils are quickly killed by chemotherapy drugs and radiation therapy. Fever, fatigue and body aches may be signs of neutropenia, which can be diagnosed by a simple blood test.
The most common treatment to reduce neutropenia and risk infection is Neupogen (filgrastin), a drug that stimulates granulocyte colony-stimulating factors (particles in the body that signal white blood cells to grow). Neulasta (pegfilgrastin) is a newer and longer lasting version of Neupogen. While these drugs can cause bone pain, they can prevent treatment delay or chemotherapy dose reduction.
When patients develop neutropenia, their doctor or nurse may advise them to take special precautions to prevent infection until their white blood cells (WBC) counts improve, such as frequent hand washing, avoiding contact with people who are sick and not eating fruit and vegetables. Fever or signs of infection in patients receiving chemotherapy should be reported to the doctor immediately.
Dr J. Celaire, (Hem/Onc)