Radiotherapy – Estro 27

Cancer Stem Cells as a Predictive Factor in Radiotherapy

Dr. Alfredo Hane Jr. — Sun, 04 Jan 2015 06:23:33 +0000

Cancer stem cells (CSC) have the extraordinary ability to increase the chance of tumour recurrences if they survive treatment. In breast cancer, the risk increases by as much as 30 times, according to UCLA scientists.Because the intrinsic radio-resistance of cancer stem cells appears to be much higher than that of non-CSCs, cancer stem cells become important for the development of predictive biomarkers. Recent clinical studies performed by the University of Manchester, among others, imply that stem-cell markers could be used to predict radio-curability of tumours, yielding results that would predict the histology and size of the tumours.The scientists at the Manchester Cancer Research Centre have studied a molecule called FAK and its role in controlling cancerous cells’ resistance to radiation, as well as in predicting the recurrence of the disease, which is called Ductal Carcinoma in Situ. DCIS is non-invasive, but if left untreated, could progress to the point where lumpectomy and radiotherapy are the patients’ only chance. However, the treatment does not prevent DCIS from recurring in nearly 20% of cases.The team revealed that cancerous cells harvested from patients that contained high levels of CSCs, also had increased levels of FAK, besides being more radio-resistant. The team then examined cases of recurrence and found that high FAK levels were linked to these cases. Subsequently, the scientists blocked FAK production and saw that this inhibited CSC activity. They then combined this inhibition with radiotherapy and achieved a synergy of positive yields. The FAK-inhibiting drug was then given to mice and positive results were also produced. These showed beyond doubt that inhibiting FAK production reduced breast CSC growth and also improved sensitivity to radio-therapy. Therefore, inhibiting and measuring FAK could reveal patient’s likelihood of experiencing recurrence.There are several clinical studies underway to identify potential markers, although the need for these studies is not unanimously acknowledged. One perspective is that innovative therapies are needed to substitute radio-therapy altogether. Still, the general direction of medical endeavours and research tends to be toward using stem cell markers alongside radiation oncology to gain control over cancer.

Cancer During Pregnancy

Dr. Alfredo Hane Jr. — Thu, 11 Dec 2014 05:32:07 +0000

Introduction

Cancer is one of the most dangerous and deadly illnesses on the planet and can in 2007 alone killed 7.9 million people. It is also one of the great unknowns of the medical world, so little is known about cancer that is can make it very difficult to treat effectively, particularly in late stages.

What is Cancer?

Cancer, often known as a malignant tumour, is a disease involving abnormal cell growth within the body. Cancerous tumours can spread to other areas of the body, making them extremely difficult to treat.There are over 100 different types of cancer known to affect humans and each of these presents symptoms, such as weight loss, stomach pain etc. However, the majority of cancer symptoms could be symptoms of other, wholly unrelated things and thus cancer is difficult to spot.Curative cancers are generally treated with high intensity treatments such as chemotherapy, radiotherapy and stem cell transplants.

Cancer During Pregnancy

Cancer during pregnancy is extremely rare and occurs in around 1 out of 1,000 pregnancies. Because of the rarity it has previously been difficult for women and doctors to know how to approach cancer during pregnancy.However in recent times it has become more common for pregnant women to start or continue cancer treatment whilst pregnant so more information is coming to light.Pregnant women with cancer are perfectly capable of giving birth to a healthy foetus, as cancer rarely affects the foetus directly. However treatment can prove problematic as many of the treatment drugs on offer will affect or harm the foetus.Indeed, both chemotherapy and radiotherapy can have a negative effect on the foetus, with surgery being the only definitively safe option. For this reason many pregnant women forgo treatment, risking their own lives to protect their babies.There are websites and many online support groups dedicated to providing a network of aid and advice to women who find themselves pregnant with cancer.

Conclusion

Being diagnosed with any kind of cancer can be a terrifying prospect, but when pregnant it can be doubly terrifying as there are now two lives to consider and hormones make it difficult to control emotions.However, many women who have found themselves pregnant with cancer have given birth to perfectly healthy children and have gone on to battle and survive the cancer and move on with their lives.

Types of stem cell transplants for treating cancer

Dr. Alfredo Hane Jr. — Tue, 18 Nov 2014 09:15:48 +0000

Treating cancer via chemotherapy and radiotherapy inevitably leads to the death of some stem cells in the patient’s bone marrow. When the treatment is completed, stem cells are given to the patient intravenously so that they may replace the ones that were destroyed through a process called engraftment. These stem cells will settle in the marrow and eventually start to produce healthy blood cells.There are three types of stem cell transplants, which are named based on the donor of the cells. We briefly outline some of the main differences between these transplants below:Autologous stem cell transplants are based on cells collected from the patient, before he had the cancer treatment. These stem cells are collected from blood or bone marrow tissue, and frozen. When the chemo and radiation therapy is completed, the cells are thawed and engrafted.The main advantage with this form of transplant is that there are no chances of having an infection passed on, or of the graft attacking your body through a condition called graft-versus-host disease.There may still be a possibility of graft failure. Also, autologous transplants don’t yield a ‘graft-versus-cancer’ effect, like other types of transplant do. Another disadvantage is that some of the stem cells harvested from your body through whichever method you choose, even the most advanced, could also have been cancerous. Studies are underway to determine how to best purge those cancerous cells before or after they were transplanted. Additionally, as the immune system is the same throughout the process and cancer cells were able to develop once, they may be able to do so again, even after the transplant.Autologous transplants of stem cells are used for conditions such as: leukaemia, multiple myeloma, lymphoma, neuroblastoma and testicular cancer, as well as some cancers children may suffer from.Tandem transplants or double autologous transplants are two consecutive treatments as described above. Two courses of chemo are followed by two stem cell transplants; both performed using cells collected from the patient before chemo started. They are usually performed within a 6-month time-frame.These transplants are occasionally used to treat multiple myeloma or advanced testicular cancer, but much research is required to minimise the risks, which are higher than those for single transplants.Allogeneic transplants are performed using stem cells harvested from a matching donor, usually a sibling. More recently, stem cells have been collected using blood from a newborn’s umbilical cord and placenta. Cord blood is very rich in stem cells with a tendency to multiply quickly, but the harvest from one cord is usually too low for an adult to use.The advantage of this technique is that the stem cells from the new donor produce their own immune cells, which could destroy any post-chemo cancer cells (graft-versus-cancer), or prevent new cancer cells from developing. Additionally, the donor’s stem cells don’t have the potential to include cancerous cells, and more can be donated at leisure.On the other hand, the graft might not take because the stem cells can be destroyed by the patient’s immune system before settling into the bone marrow. Otherwise, the patient may suffer from graft-versus-host disease. Another complication is that the patient is more vulnerable to infections, either from the donour, or from himself, which would have been kept in check under normal conditions. However, due to immunosuppressive drugs taken to allow the graft to take, infections can arise at any moment.This type of transplant is used to treat multiple myeloma, leukaemia, lymphoma, myelodysplastic syndrome and even aplastic anaemia.Mini transplants, or non-myeloablative transplants are used with patients who would not withstand complete bone marrow cells destruction during chemotherapy. Only some of the cancel cells and bone marrow cells are destroyed, just enough to allow the donor stem cells to settle.Because the donor stem cells thrive, they eventually have a graft-versus-cancer effect. Another advantage is the fact that blood cell counts aren’t decreased so drastically as with full-blown chemotherapy.A disadvantage is that the risk of graft-versus-host disease is the same as with other forms of transplant. Also, the chances of recurrence may be slightly higher, although studies are still under way. Syngeneic transplants are only limited to identical twins or triplets, where the sibling is the donor.The obvious advantage is that graft-versus-host disease will pose no threat, seeing as the new tissue is identical to the patient’s. Additionally, as the donor has no cancer cells, the chances of survival of the new stem cells are much greater.The main disadvantage is that the patient’s immune system is very much like that of the donor’s. So much so, in fact, that there will be no graft-versus-cancer effect.Half-matched transplants, or haploidentical transplants, are usually performed for people with no siblings to donate viable stem cells. In this case, parents or children of the patient will usually be the donors, but graft-versus-host disease is unavoidable as only half of the genetic content of the transplant is identical to the patient’s.

Radiotherapy and Oncology

Dr. Alfredo Hane Jr. — Tue, 11 Nov 2014 18:11:14 +0000

Introduction

Radiotherapy and oncology are two principle techniques in the treatment, diagnosis and prognosis of cancers. Oncology is the study of medicine dealing with tumours and a doctor practicing oncology is known as an oncologist. Radiotherapy is a kind of intensive radiation treatment used to help fight, and sometimes cure, cancers.

Radiotherapy

Radiotherapy, also known as radiation oncology, is therapy that uses ionized radiation to treat cancerous tumours, or to kill off dead or malignant cells.If the type of cancer is localised then radiation therapy can provide a cure for that type of cancer. However, if the cancer is metastatic then radiotherapy is used mainly to prevent further spreading.Because radiotherapy uses radiation it can prove quite an invasive process and can make patients very sick, more so than they would be on chemotherapy. However, radiotherapy is stronger and considerably more concentrated and thus can often have more positive results in the long term.A doctor who specialises is radiotherapy treatment is known as a radiation oncologist.

Oncology

Oncology is the study of cancer and there are generally three types of oncologist; medical, surgical and radiation. They will often work in conjunction with one another to treat a cancer patient.The role of an oncologist is to be responsible for the care and treatment of a patient. They will often give a diagnosis and prognosis early on in the process as well as implementing a treatment plan, through discussions with the patient.Oncologists are experts in the kind of therapy warranted and also in palliative care measures. They will be able to suggest the best course of treatment or action for a patient, as well as advising of any side-effects.

Conclusion

Overall radiotherapy is a treatment plan for cancer which is generally overseen by an oncologist, usually a specialist in radiotherapy. All the elements involved are paramount to the treatment of cancer patients and all parts of the process must work in unison to give the patient the best possible chance of recovery, survival or prolonged life.

European exhibition in Radiotherapy

Dr. Alfredo Hane Jr. — Mon, 06 Oct 2014 13:54:49 +0000

Radiotherapy is an ever changing field of medicine that encourages much discussion between health care professionals. The European exhibition of Radiotherapy is a yearly event held so that such individuals can get together and discuss new ideas, technologies and progressions in this medical field.Held by the European Society for Radiotherapy, this annual event see’s some of the leading consultants in radiotherapy, radiology, oncology and radiobiology discuss clinical trials, new evidences presented in the field of nuclear medicine, physics, oncology science, and technology. Radiotherapy relies heavily on technology as a treatment or cure for many health concerns, so it is important that the health care professionals at the forefront of the society discuss such advances.ESTRO, who hold the event, are a not for profit organisation that are dedicated to ensure doctors and radiologists world wide are educated enough to deliver a tailored treatment to each patient. They aim to promote and develop educational standards in radiotherapy and clinical oncology, as well as standards of practice. ESTRO do not only aim to educate radiotherapy and oncology professionals in training, but fully qualified members who still wish learn and develop and research the science of nuclear medicine and oncology. One of the main reasons for holding an annual exhibition, is to encourage different bodies, organizations and institutions to collaborate and share information and research.The annual exhibition of European radiotherapy is to inform and educate, and try to provide an open source for any new information. Making information readily available to any health care professionals, organizations or institutions ensures that the patient involved in cancer management receives the most up to date treatment and advice. The field of oncology and radiotherapy has been through many advances in recent years, and there is still plenty of information that we do not know, but ESTRO endeavour to educate professionals so that they may find it during research.The exhibition is not always held in the same place every year, ensuring that it is fair and everyone has a chance to have it somewhere close so they can access it. It also involves many prominent guest speakers with years of experience in nuclear medicine.