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Wednesday, June 27, 2012

Benefits of postoperative Chemotherapy

Benefits of postoperative Chemotherapy on Elderly person with lung cancer
Administering chemotherapy adjuvan in patients of lung cancer types rather than small cell stage IB-III (non-small cell lung cancer, NSCLC) visible increase relapse-free and overall survival in several clinical trials. However, the median age of patients in clinical trials that have ranged from 59 to 61 years of age. Not yet known for sure if the patient was also benefit further against the granting of postoperative chemotherapy (adjuvan therapy).

To answer these questions, conducted observational cohort study involving patients with NSCLC stage II 3324-aged ≥ 65 years IIIA of the Surveillance Epidemiology and End Results (SEER) database 1992-2005. As much as 21% (n = 684) of these patients received a platinum-based chemotherapy post-war operations. An analysis of preliminary data showed no difference in demographic factors among patients who received chemotherapy with who received no chemotherapy.

Observed an increase in life expectancy in patients stadium II and IIIA who got the chemotherapy (hazard ratio 0.80; 95% CI,-0.90 0.72). Detailed chemotherapy regimen is not assessed. Age stratification based on analysis shows that the benefits of increased life expectancy was only observed in patients aged category < 70 years and 70 – 79 years of age, but not in patients aged ≥ 80 years. Insidens hospitalization due to serious side effects at higher in patients who received chemotherapy compared to 13.0% not (vs. 6.9%) with odds ratio 2.0 (95% CI, 1.5-2.6). The benefits of giving chemotherapy also observed in patients who received radiotherapy and radiotherapy do not get.

In conclusion, the adjuvan platinum-based chemotherapy was associated with a decrease in mortality and an increase in serious adverse effects on the person with disability-IIIA NSCLC stage II. The magnitude of the benefits comparable to that observed in randomized clinical trials.

Monday, June 25, 2012

Early detection of cancer

One problem often encountered in cancer therapy is a cancer that is found already in an advanced stage. Advanced cancer have a different behavior from early-stage cancer, and would complicate recovery efforts. To increase the life expectancy of cancer patients, cancer patients should be treated as early as possible. Therefore, the cancer needs to be recognized as early as possible. The earlier known, the greater the chance for cure. Because of complaints and symptoms appear until several years the cancer grows, it needs to be increased awareness of cancer and cancer test routine checks done regularly, especially for a high risk for cancer. If there is one let alone both parents, siblings, grandparents who have cancer, these individuals need to be more aware of the possibility of cancer.

Symptoms or characteristics of cancer is often not obvious in the early moments. In general, it takes a long time (several years) before the onset of complaints or symptoms of cancer. Therefore, it is more often recognized too late cancer cases due to complaints and symptoms appear until the cancer reaches an advanced stage.

Complaints and symptoms of cancer according to the organ who have it. Symptoms of uterine cancer led to complaints in connection with the functions of reproductive organs, such as menstrual disorders. Prostate cancer symptoms appear with urinary disorders. Colorectal cancer appears to complaints bowel disorders and abnormalities in the feces.

According to Wan decentralization (2008), at least ten warning signs for a tumor or cancer towards malignancy, namely:
1. In the mammary gland, skin, tongue, or other parts, palpable lump that is not lost.
2. Moles striking changes, such as color changing, rapidly grew in size, itching, hair loose or easily removed, discharge, bleed easily.
3. Disorders in the digestive process that lasts a long time or continuously, and not soon disappear.
4. Time to swallow feels there are obstacles, pain, discomfort or discomfort behind the breastbone, there was a foreign object in throat, or pain in the gut.
5. Ringing in the ears, decreased hearing, nasal congestion, nosebleeds, ripple or issued bloody sputum, headache (continuous), lump in the neck.
6. Abnormal menstrual bleeding, outside the menstrual period, or at the time of menopause arise vaginal bleeding irregularities, also bleed when touched.
7. Hoarseness, dry cough, coughing up blood ongoing or continuous.
8. Stools mixed with blood, mucus, or diarrhea (loose stools), constipation (hard bowel movements) that occur alternately without obvious cause; bloody urine (hematuria) of unknown cause (idiopathic).
9. Wounds that never healed, or healed long ago.
10.Berat loss without apparent cause.

If you experience one or more of the above symptoms, consult your doctor.

With the advancement of science and medical technology, now we do not have to wait until the complaint or symptoms of cancer. Now with the various types of laboratory tests to check blood and tumor markers (tumor marker), many cases of cancer can be recognized already in early stages.

These various tumor marker tests (tumor markers):
• CEA (carcinoembryonic antigen): For colon cancer, pancreas, lung, breast, ovary, bladder, leukemia, thyroid, bone (also elevated in pregnancy, colitis, rectal polyps, ulcers, kidney failure, lung disease , breast cysts)
• AFP (Alpha-fetoprotein): Cancer of the liver, testicles, ovaries, stomach, pancreas, colon, breast, kidney, lung (also increased in infants with neurological abnormalities, hepatitis virus, twin pregnancy, abortion)
• PSA (Prostate-specific antigen): Prostate cancer (also elevated in benign prostate enlargement, prostatitis (prostate inflammation)
• CA 19-9 (carbohydrate antigen): Cancer of the pancreas, liver, lung, stomach, large intestine (also increased in inflammation of the pancreas, gallbladder inflammation, gallstones, cirrhosis)
• CA 125: Cancer of the ovaries, cervix, pancreas, liver (also elevated in pregnancy, endometriosis, pelvic inflammation, hepatitis, menstruation, lung disease, heart inflammation, gastrointestinal disease)
• NSE: eyeball, lung, pancreas, thyroid, breast, prostate, digestive, kidney son (also elevated in liver disease)
• BRCA-1 & 2: Breast cancer and ovarian
• EBV IgA-EA: Nose and throat

The emergence of the complaints and symptoms will lead doctors to perform the examination. Starting from the physical examination to find a lump (tumor) and the investigation with the help of x-rays, ultrasound (ultrasonography), MRI (magnetic resonance imaging), CT-Scan (computerized tomography scanning), and followed by laboratory examination of blood, urine, stool, cerebrospinal fluid, and biopsies (taking tissue fragments on the suspected type of cancer and then examined the cells under a microscope).

If you experience one or more of the above symptoms, consult your doctor.

Do not let cancer claimed the lives!

The sooner we know, the greater the expectations of our lives!

Thursday, June 21, 2012

Cervical cancer

Cervical cancer is cancer arising in the cervix or in the mouth / neck of the womb. Cervical cancer is a type of cancer most of the world's number three. The number of people with cervical cancer in Indonesia is also quite large and has recently increased. Every day found 40-45 new cases by the number of deaths reaching 20-25 people or it can be said every hour an Indonesian woman died from cervical cancer.

Cervical cancer is referred to as the "silent killer" because it is difficult to detect cancer development. The course of cancer-causing virus infection to the onset of symptoms occurs gradually, which is about 10-20 years. First, some cells changed from normal to precancerous cells which do not cause symptoms and eventually become a cancer cell will cause symptoms. This process is often not realized. Laila Nuranna doctor, SpOG (K), Chief of Obstetrics Gynecology Oncology Faculty of Medicine, University of Indonesia, said that most cases of cervical cancer are detected have an advanced stage that it is difficult to treat.

Cervical cancer often occurs in middle-aged women. The majority of cases are found to occur in women younger than 50 years. Many women do not know that with the increasing age, are increasing their risk for cervical cancer. This is why it is important for women who have aged to undergo a Pap smear test can detect pre-cancerous cells on a regular basis.

The cause of cervical cancer is infection of Human Papilloma Virus (HPV) or human papilloma virus. Approximately 70% of cases of cervical cancer is caused by infection with HPV 16 and 18. Cervical cancer can occur if the HPV infection does not heal for a long time. Moreover, the immune system or immune system is low, the infection raged, and cause cancer cells. The virus can be spread through touch: for example, there is the HPV virus in your hand and touches your genital area, then you can be infected cervical region. Or it could be from the toilet in a public restroom that has been contaminated with the virus.

In addition, there are a number of risk factors or causes of cervical cancer:
• Women aged over 40 years are more susceptible to cervical cancer.
The older the higher the risk.
• Genetic factors play a role not in cervical cancer.
But this does not mean that if your family is free of cervical cancer then you will not be affected! You should still be careful and take precautions.
• Sexual intercourse at a young age too, changing sexual partners, or sex with a man who frequently change partners. HPV virus can be transmitted through sexual contact. If a man having sex with a woman suffering from cervical cancer, and men having sex with you, the HPV virus can be contagious and infect you.
• Having too many children (more than 5 children). By the time you give birth naturally, the fetus will pass through the cervix and cause trauma to the cervix, which can trigger active cancer cells. The more often the fetus through the cervix, the more frequent trauma occurred, the higher the risk of cervical cancer.
• Whitish ongoing and untreated. There are two kinds of discharge, which is normal and not normal. On a normal vaginal discharge, mucus is actually clear, no odor and no itching. If any of these three conditions are not met, it means you are not a normal vaginal discharge. Consultation with a doctor immediately!
• Washing or cleaning genital with unclean water, eg river water or water in public toilets that are not maintained. Dirty water contains a lot of germs and bacteria.
• Use sanitary napkins that contain dioxin (bleach used to whiten the pads recycled from used goods).
• The immune system is weak, the lack of vitamin C, vitamin E and folic acid. Smoking also increase risk of cervical cancer.

In the early stages, cervical cancer symptoms are not too obvious. Here are the symptoms found in cervical cancer:
• Pain or bleeding during intercourse,,
• abnormal vaginal discharge
• Excessive Menstruation
• Lack of appetite, back pain or can not stand upright, pain in the muscles of the thigh, one leg swelling, weight up and down, unable to urinate, discharge of urine from the vagina, spontaneous bleeding after menopause, bone is fragile and pelvic pain.

With cervical cancer symptoms are not noticeable and development for a long time, things we can do is try to find cervical cancer at an early stage.
There are a number of methods to detect or find out if you get cervical cancer, among others:
• IVA - Visual Inspection with Acetic Acid.
Acetic acid solution 3% -5% is applied to the cervix would be observed if there are changes in color, such as white patches appear. If there is, then there is the possibility of infection of the cervix and should be carried out further checks.
• Pap Smear or also known as the Papanicolaou test, Pap test, cervical smear, smear test.
Pap smear has many advantages, including: low cost, fast time and accurate results. This test is recommended to be done at least once a year. Results of cervical smears and then examined under a microscope to see if there are abnormal cells, infection or inflammation. Conduct regular pap smears can reduce the risk of death from cervical cancer.
• Thin prep liquid-based method is more accurate than a pap smear, pap smear because it only takes a few cells from the cervix, while the thin prep examine all parts of the cervix. The sample is used as a slide and given a special dye to make it more clear. Special membrane is used to make preparations with thin slices, which will show an infection or abnormal tissue. The accuracy of this method is almost reached 100%.


If you are detected with 'cervical cancer', do not worry. Right now there are a number of methods to treat cervical cancer. In the early stages, cervical cancer treatment carried out by removing parts that have been affected by cancer, for example by electric surgery, laser or cyrosurgery (freeze and remove the abnormal tissue).
For the treatment of advanced cervical cancer, chemotherapy and radiotherapy therapy. At the end stage or severe cases it had to do a hysterectomy, the surgical removal of the womb (uterus) in total for cancer cells that have been developed in the womb does not spread to other parts of the body.

Prevention is better than cure. Therefore, before you get cervical cancer, here are some suggestions for preventing infection with HPV virus:
• Keep health and stamina by the consumption of nutritious foods. Live a healthy lifestyle by eating vegetables, fruits and cereals. Expand the foods that contain vitamin A, C and E and folic acid to reduce the risk of cervical cancer.
• Before using the toilet in a public place, always clean the toilet lip with alcohol. Do not clean the genitals with dirty water.
• Avoid sexual intercourse at an early age. Avoid sex with multiple partners because HPV is spread through sexual contact. Avoid having sex during menstruation / menses.
• Avoid smoking, because tobacco use can cause cancer.
• Routine screening of pap smears, or IVA cervical cancer to early detection.
• Vaccination can be performed on women aged 10-55 years with a repeat injection 3 times, namely in the months 0, 1 and 6. HPV vaccine will increase the child so it is more resistant immune to the virus.

Wednesday, June 20, 2012

Malnutrition in Cancer

Malnutrition is a state of nutritional deficiency or excess. In cancer patients, who often are malnourished. According to one source, some 30-80% of cancer patients will experience weight loss during the course of their illness. Among that number, 97.6% require nutrients. If left untreated, will lead to malnutrition kakheksia, a wasting syndrome (tissue breakdown) which would lead to immune disorders, weakness and weight loss, fat loss and muscle tissue.

According to data from the publication of the National Cancer Institute United States, 20-40% of cancer patients die from complications of malnutrition, not from cancer itself. Problem of malnutrition was not only experienced by cancer patients who were treated at the hospital, but also experienced by outpatients because it was found that outpatients were difficult to eat in sufficient quantities.

Mechanism of occurrence of malnutrition in cancer patients is multifactorial, complex and intertwined, which can be divided into two: a direct result of cancer itself and not the direct result of, among others, and the complications arising from cancer therapy.

Various causes of malnutrition in cancer patients include:
• Decrease in food intake
 - Loss of appetite
 - Not able to eat, due to: the mouth and teeth problems, blockage of the digestive tract
• Increased nutritional needs
 - Hypermetabolic state experienced by cancer patients
 - The need has increased for the fight against disease
• Increased networking solution
  - The production of substances that cause inflammation by cancerous tissue.

Malnutrition in cancer patients will lead to immune disorders, impaired wound healing, decreased the response of chemotherapy and radiotherapy, leading to apathy and fatigue, and decreased quality of life and increased complications and death.

Symptoms and Signs
In general, symptoms and signs of malnutrition develops slowly and is found through examination of weaning (screening) and the assessment of nutritional status.
Weaning examination aims to find the risk of malnutrition in patients who showed no symptoms. This examination will help if the patient is at risk of malnutrition, and can take steps to prevent malnutrition.
Assessment of nutritional status to check the nutritional status of patients and help determine whether the handling of nutrients are needed to address nutritional problems experienced by patients.
Symptoms and signs of malnutrition that may arise are tired, weak, weight loss and upper arm circumference, anemia, and others.

Nutrition Therapy
Every cancer patient nutritional status as a check that can be done by an integrated team consisting of:
• Physician
• Nurse
• Nutritionists

Integrated nutrition team will utilize specific nutrients that are beneficial to cancer patients with the objectives below:
• Preventing or overcoming nutritional problems, including preventing damage to the muscles and bones
• Reduce the side effects of cancer therapy
• Maintain strength and energy of patients
• Helps the immune system fight infection
• Improve the effectiveness of therapy
• Improve quality of life.

A variety of specific nutrients that are beneficial to cancer patients, among others:
• Protein
In accordance with the mechanism of the onset of weight loss in cancer patients is muscle tissue breakdown, protein in the cancer patient's nutritional intake will overcome the conditions of protein breakdown and promote weight loss. With the high rate of catabolism of cancer patients, the higher the protein intake of cancer patients, the better. Among the many controversies that exist regarding the amount of protein intake that is safe for cancer patients, a body of research clearly indicates that protein restriction does not alter the composition of cancer patients or rate of tumor growth, but reduces the patient's health.
• Branch Chain Amino Acids
Branch Chain Amino Acid (Branched Chain Amino Acid) is a set of essential amino acids that are beneficial to increase appetite and decrease tissue breakdown. BCAA this would also help boost the immune system that helps the body fight infection.
• Omega 3
Omega 3 fatty acid is a very good way to help reduce the inflammation that will cause cell damage and weight loss.
• FOS
FOS is a probiotic fruktooliogosakarida which is good to maintain a healthy digestive tract cancer patients.
• Anti-Oxidant
Antioxidants are useful to prevent oxidative damage
• Mineral and Vitamin
Provision of minerals and vitamins intended to meet the needs of multivitamin and mineral that is often deficits in cancer patients.

From the above, we can conclude that the nutritional status of cancer patients play an important role in survival and quality of life of patients. Worsening quality of life and decrease the survival rate of patients not only experienced by severe malnutrition, but also by who are malnourished.
With nutritional therapy that utilizes the nutrients that are specific to cancer patients, the condition, response to therapy, therapeutic effectiveness and quality of life of patients can be improved and maintained that will lead to improved patient survival.