ScienceDaily (Sep. 16, 2008) — A new study from the National Institutes of Health finds that massage therapy may have immediate benefits on pain and mood among patients with advanced cancer. The study appears in the September 16, 2008 issue of Annals of Internal Medicine.

In a randomized trial of 380 advanced cancer patients at 15 U.S. hospices, improvement in pain and mood immediately following treatment was greater with massage than with simple touch.

“When patients near the end of life, the goals of medical care change from trying to cure disease to making the patient as comfortable as possible,” said Jean S. Kutner, MD, MSPH, Associate Professor of Medicine, Division of General Internal Medicine at the University of Colorado Denver School of Medicine. “This study is important because it shows massage is a safe and effective way to provide immediate relief to patients with advanced cancer.”

Pain and depressed mood are common problems for patients with advanced cancer. While drug therapies can reduce symptoms, they don’t always work and often have troublesome side effects. Researchers think that massage may interrupt the cycle of distress, offering brief physical and psychological benefits. Physically, massage may decrease inflammation and edema, increase blood and lymphatic circulation, and relax muscle spasms. Psychologically, massage may promote relaxation, release endorphins, and create a positive experience that distracts temporarily from pain and depression.

Researchers caution that while massage may offer some immediate relief for patients with advanced cancer, the effects do not last over time, demonstrating the need for more effective strategies to manage pain at the end of life.

Adapted from materials provided by American College of Physicians, via EurekAlert!, a service of AAAS.

Scientists have developed purple tomatoes which they hope may be able to keep cancer at bay.

The fruit are rich in an antioxidant pigment called anthocyanin which is thought to have anti-cancer properties.

A team from the John Innes Centre, Norwich, created the tomatoes by incorporating genes from the snapdragon flower, which is high in anthocyanin.

The study, published in Nature Biotechnology, found mice who ate the tomatoes lived longer.

This offers the potential to promote health through diet by reducing the impact of chronic disease Professor Cathie Martin John Innes Centre

Anthocyanins, found in particularly high levels in berries such as blackberry, cranberry and chokeberry, have been shown to help significantly slow the growth of colon cancer cells.

They are also thought to offer protection against cardiovascular disease and age-related degenerative diseases.

There is also evidence that the pigments have anti-inflammatory properties, help boost eyesight, and may help stave off obesity and diabetes.

The John Innes team is investigating ways to increase the levels of health-promoting compounds in more commonly eaten fruits and vegetables.

Tomatoes already contain high levels of beneficial antioxidant compounds, such as lycopene and flavonoids.

More benefit

Professor Cathie Martin, from the centre, said: “Most people do not eat five portions of fruits and vegetables a day, but they can get more benefit from those they do eat if common fruit and veg can be developed that are higher in bioactive compounds.”

It is too early to say whether anthocyanins obtained through diet could help to reduce the risk of cancer Dr Lara Bennett Cancer Research UK

The John Innes team took two genes from snapdragon that induce the production of anthocyanins in snapdragon flowers, and turned them on in tomato fruit.

Anthocyanins accumulated in tomatoes at higher levels than anything previously achieved in both the peel and flesh of the fruit, giving them an intense purple colour.

Tests on mice bred to be susceptible to cancer showed that animals whose diets were supplemented with the purple tomatoes had a significantly longer lifespan compared to those who received only normal red tomatoes.

Professor Martin said: “This is one of the first examples of metabolic engineering that offers the potential to promote health through diet by reducing the impact of chronic disease.

“And certainly the first example of a GMO [genetically modified organism] with a trait that really offers a potential benefit for all consumers.”

She said the the next step would be test the tomatoes on human volunteers.

Exciting

Dr Lara Bennett, of the charity Cancer Research UK, said: “It is exciting to see new techniques that could potentially make healthy foods even better for us.

“But it is too early to say whether anthocyanins obtained through diet could help to reduce the risk of cancer.

“We do know that eating a healthy, balanced diet that is rich in fibre, fruit and vegetables - and low in red and processed meat - is an important way to reduce your cancer risk.”

Dr Paul Kroon, of the Food Research Institute in Norwich, said the research was an “important study”.

“The technology offers great scope for altering colours of fruits and vegetables, and their content of potentially health-protective compounds.”

However, he said it would be wrong to assume the effects seen in mice would necessarily occur in humans.

Anna Denny, a nutrition scientist for the British Nutrition Foundation, stressed there was no “magic bullet” against diseases such as cancer and heart disease.

“Fruit and veg with higher levels of health-promoting compounds should not been seen as a replacement for eating a healthy balanced diet.”

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7688310.stm

Published: 2008/10/26 15:52:22 GMT

© BBC MMVIII

ScienceDaily (Sep. 10, 2008) — Pain is one of the most common symptoms of cancer patients, yet many of them do not receive adequate therapy for the pain caused by their disease or treatments, according to a study in the September 1 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

For cancer patients, pain can come from the cancer itself, chronic inflammatory changes or infections. Standard cancer treatments, such as surgery, chemotherapy and radiotherapy can also cause pain, but despite its common occurrence, pain is a frequent source of patient anxiety due to improper management.

Researchers at the University of Pennsylvania Department of Radiation Oncology in Philadelphia and the Radiation Oncology Branch of the National Cancer Institute in Bethesda, Md., sought to determine the main reasons that patients fail to receive optimal pain therapy.

Between November 2005 and April 2006, 106 radiation therapy patients responded to an Internet-based questionnaire that evaluated their medication use, pain control and attitudes toward pain medication, including prescription and over-the-counter pain medications. Fifty-eight percent reported pain from their cancer treatment and 46 percent of patients reported pain directly from their cancer, yet 80 percent of those patients said that they did not use medication to manage their pain.

Most patients said the main reason they did not take pain medication was because their healthcare provider did not recommend it. This reason was followed by a fear of addiction or dependence and the inability to pay. Some patients also reported using alternative therapies for pain relief, including physical therapy, massage and acupuncture.

“To eliminate barriers to optimal pain management for cancer patients, healthcare providers should talk with their patients about pain symptoms and pain medications,” Charles Simone, M.D., a resident at the National Cancer Institute Radiation Oncology Branch in Bethesda, Md. and lead author of the study, said. “At our institution we have taken these steps by transitioning to an electronic medical record system that has been designed to require an evaluation and documentation of patient pain levels and pain medication responses by healthcare providers at each patient encounter.”

Adapted from materials provided by American Society for Therapeutic Radiology and Oncology, via EurekAlert!, a service of AAAS.

Cancer pain: Relief is possible

From MayoClinic.com
Special to CNN.com

Not everyone with cancer experiences cancer pain, but one of out three does. If you have advanced cancer — cancer that has spread or recurred — your chance of experiencing cancer pain is even higher.

Cancer pain strikes in many ways. Your pain may be dull, aching or sharp. It could be constant, intermittent, mild, moderate or severe. Timothy Moynihan, M.D., a cancer specialist at Mayo Clinic, Rochester, Minn., offers some insight into cancer pain, reasons why people might not get the pain treatment they need and what they can do about it.

What causes cancer pain?

Cancer pain can result from the cancer itself. Cancer can cause pain by growing into or destroying tissue anywhere near the cancer. Cancer pain can come from the primary cancer itself — where the cancer started — or from other areas in the body where the cancer has spread (metastases). As a tumor grows, it may put pressure on nerves, bones or other organs, causing pain.

Recent research has shown that cancer pain may not just be from the physical effect of the cancer on a region of the body, but also due to chemicals that the cancer may secrete in the region of the tumor. Treatment of the cancer can help the pain in these situations.

Cancer treatments — such as chemotherapy, radiation and surgery — are another potential source of cancer pain. Surgery can be painful, and it may take time to recover. Radiation may leave behind a burning sensation or painful scars. And chemotherapy can cause many potentially painful side effects, including mouth sores, diarrhea and nerve damage.

How do you treat cancer pain?

There are many different ways to treat cancer pain. The ideal way is to remove the source of the pain, for example, through surgery, chemotherapy, radiation or some other form of treatment. If that cannot be done, pain medications can usually control the pain. These medications include:

• Analgesics, such as aspirin or acetaminophen (Tylenol, others)
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others)
• Weak opioid (derived from opium) medications, such as codeine
• Strong opioid medications, such as morphine, oxycodone, hydromorphone, fentanyl or methadone

These drugs can often be taken orally, so they’re easy to use. However, it you’re unable to take medications orally, they may also be taken intravenously, rectally or through the skin using a patch.

In September 2006 the Food and Drug Administration approved a new form of the opioid fentanyl (Fentora) that dissolves in your mouth. This medication may be particularly effective for intermittent pain episodes, which are sometimes called “incident pain.” These fentanyl tablets dissolve rapidly, and the drug is absorbed through the lining of your mouth.

Specialized treatment, such as nerve blocks, also may be applicable. Nerve blocks are a local anesthetic that is injected around or into a nerve, which prevents pain messages traveling along that nerve pathway from reaching the brain. Other therapies, such as acupuncture, acupressure, massage, physical therapy, relaxation, meditation and humor, may help.

In your experience, what are some reasons for not receiving adequate treatment for cancer pain?

Unfortunately cancer pain is often undertreated. There are many factors behind that, some of which include:

• Physician knowledge. One factor has to do with a physician’s knowledge and ability to treat and recognize pain. Some physicians and other health care professionals may not specifically ask about pain, which should be a normal part of every cancer patient’s visit. Cancer patients should be asked if they are having any pain. If they are, the physician should stop there and deal with the issue. Some doctors don’t know enough about proper pain treatment. If this is the case, your doctor might refer you to a pain specialist.
• Patient reluctance. A second factor might be a patient’s own reluctance. Some people might not want to “bother” their doctors with the information, or they may fear that the pain means that their cancer is getting worse. Some are reluctant to report it or report it as thoroughly as they should because they’re worried about what doctors or other people might think of them if they complain. They might feel that because they have cancer, they’re supposed to have pain and be able to deal with it. That simply isn’t true.
• Fear of addiction. Another factor might be a person’s fear of becoming addicted to the pain medications. This is something that we know doesn’t typically happen if you take medications for pain. If you take them when you’re not in pain or to get high, then, yes, you can get addicted. But the risk of addiction for people who take pain medications in an appropriate fashion — for pain — is very low, so this shouldn’t be a concern.
• Fear of side effects. Some people fear the side effects of pain medications. Many are afraid of being sleepy, unable to communicate with family and friends, acting strangely, or being seen as dependent on medications. People are also sometimes afraid that taking morphine may shorten their life. There is no evidence of any of these happening if the medication is dosed appropriately. And although strong pain medications can cause drowsiness when you first take them, that side effect usually goes away with steady dosing.

What side effects can you expect from cancer pain treatment, and what can you do about them?

Each pain treatment may be accompanied by its own unique side effects. For example, radiation treatments may cause redness and a burning sensation of the skin. And, depending on what part of the body the radiation is applied to, the radiation may cause diarrhea, mouth sores or other problems, such as fatigue. Chemotherapy certainly can cause side effects, such as nausea, fatigue, infection and hair loss, but it can be effective in relieving pain if it shrinks the tumor. There are medications to help with nausea. Relaxation techniques also may help.

Pain medications each have their own unique side effects that should be reviewed with your physician before taking them. One of the common side effects of the stronger pain medicines is constipation — common to opioids. It can be treated with appropriate bowel regimens as prescribed by your doctor, such as adding a stool softener and something to stimulate the bowels. Preventing constipation is much easier than treating it, so anyone who takes these strong pain medications should automatically begin a regimen to keep their bowels moving. Some of the other side effects of the strong pain medications include confusion, lethargy and sleepiness. The severity of these effects varies from person to person and commonly occurs with the first several doses. But once a steady amount of the medicine stays in your body, the side effects usually resolve. Hallucinations and behavior changes are uncommon.

The less potent pain medications actually may have more side effects, which also should be discussed with your physician before taking them. For instance, anti-inflammatory drugs might damage your kidneys, cause ulcers or increase your blood pressure. Aspirin can cause gastrointestinal bleeding, and acetaminophen (Tylenol, others) can cause liver damage if you take too much.

When should you discuss cancer pain with your doctor, and what points should you bring up?

Report any bothersome pain to your physician. If there is a minor pain that goes away, don’t worry about it. But if the pain interferes with your life or is persistent, it needs to be reported and should be treated. Although no one can guarantee that all pain can be completely eliminated, most pain can be lessened to the point where you can be comfortable.

It may help to keep track of your pain by noting how strong it is, where it’s located, what makes it worse, what brings it on, what makes it better and anything else that happens when you have the pain. A pain-rating scale from 0 to 10 — with 0 being no pain and 10 being the worst pain you can imagine — may be helpful in reporting pain to your doctor. In addition, pay attention to what happens when you attempt to relieve your pain. If you take medicine, do you feel any ill effects from it? If it’s a massage or something physical that relieves the pain, those therapies are important to report, too. Note whether they cause any ill effects.

What steps can you take to make sure you’re receiving adequate cancer pain treatment?

First, you need to talk to your doctor or health care provider if you’re having pain. Second, you and your doctor should set a goal for pain management and monitor the success of the treatment against that goal. Your doctor should track the pain with a pain scale, assessing how strong it is. The goal should be to keep the pain at a level with which you’re comfortable. If you aren’t achieving that goal, talk to your physician. If you’re not getting the answers you need, request a referral to a facility more skilled in the care of pain, particularly a major cancer center. All major cancer centers have pain management programs. For the most part, the medications and treatment for pain are covered by standard insurance.

The immune system is the system of specialized cells and organs that protect an organism from outside biological influences.

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(Though in a broad sense, almost every organ has a protective function - for example, the tight seal of the skin or the acidic environment of the stomach.) When the immune system is functioning properly, it protects the body against bacteria and viral infections, destroying cancer cells and foreign substances.

If the immune system weakens, its ability to defend the body also weakens, allowing pathogens, including viruses that cause common colds and flu, to grow and flourish in the body.

The immune system also performs surveillance of tumor cells, and immune suppression has been reported to increase the risk of certain types of cancer..

For more information about the topic Immune system, read the full article at Wikipedia.org, or see the following related articles:

Natural killer cell — Natural killer cells (also known as NK cells, K cells, and killer cells) are a type of lymphocyte (a white blood cell) and a component of innate …  > read more

White blood cell — White blood cells (also called leukocytes or immune cells) are cells which form a component of the blood. They help to defend the body against …  > read more

T cell — T cells are a subset of lymphocytes that play a large role in the immune response. The abbreviation “T” stands for thymus, the organ in which their …  > read more

Antiviral drug — Antiviral drugs are a class of medication used specifically for treating viral infections. Like antibiotics, specific antivirals are used for …  > read more

Note: This page refers to an article that is licensed under the GNU Free Documentation License. It uses material from the article Immune system at Wikipedia.org. See the Wikipedia copyright page for more details.

Routine Oral Care

Continuing good dental hygiene during and after cancer treatment can reduce complications such as cavities, mouth sores, and infections. It is important to clean the mouth after eating. The following are guidelines for everyday oral care during chemotherapy and radiation therapy:

Tooth brushing

• Brush teeth and gums with a soft bristle brush 2 to 3 times a day for 2 to 3 minutes.

• Rinse the toothbrush in hot water every 15 to 30 seconds to soften the bristles, if needed.

• If it is necessary to use a foam toothbrush, use it with an antibacterial rinse, when possible.

• Allow the toothbrush to air dry between brushings.

• Choose toothpaste with care:
  • Use a mild-tasting toothpaste; flavoring may irritate the mouth.
  • If toothpaste irritates the mouth, brush with a solution of 1 teaspoon of salt added to 4 cups (1 quart) of water.
  • Use a fluoride toothpaste.

Rinsing

• Rinse the mouth 3 or 4 times while brushing.
• Avoid rinses containing alcohol.
• One of the following rinses made with salt and/or baking soda may be used:
  • 1 teaspoon of salt in 4 cups of water.
  • 1 teaspoon of baking soda in 1 cup (8 ounces) of water.
  • ½ teaspoon salt and 2 tablespoons baking soda in 4 cups of water.
• An antibacterial rinse may be used 2 to 4 times a day for gum disease. Rinse for 1 to 2 minutes.
• If dry mouth occurs, rinsing may not be enough to clean the teeth after a meal. Brushing and flossing may be needed.

Flossing

• Floss gently once a day.

Lip care

• Use lip care products to prevent drying and cracking.

Oral Mucositis

Mucositis is an inflammation of mucous membranes in the mouth.

The terms “oral mucositis” and “stomatitis” are often used in place of each other, but their meanings are different.

• Mucositis is an inflammation of mucous membranes in the mouth. It usually appears as red, burn-like sores or as ulcer -like sores throughout the mouth.

• Stomatitis is an inflammation of tissues in the mouth, such as the gums, tongue, roof and floor of the mouth, and tissues inside the lips and cheeks. It includes infections of mucous membranes.

Mucositis may be caused by either radiation therapy or chemotherapy. In patients receiving chemotherapy, mucositis will heal by itself, usually in 2 to 4 weeks when there is no infection. Mucositis caused by radiation therapy usually lasts 6 to 8 weeks, depending on the duration of treatment.

The following problems may occur:

• Pain.
• Infection.
• Bleeding, in patients receiving chemotherapy. Patients undergoing radiation therapy usually do not have a bleeding risk.
• Inability to breathe and eat normally.

Swishing ice chips in the mouth for 30 minutes may help prevent mucositis from developing in patients who are given fluorouracil. Medication may be given to help prevent mucositis or keep it from lasting as long in patients who undergo high-dose chemotherapy and bone marrow transplant.

Care of mucositis during chemotherapy and radiation therapy focuses on cleaning the mouth and relieving the symptoms.

Treatment of mucositis caused by either radiation therapy or chemotherapy is generally the same. After mucositis has developed, proper treatment depends on its severity and the patient’s white blood cell count. The following are guidelines for treating mucositis during chemotherapy, stem cell transplantation, and radiation therapy:

Cleaning the mouth

• Clean the teeth and mouth every 4 hours and at bedtime, more often if the mucositis becomes worse.

• Use a soft bristle toothbrush.

• Replace the toothbrush often.

• Use water-soluble lubricating jelly to moisturize the mouth.

• Use bland rinses or plain sterile water. Frequent rinsing removes particles and bacteria from the mouth, prevents crusting of sores, and moistens and soothes sore gums and the lining of the mouth. The following rinse may be used to neutralize acid and dissolve thick saliva:
  • ½ teaspoon salt and 2 tablespoons baking soda in 4 cups of water.

• If crusting of sores occurs, the following rinse may be used:
  • Equal parts hydrogen peroxide and water or saltwater (1 teaspoon of salt in 4 cups of water).

This should not be used for more than 2 days because it will keep mucositis from healing.

http://www.cancer.gov