PRRT and the promise it holds for cancer treatment

As we continue our conversation on Precision Medicine for cancer, a popular therapy used to treat NET tumours or Neuro Endocrine Tumours is PRRT or Peptide Receptor Radionuclide therapy.
Neuroendocrine tumours are a rare form of cancer and originate from Neuro endocrine cells in the body and hence the name.They are different from adenocarcinoma’s and often do not do not respond well to chemotherapy, the 1st line of treatment for most cancers.

By administering radioactive protein lutetium octreotate, it is possible to treat NET tumours or neuro endocrine carcinoma with precision and offset progression of disease.

PRRT for neuroendocrine tumour
PRRT treatment for metastatic cancer cells spreading and growing. Tailor-made precision medicine based on genetic profile and molecular structure of the tumour.

In PRRT a peptide or a cell targeting protein is combined with a small amount of radio active nuclide creating what is called as a radio peptide. The radio peptide when injected into the patients blood stream travels and binds to a neuro endocrine tumour, delivering a high dose of radiation to the tumours. This also limits damage to the nearby healthy tissue and hence lesser and milder side effects than chemotherapy.

What kind of cancers can be treated by PRRT?

Along with Neuroendocrine tumours, carcinoids, islet cell carcinoma of the pancreas, small cell carcinoma of the lung a form of lung cancer, pheochromocytoma (a rare tumor that forms in the adrenal glands), gastro-enteropancreatic (stomach cancer , intestine cancer and pancreas) neuroendocrine tumors, and rare thyroid cancers that are unresponsive to treatment with radio iodine are often treated with PRRT.

Role of PRRT is also being explored for treatment of prostate cancer.

When is a patient a candidate for PRRT ?

Patients with following conditions are often proposed for PRRT

  • When neuro endocrine tumours are not responsive to other lines of cancer treatment
  • When surgical removal of tumours is not possible at current stage, PRRT may be used to reduce size of the tumours.
  • PRRT is also a treatment option for last stage inoperable cancers when metastasis has set in.
    The main aim of PRRT is then to slow down progression of disease, offer relief and prolong life.

However, not all neuroendocrine tumours respond to PRRT. First an OctreoScan is done. If the patient is found to have a positive OctreoScan and meets other requirements, PRRT is proposed.

What happens during PRRT ?

For patients having a positive octreoscan, to start with an amino acid solution is delivered to protect the kidneys.

As most net tumours have a lot of a specific type of surface receptor, a protein called somatostatin. Octreotide, is a lab version of somastostatin. During PRRT, a dose of radio nuclides such as Lutetium, Yttrium are often combined with octreotide and injected into the blood stream.

Molecular imaging and scans follow to see whether the radio peptide has latched on of the tumour sites correctly.

The entire session usually lasts for about 4 hrs and is often done as an out patient procedure.

The main goals of PRRT hence are to provide symptom relief, to stop or slow tumor progression and to improve overall survival.

Advantages of PRRT ?

PRRT along with other molecular therapies or targeted therapies offer excellent results as they are tailor made keeping in mind molecular properties of the tumour and also biologic characteristics of the patient.

PRRT is offered in Germany , USA, UK and other developed countries at a significant cost, In India, a single session of PRRT costs approx USD 6300.

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Bowel Cancer- Are there a few red flags to watch out for ?

Bowel cancer is defined as cancer of the bowel or parts of bowel. Depending upon where the cancer is based, it is also known as colon cancer, rectal cancer or colorectal cancer.

Colon cancer is cancer of the rectum. Rectal cancer is cancer of the rectum.

Colorectal cancer is cancer affecting the colon and the rectum.

Most colon cancers are lethal simply because they are diagnosed at a very late stage. Most patients present themselves with symptoms and often visit doctors but symptoms are often missed .

A short guide on awareness of possible symptoms, which are red flags but are often missed during doctor visits.

ColonCancer
Bowel, colon and rectal colorectal cancer symptoms causes risk factors diagnosis
  • Blood in the stool which shows rectal Bleeding
  • Change in Bowel Habits
  • Diarrhoea
  • Abdominal Pain

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Stomach Cancer- Why does it catch us unawares ?

Stomach cancer is defined as the growth of cancerous cells in the stomach lining.
According to the National Cancer Institute (NCI), there will be approximately 24,590 new cases of stomach cancer every year.

Stomach cancer
Clinical stages of stomach cancer. How stomach cancer spreads?

Stomach cancer is often left undiagnosed because it doesn’t have many early symptoms – it is diagnosed when cancer spreads to other parts of the human body.

A few early signs are:
Nausea and Vomiting: Nausea is defined as a feeling of queasiness at the back of your throat or stomach. Vomiting, on the other hand, is defined as the contraction of your stomach muscles that push the digested food back through your oesophagus. Both nausea and vomiting may be early symptoms of stomach cancer especially if one’s blood shows in the vomit.
Bloating: If one faces bloating, which doesn’t ease up and persistent, it calls for a visit to the doctor and an ultrasound at least to start with.

H. Pylori Infection: If one suffers from frequent indigestion, bloating,one must get tested for bacterial Infection with H pylori, as it is the most prominent indication of people developing stomach cancer later.

Research has shown that people suffering from H.Pylori infections have a much incidence of stomach cancers.

Weight loss: Stomach tumours cause blockages, preventing food from passing into the stomach or into the intestines causing loss of appetite. Similarly, stomach cancer causes energy from food to be burned at a faster rate which combined with nutritional loss causes weight loss.

Stomach Pain: Unexplained stomach pain , the kind which persists is also a warning sign that something may be wrong.

Frequent HeartBurns:  Frequent heartburns could be because of ulcers and may also indicate that everything is not ok.

Inability to eat: As the tumour progresses, it blocks various parts of the digestive system. Coupled with body’s inability to digest food,  there is a reduced appetite, which at a later stage is often total inability to eat and digest food.

As the symptoms are so generic, they are often missed leading to diagnosis at a much later stage when the cancer has spread or metastatised to other parts of the body.

Is there a co-relation between our habits and stomach cancer?
Food: Food and stomach cancer have a direct relationship. The right dietary intake can lower the risk of stomach cancer. Storage of food through refrigeration instead of by smoking, salting and pickling also reduces the risk because the nitrates and nitrites in smoked food increase the risk of stomach cancer.
Smoking: The use of tobacco increases the risk of stomach cancer. It is said that the rate of risk of stomach cancer is doubled in smokers as compared to non-smokers. This is because smoking reduces the production of natural substances that protect the stomach and duodenum from tissue damage. Additionally, smoking promotes the duodenum reflux and increases the acidity of the duodenum making it vulnerable to H. Pylori bacteria. Smoking also constricts the blood vessels in the stomach reducing the blood flow in the stomach. All these mechanisms strengthen the link between stomach cancer and smoking.

Treatment of stomach cancer involves, surgery if detected at an early stage, followed by chemotherapy as the 1st line of treatment.

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Anaemic ! Could it be You ?

sickle cell anemia
anemia

Anaemia is very common medical condition, where the body does not produce enough healthy red blood cells or excessively destructs blood cells.
Most people have anaemia due to poor dietary habits and inadequate nutrition while certain forms of anaemia are hereditary.
Some of the early warning signs , which are common across all 400 types of anaemia are:

anemia symptoms
Early warning sign and symptoms that may appear in anemia

Fatigue : The most common warning sign of anaemia is fatigue. It occurs because the body doesn’t have enough Red Blood Cells to carry haemoglobin which contains oxygen to the cells leading to exhaustion.

Pale Skin : Paleness of the skin is usually dependent on the thickness and density of blood vessels below the skin. A lack of red blood cells due to anaemia

A very pale pallor can also be due to sickle cell anaemia ( a medical condition where abnormally shaped red blood cells block the flow of blood).

Swollen or Sore tongue : A big warning sign of anaemia is an anaemia tongue wherein ones tongue gets inflamed due to low iron levels in the body. The surface of the tongue can often smoothen out or your tongue can morph into different shades.

Swollen Hands and feet : Swollen hands and feet are a symptom of sickle cell anaemia. In sickle cell anaemia, the sickle shaped red blood cells clump together and block the flow of blood in the body – leading to the blood flow being cut off from the tissues and organs.

Shortness of breath : This occurs because the red blood cells carrying oxygen have less haemoglobin and less capacity to bind oxygen causing shortness of breath.

Brittle nails : Nails have a protective hard layer called keratin that protects the soft tissue in your nails. Lack of red blood cell production due to anaemia prohibits the growth of nails. Ridges and banding in the nails are often indicators of anaemia.

Appetite for inedible items : Pica is defined as a craving to chew or eat substances of no nutritional value such as ice, paper, chalk, pencils, wall putty etc. These unusual cravings in order to satiate the body’s appetite for iron must not be ignored as it is the first sign of anaemia.

Sickle cell anaemia is a very severe form of anaemia and is often inherited. Although those suffering from anaemia and sickle cell disease suffer from fatigue, pale pallor, shortness of breath, people suffering from just anemia rarely suffer from frequent chest infections or have painful crisis

Sicklers or people suffering from sickle cell anaemia, often have painful crisis situations, when the haemoglobin can even drop to between 1 and 3 leading to even death within few hours.

Sickles often suffer from organ damage and  may need a hip replacement . a shoulder replacement or rarely even a knee replacement.

Although Sickle cell anaemia can be managed with hydroxy urea, if the patients has reached a point where he or she suffers from chest infections, frequent painful crisis, or needs a hip replacement or shoulder replacement, a bone marrow transplant should be considered.

A bone marrow transplant, with matching donors has more than an 85% success rate and is the only possible cure and treatment for sickle cell anaemia.

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Cancer Treatment in India, Colon Cancer

colon cancer
colon cancer

Colon Cancer Treatment:

Colon Cancer occurs when there is uncontrolled cell growth in the large intestine. Mostly it grows out of tumors known as adenomatous polyps that occur in the walls of the large intestine.

Major causes of colon cancer include polyps, genes, traits, habits, diet and other medical factors. Cancer Treatment in India involves diagnosis and starting of the treatment process.

Types of Colon Cancer:

The types of colon cancer include:

1. Primary colorectal lymphomas
2. Gastrointestinal stromal tumors
3. Lecomyosarcomas
4. Carcinold tumors
5. Melanomas

Colon Cancer Symptoms:

  • Weight loss Anemia
  • Abdominal pain
  • Blood in the stool
  • Stool consistency change
  • Diarrhea or constipation maybe experienced
  • Stools maybe narrow
  • Bowel movement pain
  • Fatigue

Diagnosis of Colon Cancer

For a diagnosis full physical examination and also personal examination and family medical histories may be examined. The diagnosis is done after an endoscopy is conducted.

Endoscopy is a procedure for examining a person’s digestive tract using an endoscope. In the case for diagnosing colon cancer an endoscopy known as sigmoidoscopy or colonoscopy is done.

It involves inserting a long flexible tube with a camera on one end into the rectum for inspecting the colon inside. When polyps are found inside the colon are removed and further examined under a microscope so as to detect any cancerous cells.

The process of endoscopy begins with the patient staying without food or drinks for a number of hours before the procedure.

Through the rectum a liquid containing the element barium is injected to the colon to line the intestine then an X-ray is done of both the colon and the rectum.

The element will show white color on X-ray tumors and it will show dark outlines on polyps. To know how far the cancer has spread chest X-rays, CT scans of the lungs, liver and abdomen are done. In other cases a blood test is done to determine whether carcinoembryonic antigen which is a substance produced by some cancer cells.

The stage of cancer is determined after diagnosis and this helps in knowing choices available for treatment and it also informs prognoses. The staging method of cancer is called TNM system.

T shows how the intestine has been invaded by the cancer cells.

N shows the degree to which cancer has spread to the nearby lymph nodes.

M shows whether cancer has spread to other body organs.

Colon cancer is also grouped according to TNM classification 0 to IV. 0 Tis, N0, M0 where (Tis) is carcinoma this is when the tumor is in the inner layer of the colon or rectum only. N (Mi) shows cancer that has spread to other organs throughout the body.

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Diagnosing Kidney Cancer

First off all, one need to see a doctor to examine the condition, He may carry out some physical examination before requesting further test.

Several test may be requested to ascertain the condition, these include; Urine test which shows accumulation of certain unwanted substances in the urine.

Ultrasound scan uses high frequency sound wave to determine the size , shape and contour of the kidney.

Computed tomography urogram scanning would shows detail picture of the urinary system including the kidney which makes it possible for doctors to spot any anomalies.

Cystoscopy is recommended for people with blood in their urine. Here a thin tube with eyepiece called a cystoscope is inserted into the urinary tract to produce pictures of the bladder and kidney on a TV screen connected to the cystoscope.

The cystoscope is also equipped with a small knife for cutting of tissue for histological findings.

Next Article: Treatment of kidney cancer Surgery

Cancer Treatment- Why travelling to India is a good option

Cancer Treatment- Why travelling to India is a good option Cancer Treatment in India:

Have you just been diagnosed with cancer and do not know what to do? Have you searched for high quality cancer treatments locally and found none? Recent research has shown that cancer is one of the world’s most feared terminal illnesses. This fear has lead to many people to believe that the disease cannot be effectively treated. However, cancer medical specialists argue that the disease can easily be treated and controlled if it is detected during its early stages. Many cancer patients have died because of they were unable to raise the amount of money that was required for treatment abroad. But there is a ray of hope for many cancer patients who might be struggling to raise the abnormal medical fees for them to be treated. This article will offer all the information about Cancer treatment, cost in India compared to other countries in the whole world.

Reasons why seeking cancer treatment in India is the best option ever:

There has been a major exodus of cancer patients refusing to be treated in local hospitals in their countries of origin. This has made India as the leading cancer treatment provider in the whole world. India has one of the best world cancer treatment facilities in the world. We investigated some of the major reasons for this mass exodus of cancer patients to India and found out the following observations as discussed below;

Lower cost of treatment

Unlike in many countries around the world where cancer treatment is expensive, cancer treatments,cost in India is mush affordable. Despite the kind of cancer your patient might be having, taking him to India for treatment would save you a lot of money. Recent cancer treatments showed that it is only India where you can access high quality services at very low costs. There were some countries where the researched showed that the cost of flight plus cancer treatments cost only costs half that would be charged at the local hospitals. There are many cancer treatment hospitals in India which greatly contributes to the reduction of cancer treatments, cost in India.

Highly qualified Cancer specialists

It is a known that Indians are well gifted in the field of medicine and surgery. India has produced one of the most renowned surgeons and medical practitioners that have high competency levels in the filed. This also applies to cancer where most cancer specialists are Indians, This makes travelling to India for cancer treatment as the best option compared to local hospitals.

Modernized cancer equipments

India has the latest digital equipments for detecting and screening cancer that are not easy to find other countries around the World. The equipment uses one of the latest technologies for diagnosing cancer among the patients. The equipments make the detection and diagnosis of cancer related ailmets to be worked faster and efficient. This is why traveling to India for cancer treatment would be the best cancer treatment option that being treated at local hospitals.

CONCLUSION

It is now evident that cancer treatment, cost in India is lower compared to other countries in the whole world. This article is a must read for people who might be having cancer patients at home who need medical attention but are stranded due to high cost of treatment in local hospitals.