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Old 09-27-2010, 03:09 PM
Dross Dross is offline
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Default War on cancer produces collateral damage to the heart

Philadelphia, PA, September 21, 2010 – For the past two decades, cancer therapy has become more sophisticated and effective, resulting in an ever-expanding group of long-term cancer survivors. There is also a growing awareness of the potentially negative effects of cancer treatment on the heart and the management of cardiac disease during and after cancer therapy. In the September/October issue of Progress in Cardiovascular Diseases an international group of experts takes an in-depth look at the ways in which cancer treatment profoundly impacts patients' cardiovascular function and can become a major detriment of overall survival.

Guest Editors of this issue, Douglas L. Mann, MD, and Ronald J. Krone, MD, both of the Division of Cardiology, Washington University School of Medicine, St. Louis, put the situation into perspective. "The management of heart disease in all its forms in patients with cancer in all its forms presents special challenges to the cardiologist. In the war on cancer, the cardiologist is not in the front lines, directly confronting the enemy, but in the role of support and supply, providing the oncologist the ability to keep the warrior strong enough to defeat the enemy. In fighting the war on cancer, there is, like in any war, unwanted 'collateral damage.' There is no 'silver bullet' but, in many ways, a refined shotgun, blasting the tumor while pellets hit other vital organs. The bone marrow, liver, and nervous system get their share of hits; but the heart and vascular system are certainly at risk depending on the weapon used, particularly because the vascular system and blood supply are intimately involved in any treatment delivery. Just as in a war, not only must the enemy be destroyed; but the damage must be contained to permit the rebuilding of the homeland."

This issue of Progress in Cardiovascular Disease was inspired by the very successful third International Symposium of the Cardiology Oncology Partnership, which was held in September 2009 in Milan, Italy. This meeting marked the inauguration of the International Cardioncology Society, an international society responding to the need for cooperation between these medical disciplines.

"The recent recognition of the frequent collateral damage of the heart from many of the newer chemotherapeutic agents, as well as the classic anthracyclines, and the importance of this to management of the cancer, should spur the acquisition of cardiac outcomes data and ultimately trigger the development of specific evidence-based practice guidelines to keep the heart from interfering with the war on cancer," commented Dr. Mann and Dr. Krone.

Last edited by gdpawel : 05-28-2012 at 12:26 AM. Reason: post full article
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Old 09-27-2010, 10:20 PM
gdpawel gdpawel is offline
Join Date: Feb 2007
Location: Pennsylvania
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Default Side effects of treatment a reality

By analyzing non-cancer deaths among cancer patients, it becomes clear that orthodox therapies often do more harm than good. For example, cancer treatment can damage the heart and cause deaths from heart failure. This means fewer deaths from cancer. Analysis of the records of 1.2 million cancer cases in the Surveilance, Evaluation and End Results (SEER) database showed that non-cancer deaths accounted for 21 - 37% of all deaths. The authors attributed this effect to the damage caused by cancer treatment (mainly radiotherapy and chemotherapy).

Some common chemotherapeutic agents (paclitaxel, doxorubicin, and trastuzumab) can trigger hypertension or problems with the heart, such as arrhythmias, congestive heart failure, or bradycardia. Such drugs like doxorubicin and daunorubicin can damage the heart and produce dilated cardiomyopathy. There are some, like 5-FU [fluorouracil] and Xeloda [capecitabine], that can cause chest pains, resulting from spasms of the arteries that go to the heart. Many patients on chemotherapy become anemic, and that can trigger further cardiac complications. Other agents affect the kidneys, sometimes to the point of requiring dialysis. In addition, because many patients on chemotherapy are immunocompromised, pulmonary infections are quite common.

It's interesting. Results from clinical trials indicated that most "targeted" therapies of today do not cause the usual side effects associated with cancer treatment, such as hair loss and fatigue. However, other side effects may occur with these drugs, including rash, hand/foot syndrome (sores on the hands and feet) and an increased risk of heart attack and stroke. Exchanging one set of side effects with another set of side effects?

Bacterial infections (with pseudomonas being a very common offender) have been a recognized risk of chemotherapy since the 1940's. In fact, the number one cause of chemotherapy-related mortality (save for the likely probability that it induces mutations in genetically unstable cancer cells to produce a more aggressive cancer cell) is infection, resulting from immunosupression. There are several mechanisms of immunosuppression, the most obvious being the predictable reduction in the white blood cell count following most forms of chemotherapy. The main justification of having medical oncology be a medical specialty unto itself is the expertise it requires to push the envelop with toxic drugs to kill the tumor without killing the patient. The second mechanism of immunosuppression is a reduction in lymphocytes and plasma cells, which also assist in fighting infections.

It's analogous to the old medical specialty of syphilology. There was a big medical specialty called syphilology which existed because of the expertise it took to give toxic cocktails of the various (mostly ineffective drugs). The formulas were quite complicated, but they persisted until the discovery of penicillin, which finally killed off not just the syphillis spirochete but also the specialty of siphilology. I would hopefully expect that something like this will happen with medical oncology, and I would be thrilled if it happened while I was still around to see it.
Gregory D. Pawelski

Last edited by gdpawel : 06-27-2012 at 01:32 PM. Reason: spelling error
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Old 05-28-2012, 12:35 AM
gdpawel gdpawel is offline
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Location: Pennsylvania
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Default Cancer Survivors: Nearly Half Eventually Die of Something Other than Cancer

Nearly half of cancer survivors die from other disorders, according to a study reported at the AACR Annual Meeting (Abstract LB 339). Researchers examined data on 1,807 cancer survivors who participated in the 1988–1994 and 1999–2004 National Health and Nutrition Examination Surveys (NHANES). They were followed for a median of seven years, during which time 776 of them died.

Fifty-one percent died of cancer and 49% from other causes. Cardiovascular disease was responsible for 69% of the non-cancer deaths. Chronic lower respiratory diseases claimed 15% of their lives, and Alzheimer's disease and diabetes were each responsible for 4% of non-cancer deaths.Said Yi Ning, MD, ScD, Associate Research Member at the Virginia Commonwealth University Massey Cancer Center: "Cancer, in general, is regarded as one of the most life threatening diseases. In the past decade, with the application of advanced scientific and medical technologies for cancer early detection, prevention, and treatment, cancer survivors are now living much longer and do not die directly from cancer, but rather, from other diseases and complications. It therefore becomes increasingly important to understand major causes of death among cancer survivors to improve the quality of life and prolong life expectancy of cancer survivors. Our results showed that although cancer is the major cause of death among cancer survivors, approximately half of participants died from other diseases and complications, such as cardiovascular and respiratory diseases. Clinicians and cancer survivors should pay attention to the prevention and treatment of other diseases and complications."

Oncology Times: 25 May 2012 - Volume 34 - Issue 10 - p 16

Yoga Study Finds Yoga to be a Safe, Effective Therapy for Heart Patients

Gregory D. Pawelski

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