22.06.2016

Clinical cancer research highlights

Clinical research at the National Institute of Radiological Sciences has confirmed effectiveness against the following site-specific cancers.
In patients with a tumor diameter of at least three and at most five centimeters, for whom treatments such as percutaneous ethanol injection therapy (PEI), radiofrequency ablation (RFA), and so on were difficult to implement, both the three- and five-year local control rates were favorable (92%), while the three-year rough survival rate was 77% and the five-year rough survival rate was 65%.
These results indicate that the survival rate is 10a€“15% higher than that for a combination of X-ray therapy and hormone therapy.
Bone and soft tissue tumors are among the most favorable indications of heavy ion radiotherapy, although they are usually radioresistant. Kombuchaa€™s high levels of antioxidants may help protect liver cells from being damaged by toxins.
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A gastrectomy is when all (total gastrectomy) or part (sub total gastrectomy) of the stomach is removed in order to treat stomach (gastric) cancer. A total gastrectomy is performed if the cancer is towards the top portion (proximal) of the stomach.
Also taking the IMPACT supplement drinks for five days prior to your surgery has shown to promote wound healing and reduce the risk of complications. Your operation will be performed in either Royal North Shore Hospital or North Shore Private Hospital. For the first week you will have various intravenous drips which are used for hydration, a nasogastric tube to keep your stomach empty and a feeding tube.
After one week, you will be given some blue dye to drink as well as some contrast to drink while being x-rayed. You will be seen by the physiotherapist on a daily basis, and you will be encouraged to perform deep breathing and coughing exercises as well as mobilising.
In some instances such as if you alone or having a slower recover it may be possible for you go to a local rehabilitation hospital for further care, or to have services to come into your home to assist you.
You have had a major operation and it will take between 3 and 6 months to fully get back to how you were when you were well. We recommend to follow the dietary literature and advice given to you by the dietician while in hospital. Intermittenty you will feel a sharp pain in the wound – this is just the muscles healing and you should not be concerned. The Cancer Nurse Coordinator will contact you by phone regularly once you are discharged from hospital. The CNC when she contacts you will assess how your recovery from surgery is going and will include such questions about your diet, pain, wounds, bowels and mental wellbeing. Contact with the CNC will allow you and your family to feel well supported and have an easy transition from hospital to home.
You will see your surgeon in his rooms 2 – 3 weeks after the operation and on this consultation you will probably have your feeding tube removed if it has not been done so already.
For more advanced disease, such as the situation where the tumor has spread to the lymph nodes in the center of the chest, more broad, yet still highly focussed radiation is preferred, with techniques known as three dimensional conformal radiotherapy, intensity modulated radiation therapy (IMRT) and image guided radiation therapy (IGRT). In the postoperative setting,A radiation is oftenA used as an adjuvant treatment to improve local control.
The ability to precisely target the tumor volume with highly conformal radiation dose delivery thereby allowing substantial sparing of surrounding normal tissues has improved substantially in recent years.
Intensity modulated radiation therapy (IMRT) improved upon traditional 3D conformal therapy, by varying the intensity of the radiation beam as needed, allowing for even more conformal treatment. IGRT or image guided radiation therapy refers to imaging the tumor prior to each treatment, which can be done with a CT scan built into the treatment machine. Multiple radiation beams are used to deliver a high dose of radiation to the tumor while minimizing the dose to normal tissue. The anatomy of cancers in the chest may be complicated and the interpretation of radiology studies challenging. The combination of CT and PET imaging has significantly improved the ability to accurately map the distribution of cancer within the chest, and the newest generation of radiation therapy planning computers has the ability to take full advantage of both study types in the treatment planning process.
Images on the right show how the radiation dose conforms to the tumor which appears as a white shadow, which is the PET scan image overlayed on the CT scan image.


The following are theA most commonA side effects, both acute and chronic, resulting from radiation. Skin changes within the treated area usually include rednessA of the skin similar to a sunburn.
Long-term effects of radiation may be serious and involve inflammation or scarring within the lung and possible damage to the spinal cord. Esophageal cancer operations are tailored to the specific type and location of the tumor.  Common tumors of the esophagus are characterized as squamous cell carcinoma or adenocarcinoma and can occur in the upper, middle or lower part of the esophagus. The most common type of esophageal tumor occurs in the lower part of the esophagus and frequently arises in the setting of chronic gastroesophageal reflux. The goal of the operation is to remove the tumor with an adequate margin, along with any surrounding lymph nodes that may contain microscopic tumors in them. The Department of Surgery has several specially trained cancer surgeons who work together to perform these operations in a safe, thorough, and minimally invasive manner whenever possible. The standard esophageal cancer operations have the same goals as the minimally invasive approach.
Comparison with hepatectomy has suggested a more favorable prognosis for heavy ion therapy.
Both the three- and five-year local control rates were 84%, while the three-year survival rate was 68% and the five-year survival rate was 49%. Both of which will support, guide, and inspire you toward the best possible health outcomes for you and your family. This term indicates that many lymph nodes around the stomach are removed during the surgery. Either the dietician or Cancer Nurse Coordinator will speak with you about the benefits of these supplements and they can be purchased through your specialist rooms at a discounted price. Prior to surgery you will need to attend the pre admission clinic this takes generally a few hours. The feeding tube enters directly into the intestines, this gives the anastomosis the opportunity to begin healing prior to the introduction of food. Both of these tests enable your surgeon to establish whether the anastomosis is healing adequately. This is the most important thing you can do to help speed up your recovery and prevent pneumonia from developing. Normally people feel quite well for the first couple of days at home and can over do activities.
If at any stage you have any dietary concerns or questions we can refer you to our dietician. You and your family can contact the CNC for advice, resources and support and because the CNC works closely with your surgeons she will keep them up to date of your progress. From these assessments the CNC may feel that referrals to a dietician, physiotherapist, community nurses etc, may be necessary to aid your recovery process.
In early stage disease, surgery is often considered the first choice, however radiation treatment, particularly with a method known as stereotactic radiosurgery can very successful in disease eradication and is the preferred method for some patients. As these tumors are extremely responsive to chemotherapy, treatment is often initiated with chemotherapy, followed by external beam radiotherapy. This allows for better tolerance to treatment in addition to giving the ability to increase the dose to improve likelihood of cure. In traditional 3D approach,A each radiation beam is of uniform intensity, which is analagous to the uniform brightness of light emanating from a flashlight.
Again, by way of analogy, this can be visualized as light coming from a flashlight, but instead of uniform brightness across the beam, there are varying degrees of brightness across the beam. By visualization each day, the accuracy is improved as adjustments can be done at the time of each treatment, allowing for more accurate delivery, and further sparing of surrounding normal tissue. For example, cancer and pneumonia often coexist in the same patient and it may be difficult to define where one condition stops and the other one starts. This is done by co-registering or fusing the images from different planning studies in three dimensions on the same display.
Unforeseen side effects may occur because of the unique and varied tolerance of individual persons.
The course of treatment may last from 3 to 7 weeks and most often is given in a single treatment each day, five days a week, although two treatments per day are sometimes employed for specific tumors.


This usually begins during the second or third week of treatment and gradually increases until the treatment series has been completed. This usually starts during the second or third week of treatment and increases until the treatment series has been completed. Depending on the stage of the tumor, some cancers are treated with a combination of chemotherapy and radiation therapy either before or after the esophageal cancer operation.
The esophagus is then replaced with another portion of the intestine (usually the stomach) to re-establish intestinal continuity and permit regular food intake. A minimally invasive esophagectomy generally involves smaller incisions on the abdomen, chest or neck through which the surgeons insert small videoscopes and instruments to conduct the operation. Removing the lymph nodes helps in determining further treatment and may improve the results of surgery. You will be carefully monitored by your surgeon and nursing staff to prevent these complications. At this appointment you will see an anaesthetist, have bloods taken, and then be assessed by the nursing staff and a physiotherapist. The breathing tube may also be left in for a few hours post operatively, but you should not be concerned because you will be drowsy that night and therefore will not remember much, including visitors. You may then find that on the subsequent days you will be lethargic and unmotivated, so it is important to take each day as it comes and listen to your body.
The cancer may also involve lymph nodes in the mediastinum (central part of the chest between the lungs), which may be problematical to accurately detect with conventional studies. In this way the anatomic information provided by the CT and the cancer biological information provided by the PET study are combined in the computer. The side effects may vary substantially depending on the size and location of the treated area and whether or not chemotherapy is also given. Recovery occurs over the following 2 to 4 weeks, although a tanned, dry skin condition may persist to a mild degree as long as 6 to 12 months after treatment.
Lung injury occurs in 5% or less, and spinal cord injury occurs in approximately 1 in 1,000 patients. A temporary feeding tube may be placed at the same time, providing additional nutrition to enhance recovery.
Local control was observed in all patients treated with the finally established radiation dose.
You will be given a contact phone number to call on the day prior to surgery to find out the time you will need to come into hospital on the following day and when to fast from. You will also have chest drains which will be removed once your surgeon is happy with your recovery. If there is a delay in the healing of the anastomosis then the introduction of food and drink will be delayed. It delivers a high dose to a small volume, in a very 'pin point' fashion to the tumor, causing ablation.
This in turn allows us to design the most accurate possible radiation treatment volume, which means a higher dose of radiation to the target volume, more accurately directed, with better sparing of surrounding tissues. This is not normally debilitating and, in itself, should not affect your daily activities or ability to drive. Skin changes may be treated with a variety of measures including aloe vera gel, moisturing lotion, or cortisone cream.
Your surgeon will contact your relatives to tell them how the operation went and to discuss the findings. This improves that chance of destroying the tumor without creating too much collateral injury to surrounding tissues. However, you may wish to go to bed earlier or take an afternoon nap during this period.A Fatigue and weakness are worse in patients who lose weight. Accordingly, we strongly encourage you to supplement your diet with high calorie foods or commercially available nutritional supplements (for example Ensure Plus, Sustacal, Boost), if necessary to maintain your weight.



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Comments to «Clinical cancer research highlights»

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