Ayurveda to the rescue of cancer patients

Pune : Ten ayurveda practitioners, nutritionists and field assistants in the city have undertaken an ambitious clinical research project for the benefit of cancer patients.Using traditional medicinal herbs available locally, the project seeks to help cancer patients maintain their overall nutritional health status while minimising the toxicity levels and other side-effects caused by chemotherapy.While about 10,000 cancer patients, some of whom are terminally ill, will be included from Pune and neighbouring Pimpri-Chinchwad areas in the efficacy programme, the second phase of the programme would cover similar cases under the Brihanmumbai Municipal Corporation. Read more

Vataja granthi presents with a visible tumor that is black or dark in color and is non fixed

Vataja granthi presents with a visible tumor that is black or dark in color and is non fixed. It is able to move from place to place if pushed. Its size may fluctuate. It tends to be soft and if pricked, exudes a clear, thin fluid. Read more

Nidana: A long list of non specific causes are provided by the classical texts

Nidana: A long list of non specific causes are provided by the classical texts for the origin of gulma that include the suppression of natural urges, grief, becoming weakened by fever, vomiting or diarrhea and then eating food that vitiates vata. Other causes include drinking cold water when hungry and beginning purification without proper oleation and fomentation. These causes are quite generalized toward poor health practices and emphasize those that vitiate vata. Read more

In malignancies, pitta is also vitiated and the condition becomes sannipattika in nature

In malignancies, pitta is also vitiated and the condition becomes sannipattika in nature. In these conditions, the agni of the affected tissue is increased making it very aggressive to its surroundings as it slowly digests the tissues of the body. Read more

In malignancies, pitta is also vitiated and the condition becomes sannipattika in nature.

In malignancies, pitta is also vitiated and the condition becomes sannipattika in nature. In these conditions, the agni of the affected tissue is increased making it very aggressive to its surroundings as it slowly digests the tissues of the body. Read more

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A tumor located in a vital organ

A tumor located in a vital organ or near a vital function of the body is more difficult to treat. Finally, the type of cell involved in the cancer can indicate how aggressive the cancer will tend to be. Read more

By far, cancer is the most feared of all disease

By far, cancer is the most feared of all disease. Taunting humanity with the threat of a slow, painful death it is often the first disease people think they have when they experience pain or feel a lump in their bodies and the last they want to talk about. Going to the doctor, patients wait with baited breath for the phone call that tells them, yes or no. That one phone call either brings tremendous relief, exhilaration and an appreciation for life or it brings shock and despair. Read more

Cancer rates fall, lung cancer still problem, report says

Rates of new cancer diagnoses and deaths for U.S. men and women have fallen for the first time, according to a new report from leading cancer and medical research organizations. The annual report, published online Tuesday in the Journal of the National Cancer Institute, showed this simultaneous drop in overall cancer incidence and mortality for the first time since reporting began in 1998, the study authors said. full story

Hospice: An Overlooked Option

(HealthDay News) -- Hospice care helps terminally ill patients prepare for death, treating their symptoms and pain and preparing them -- and their families -- for the end.

The patients maintain their dignity and some semblance of control over their life. Their families receive counseling to help them come to terms with their impending loss.

It's humane. It's caring. It's thoughtful.

Why, then, do so few Americans chose to receive hospice care, even though Medicare covers the expense?

A study published in July in the New England Journal of Medicine found that only one-third of Americans die under the care of hospice, despite hospice being essentially free of charge.

And those who avail themselves of hospice care often aren't getting the full benefit of it, said Dr. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization, the world's oldest and largest nonprofit membership organization devoted exclusively to promoting access to hospices.

"They hold off the ultimate [decision] until they finally have to face it," Schumacher said. "And when we speak to families, the question we hear over and over again, is, 'Why didn't we come into hospice sooner?' "

There currently are more than 3,500 hospices in the United States, and more are being built every year, Schumacher said. "Approximately 500 new hospice licenses were issued over the past two years," he said.

Hospice care is end-of-life care provided by health professionals and volunteers.

The hospice plan provides medical, psychological and spiritual support, the goal of which is to help people who are dying experience peace, comfort and dignity. Caregivers control pain and other symptoms as much as possible, so a person can remain as alert and comfortable as possible.

But hospice also focuses on the family members as well, helping them deal with the reality of death, said Carol Spence, director of research for the National Hospice and Palliative Care Organization.

"We outright make the patient's family our unit of care, so there's a lot of attention given to the family caregivers, including bereavement care following the death of the patient," she said.

Usually, patients are given hospice care when they are expected to live six months or less.

Hospice care can take place at their home or in a hospice center. Seeing the value of the care, hospitals and nursing facilities also are opening hospice units to help the dying.

Part of the difficulty in choosing to use a hospice can be how hard it is to really know how much time a person has left, Spence said.

"It's difficult in general to come up with an accurate picture of disease projections," Spence said. "People are living with chronic illnesses that will have an inevitable downward course, but knowing precisely when death will approach is not an easy thing.

"Bringing hospice in doesn't mean they're going to die tomorrow. It means a better quality of life for whatever amount of time you have left, whether it's a week or a month or six months," she continued.

Another possible reason for people failing to use hospice can be found in American attitudes toward dying -- going to hospice can seem the equivalent of "failing" or "giving up," she said.

"Our American culture is death-averse," Spence said. "The medical community and the general population, the attitude is shown in the metaphors used, whatever the disease you have -- 'I'm going to fight it, I'm going to beat it.' "

There's also some misunderstanding over who can utilize hospice care, with many people believing it's mainly for those dying of cancer. In fact, about 40 percent of U.S. hospice admissions are for patients suffering from some other life-ending disease, such as end-stage heart disease, dementia, lung disease or stroke, according to the National Hospice and Palliative Care Organization.

The misunderstandings also involve the cost of care. Many people believe hospice is too expensive or out of their price range, even though Medicare or private insurance covers the full cost of hospice care.

Despite all this, the number of hospices and the number of people turning to them are expected to grow as baby boomers enter retirement age and begin facing their own mortality, said Schumacher, a member of that generation himself.

"We're as much a part of this death-denying culture as anyone, but we are consumers, and we look for alternatives," he said. "I think in the long run, we will be a group who will choose this option much sooner."

More information
To learn more, visit the National Hospice and Palliative Care Organization.

Cancer Patients Gain From Reporting Symptoms Online

(HealthDay News) -- Having cancer patients report to doctors on their symptoms and side effects online may improve their care, a new study finds.

Even the sickest cancer patients are willing and capable of reporting their symptoms online, says a team from Memorial Sloan-Kettering Cancer Center in New York City.

"Cancer care has become increasingly complex, causing office visits to become more compressed. This makes it challenging for the clinician to comprehensively assess each patient's symptoms in that brief window of time," study author Dr. Ethan Basch, a medical oncologist, said in a prepared statement.

"Because cancer therapies can be highly toxic, early detection of symptoms and timely treatment is vital. What is exciting to us about online self-reporting is that patients can alert clinicians to crucial symptoms in real time," Basch said.

The study included 107 lung cancer patients receiving outpatient chemotherapy who had access to a secure Internet patient reporting system developed by Basch and his colleagues. The patients were able to access the Symptom Tracking and Reporting (STAR) site using computers in waiting room kiosks and at home to report cancer symptoms and chemotherapy-related side effects.

The patients were followed for up to 16 months and 40 visits. All of the patients used the waiting room kiosks at some or all of their office visits, and an average of 78 percent logged onto the system at any given office visit. Patients were more likely to use STAR if they had prior computer experience.

The study found that 98 percent of patients found STAR easy to use, 90 percent said it was useful, and 77 percent believed it improved the quality of their discussions with clinicians.
The study appears in the Dec. 1 issue of the Journal of Clinical Oncology.

More information
The U.S. National Cancer Institute has more about coping with cancer.

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Cannabis Compound May Stop Metastatic Breast Cancer

(HealthDay News) -- A non-toxic, non-psychoactive compound in marijuana may block the progress of metastatic breast cancer, according to a new study by researchers in California.

"This is a new way to treat a patient that is not toxic like chemotherapy or radiotherapy. It is a new approach for metastatic cancer," said lead researcher Sean D. McAllister, an associate scientist at the California Pacific Medical Center Research Institute in San Francisco.

The compound found in cannabis, called cannabidiol (CBD), inhibits a gene, Id-1, that researchers believe is responsible for the metastatic process that spreads cells from the original tumor throughout the body.

Opting for a musical metaphor, senior researcher Pierre-Yves Desprez likened Id-1 to "an [orchestra] conductor. In this case, you shoot the conductor, and the whole orchestra is going to stop. If you shoot the violinist, the orchestra just continues to play."

In humans, the Id-1 gene is found only in metastatic cancer cells, said Desprez, a staff scientist at the institute. Before birth, they are present and involved in the development of human embryos, but after birth, they go silent -- and should stay that way, he said.

But in metastatic cancer "when [the genes] wake up, they are very bad," he said. "They push the cells to behave like embryonic cells and grow. They go crazy, they proliferate, they migrate." Desprez said, "We need to be able to turn them off."

According to the study, CBD does exactly that.

"We are focusing on the latest stages of cancer," Desprez added. The cancer cell itself is not the problem, because a tumor can be "removed easily by surgery," he said. The problem is the development of metastatic cells which is "conducted" by Id-1.

McAllister and Desprez said they are not suggesting that patients with hormone-independent metastatic breast cancer smoke marijuana. For one thing, a sufficient amount of CBD could never be obtained in that way, they said.

The research that has been done on marijuana and its compounds, however, is helpful, McAllister, said. CBD has been around for a long time, and researchers have found it is not psychoactive, and its "toxicity is very low," he added.

The new findings are published in the November issue of Molecular Cancer Therapeutics.
If McAllister's and Desprez's work results in the development of a cancer treatment, someone with metastatic cancer might be placed on CBD for several years. That means low toxicity is important, McAllister explained.

McAllister also suggested that Id-1 is "so important in providing the [metastatic] mechanism in these cells in so many types of cancers" that they "provide us an opportunity potentially to target other types of cancers."

The study's findings were "were a serendipitous discovery, in a way," McAllister said. Desprez noted that he had been working on the Id-1 gene for 12 years. His lab had demonstrated that it was a key gene for invasive breast cancer and tumor progression, and Desprez had found a way to inhibit it in mice, but not in humans.

Then, two years ago, McAllister -- an expert on cannabinoids -- and Desprez, a cancer researcher, started to work together. Through their combined forces "what we found is actually what I was looking for for the last 12 years," Desprez said.

Further study is needed before CBD can be conclusively identified as a treatment option, McAllister and Desprez said. "We need to involve a team of physicians, because we are bench [basic] scientists," McAllister said.

One expert called the findings intriguing but preliminary.

"This is the first evidence that a cannabinoid can target the expression of an important breast cancer metastasis gene," noted Manuel Guzman, a Spanish expert on cannabinoids and cancer. He described the California study as giving "preliminary insight into the question of whether CBD could be used clinically to treat metastatic breast cancer."

However, "all the experiments in the paper have been conducted in cultured cells and none of them in any animal model of breast cancer, which would be one of the steps for further research," added Guzman, who is a professor of biochemistry and molecular biology at Complutense University in Madrid.

Guzman also noted that "Id-1 is just one of many genes involved in breast cancer metastasis" and that future research also needs to examine the impact of CBD on these other metastasis genes.

More information
There's more on breast cancer at the U.S. National Cancer Institute.

Emotional State Doesn't Affect Cancer Survival

(HealthDay News) -- Neither positive nor negative emotional states predict how long a person with cancer will survive, a new study finds.

University of Pennsylvania researchers say that among head and neck cancer patients, emotional health -- good or bad -- is not an independent factor affecting prognosis.

"We anticipated finding that emotional well-being would predict the outcome of cancer. We exhaustively looked for it, and we concluded there is no effect for emotional well-being on cancer outcome," said study author and University of Pennsylvania psychologist James Coyne. "I think [cancer survival] is basically biological. Cancer patients shouldn't blame themselves -- too often we think if cancer were beatable, you should beat it. You can't control your cancer. For some, this news may lead to some level of acceptance."

The study, expected to be published in the Dec. 1 issue of Cancer, culled data from almost 1,100 patients enrolled in two phase III clinical trials for new head and neck cancer treatments.

The patients completed questionnaires about their attitude and social networks at the beginning of the study and at follow-up. The questionnaire included five questions to assess emotional well-being, including such items as "I am sad" and "I am losing hope in my fight against my illness."

By the end of the five-year study, 646 patients died. When the data was analyzed, the researchers found that emotional status had no effect on the course of the cancer or the patient's survival.

Although there is no evidence that psychotherapy or support groups contribute to the chance of survival, Coyne said that if cancer patients need mental health help to improve their quality of life, they should pursue it.

Study co-author Dr. Benjamin Movsas agreed, saying that quality of life may indeed be a factor in a patient's survival of cancer, but it is a much bigger concept than mood and attitude.

"In a separate study, we found that single males with head and neck cancer appeared to be at risk for lower survival... and in another study, we found single males with cancer had among the lowest quality of life," said Movsas, who is chairman of radiation oncology at Henry Ford Hospital in Detroit.

About 40,000 new cases of head and neck cancer are diagnosed each year, and about 11,000 people die from these cancers annually, according to the American Cancer Society.

The role of the patient's attitude in cancer treatment has been in debate for years. This is not the first study to assess whether emotional state could affect the course of cancer. However, this study had a larger number of deaths than some other studies had enrollees, the researchers noted, allowing them greater control over issues of chance that could affect the study results.

One advantage to working with people in a clinical trial, Coyne said, is knowing that they are all receiving the same treatment.

But positivity or negativity are not the issue, suggested Dr. David Spiegel, associate chairman of psychiatry and behavioral sciences at Stanford University School of Medicine in California. What matters is the way in which a cancer patient approaches the stresses in his or her life, Spiegel said.

"The authors vastly overstate the quality of their data and the findings," said Spiegel. "They used a subscale of a quality-of-life measure which is hardly a reliable measure of depression and provides, by definition, limited variance in mood, making it, by design, difficult to show a relationship with any other variable."

Spiegel also noted that head and neck cancers generally have a "very poor prognosis," are not hormone-sensitive, and usually require serious surgery and radiotherapy -- all of which has social and psychological consequences.

"Our research shows that it is not a positive attitude but rather facing and dealing well with the ups and downs of life with cancer that is, at the least, psychologically helpful," Spiegel said.
But an Australian study released in the February issue of Cancer showed similar results for lung cancer patients. Patients in that study also completed questionnaires about their outlook before treatment and after treatment.

As with the current study, the Australian research team found no relationship between attitude, positive or negative, and outcome.

Another study released in the Nov. 1 issue of the British Medical Journal analyzed data from 26 studies of emotional outlook and cancer survival and came to the same conclusion: A positive outlook may be a good thing in general but has no impact on cancer outcomes. The same was true for negativity.

But more research is needed, argued Spiegel. The connection between true depression and the course of cancer is still not well understood.

"Patients in my support group joke, 'Am I living longer yet?' They grieve deaths when they occur, but feel they grow stronger doing so," said Spiegel. "They joke about the prison of positive thinking. The connection between mood and cancer is not about 'positive thinking,' it is about managing the very real stressors of life-threatening illness."

Another expert said he wasn't surprised by the Pennsylvania findings.

"People are more likely to find this news a relief than a disappointment," said Dr. Michael Fisch, an associate professor of gastrointestinal medical oncology at the University of Texas M.D. Anderson Cancer Center, in Houston.

Survival depends on the location of the cancer, the risk factors for the cancer, and how advanced the cancer is when it's diagnosed, said Fisch.

According to Fisch, who treats head and neck cancer patients in Houston, survival also has more to do with access to health care and the biology of the cancer in question than attitude. Good social support and a spiritual sense of something greater than yourself are also beneficial, said Fisch.

Fisch pointed out that probably only 5 percent of head and neck cancer patients ever enter a phase III clinical trial, and those that do are likely to already have more social and medical support than their peers. In other words, they came into the study with an advantage which would make data based on their reported attitudes difficult to generalize to other cancer patients.

Fisch favors a concept he calls "rooting styles" -- comparing the way people approach cancer with the way they root for a sports team. Some are diehard, never-say-never fans, and others may allow for the possibility of losing a game or a season, but both fans are backing the same team.

"Some people have a style where they are optimistic. Some have a style where, if you ask them what they think the outcome will be, they are less certain. They have a coping style that is not a positive-attitude coping style, but it keeps them edgy and works for them," said Fisch.

In fact, Fisch added, trying to encourage a person with a less positive way of talking about their cancer to think more positively would just cause them more stress. That's what he calls the "tyranny of the guilt systems," where others imply that a patient has some mental control over their cancer's outcome.

Clashes between different rooting systems can become a challenge when families or couples have different styles, Fisch said. The key is to find what works for the patient and support that.

More information
For advice on talking to someone diagnosed with cancer, head to the American Cancer Society.

Stressful Jobs Hard on the Heart

(HealthDay News) -- Chronic on-the-job stress doubles the risk that someone who has had a heart attack will have another major coronary event, a Canadian study finds.

Other studies have shown that workplace stress boosts heart woes, but this is the first to link job anxieties with recurrent heart attacks and other major events, the report's authors said.

The study, published in the Oct. 10 Journal of the American Medical Association, provides "very solid scientific evidence" on how job strain might contribute to coronary trouble, said Dr. Paul J. Rosch, president of the American Institute of Stress.

In their study, a group led by Dr. Corine Aboa-Eboule, professor of psychology at the Universite Laval in Quebec, gathered information on 972 men and women ages 35 to 59, all of whom had returned to work after a heart attack.

The participants were interviewed an average of six weeks after returning to work and were followed for an average of almost 6 years.

Job stress, or "strain" as the researchers called it, was defined as workplace environments with high psychological demands but low worker control of decisions made on the job.

During the follow-up period, 82 of the participants suffered unstable angina (chest pain), 111 had nonfatal heart attacks, and 13 had fatal heart attacks.

After adjusting for risk factors for heart disease, as well as lifestyle, sociodemographic and work-environment characteristics, workplace stress doubled the odds of such heart troubles, the team found.

One striking finding: There was no association between the social support workers got and their increase in heart risk, Rosch said. "The most powerful buffer we know against stress is strong social support," he said. However, "in this study, it did not have that effect, which is sort of counterintuitive," Rosch added.

For that and other reasons, the new study provides "many more questions than answers," Rosch said. People who feel that job stress might be affecting their health could try changing jobs, he said, but "you never know whether you're going from the frying pan into the fire."

"Further studies are needed to establish optimal interventions," the researchers wrote. But, they said, "information about the results of this study should be disseminated in cardiac practice and in occupational health services with the aim of reducing job strain for workers returning to work" after a heart attack.

A review of the scientific literature on the relationship between stress and disease, published in the same issue of the journal, finds that stress contributes to illness from depression, cardiovascular disease and HIV/AIDS.

The review is based on a paper commissioned by the U.S. Institute of Medicine to consider the behavioral and biological mechanisms by which stress contributes to disease. Sheldon Cohen, professor of psychology at Carnegie Mellon University, is the principal author.

His team found the strongest evidence for a link between stress and depression, although studies such as the one just done in Canada also show stress boosts heart risks, too. Recent studies have shown links between stress and progression of HIV/AIDS, the review found.

One possible mechanism for the effect is behavioral, with people under stress sleeping poorly, eating badly, not exercising and not complying with medical orders, the review authors said.

Stress might also have adverse effects on the body's immune and inflammatory systems.

Stress' role in cancer remains unclear, since there are many forms of cancer, some of which take a long time to develop. For that reason, progression is often difficult to measure, the authors said.

More information
There's more on stress' impact on sickness and health at the American Institute of Stress.

Wine, Beer, Spirits Boost Breast Cancer Risk Equally

(HealthDay News) -- Three or more drinks a day boosts a woman's risk for breast cancer by 30 percent. And it doesn't seem to matter which form of alcohol -- wine, beer, or spirits -- is consumed, researchers report.

"The majority of previous studies have found an association between alcohol and elevated breast cancer risk," said lead researcher Dr. Yan Li, an oncologist at Kaiser Permanente in Oakland, Calif.

What hasn't been as clear, she said, is how much alcohol raises the risk and whether one type of alcohol boosts that risk more than another.

Li tackled those questions with Dr. Arthur Klatsky, an investigator at the Kaiser Permanente Division of Research in Oakland and a long-time researcher on the health benefits and risks of alcoholic beverages. Klatsky is due to present the team's findings Sept. 27 at the European Cancer Conference in Barcelona, Spain.

The researchers first evaluated the drinking habits of more than 70,000 women, all members of the Kaiser Permanente HMO. The women had undergone health exams during the years 1978 to 1985. By 2004, more than 2,800 women had experienced a breast cancer diagnosis.

Comparing the women's drinking habits to the incidence of breast cancer, the team found that women who drank between one and two alcoholic drinks a day increased their risk of breast cancer by 10 percent compared to light drinkers -- defined as those who drank less than one drink a day.

That risk rose as drinking rates increased. "The risk of breast cancer increased by 30 percent in women who drank three or more drinks per day" compared to light drinkers, Li said.

"What we are saying is, whatever your baseline risk is of getting breast cancer, by consuming alcohol you have this increment," Li said.

The risk of breast cancer in individual women varies greatly, Li said, depending on their family history and whether they are genetically predisposed due to mutations of the so-called breast cancer genes, BRCA-1 and BRCA-2.

In the general population, the lifetime risk of getting breast cancer is one in eight women, Li said. Based on the study findings, however, "if you drink three or more drinks a day, that risk -- rather than one in eight -- will be one in six," she said.

The increase in risk was similar no matter which type of beverage was typically consumed. "It makes no difference whether women drink wine, beer or liquor in terms of their risk of breast cancer," Li said. "It's the alcohol itself. And it's the quantity consumed that increases breast cancer risk."

The researchers didn't find any difference in risk between red and white wine, although some previous research has found red wine more heart-protective than white. That cardiovascular benefit has been linked to the presence of antioxidant flavonoids in red wine, especially one flavonoid called resveratrol.

Another expert familiar with the new study said the research adds some valuable information to what is known about breast cancer risk. Especially valuable -- because it is new -- is the information about all types of alcohol seeming to raise risk equally, said Coral Lamartiniere, a professor of pharmacology and toxicology at the University of Alabama at Birmingham.

He has researched resveratrol, which has shown both antioxidant and anticancer properties. In a study published in August in the journal Carcinogenesis, Lamartiniere found that animals fed resveratrol had an 87 percent reduced risk of getting prostate tumors.

How do his findings that the resveratrol in wine protected against prostate cancer -- at least in animals -- square with the new findings that neither red nor white wine seem protective against breast cancer in women? At least at first glance, "the alcohol is obviously a more potent carcinogen than resveratrol is protective against cancer," Lamartiniere said.

But, he said, "different red wines have different potencies of resveratrol. Cabernet sauvignon has the highest." What isn't clear, he added, is how much resveratrol was in the red wine typically consumed by the women in the Kaiser study.

So, what's the best advice for women interested in minimizing their breast cancer risk? "Modest consumption of anything is the way to go," Lamartiniere said.

Li emphasized that alcohol consumption is just one of the factors that could raise breast cancer risk. To reduce overall breast cancer risk, she advises women to follow a healthy lifestyle by eating a good diet, exercising, not smoking and not drinking heavily.

More information
To learn more about breast cancer, visit the American Cancer Society.