Hawaii Personal Injury Blog - treatment

GIFT15 - Is A Cure For Multiple Sclerosis On The Horizon?

Wayne Parsons — Thu, 13 Aug 2009 21:49:11 GMT

McGill University researchers in Canada have announced that _ in mice _ they may have found a way to treat and cure multiple sclerosis (MS). In animals they can reverse the devastating disease with a new treatment that suppresses the immune system and forces MS into remission.

Will the treatment work equality well in humans? Let's hope so! Our wishes for success go out to researchers at the Jewish General Hospital Lady Davis Institute for Medical Research and McGill University in Montreal.

MS is an autoimmune disease in which the immune system attacks the central nervous system. This attack causes physical and cognitive disability that progresses over time. According to the news out of McGill new combination of two proteins stops this process:

The new treatment, appropriately named GIFT15, puts MS into remission by suppressing the immune response. This means it might also be effective against other autoimmune disorders like Crohn's disease, lupus and arthritis, the researchers said, and could theoretically also control immune responses in organ transplant patients. Moreover, unlike earlier immune-suppressing therapies which rely on chemical pharmaceuticals, this approach is a personalized form of cellular therapy which utilizes the body's own cells to suppress immunity in a much more targeted way.

Dr. Jacques Galipeau of the JGH Lady Davis Institute and McGill's Faculty of Medicine discovered GIFT15. The news shook the world of science and raised the hopes of the patients who suffer from MS when it was published on August 9, 2009 in the journal Nature Medicine.

GIFT15 is 2 proteins, GSM-CSF and interleukin-15, combined in the laboratory. Individually each protein normally stimulates the immune system. Together however they suppress the immune system.

"You know those mythical animals that have the head of an eagle and the body of a lion? They're called chimeras. In a lyrical sense, that's what we've created," said Galipeau, a world-renowned expert in cell regeneration affiliated with the Segal Cancer Centre at the Jewish General and McGill's Centre for Translational Research. "GIFT15 is a new protein hormone composed of two distinct proteins, and when they're stuck together they lead to a completely unexpected biological effect."

Together as GIFT15 they change B-cells -- a common form of white blood cell normally involved in immune response -- into powerful immune-suppressive cells. Unlike their better-known cousins, T-cells, naturally-occurring immune-suppressing B-cells are almost unknown in nature and the notion of using them to control immunity is very new.

"GIFT15 can take your normal, run-of-the-mill B-cells and convert them -- in a Superman or Jekyll -Hyde sort of way -- into these super-powerful B-regulatory cells," Galipeau explained. "We can do that in a petri dish. We took normal B-cells from mice, and sprinkled GIFT15 on them, which led to this Jekyll and Hyde effect.

"And when we gave them back intravenously to mice ill with multiple sclerosis, the disease went away."

To effectively treat multiple sclerosis it must be attacked as early as possible. Of course human trials to study safety and efficacy are needed now. In the current animal studies side effects were non-existent.

Impressively the treatment was fully effective in a single dose of GIFT15.

"It's easy to collect B-cells from a patient," he added. "It's just like donating blood. We purify them in the lab, treat them with GIFT15 in a petri dish, and give them back to the patient. That's what we did in mice, and that's what we believe we could do in people. It would be very easy to take the next step, it's just a question of finding the financial resources and partnerships to make this a reality."

PLEASE NOTE: DR. GALIPEAU IS AVAILABLE FOR MEDIA INTERVIEWS ONLY AS OF WED., AUGUST 12.

Contact: Mark Shainblum
mark.shainblum@mcgill.ca
514-398-2189

Originally posted at InjuryBoard by Wayne Parsons

Natural Product From The Hydrangea Plant Offers Hope to People With Cancer, Multiple Sclerosis,and Other Autoimmune Diseases

Wayne Parsons — Thu, 11 Jun 2009 04:23:55 GMT

New Lead for Autoimmune Disease Posted by SR in News, tags: auto-immune, lead identification, natural product

Do you like Hydrangeas?

They are beautiful flowering plants and now medical research has discovered a natural product in the Hydrangea, halofuginone, that may help patients with autoimmune diseases like multiple sclerosis, diabetes and many cancers.

To treat autoimmune diseases like MS you must stop tissue damage without what is known as general immunosuppression. US researchers think that an effective way to accomplish those competing goals is to selectively reduce what is called the T_H17 response using halofuginone from the Hydrangea.

The June 5^th edition of the journal Science reports that halofuginone specifically inhibits the development of T_H17 cells which are believed to play a key role in tissue injury in autoimmune diseases such as inflammatory bowel disease, multiple sclerosis, type 1 diabetes, eczema and psoriasis. As reported in Drug Discovery this natural prod

When halofuginone was added to cultures of naïve mouse CD4⁺ T-cells containing cytokines that would normally induce differentiation into T_H17 cells, the number of T_H17 cells – but not T_H1, T_H2 or T regulatory cells – was substantially reduced. In cultured human CD4⁺ T-cells, halofuginone also selectively suppressed levels of IL-17, the main cytokine produced by T_H17 cells. In mice with experimental autoimmune encephalitis (EAE), an artificially-induced immune disease resembling multiple sclerosis and marked by infiltration of T_H17 cells into the central nervous system, treatment with low doses of halofuginone significantly reduced both the development of EAE and its severity.

To understand how halofuginone works, the researchers looked at alterations in gene expression in response to drug treatment and found that a cytoprotective signalling pathway, the amino acid starvation response (AAR), was activated. Inhibition of T_H17 differentiation by halofuginone could be overcome by the addition of excess amino acids and was mimicked by AAR activation in response to selective amino acid depletion.

As reported in Forbes, Herb May Offer Hope for Autoimmune Diseases

"This is really the first description of a small molecule that interferes with autoimmune pathology but is not a general immune suppressant," said the study's lead study author, Mark Sundrud, from the cellular and molecular medicine program and the Immune Disease Institute at Children's Hospital Boston.

Autoimmune diseases occur when the immune system mistakenly attacks and destroys healthy tissues and organs.

The disorders, which include multiple sclerosis, lupus and rheumatoid arthritis, are difficult to treat because drugs that can suppress inflammatory attacks by the immune system on body tissues often have the side effect of suppressing the functioning of the immune as well.

Halofuginone is a synthetic analogue of febrifugine, the active principal of the Chinese herb, chang shan (Dichroa febrifuga), which has been used to treat fever and malaria for more than 2000 years. Febrifugine itself causes severe emesis and gastrointestinal irritation and, in the 1960s, a number of analogues – including halofuginone – were synthesized by U.S. Army scientists looking for novel antimalarials. Halofuginone also inhibits synthesis of collagenase and collagen type 1 and underwent clinical trials for the treatment of scleroderma, a chronic, autoimmune condition of the connective tissue. In animal husbandry, halofuginone (as Stenerol®) is used prophylactically to control coccidial infection in poultry flocks.

Originally posted at InjuryBoard by Wayne Parsons

Mayor Hannemann Puts People and Health First With Plans For Sewage System

Wayne Parsons — Tue, 27 Jan 2009 14:02:00 GMT

Laurie Au of the Honolulu Star Bulletin reported on January 19, 2009 that Mayor Mufi Hannemann has responded to a recent federal ruling forcing the city to upgrade two major waste-water treatment plants by asking the state Department of Health to update its water quality standards.

Hannemann criticized the Department of Health for its delay in updating its water quality laws in light of a recent final decision by the U.S. Environmental Protection Agency, at an informational briefing of the state House and Senate committees.

Hannemann asked the state to correct the standards for almost a year and as a result of the delay, he says, the city may have to raise sewer fees to pay for upgrades to the Honouliuli and Sand Island waste-water treatment plants.

"Here we are, one year later, faced with the potentially tremendous financial impact of a mandate to upgrade our two largest treatment plants to secondary, when all of this might have been averted had the DOH fulfilled its legal obligation to timely review their water quality standards and correct what they have acknowledged is a typographical error," Hannemann said.

The city will appeal a decision by the EPA that ruled discharge into the ocean exceeded bacteria and toxic levels set by the state and could harm the public. It would be refreshing if government would respond before being caught polluting the Hawaii ecosystem rather than only take action to protect the public after being caught. Think about who in those government offices failed to take action on this health issue long ago. Changes must be made in these agencies to protect the public. Mayor Hannemann did his part and the delays are inexcusable.

According to federal law, states are encouraged to review their water quality standards every three years and change them if necessary. The last time Hawaii changed some of its standards was in 2004, according to Lawrence Lau, state deputy director for environmental health.

But it is unclear and unlikely whether the changes in the state standards would have ultimately affected the EPA's decision, said EPA spokesman Dean Higuchi.

"We evaluated it both ways," Higuchi said. "It still didn't really alter our final decision. It's really the city's choice to use what they want for their appeal."

Lau acknowledged that there was at least one typographical error in the state's water quality standard: a misplaced decimal point in a figure denoting safe levels of pesticide in fish. Now isn't that great! They move a decimal point and hide the health risk. I smell a rat ...... or maybe a rotten fish. What do you think? Aren't you tired of these stories? If it is the politicians fault then vote them out of office. And if the agency employees are engaged in a cover up I hope we have some who are courageous enough to become whistle blowers!

However, in the EPA's report for Honouliuli, it found that the pesticide levels exceeded the state's standard even with the intended amount.

"Even with the typographical corrections, even with the updated standards, there would still be some exceedances, maybe not as many as before," Lau said. "I do agree we should update the standards, and we're working on that."

I am not sure if "exceedances is a word but you get the idea. Lau said the department had some personnel changes in 2005 that impeded its ability to update the water standards. Is that weak or what? This is about public health, cancer, disease!

The EPA ruled that the city needs to upgrade these treatment plants to include an additional level of filtering, called "secondary treatment." The city estimates construction for the upgrades costs about $1.2 billion.

Originally posted at InjuryBoard by Wayne Parsons

Improve Injury and Illness Recovery Time And Treatment by Keeping A Symptom Diary.

Wayne Parsons — Wed, 07 Jan 2009 11:54:02 GMT

Have you ever looked at articles produced by About.com? Try it someday. Today I am posting an article that is particularly relevant to my clients: "How to Keep a Symptom Diary How a Written Record Can Maximize Recovery". Our memories are only so good and to optimize medical care the day to day events that an injured or ill person experiences are crucial for the doctors and therapist. I suggest that every patient in treatment keep a Symptom Diary. As an attorney in Honolulu helping injured and ill patients this article is one that I will give to each person that I represent. The article below pertains to a cancer patient receiving chemotherapy but applies to other illnesses and injuries, too. The American Cancer Society has a downloadable form. They suggest tracking symptoms as well as side effects. If you or a loved one are being treated for an injury or illness I strongly suggest that you follow this program. Here is the article.

From Betsy Lee-Frye, for About.com

Updated October 27, 2008

About.com Health's Disease and Condition content is reviewed by our Medical Review Board

(LifeWire) - Chemotherapy and radiation, which are meant to obliterate cancer, can take a heavy toll on the rest of your body. By keeping a symptom diary during your diagnosis and treatment, you can help your doctor be aware of the side effects that are bothering you, such as nausea, or pain and fever, which could signal an infection.

What Is a Symptom Diary?

Your symptom diary should be a record of how you feel each day, even when you are symptom-free. According to the American Cancer Society, patients should record everything from fatigue to skin irritation to fevers and chills.

Make sure you talk to your oncologist about your side effects and symptoms that warrant a phone call to the doctor's office and a trip to the emergency room. Record these in a place that's easy to find. Don't be afraid to call or go in if you experience any of the symptoms your doctor mentions.

Your journal is also a place to jot down any questions and concerns you have along the way. It can be difficult to remember these concerns if you don't jot them down, and your diary is a perfect place to record them. Make a note and bring the journal in for your regular appointments. Communication is important to a healthy doctor-patient relationship, so don't be afraid to pose your questions.

Why Keep a Symptom Diary?

The most important reason to keep a symptom diary is your health and well-being. These notes can help your doctor be aware of and treat your side effects and symptoms. For example, after reading your journal, your doctor might prescribe anti-nausea medication. Or if you are experiencing fatigue, he may also order blood tests to rule out other conditions, like anemia. The diary may also help your physician catch an infection, which can be serious for cancer patients.

You might also use your journal as a way to share information and learn from others with cancer. If you learn you are having a problem with fatigue at specific times, you may want to talk to people in a cancer support group or through an online forum about ways to deal with it. Then you can also share these tips and the advice you learn with others.

How Do I Get Started?

There are a variety of ways to start a symptom journal. You could simply pick up a blank notebook or you can download a sample diary from the American Cancer Society, which offers diaries specific to those patients who are undergoing chemotherapy, radiation and interferon, or interleukin treatments. The society also offers a downloadable pain diary.

Your diary should include symptoms resulting from your treatment, including fatigue, pain, fever, chills, mouth sores, nausea, vomiting, constipation, difficulty swallowing and skin irritations. If you'd rather start your own diary, take a look at the American Cancer Society forms for ideas.

There is no need to write in your diary every hour. Just keep your journal at your bedside and make some notes before you turn out the light. Regardless of how you choose to create your diary, leave space for any questions or concerns.

Sources:

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Betsy Lee-Frye is an independent journalist living in Kansas City, Mo. Her work has appeared in The Dallas Morning News, Kansas City Magazine and Better Homes and Gardens Special Interest Publications.

"Chemotherapy and Your Emotions." cancer.org. 2008. American Cancer Society. 1 Oct. 2008

"Side Effects and Ways To Manage Them." cancer.gov. 29 Jun. 2007. National Cancer Institute. 1 Oct. 2008 .

"Social Life and Activities during Chemotherapy." cancerhelp.org. 8 Jun. 2007. Cancer Research UK. 1 Oct. 2008 .

"Track Side Effects." cancer.org. 2008. American Cancer Society. 1 Oct. 2008 .

Originally posted at InjuryBoard by Wayne Parsons

Phosphorus-lowering Drugs Linked To Lower Mortality In Dialysis Patients

Wayne Parsons — Sat, 03 Jan 2009 15:04:48 GMT

I am posting here an excellent article from Science Daily. I find Science Daily to be the best source of health and science news of all types and highly recommend it to everyone as a source of information. Here is the story. Related information can be found on the Science Daily site.

ScienceDaily (Dec. 27, 2008) — For patients on dialysis, taking medications to reduce levels of the mineral phosphorus in the blood may reduce the risk of death by 25 to 30 percent, reports a study in the Journal of the American Society of Nephrology (JASN): Isakova et al. Phosphorus Binders and Survival on Hemodialysis. Journal of the American Society of Nephrology, 2008; DOI: 10.1681/ASN.2008060609

The drugs, called phosphorus binders, were associated with improved survival in new dialysis patients, including those patients with only modest or even no increase in their blood phosphorus levels. "This important finding suggests that perhaps treatment with phosphorus binders should be extended back to patients with less-severe chronic kidney disease (CKD)," comments Myles Wolf, MD, MMSc, of the University of Miami in Miami, Florida, one of the study authors. "This is a much larger population of patients, virtually all of whom have near-normal blood levels of phosphorus but a markedly increased risk of premature death."

The researchers compared mortality rates in two groups of dialysis patients: 3,555 patients who started treatment with phosphorus binders during the first 90 days after starting dialysis and 5,055 who did not receive phosphorus-lowering treatment during the same period. During the first year on dialysis, patients treated with phosphorus binders had a significantly lower risk of death—30 percent lower, after adjustment for other risk factors.

A further analysis compared mortality rates in a large subgroup of treated and untreated patients, who were closely matched in terms of their initial blood phosphorus levels and their likelihood of receiving phosphorus-lowering treatment. In this "propensity score-matched" analysis, risk of death was 25 percent lower in patients treated with phosphorus binders. The protective effect of phosphorus binders was smaller, but still significant, in an analysis that excluded patients who died in the first 90 days on dialysis.

High phosphorus levels(hyperphosphatemia) are common in patients with kidney disease. "Because hyperphosphatemia is a risk factor for death, phosphorus binders are widely prescribed to dialysis patients," Dr. Wolf explains. "Nephrologists have assumed that this treatment strategy will improve the clinical outcomes of our patients, such that the target range for serum phosphate levels in dialysis patients has been lowered in recent years."

However, these recommendations are based largely on opinion. "Whether treatment with any dietary phosphorus binders versus no treatment would improve survival had never been studied until now," says Dr. Wolf. The new results provide an important missing piece of information by showing a lower risk of death in dialysis patients receiving phosphorus binders.

If phosphorus binders improve survival even in new dialysis patients with relatively normal phosphorus levels, then it is possible that they might also be beneficial for the much larger group of patients with less-advanced kidney disease. "Whereas there are roughly 400,000 dialysis patients in the US, there are estimated to be more than 15 million patients with less severe CKD," adds Dr. Wolf. "These patients are typically not considered for treatment with phosphorus binders, which are approved by the FDA only for use on dialysis. If further studies could demonstrate a similar survival benefit of binders in patients with pre-dialysis CKD, the results could have a significant impact on the public health."

The study has some important limitations. Since it was not a randomized trial, it is prone to certain forms of bias and confounding. Other limitations include the limited (one year) follow-up and the lack of data on patients' dietary phosphorus intake and whether they actually took their prescribed phosphorus binders.

Dr. Wolf has received research support from Shire and honoraria from Genzyme, Abbott and Ineos.

Originally posted at InjuryBoard by Wayne Parsons

Researcher Shows How Cancer Evades The Immune System

Wayne Parsons — Tue, 30 Dec 2008 12:34:36 GMT

Fundamental to cancer is its ability to avoid the immune system. Now according to researchers from the University of Southern California that trait may become cancer's greatest vulnerability. In human breast and colorectal cancers a technique for determining a tumor’s “immune signature,” could be useful for diagnosing and treating specific cancers.

The immune system can kill cancer cells and does so regularly. What allows cancer to propagate is the ability of genetic changes in the cancer cells to evade the immune system. The immune system is confused about whether a cancer cell is a foreign invader or just another one of your cells.

In an article published in Clinical Cancer Research, a publication of the American Association for Cancer Research, the researchers show how to determine which genes have been altered in a tumor to allow it to evade the body’s natural defenses. This could become a standard practice in cancer diagnosis and treatment.

“The implication is that once you know the mechanism by which tumors evade the immune system, you can match that tumor to available therapies,” said senior author Alan L.Epstein, M.D., Ph.D., professor of Pathology at USC’s Keck School of Medicine. “First, we find the genetic changes that allow a tumor to defeat the immune system, then we can apply therapies that compensate for these genetic alterations.”

Cancer cells exhibit a broad array of genetic and biological variations. The differences vary widely between cancer types, even between subcategories within a particular type of cancer. However, while the genetic variations that comprise an immune signature are complex, the researchers discovered that a small subset of genes is integral in explaining immunological behavior.

Encourage your oncologist to have genetic testing done to assess the best cancer treatment for your particular type of cancer.

Originally posted at InjuryBoard by Wayne Parsons

Basic Rules That Make Good Cells Go Bad In All Cancers

Wayne Parsons — Sun, 30 Nov 2008 12:58:25 GMT

The general approach to cancer research is to treat each cancer as a unique disease. Now Hartmut "Hucky" Land, Ph.D., is taking the opposite approach: what do all cancers have in common and how can scientists create treatments from those similarities? The James P. Wilmot Cancer Center at the University of Rochester Medical Center has received a $2.7 million grant from the National Cancer Institute to study gene networks at the heart of colon cancer. Dr. Land is the Director of the James P. Wilmot Cancer Center.

Dr. Land who is professor and chair of the Department of Biomedical Genetics published an article in the prestigious journal Nature recently, that describes a new discovery that pinpoints genes that are involved in changing normal cells to cancer cells. The article "Synergistic Response to Oncogenic Mutations Defines Gene Class Critical to Cancer Phenotype", Nature 453, 7198 (25 May 2008) identifies a major scientific breakthrough.

"No matter what type of cancer a person has, a similar program is happening in every cell that becomes cancerous. We're trying to figure out that program and then dismantle or destroy it."

The new study focuses on colon cancer which claims 50,000 lives each year. Others involved are Craig Jordan, Ph.D., professor of Medicine and director of translational research at the James P. Wilmot Cancer Center, and Anthony Almudevar, Ph.D., and Peter Salzman, Ph.D., who are both assistant professors in the Department of Biostatistics and Computational Biology.

Normal cells that turn cancerous go through thousands of changes and it is hard to tell which changes are necessary to the end result of cancer and which changes are merely a result of the process. To distinguish between those changes is a big problem in cancer research. Land says the task is like sorting out the molecular "drivers" that push a cell to become cancerous vs. the molecular "passengers" that are simply along for the ride.

In Nature article, Land describes a simple distinction in that the important genes in the whole genome respond to several mutations in a synergistic way, increasing their activity to a greater extent than would be expected if the changes caused by any of these mutations separately were simply added together. The research helps scientists who are trying to decide which genes and proteins to target in the fight against cancer.

"We believe this is a way to identify what we call cancer addiction genes. These are the genes that cancer simply must affect to cause the disease."

Twenty-five years ago Land discovered that the development of cancer always involves more than one mutation. Since then, he has focused on how genes must cooperate for cancer to occur.

When a cell is becoming cancerous a complex scene, similar to a battlefield appears under the microscope. Land's team is sorting out the scene to find order beyond the chaos and identify the key elements in command of cancer's assault on cells.

"Now that we have a way to identify the genes that cancer is addicted to, we're moving to the next step and working out the relationships among them. These additional targets dramatically expand our opportunity for intervention to help patients."

Cancer will be cured through work like that at The University of Rochester.

Originally posted at InjuryBoard by Wayne Parsons

Proton Therapy Offers More Effective and Less Painful Cancer Treatment

Wayne Parsons — Sun, 09 Nov 2008 12:35:28 GMT

Ian Lawrence is a physicist is suffering from a cancerous tumor that was discovered on the optical nerve leading to his left eye. According to BBC News, Europeans are looking to a small number of European Centers that offer Proton Therapy, and the U.S. where more Proton Therapy centers are coming on line, for treatment. He had most of the tumor removed by surgery but a portion which remains which could not be removed. As a physicist Lawrence speaks from a position of knowledge when he states that physics explains why proton therapy provides a superior method of "cooking" cancer cells. Conventional radiotherapy does not provide the same effectiveness as proton therapy according to Ian Lawrence.

Ian Lawrence will undergo a six-week course of proton therapy treatment at a hospital near Paris. Unfortunately he will have to pay for the treatment out of his own pocket and the treatment is very expensive.

Alex Barnes from England is 5 years old and is suffering from brain cancer. He has undergone two surgical treatments in Florida and now will undergo proton therapy there to attack the remaining portions of the brain tumor.

So what is proton therapy? Proton therapy is a much more highly targeted form of conventional radiotherapy. In proton therapy a stream of charged subatomic particles called protons is fired into the body from a huge device known as a cyclotron. The protons only release their energy when they reach the site of the tumor, thus not harming surrounding tissue. A good resource on how proton therapy works can be found at the website of The Radiological Society of North America (RSNA). RSNA publishes information at "Radiology Info - The Radiology Information Resource For Patients" and has a section explaining Proton Therapy. According to RSNA the following cancers are being treated with Proton Therapy:

Lung (see Lung Cancer page)

Prostate (see Prostate Cancer page)

Brain (see Brain Tumors page)

Spinal or vertebral body tumors

Skull base sarcomas

Pediatric brain tumors

Head and neck (see Head and Neck Cancer page)

Eye melanomas

Conventional radiotherapy involves shooting another type of particle, X‑rays, that kill cancer cells but also kill the healthy tissue that surrounds the cancerous tumor and that X‑ray beam passes through before and after it hits the tumor. Conventional radiotherapy is dangerous, especially for children with cancer, because the side effects can damage the child's development and for children and adults if the tumor is right next to an especially sensitive organ such as the brain, spinal cord or the eye, the collateral damage from the X‑ray beam can cause serious injury. In some cases it is impossible to provide any significant dose of killing X‑ray beam to the tumor site because of this fact and so the amount of radiation that is delivered is very low and thus not very effective in killing the tumor.

The cyclotron that produces the beam of protons is a huge machine that costs a huge some of money and therefore there are very few proton centers in the world. The device itself is highly radioactive when in operation and is usually buried in the ground outside of the laboratory where the treatment is provided. A fully equipped proton therapy center could easily cost in excess of $200,000,000.00. On the other hand the benefits in providing treatment for certain types of cancer is huge and several proton therapy centers are being currently constructed in the United States.

In the US hospitals such as the Jacksonville, Florida Proton Therapy Center is treating hundreds of cases of prostate cancer and other forms of cancer that previously have been treated with targeted radiation therapy. The National Association of Proton Therapy (NAPT) is a clearing house for Proton Therapy information for doctors and patients. According to NAPT the following U.S. Centers are in operation or development:

Operating Proton Centers:

James M. Slater, M.D. Proton Treatment and Research Center at Loma Linda University Medical Center

Francis H. Burr Proton Center at Mass. General Hospital

Midwest Proton Radiotherapy Institute at Indiana University

The University of Florida Proton Therapy Institute

M.D. Anderson Cancer Center's Proton Center, Houston

Proton Centers under Construction:

The Roberts Proton Therapy Center at University of Pennsylvania Health System

Hampton University Proton Therapy Institute

Northern Illinois University Proton Therapy Center

ProCure Proton Therapy Center, Oklahoma City, located at the INTEGRIS Cancer Campus

Proton Center in Development:

South Florida Proton Center at University of Miami

One of the problems that proton therapy faces is that there are few scientific studies or clinical trials that have demonstrated the benefit of proton therapy although scientists agree that it should be very effective. A typical clinical trial would involve giving some patients the proton therapy treatment and following another group-the controlled group-who do not receive the treatment. Some cancers specialists are skeptical about proton therapy but its proponents are many and believe that the patients who have been treated and benefited are testimony to the validity of the treatment.

This situation is changing rapidly as over 150 clinical trials are underway for proton therapy and a wide variety of cancers including, brain, pancreatic, lung, prostate and liver solid tumors.

For anyone suffering from cancer which involves a solid tumor that the doctors say is unresectable (inoperable), consideration of proton therapy should be at the top of your list of treatments. Ask your doctor to send the scans of the tumor to a proton therapy center to see if the treatment is applicable. If it is applicable, proton therapy may be the difference between life and death for the patient. In addition, proton therapy offers the benefit of fewer side effects and therefore a higher quality of life which is a major factor for most cancer patients in selecting a treatment.

Do not be discouraged if your oncologist is negative about the treatment, and also do not be discouraged if the interventional radiologist at the facility where you are being treated does not recommend the treatment. Oncologists and interventional radiologists oftentimes discourage patients from seeking treatment outside of that offered at the center where the patient is being treated.

Be hopeful and inspired by the tremendous work being done by the Lance Armstrong Foundation (www.livestrong.org). Cancer patients must often get past their initial treating physicians to find the best treatments. Remember that the hospital or cancer facility where the patient initially goes for treatment has only certain treatments that they can provide and they make money by selling those treatments to patients with cancer. They want to encourage the use of their facility and the use of their treatments because hospitals are businesses and are competing for patient and insurance company dollars. You must be proactive and look to the institutions that are performing clinical trials as well as organizations such as Lance Armstrong.

Originally posted at InjuryBoard by Wayne Parsons

Treatments For Type 2 Diabetes Escalate Costs

Wayne Parsons — Fri, 07 Nov 2008 16:00:58 GMT

Type 2 Diabetes treatments increase in number and cost. A new report in the Archives of Internal Medicine documents the increase over the past few years of a more complex and expensive range of treatments for Type 2 Diabetes.

G. Caleb Alexander; Niraj L. Sehgal; Rachael M. Moloney; Randall S. Stafford. National Trends in Treatment of Type 2 Diabetes Mellitus, 1994-2007. Arch Intern Med., 2008;168(19):2088-2094

Coupled with an increasing number of patients and a growing tendency by doctors to prescribe multiple medications, the annual cost of Diabetes drugs has doubled in the past six years. It rolls from $6.7 billion in 2001 to $12.5 billion in 2007. The report includes that the greatest cost of the increase was the use of new expensive medications.

More than 11 million Americans have been diagnosed with Diabetes in 2000 and the report projects the number to climb to 29 million by 2050. The annual cost of Diabetes is $132 billion at the present time. As of the year 2002 one-tenth of US healthcare costs were from Diabetes. The report also noted that physicians are prescribing more medications to each patient and combining different classes of drugs in the treatment for a single patient.

G. Caleb Alexander, M.D., M.S. and colleagues from the University of Chicago Hospitals collected prescription information and costs from national databases. The analysis covered patients age 35 and older with Type 2 Diabetes who had visited a doctor's office between 1994 and 2007.

The data showed that:

1. Yearly patient visits to treat Diabetes increased from 25 million to 36 million.

2. The number of medications prescribed per patient increased on average from 1.14 to 1.63.

3. For treatments where any treatment was given the patients who were given only one drug decreased from 82 percent to 47 percent.

4. Insulin use decreased from 38 percent to 28 percent from 1994 to the present. The use of Sulfonylurea drugs decreased from 67 percent to 34 percent while the use of new drugs such as Diguanides and Glitazones increased to 54 percent and 28 percent in 2007. The new drugs were attributed to the in crease in average cost for prescription from $56.00 in 2001 to $76.00 in 2007 as well as the overall medication expenditures stated above from $6.7 billion in 2001 to $12.5 billion in 2007.

The study did not evaluate the effectiveness of the new treatments or make any attempt to assess cost effectiveness.

Originally posted at InjuryBoard by Wayne Parsons

Unrestecable Non-Metastatic Pancreatic Cancer Standard of Care

Wayne Parsons — Thu, 25 Sep 2008 14:47:04 GMT

People afflicted with pancreatic cancer have a poor prognosis and oncologists do not agree on a standard of care regarding what treatment is best. I have previously reported on spectacular new research on pancreatic cancer vaccines being developed at top centers like Johns Hopkins University in Baltimore. New resaerch from Europe provides more information on what to do. Local oncologists are unlikely to be familiar with this resaerch so a patient must always educate themselves about treatments and use research centers like the University of Pittsburg, M.D. Anderson in Houston and Tampa Bay General Hospital in Florida as places to ask questions and get informed answers. An initial inquiry should always be to look at radioembolization with Y-90 microspheres at a top center like Wake Radiology in Cary, NC.

The new research in Sweden compared patients with who were able to have their pacreatic tumors removed surgically with a group of patients whose tumors were inoperable. The latter group received chemotherapy and radiation to their tumors and then in some cases had the tumor removed after it was reduced in size. This group had a pancreatic tumor with no metastasis ( non-metastatic unresectable adenocarcinoma pancreatic cancer - PAC).

The researchers concluded that"

"The median overall survival for the latter group was 29 months, which compared favourably with our control group of patients undergoing direct curative surgery for primarily resectable PAC (median OS: 16 months; R_O-rate: 75%)."

The paper published in the journal Oncology concludes that downstaging a pancreatic tumor with chemo-radiation (RCT) before curative surgery produces the same survival rates as patients whose tumors are surgically removed at the outset and results in a less severe and dangerous surgery.

Originally posted at InjuryBoard by Wayne Parsons