Monday, July 12, 2010

Preoperative radiotherapy for colorectal cancer radiotherapy

Another cancer radiotherapy is the use of preoperative radiotherapy.

Preoperative radiotherapy has the following advantages: a good blood supply of the target cells, high ammonia level in Asia, on the radiation sensitivity of high clinical outcome. Radiation can shrink tumors, lower lesions of (down-staging), to enhance tumor resection rate, not only undercut rate, rectal success rate has improved markedly. Small intestine were significantly narrowed the scope of exposure, the incidence of radiation damage of small intestine was significantly reduced. Recovery occurred after continuous intestinal radiation proctitis, anastomotic stricture, and intestinal dysfunction, the chances of complications such as greatly reduced. The sacral fascia fibrosis after radiation thickening of the vascular protective effect of strengthening the presacral, presacral vein surgery less chance of injury, especially for locally advanced disease, surgery safety relative to preoperative radiotherapy there are so many advantages, but there is a fatal drawback, may be carried out as part of radiation therapy without radiation therapy, which is treated too far, because of radiation, after all, has some damage to normal cells.

In addition, the current special emphasis on the patient before surgery on the correct assessment of disease through clinical examination, B-cavity, pelvic CT / MRI, a series of simulated intestinal microscopic examination of the diseased patients to make more accurate assessment of the operation provide the basis before radiotherapy, to avoid unnecessary and inappropriate treatment.

From the mid-70s has at least 12 on the resectability of rectal cancer with preoperative radiotherapy randomized study reported, but no application of full dose (≥ 45Gy), the majority of the radiation technique used and not satisfied, from radiation to surgery after not enough time interval of (4 to 6 weeks), resulting in only six reported local recurrence rate was statistically significant.

Sweden, a group of reports (SRCT) 1183 patients were receiving surgery alone or surgery plus short-term preoperative radiotherapy, radiation dose of 25Gy, in 5 days 3 or 4 applied radiation field, radiotherapy after surgery a week showed the local recurrence rate significantly decreased (27% vs1% P <0.001), 5-year survival rate was significantly increased ((48% vs58% P = 0.004). But the second group received AP resection is the same as the ratio of ((59% vs58%), Therefore, the Swedish preoperative radiotherapy 5 days a week program did not agree with the U.S. counterparts, who believe that this program has several shortcomings: ① chemotherapy is not appropriate at the same time; ② not help to improve the success rate of sphincter preserving surgery; ③ increased incidence of postoperative complications. Paty so that the greatest advantage of preoperative radiotherapy is beneficial to improve the success rate of sphincter preserving surgery.

Minsky reported 30 cases of rectal cancer from the anal margin of 1.5-6cm of the original development of AP resection, in the full dose by 5040cGy after preoperative radiotherapy, 83% completed a low anterior resection for colon-anal anastomosis.

Rouanet and other similarly reported low rectal cancer after preoperative radiotherapy can do 78% of rectal surgery. This preoperative radiotherapy, surgery postponed at least 8-10 weeks, increased the risk of tumor spread far, this has recently carried out many scholars combined preoperative chemotherapy in the neoadjuvant treatment, short-term effect is significant again with postoperative chemotherapy, to prevent the spread, the 5-year survival is possible in theory, of course, the final conclusion will wait for the results of long-term follow-up to confirm.

TCM Treatment of Lung Cancer

Chinese medicine for lung cancer, as early as the Song Dynasty some of the treatment side the book contains information on Ben, cough, breathlessness and cough pain, coughing blood, mediastinoscopy stasis, nausea, vomiting phlegm birth, such as lung cancer, thin yellow noodles common prescription card. Jin and Yuan Li Dongyuan pulmonary Ben pill product of interest, the rule permits are similar to the symptoms of lung cancer. Modern physicians practice in a large number of clinical practice and research identified the syndrome is more stable model to modern medical methods of diagnosis, after examination, under the guidance of TCM theory, to distinguish right from wrong actual situation, be cubic removal medicine. According to the combination of local and overall view of the syndrome differentiation with disease differentiation therapy combined with anti-cancer treatment Fuzheng combination of methods, applied to lung cancer treatment, in improving symptoms, modulation of immune function, prolong survival achieved certain aspects efficacy.

1) Spleen dampness type.

Main symptoms: cough, phlegm, A thin white color, Shenpi fatigue, chest tightness, pay less, bloating loose stools, body floating arsenic, looking disappointed white, moving the shortness of breath, fat tongue, the tongue side of teeth marks, pale tongue, thin greasy tongue coating, How How slow or slide.

Governing Law: Spleen Qi, phlegm cancer.

Recipe: Six Gentlemen Decoction ("Woman prescription") addition and subtraction, Astragalus 20g, Radix Codonopsis 30g, Atractylodes 10g, Poria 12g, tangerine peel 10g, law Pinellia 10g, Polyporus 15g, Chinese yam and medicine 20g, Coix Seed 20g, 8 Sapporo month 15g, Houttuynia 30g, iron leaves 30g, diffusa 30g, licorice 5g.

Slightly by the Framework of phlegm hard pumice, Gualou; sweating shortness of breath Jiamai winter, Schisandra, and to increase the amount Codonopsis; pleural effusion Nan Xiao, edema plus Tinglizi, Solanum nigrum, Plantago; heat were added gypsum, Zhimu, buffalo.

Analysis: prescription Codonopsis, Atractylodes, Poria, Polyporus, Yiyiren spleen dampness; peel, Houttuynia phlegm, Sanjie, clearing the lungs; Astragalus, Codonopsis, Atractylodes, Poria fill the gas lung and spleen, spleen Qi Wang is abundant; coupled August Sapporo, Hedyotis diffusa detoxify cancer; iron leaves blood stasis. Combination of various drugs, playing a total of spleen qi, Blood cancer of the function.

2) Heat Yin evidence.

Main symptoms: cough without phlegm, or sputum slightly less difficult, blood stained sputum, or a small amount of hemoptysis, upset, dry mouth, chest pain and shortness of breath, hot flashes, night sweats, urine short red, emaciation, red tongue less-chun, moss, or spend less stripping, pulse breakdown.

Governing Law: Ziyinqingre and lungs fluid, accompanied cancer.

Recipe: Lily Tang ("Medical side Annals") addition and subtraction, lily, raw land, Rehmannia the 10g, Scrophularia 12g, Radix 15g, Chinese angelica 5g, white peony root 10g, Chuanbei 10g, almonds, 10g, 20g of Cortex Mori , Gualou shell 20g, Scutellaria 15g, Scutellaria barbata, Hedyotis diffusa each 30g.

Shortness of breath, fatigue and Astragalus, Codonopsis; chest pain plus peach kernel, safflower, centipede; sputum blood plus Puhuang carbon, multiple intersecting carbon, Agrimony, White RB or Yunnanbaiyao; low heat plus silver Bupleurum, Cortex Lycii, Artemisia .

Analysis: Lung gold is not raw water, water, dry Huo-yen, so the water by two to kidney cooling King and AIDS drugs, Lily and lung nerves, Radix clearing heat and moistening, Scrophulariaceae help two places to raw water, Fritillaria Lung Yu San and Chu Tan, angelica, peony nourishing and to Calming the Liver, lung and Lee declared Campanulaceae refreshment, and licorice to reconcile various drugs, and then with barbata, snake tongue grass together and used anti-cancer drugs can be Yin Ye gradually to full, virtual fire from clear, the condition under control.

3) Qi stagnation type.

Main symptoms: cough, sputum hell, coughing blood, chest tightness, chest pain, such as thorns, the pain has set office, constipation, dark lips, Violet, and even then a wrong skin, skin exposed to superficial vein engorgement, dark tongue, or ecchymosis blood spots, thin yellow tongue coating thin tired or bored, thready pulse astringent or thin string.

Governing law: promoting blood circulation and stopping pains, combined with the anti-cancer.

Recipe: Blood Stasis ("Correction of Medicine"), subtraction, Bupleurum 6g, Chishao 1Zg, Fructus 1Zg, Angelica 15g, habitat 15g, walnuts 9g, SM 20g, Gualou 12g, safflower 3g, Health Astragalus 15g, green tangerine peel the 5g, Campanulaceae 3g, diffusa 30g, thousands of toad skin 12g, stone see through 15g.

Analysis: The block party for qi, blood stasis in the chest and set up, peach kernel, safflower, red peony root, angelica, Salvia blood circulation and blood, Bupleurum, Citrus Green, Citrus aurantium Qi Chest, Eustoma Open lung, with the detoxification of dry toad skin cancer, since colored snake tongue grass, stone see through, all-organic combinations, for qi stagnation of lung cancer patients, quite out of step.

4) Qi and Yin deficiency.

Main symptoms: cough, less sputum, blood stained sputum, or hemoptysis sputum, Shenpi fatigue, shortness of breath, disinclination to talk, move the breathlessness and fear the wind spontaneous sweating, chest tightness, poor appetite, pink or reddish tongue, the tongue body fat edge have scalloped or thin yellow tongue coating thin since, pulse small or thin.

Governing Law: Nourishing Yin detoxify cancer.

Recipe: Shengmaisan ("Book of Master within the trauma theory") co-Bufei soup ("Wing type seal side"), ginseng 9g, Radix 15g, Schisandra 9g, Radix Astragali 30g, Cortex Mori 9g, Rehmannia 15g, Chuan Tony 12g, banzhilian 30g, Houttuynia 15g, Hedyotis diffusa 30g.

Cough, weight increase Coltsfoot Flower, Aster, Peucedanum; sputum Huang clamshell, Xianzhuli, skullcap, Morus alba; fever plus honeysuckle, forsythia, antelope horn; hemoptysis plus Baiji, Agrimony, thistle grass, madder .

Analysis: Shengmaisan from Cough lung deficiency Shangyin of view, taking ginseng Gan Ping lungs and large rely on strength for King and medicine, Radix Gan Han YangYinShengJin as minister, Schisandra acid convergence Tianjin. Astragalus lungs in addition Bufei soup using gas, supplemented by Aster, Morus alba refreshment, Rehmannia kidney. Gift to the snake tongue grass, barbata, Houttuynia detoxify cancer, the number of drug combination, taken Qi, Sheng Jin convergence lung cancer three methods in order to rule the chart, so that both Qi and Yin Fu, Lung Yun Jin-sheng, cancer drug to control.

5) kidney deficiency syndrome.

Main symptoms: cough, shortness of breath, moving the breathlessness, ringing in the ears dizzy, weak waist, side green limbs, chills Shenpi, Hung red tongue, thin white fur, the pulse was fine.

Governing Law: kidney yang, combined with the cancer.

Recipe: Jinkuishenqiwan ("Golden Chamber") addition and subtraction, the system attached to pieces 12g, cinnamon 6g, Rehmannia 12g, Fructus Corni 15g, Chinese yam and medicine 20g, Alisma L2g, Poria 15g, walnut meat, 15g, 15g Cyathula * Cistanche 15g, flea 20g, Hedyotis diffusa 30g.

Hemoptysis more than those who add Agrimony, multiple intersecting carbon, Puhuang carbon; chest pain plus Cyperus rotundus, turmeric; anorexia fatigue were added villosum, fried malt; a malignant pleural effusion were added nigrum, Tinglizi, jujube; Sunburn increases burst collapse are Astragalus, Ginseng, or Panax quinquefolius.

Analysis: The deficiency is the key to lung cancer is virtual, so they chose mainly Jinguishenqi Warming kidney. Prescription dry yellow nourish the kidney yin, dogwood, yam nourishing the liver and spleen, and a small amount of Gui, Fu Zi Wen kidney in Sanyang, is intended to grow slightly less fire to health kidney, prescription paeonol, Alisma, Poria clear diarrhea anger, Wetting of water, and Warming kidney match medicine, intended to fill in a crash, without getting tired, just as King Yue as saying: "Good BHD who will be in the Yang Deficiency, then the yang may help the biochemical yin infinite. "Yang for patients with lung cancer pathogenesis and set up, so this in order to obtain a certain effect.

Radiation side effects and treatment of gastric cancer

Radiotherapy is one of the main method of treatment of gastric cancer, but radiotherapy in killing cancer cells also have some side effects, side effects following radiation therapy to cancer and its treatment methods are described below:

1 Fatigue: During radiotherapy, the human body to self-energy-consuming rehabilitation. Diseases of the stress from daily treatment, and radiation effects on normal cells can lead to fatigue. Most of radiotherapy for liver cancer patients will feel tired after a few weeks, and continuing with the radiation would be more a sense of fatigue.

After radiotherapy, weakness and fatigue will gradually disappears. During radiotherapy, patients with gastric cancer should be less to do something. If you are tired, then the idle would be less activity, more rest. Sleep early at night, may need to rest during the day.

2, Skin: gastric cancer patients after radiotherapy, the skin often becomes dry. Patients with these symptoms should tell the doctor, the doctor will make recommendations to eliminate your discomfort. After a few weeks after radiotherapy, the majority of skin reactions would eliminate. Patients should take their skin care, here are some suggestions:

(1) the use of cold water and mild soap; let the water through the skin of radiotherapy, not friction.

(2) clothes in the treated area should not wear too tight.

(3) Do not rub, scratch sensitive parts of grasping.

(4) Do not put hot or cold things, such as hot towels or ice packs on the skin of radiotherapy, unless a doctor recommends it.

(5) in the treatment you are receiving treatment and the end of weeks, do not rub on the site of radiotherapy powder, skin cream, perfume, deodorant, creams, lotions and household medicines unless a doctor permission. (Many skin products will leave a layer of the skin, this may prevent radiation or rehabilitation).

(6), radiation therapy and radiation therapy after one year, do not let the site of radiotherapy exposure to the sun. If you want to stay a few minutes in the sun, we must wear a protective effect of clothing (such as wide-brimmed hat and long-sleeved shirts) and use sunscreen.

3, blood: the radiation is almost not reduce the number of white blood cell count or platelets. These blood cells help the body fight infection and prevent bleeding. If the patient's blood test showed liver radiotherapy reduced the leukocyte count or platelet count, treatment will be suspended a week in order to increase the patient's blood cells.

4, diet: cancer radiotherapy side effects include diet and digestive problems. In the course of treatment, you may have no appetite. Even if you feel hungry, more protein and calorie intake is also important. Doctors found a very good appetite, patients can better cope with cancer and its side effects.

The following is to help solve the food problem of gastric cancer patients in the guidelines and methodologies.

(1) If you chew and swallow food feel pain, I suggest you eat powdered or liquid food. These foods can be bought in stores, but also a lot of taste. They can be used with other foods.

(2) The following suggestions will help you to raise your appetite appetite and make you eat as much as possible.

1) Eat small meals.

2) do not drink, alcohol will increase the side effects of radiotherapy.

3) may take some spleen appetizer of Chinese medicine.

(3) If you can only eat small quantities of food, you can through the following methods to improve energy intake:

1) The Food and adding butter or margarine.

2) drink milk instead of water.

3) After eating something to drink milk.

4) add some vegetables or cream sauce.

5, emotional: many patients feel depressed, fear, anger, failure, loneliness or helplessness. You may feel tired because radiation to destroy your mood. You can on these issues to the doctor or the local Cancer Society advice, and find people who care about you the opportunity to work together to solve these problems.

Overall, gastric cancer radiotherapy will inevitably damage the body's normal cells, it is recommended in patients with radiotherapy, while taking some anti-tumor effect and the righting of Chinese medicines such as Traditional Chinese Academy of Sciences of the spleen and kidney particles, on the one hand enhance the effect, on the one hand to reduce the side effects of cancer radiation therapy to improve immune function.

"Sixteen-Character Policy" treatment of gastric cancer

Surgical excision:

Treatment of choice for gastric cancer surgery. In addition to gastric cancer, no lymph node metastasis, or less than 2 cm protruding's do reduce the operation, except for gastric cancer with radical surgery should be done, plus lymph node dissection.

Patients should pay attention to the patient's urine output and drainage. Urine can determine how much heart and lung function of patients. Drainage tube is like a sentinel, can detect the wound recovery, open surgery or later, if there is exudate oozing out of anastomotic bleeding or stomach bleeding, the drainage tube can be seen a look.

Chemotherapy supplemented by:

Adjuvant treatment of gastric cancer to chemotherapy, and radiotherapy less use. More than in the postoperative adjuvant chemotherapy in the past, aimed to consolidate the surgery, surgery to kill residual tumor suppression and tumor cells. More recent years, advocates of preoperative chemotherapy, also known as neoadjuvant chemotherapy in gastric cancer is diagnosed, the surgery is not necessarily right away, first give a number of chemotherapeutic agents to control and shrink the tumor before surgery, to improve the success rate of surgery. This is like not playing around the Northeast campaign strategy, first tumor and lymph nodes are controlled, the final in the operation around and annihilate. So after the diagnosis of gastric cancer surgery not fixing authorities merely to go.

Comprehensive treatment:

Cancer treatment and, like most other tumors, therapeutic measures should be integrated, the various methods of each other, coordinate, rationalize the use, in order to achieve the best effect. In addition to surgery, chemotherapy and radiotherapy, there are Chinese medicine, immunotherapy, etc., can choose to use, enhance immunity and quality of life and reduce the recurrence risk transfer.

Attention to rehabilitation:

As the saying goes, "stomach-third rule, seven support", not the surgical treatment of gastric cancer, chemotherapy after the end, there is a long-term recovery, follow-up and rehabilitation process, which is important in patients with long-term survival. Do not over-diet diet, not picky eaters, but do not drink and smoke, eat right medicine can improve the immunity. And then just normal to be treated, regular physical activity, participate in group activities, regular follow-up.

About cancer drugs attack

Attack cancer Background:

● Cetuximab treatment of advanced lung cancer, a study published in 2008 found that the standard chemotherapy and targeted therapies that can make patients with advanced non-small cell lung cancer survival rate greatly increased.

● gemcitabine treatment of pancreatic cancer in 2008, for early pancreatic cancer in a large study found that: After primary tumor resection, chemotherapy with gemcitabine prolong the patient's overall survival.

● endocrine therapy to reduce breast cancer recurrence

Recent study found that breast cancer if detected early, adequate treatment with tamoxifen or the application of aromatase inhibitors, endocrine therapy, can significantly reduce the risk of recurrence.

● long-acting interferon treatment of melanoma

Malignant melanoma patients, application of this new year of interferon therapy can reduce the risk of recurrence of 18%.

● PARP inhibitor treatment for refractory breast cancer a new targeting drug --- PARP inhibitors to treat three types of refractory breast cancer. The drug can increase the sensitivity of tumor cells to treatment, and promote tumor cell death.

● Trastuzumab improved HER-2 (+) advanced gastric cancer survival of HER-2 is involved in the regulation of tumor growth and an important factor. Trastuzumab combined with standard chemotherapy in patients with advanced gastric cancer can be the class of 26% lower risk of death, prolonged survival of 13.8 months.

● With the standard treatment for advanced bile duct cancer British researchers found that, with gemcitabine monotherapy, compared with gemcitabine and cisplatin in patients with advanced bile duct cancer can be prolonged survival of 11.7 months, and reduce the risk of disease progression.

● reduction of prostate cancer after radiation transfer previous studies have shown that patients with early prostate cancer after about 1 / 3 of the transfer can occur. New research shows that postoperative radiotherapy may reduce the risk of distant metastasis 29%, survival up to 14.7 years

Friday, July 9, 2010

Auxiliary: cancer more easily

If we say that surgery, radiotherapy, chemotherapy is the treatment of cancer of the weapon, it is to protect patients adjuvant armor. Shen Lin, Tumor Hospital, Peking University, Professor of Medicine told reporters, treatment increased, supporting the progress of medicine is also very fast.

Antiemetic including the 5 - HT blockers and adjust the body's stress hormones, as well as the patient semi-dormant or dormant sedatives. Many cancer treatment by inhibiting the bone marrow makes white blood cells, platelets and so reduce. Light by stopping can be restored, serious use of granulocyte colony stimulating factor 2-3 days to increase white blood cells.

For thrombocytopenia, may be blood transfusion or use of thrombopoietin. For pain patients, mild to moderate use of non-steroidal painkillers, heavy to use opioid analgesics. Reaction of the other special needs to a variety of symptomatic treatment, such as liver function impairment, you can use the liver cell membrane protective agent; nerve impaired, oral vitamin B; mucosal damage, using acid suppression agent.

Overcome by individual treatment of cancer

"In the 21st century, the clinical oncology should focus on evidence-based medicine, standardized and individualized." Chinese Academy of Engineering, Chinese Academy of Medical Sciences Cancer Hospital Medicine Professor Sun Yan told "Life Times" reporter said.

"Tumor pathogenesis and clinical course of treatment is full of complexity and diversity of the years new technologies, new drugs are emerging, if not a certain treatment guidelines and selection of evidence, doctors in the choice of treatment may face more confusion when . Thus, evidence-based medicine, standard treatment is the basis for cancer therapy. "Sunyuan Shi said.

Of course, just do standard is clearly not enough.

"Today, the hottest topic in cancer treatment is individual therapy, which is Chinese experts should be more areas of concern, there are many things you can do." Sunyuan Shi stressed that, in fact, Chinese traditional medicine has been in the emphasis on "individual treatment "concept, its essence lies in" syndrome differentiation "and" the same disease with different treatment, different diseases, "which offers a lot to learn from cancer treatment.

"It's just, Chinese medicine is to distinguish cold and heat, and cancer treatment to distinguish the disease in the late morning, a gene mutation, receptor and key enzymes."

Get lung cancer, the early, middle and late treatment of patients vary widely. Early stage, surgery is the preferred solution; by advanced, chemotherapy, radiotherapy status will be greatly enhanced. Again, the targeted therapy gefitinib in non-small cell lung cancer is better, but not suitable for all patients, the efficacy of Europeans and Americans and Asians, on the far, with or without EGFR mutations and K-ras mutation is key.

As for breast cancer, in addition to the applicable principles of operation, the estrogen and progesterone receptors is not positive, Her-2 gene over-expression is not the treatment program is also completely different. Appropriate treatment is selected program will directly affect the patient's prognosis.

Sun Yuanshi that surgery, chemotherapy, radiotherapy and other methods used for the integrated treatment of individual patients to provide the maximum possible. "The development of targeted therapy in oncology in the development process more landmark, target detection will be the diagnosis of cancer and to develop individualized treatment programs a must and should be more attention."

Surgery: Late also do

The question of "tumor", the first reaction is that people cut off --- it. Medical development today, the majority of cancer radical surgery is still hope. Director of Thoracic Surgery, Beijing Union Medical College Hospital Dr Guohui Qin told "Life Times" reporter, to lung cancer as an example, patients have undergone radical surgery may have long-term survival.

Previously, only patients with operable early stage, with the development of medicine, surgery patients can be increased. Guohui Qin said that currently applies to three types of lung cancer surgery: best choice in patients with early stage lung cancer surgery, postoperative pathological findings according to additional chemotherapy or immune therapy, to significantly reduce the risk of recurrence. Patients with advanced lung cancer by radiotherapy and chemotherapy can make tumors shrink, and then by radical surgery.

In addition, metastasis can be removed independent primary and metastatic lesions. Even if there is no cure patients with advanced, you can have surgery to alleviate the symptoms. Such as occurs with advanced lung cancer patients with obstructive pneumonia, severe hemoptysis, or pneumothorax, can have surgery to relieve pain and improve quality of life. Previously, large range of tumor surgery, fear not clean cut. With a detailed study, narrowing the scope of tumor surgery.

Maximize tumor removal, while maximizing retention of normal tissues and organs is the principle. Take breast cancer for the past advocated the expansion of radical, but with chemotherapy in a comprehensive way to improve, now narrowed the scope of surgical dissection, as far as possible to retain the breast, so that medical treatment and beauty have both.

Guohui Qin said, lung cancer, radical surgery is generally lobectomy plus lymph node dissection, but for coronary heart disease, poor lung function, or older persons, lobectomy is not necessary for the.

Chemotherapy in elderly lymphoma patients you can do

I am 70 years old. A few months ago, I found that there was a left neck mass. Go to the hospital examination, the doctor confirmed I was suffering from lymphoma, advised me to chemotherapy. I ask, I am very old and suffering from hypertension, do drugs?

Hunan Huang Qi Ming

Huang Qi Ming reader:

Lymphoma is a group originated in the lymph nodes or other lymphoid malignancies, can be divided into Hodgkin's disease and non-Hodgkin lymphoma in two categories. Lymphoma in patients with typical clinical symptoms often appear as painless lymph node enlargement.

In addition, the disease can also occur in patients with liver and spleen enlargement, may occur late in the disease cachexia, fever and anemia and other symptoms. After histological examination, can be found in the lymphocytes and other tumor cell proliferation can occur. Lymphoma treatment methods include chemotherapy, molecular targeted therapy and radiation therapy. Lymphoma is very sensitive to chemotherapy.

Chemotherapy in patients with the disease can be achieved if good results. By standard chemotherapy, more than half of patients with this disease can be cured. However, if treatment is not effective, highly malignant lymphoma patients, the median survival of only a few months.

With age, people suffering from lymphoma will gradually increase the chances, so elderly patients with lymphoma is not uncommon in clinical practice, the incidence rate. Data show that in lymphoma patients, about 50% of people over the age of 65.

The prognosis of elderly lymphoma patients worse than younger patients. This is because the elderly with age, the heart, lung, liver, kidney and digestive function of apparent decline, the tolerance to chemotherapy is also poor. Suffering from heart disease, diabetes and other chronic diseases of the elderly, conducting anti-tumor therapy adverse reactions will be more severe.

Some doctors worry that elderly patients with lymphoma can not afford chemotherapy, on the use of so-called "conservative therapy." In fact, this will delay the timing of treatment in these patients. Some doctors also adopted a "compromise" approach to reduce chemotherapy for elderly patients with lymphoma when the dose of drugs.

That may ease the symptoms of adverse reactions, but also will effect greatly reduced, or even make them lose their chance of cure. Therefore, how the elderly lymphoma patients without affecting the efficacy of chemotherapy in case of reasonable use of drugs, reduce drug side effects, is the key to the success of disease treatment.

You are also suffering from lymphoma, and hypertension, should be used epirubicin, pirarubicin and other less toxic to the heart anthracycline chemotherapy treatment, if you are suffering from B-cell lymphoma, can be added with molecular targeted therapy drugs, both to improve the curative effect, it will not increase the side effects of drugs.

With advances in medical technology, cancer treatment is no longer as before, "overwhelmed with grief." Many new drugs to the mounting effects of chemotherapy, but also make side effects more and more. Clinically, doctors lymphoma patients based on the specific circumstances, to choose the most appropriate treatment for their program, and will support their active symptomatic treatment (such as control of blood pressure, blood glucose monitoring, preventive use of the gastric mucosal protective agent ) to increase the safety and effectiveness of treatment.

The preferred colorectal cancer screening colonoscopy

Universal sigmoidoscopy every year can save thousands of lives. The new results published in the latest issue of "Lancet" magazine, the British Imperial College and other institutions of research by 10 years of research, a total of about 17 million people tracked the health, of which about 4 million accepted sigmoidoscopy.

Sigmoidoscopy can find not only signs of early detection of cancer, and because the inspection can remove polyps, timely removal of precancerous polyps in his, the process itself reduces the incidence of cancer. The results showed that the age between the ages of 55 -66 people, to accept such inspection could decrease the incidence of colorectal cancer 1 / 3.

In colorectal cancer mortality due to accept the check than the rest of the crowd to 43%. Compared with colonoscopy, sigmoidoscopy only 5 minutes, time-consuming short, trauma, without anesthesia.

Thursday, July 8, 2010

Survive for three magic weapons

Magic one's own initiative

Early cancer surgery, eat as much as possible the sooner the better, do not have to rigidly adhere to a standard fasting a week or even longer. Extent, from the physical rehabilitation, early feeding is necessary. Only a comprehensive nutritional intake only help speedy recovery. As early as possible to eat more nutrient input a few eggs.

Magic 2 Integrative Medicine

Currently, no method can cure cancer in late, but early it is curable. Chinese medicine in cancer prevention, to reduce the side effects of chemotherapy, tumor metastasis and recurrence and tumor perioperative period, the physical recovery after radical operation has its unique advantages. For patients with advanced cancer, Chinese medicine treatment can prolong survival and improve quality of life. However, relying solely on Chinese medicine is not scientific.

Magic 3 powerful spiritual force magic

If the psychological pressure, the body will secrete a variety of unhealthy hormones; and mind to relax, have confidence in the disease, the disease has a very important role in recovery. Therefore, in the same living environment, optimistic, cheerful, not too much stress and trauma are less likely to get cancer, even if you have cancer, recovery is also good.

Cancer pain can prolong survival in patients

Patients with cancer pain often leads to reduced quality of life, and advanced cancer pain is immense. Pain in the end is the rule or the dead? Many patients and families prefer to use pethidine, are unwilling to touch opioid drugs, not the use of opioid analgesia will certainly addictive?

Standing Committee of the National Society of Anesthesia, Pain Therapy Committee chairman, Professor Xu Jianguo pointed out that the main drug as a treatment for cancer pain, opioids have a prominent place, but many patients and their relatives on opioids at the mere mention that the use of opioid analgesia in patients will lead to addiction, in fact, this is a huge misunderstanding, as long as the standard drug, drug sources the use of opioid drugs to patients with virtually no addiction, domestic use of opioids for cancer pain has been more than 200,000 cases , there is no reported occurrence of addiction.

Prominent experts in medical oncology, anti-cancer association cancer palliative care and rehabilitation professional committee chairman, said Professor Yu Shiying, cancer pain is the most common symptoms of cancer patients, also affect the quality of life of cancer patients the main reason for cancer pain in China patients, pain in patients with advanced cancer incidence is about 60% to 80%, one third of patients with severe pain, while only 41% of patients have been effectively relieve pain, but only with advanced cancer pain 25% effective mitigation.

Professor Xu Jianguo said that pain is a disease in patients with endocrine causes, psychological and other aspects of the change in pain treatment helps to prolong the survival period.

It is understood, first proposed in 1986, the World Health Organization cancer pain therapy, the principles of the three steps, according to the different levels of pain intensity in the selection of different analgesic drugs, while emphasizing timely delivery, delivery by analgesic ladder, non-invasive drug delivery . Experts believe that as the main treatment for cancer pain drug, opioid especially potent opioid pain medication is the treatment of post-core drugs, not only in severe pain, mainly opioid analgesia, pain can be mild with a small dose of opioid as the primary analgesic. However, a long time, domestic patients and medical workers on the understanding of opioid incomplete, many people mistakenly believe that use of opioid analgesia in patients will lead to addiction, in fact, standardized use of opioids does not lead to widespread social concerned about the side effects of addiction, opioid side effects are also greatly reduce the other.

Xu Jianguo said that love film for cancer patients using the drugs do not require lifelong medication, if the pain stopped, most patients would choose to withdrawal, even though there sometimes physical dependence does not mean that the patient also had psychological dependence.

Classic treatment of esophageal cancer

One is the classic treatment of esophageal cancer surgery, radiotherapy and chemotherapy, which is the classic treatment. Of course there are other adjuvant therapy, such as immunotherapy, and some Chinese medicine, this is only secondary, and we have a consciousness, not simply relying on traditional Chinese medicine can cure esophageal cancer, this concept may be a misunderstanding of.

It is reported: one is the treatment of esophageal classic surgery, radiotherapy and chemotherapy, which is the classic treatment. Of course there are other adjuvant therapy, such as immunotherapy, and some Chinese medicine, this is only secondary, and we have a consciousness, not simply relying on traditional Chinese medicine can cure esophageal cancer, this concept may be a misunderstanding of. Chinese only as an aid in regulating the immune function was good, so now, in China, Chinese traditional medicine, we can use, but the cancer can not rely on Chinese medicine.

From the choice, in the classic three methods of surgical treatment should be preferred, as long as they can be allowed to cut off cancer, and patients can afford this surgery, surgery should be preferred. Of course, such commitment to surgery and to surgery, these two concepts requires doctors have more experience, he was able to determine the depth of tumor invasion, the scope of what I can do surgery. I think this is very important. To patients after surgery, the patient's recovery also provides a very good condition. Overall, the survival rate of surgical treatment should be longer than the other.

Radiotherapy course is a partial cure, radiotherapy normal circumstances is through a direct rays to kill tumor cells, of course this case it also caused some destruction on the good cells. But generally if you do this tumor radiotherapy, radiotherapy only one cycle, for example to a certain dose, and next time will not be able to do, and if do, can be very serious complications, such as the consequences of radiation injury, the problem great.

Currently, through research, development, and chemotherapy drugs have a lot of progress, indeed, improve the efficacy of chemotherapy. However, there is a problem, first, chemotherapy is not 100% effective, because only part of the patient to be effective, this part of the patients is 30% to 40%. The remaining patients were not effective. Second, chemotherapy is a double-edged sword, on the good organization also has anti-role, so, in which case, the body can not withstand is a condition.

Now, some means is available, and how to improve the efficacy of chemotherapy, we can determine, such as chemotherapy drugs on the responsiveness of tumor cells, which is now allowed to do. This after his chemotherapy may be improved. Blindness is less than in the past.

Other therapies

Esophageal cancer has its particularity, such as liver and lungs are not the same. Not the same place because it is a digest of the pipeline, it is necessary to keep it smooth, but also to maintain its integrity. Once it's clear to die, the patient can not eat, if it undermines the integrity, it appears left out, so will bring about infection. Therefore, the overall treatment for the classic or current treatment of these methods. Of course, there are some palliative treatment, such as to solve the smooth Wen Ti, we take due to give him up a support, the stent into them, if possible, coupled with some of the treatment, such treatments may be on the quality of life of patients enhanced, because the patient first of all to eat, and then a good nutritional status, and physical strength, you can also do some further treatment. This is the case.

Of course, now there are some drugs you can try, such as targeted drug, now in the world are tentatively applied, also has some efficacy. Because of this targeted drug is now mainly used for lung cancer, esophageal cancer cases, but which also has a certain effect, which is also a way you can try.

Treatment of oral cancer

Surgery and radiation therapy (radiotherapy) is still the treatment of oral cancer, two of the most effective way, often better than the comprehensive application of the two alone. Chemical treatment (chemotherapy) is still an adjuvant therapy for surgery and radiotherapy before or with the application. Select suppressing radiation surgery, in addition decided to illness, but also depends on the clinical experience of doctors by the government and the hospital conditions and technical equipment. Patient should be an objective estimate of a multidisciplinary consultation methods to determine treatment. Oral cancer treatment to a large extent determined by the success of the 1st treatment is correct.

Surgical treatment can be used with the following conditions: ① no distant metastasis; able to secure borders and cervical resection of primary tumor metastases; ② disease who are poor radiation effects; ③ oral surgery caused little injury, or big but But through reconstruction or prosthesis can be a considerable degree of compensation to and obtain the patient's consent.

Oral cancer is usually very small when the initial visits in patients with distant metastasis. If the suspect had distant metastasis, especially in the primary cancer is small, should first rule out the first two primary cancer. Adenoid cystic carcinoma of the earlier occurrence of distant metastasis, but this cancer was long, the primary tumor can still surgical resection could be considered.

Estimated to be complete resection of primary tumor surgery and neck metastases, it can also cut around a certain amount of normal tissue without endangering the important organizations such as the carotid artery, carotid artery, brain, etc., you can consider surgery. Carcinoma CT may help estimate the scope of violations, but still found in the operation of its invasion of larger than originally estimated. This situation should be fully considered before surgery. Surgical field visible residual cancer even though few, will also significantly reduce surgical treatment failure or treatment. Preoperative estimate to complete resection of the carcinoid tumor but could not secure the border, after preoperative radiotherapy and / or carcinoid tumor after chemotherapy, there may also consider reducing surgery, can also be the first post-operative radiotherapy.

Following radiotherapy for poor results when: ① the source of oral epithelial carcinoma, verrucous squamous cell carcinoma, squamous cell carcinoma of central necrosis with hypoxia were not sensitive to radiotherapy or after radiotherapy, although sensitive, but still have residual cancer. ② violations or close to bone cancer, such as gum cancer, palate or tongue cancer, buccal, floor of mouth, etc. carcinoma invading the upper and lower jaw when. Bone tissue susceptible to radiation damage, barely radical dose radiation therapy often lead to bone each other so bad even further surgery. ③ already clear neck metastasis. Cervical metastasis of oral cancer is difficult to cure with radiation therapy is recommended because the surgery. Even small primary cancer can be radiation control, radiation from start to finish takes about 2 months or so to make neck surgery, this time to the development of cervical metastases may be difficult surgery, or for the primary tumor and cervical metastases the rule of joint operation to root properly. Unless the primary cancer has been late, or could be considered for primary and neck metastases after preoperative radiotherapy surgery.

Second, radiation therapy

Radiation therapy either alone or with surgery integrated application, both in the treatment of oral cancer plays an important role. Early lesions with interstitial implantation with external radiation therapy is surgery the same effect, and can maintain the beauty, the normal chewing, swallowing and voice function, to improve the quality of life in patients. On the middle and late disease, especially lymph node metastasis occurs when the poor radiotherapy alone. The ideal treatment choice is subject to radiologists and surgeons with each other, according to anatomic location, infiltration areas, cervical lymph node metastasis and the patient's general condition and other developing integrated treatment programs.

1, external radiation therapy

Applicable for various reasons can not accept the Integrated interstitial or surgical therapy, and treatment of local recurrence or disease after extensive palliative therapy.

2, preoperative radiotherapy

To control the primary tumor or neck lymph nodes subclinical lesions, surgery to reduce the spread opportunity, while the tumor size decreased, so that the original becomes inoperable tumor lesions can be surgery, thereby increasing the resection rate, a decrease of local recurrence rate.

3, postoperative radiotherapy

For residual cancer after surgery or pathological examination prompted a cutting edge or cutting edge cancer tumor tissue from the edge of less than 0.5cm cases. Wound healing after radiotherapy can be carried out.

4, interstitial radiotherapy

Radium needle interstitial implantation is widely used in clinical treatment in half a century, and the tongue, buccal cancer, mouth cancer and other end of the treatment of local control with satisfactory results. With the artificial radioactive isotope 192Ir, 125I, 198Au, and after the emergence of other equipment technology, laser acupuncture has been the treatment of interstitial 192Ir afterloading replaced.

5, oral tube light

Applied to lesions shallow, easy-to-exposure, and to maintain exposure to the location of small lesions, and carcinoma invasion is less than 0.5cm. As external irradiation before or after a dose of radiation technology, using kV X ray or electron beam irradiation to be reduced jaw tumor area increased dose, to reduce late complications.

Third, chemical treatment

Most of head and neck squamous cell carcinoma, is less sensitive to chemotherapy. In the treatment of rare head and neck cancer chemotherapy alone, often with the comprehensive application of radiation or surgical treatment to kill the sub-clinical cancer; or combined with radiotherapy to increase the radiation sensitivity; also used for advanced or recurrent head and neck cancer of palliative care. Clinical data reported for head and neck cancer chemotherapy drugs are mainly methotrexate (MTX), bleomycin (BLM), cisplatin (DDP) and 5 - fluorouracil (5-FU). Poor efficacy of a single drug, multiple drugs combined with radiation or surgical treatment with good effect. And taking it in rather hydroxyl results would be better.

Imaging diagnosis of nasopharyngeal carcinoma compared

Nasopharyngeal carcinoma is the most common head and neck cancer, its diagnosis depends mainly on endoscopic and histological examination, although the CT and MRI evaluation of lesions consistent with the clinical examination, but the spread of nasopharyngeal carcinoma and the surrounding area structure violations, CT and MRI in the clinical examination is different. Now in June 2006 to 2008, 12 pathologically diagnosed as nasopharyngeal carcinoma tissue of 80 untreated patients with CT, MRI examination results are as follows:

1 Materials and Methods

1.1 General Information

June 2006 ~ December 2008 after 80 cases with histopathological diagnosis of nasopharyngeal carcinoma patients with untreated CT, MRI examination intervals of not more than 15 d, of which 42 males and 38 females; age ranged from 16 75 years, mean 60 years; Initial treatment of 30 cases, 50 cases of re-treatment; well-differentiated squamous cell carcinoma in 1 case, 69 cases of poorly differentiated squamous cell carcinoma, vesicular nucleus cell carcinoma in 10 cases; in which the pathological diagnosis was undifferentiated non-angle resistance of cancer 78 cases, differentiated non-keratinizing carcinoma in 2 cases.

Method 1.2

For CT and MRI, which include enhanced diagnostic CT scan, MRI examination included T1, T2 weighted images and enhanced T1-weighted image.

1.2.1 CT diagnosis of nasopharyngeal CT should have the transverse and coronal images. Thickness of 5 ~ 6 mm. Transverse sweep up from the level of soft palate to the level of intracranial suprasellar cistern, coronal to the sella from the nose after the level of the posterior clinoid. CT scan with GE16 spiral CT scanners, to OM line as baseline, scan range from the level of sternoclavicular joint to the saddle on the pool, with the enhanced scan. Scanning parameters for the 140 kV, 320 mA, are used axial scanning, plain and enhanced scans, in addition to soft tissue out of the window to provide the necessary level of bone window. CT scanning level no more than 3 mm. If suspected skull base should be 1 ~ 2 mm of continuous levels of scanning.

1.2.2 MRI diagnosis of MRI scans using 3.0T magnetic resonance imaging, joint head and neck coil. Are as fast spin echo, SE sequence, the scanning direction for the cross-section, sagittal and coronal plane scanning range from the saddle area to the lower edge of 2 cervical vertebrae. Thickness: axial 5 mm, spacing 1.0 mm; coronal, sagittal 4 mm, spacing 0.5 mm. Scan in all cases after the intravenous injection of gadolinium - 2 pentamine acid 0.1 mmol / kg body weight, in accordance with the plain levels T1WI axial, sagittal and coronal enhanced CT scans.

1.3 Statistical analysis

Using SPSS 11.0 software for statistical analysis, with a ratio using χ2 test, P <0.05 for the difference was statistically significant.

2 Results

Nasopharyngeal cavity in the ultra-infringement retropharyngeal lymph node metastasis, skull base and intracranial cavernous sinus area violations, MRI detection rate higher than the CT has obvious advantages, in comparison, the difference was significance (P <0.05).

CT group and the MRI group compared retropharyngeal lymph node metastasis, metastasis detected only between the left common carotid were 20 cases (30.8%) and 24 cases (32.9%), only the transfer of the right neck were 17 cases (26.2%) and 18 cases (24.7%), bilateral neck metastasis were 28 cases (43.1%) and 31 cases (42.5%). Violations of the skull base bone, the detection of the two flange were 6 cases (14.3%) and 9 (13.6%), the slopes were 14 cases (33.3%) and 18 cases (27.3%), petrous apex were 10 cases (23.8%) and 24 cases (36.4%), sphenoid body or sphenoid sinus were 8 cases (19.0%) and 11 cases (16.7%), sphenoid wing were 4 cases (9.5%) and 4 cases (6.1%). Intracranial cavernous sinus, the detection of two groups of unilateral invasion were 60 cases (89.6%) and 67 cases (91.8%), bilateral involvement from the two groups were 7 cases (10.4%) and 6 (8.2 %).

3 Discussion

World Health Organization material showed 80% of the world occurred in China, nasopharyngeal carcinoma, nasopharyngeal carcinoma was highly malignant and often early in the disease, there is infiltration of adjacent structures, its mortality rate Cancer mortality rate ranks first in China 8. With the development of modern medical science, medical imaging in the diagnosis of nasopharyngeal carcinoma has played a very important role. MRI because of its excellent soft tissue contrast and multi-parameter imaging, clearly the change from the morphology and function of tumor location, nature provides a wealth of diagnostic information, and its ultra-nasopharyngeal cavity violation retropharyngeal lymph node metastasis, cranial end abuse and intracranial cavernous sinus bone and other aspects of high sensitivity with a detection rate higher than the CT has obvious advantages.

Application of contrast-enhanced scan and pressure grease is the assessment of nasopharyngeal carcinoma sequence of lesions, grading and staging the best imaging method. The results suggest, CT group and the MRI group in the ultra-cavity violations, retropharyngeal lymph node metastasis, skull base invasion and intracranial cavernous sinus, the number of detected cases and the detection rate was 57 cases (71.3%) and 71 cases (88.8%), 65 cases (81.3%) and 73 cases (91.3%), 42 patients (52.5%) and 66 cases (82.5%), 67 patients (83.8%) and 73 cases (91.3%), MRI than CT showed obvious superiority.

MRI is the use of nuclei generated in the magnetic field resonance signal, the reconstructed image of a technology. Because the magnetic field, the different organizations produce different signals, so the high resolution MRI of the organization, can clearly show the normal structure of the nasopharynx and tumor areas showing the nasopharyngeal mucosa and the palate infiltration Fan levator, tensor fascia violations of the skull base and pharynx level, particularly for soft tissue such as bone marrow signal changes are particularly sensitive, can not display partial destruction of trabecular bone on bone marrow cavity of tumor infiltration. Because CT and MRI diagnosis of skull base mechanism on different skull base early, CT performance may be normal, but MRI showed tumor replaced by yellow marrow signal change, able to distinguish the lesions of fibrosis after radiotherapy, and tumor recurrence.

Functional MRI of the number of sequences, such as the slope dynamics can be used to identify tumor infiltration or radiation therapy after bone damage caused by bone necrosis. When the NPC through the oval foramen into the intracranial and other natural channel when, CT can show the increase of channels and violations of the edge, MRI showed soft tissue signal is on the soft tissue and high resolution imaging by multi-directional, more accurate than the CT picture of the extent of tumor invasion, cavernous sinus lesions found in advance on the diagnosis. Rich base of the skull bone marrow, is the birthplace of distant metastasis, local recurrence after radiotherapy is a major factor, the rate was 14.5% ~ 57.7%, or even as high as 76.9%.

Many patients because of inadequate treatment, not in time they pass leading to local recurrence and distant metastasis. Therefore, accurate to judge whether the violation of nasopharyngeal carcinoma skull base, help determine the correct treatment and prognosis of clinical significance. As the high-resolution MRI of soft tissue, can show the scope of nasopharyngeal carcinoma, avoiding the complexity of skull base anatomy, location, and other deeper problems, the detection rate of the skull base is superior to CT. Skull base combination of clinical and imaging features, diagnosis and design of radiation can target, according to avoid leakage and reduce the recurrence rate of nasopharyngeal cancer, improve survival, the clinical determination of patients with newly diagnosed nasopharyngeal carcinoma more valuable, particularly is a violation of the NPC patients with skull base is particularly important.