BiomedNews.org

When death is near, do lung cancer patients live longer with chemotherapy or with early palliative care?

Of the three types of lung cancer, non-small cell lung cancer is the most common. Oncologists have been trained to treat it aggressively, including heavy use of chemotherapy.  Some researchers decided to test informal conclusions reached earlier that seemed to show that such aggressive use of chemo in the last stages of cancer improved survival.

Unlike previous looks at these alternatives, the current study was carefully designed, and it found conclusively that giving patients early palliative care—i.e., treating only to relieve symptoms rather than trying to cure the disease—along with standard oncology care, but excluding chemotherapy, actually does increase patient survival times. What’s more, it definitively improves quality of life during the last 60 days before death.

A part of that QOL improvement in the study came because, in stopping the aggressive treatment, doctors were not inadvertently leading patients to believe that such treatment might still potentially save their lives. The patients  better understood the truth of their situation.

I am glad to hear there is now scientific backing for this quieter end to life. It’s hard enough knowing you’re going to die, but even worse to have to meanwhile suffer the discomforts and indignity of having your body bombarded with and fighting the effects of poisonous chemicals. This is a time when you may want all your strength and clarity of mind to find closure with your loved ones and peace with the end of your life.

Blood flow in the brain - Image via Wikipedia

Stroke is the #3 killer in the U.S. and other industrialized countries. Plus, the death of brain cells as a result of a stroke can induce disability at one level or another across a critical range of human functions—speech, movement, thought processing, writing, etc.

Nitric oxide (NO) doesn’t normally affect blood flow in the brain. But now a few studies have shown a stroke can change that. Inhaling nitric oxide with an oxygen/air mix actually increases blood flow into areas of the brain where arterial blood was blocked during the stroke. They’ve confirmed this phenomenon in two studies in mice and one with large animals.

Another accomplishment for NO, this miraculous substance we produce in our bodies. Read a few more posts about  nitric oxide here.

Good source of potassium - Image by Getty Images via @daylife

We’ve all heard since we were young, if you have high blood pressure you have to  cut your salt. Now scientists have found more people with high salt levels are dying of cardiovascular and all other causes—when they also have low potassium levels.

Sodium is known to  raise blood pressure and stiffen arteries. Potassium activates nitric oxide, which relaxes arteries and combats high blood pressure. Sodium also interferes with the body’s ability to use nitric oxide. Read more at National Institutes of Health on sodium-potassium.

A poor ratio of salt to potassium is found with more deaths from cardiovascular causes and from all causes. It’s a question of balance, according to a recent study in the Archives of Internal Medicine put out by the Centers for Disease Control and Prevention.

And of course, the study does not say that the high-salt-low-potassium levels are what actually killed people—just that many deaths were associated with the poor ratio. Other causes could certainly be more directly responsible for the deaths they counted. Perhaps a reasonable conclusion we might make is that if you eat too much salt you might also be prone to make other less-than-ideal lifestyle and nutrition choices.  Geez, these days we can’t get away with anything…

Image via Wikipedia

But either way, folks with high blood pressure or congestive heart failure must carefully ration consumption of foods high in sodium–which includes almost anything you buy in packages or eat in restaurants—and eat lots of foods high in potassium. Thankfully there are dozens of tasty foods loaded with it, so most people don’t have to look to supplements. Like have a baked potato—one of the richest and best-tasting sources of potassium you can get. By the way, start gradually substituting no-fat yogurt for your sour cream. Then when you use just yogurt on your baked potato you get another boost to potassium along with other nutrition benefits.

Studies show that Americans get about 75% of their sodium from prepared foods and restaurant meals. I’ve personally found that if I eat mostly fresh foods and those I cook from scratch, I don’t have to totally avoid salting my food. So it may be that if you don’t get the gross overload of sodium from prepared foods, there’s room for enough salt to safely make your own cooked foods taste very good. Naturally, though, your doctor is the last word on all of this.

Have a happy, healthy new year—and eat some spinach in your scrambled eggs tomorrow to combat the potato chips and cheese in your NYE feast tonight…

My sister and her husband recently had to cut short their vacation in the mountains of western U.S. They got extremely sick with altitude sickness. Scary.

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Well, apparently even 500 years of living at high altitudes is not enough time for humans to adapt so that their lungs work well enough to prevent altitude sicknesses. But Tibetans, who’ve been living at high altitudes for 25,000 years, and Bolivians who’ve also lived in the mountains for thousands of years have adapted so well that they completely avoid altitude sickness. Their lungs now automatically produce more nitric oxide than we plain dwellers, according to this article on CNN.com about how Tibetans and Viagra demonstrate the power of nitric oxide.

They don’t advise mountain climbers to run out and buy Viagra to solve the issue. The drug comes in big doses and only lasts “up to 4 hours,” but your lungs don’t need that much. More research will certainly be done to determine the magic combination and proper dosage that will work for high-altitude short-termers.

I love discovering new uses for this multi-talented substance that our bodies produce. Check out some interesting BioMedNews posts on nitric oxide.

Most deaths from cancer come after the primary tumor has been treated—usually with some combination of surgery and chemo or radiation—when stray cancer cells from the tumor escape and spread to other parts of the body (metastasis).

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Since not all cells from cancer tumors behave the same way or have the same DNA, researchers have been looking for a way to study single cells. The problem was separating them. Now this new nanoparticle approach uses magnets to detect whether cells are growing, dividing or dying. It spins the cells in a magnetic field where each type rotates at a different speed. Larger, dying or dividing cells rotate more slowly and in specific patterns. so they can be separated into a group of single cells. Thus the researcher can focus on investigating the behavior of those particular cells.

One of the big promises of this approach is that scientists may now be able to test drugs on just the cells themselves instead of on the entire human organism—thus avoiding some of the worst side effects for patients. And, instead of throwing everything they have at the patient in hopes of affecting the disease, doctors can work with the cells and then with greater confidence prescribe medicine they’ve been able to test as working best for this individual person.

What a blessing for cancer patients this will be.

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It’s only a small group of patients, but the results are dramatic. A new gene therapy for advanced heart failure looks really promising.

People can live a long time with heart failure if it’s kept under control. But if it gets to where they can’t keep the water from accumulating beyond safe levels in the body’s tissues, patients begin to feel like hell and experience more frequent cardiac events that put them in the hospital.

Researchers conducted a Phase II trial at Mount Sinai School of Medicine with a gene therapy developed there and found it stabilized or improved cardiac function in people with severe heart failure. The patients who were given a high dose of the therapy, called SERCA2a, benefited clinically (which means they felt better or lived longer) and had significantly fewer cardiovascular hospitalizations. The study appears online in the June 27 issue of the American Heart Association journal Circulation.

Simply put, the SERCA2a therapy consists of delivering an inactive virus that carries medication into cardiac cells. It then stimulates the heart cells to produce an enzyme that helps the heart pump more effectively in people with advanced heart failure.

Quality of life is often just as important as longevity. If you can feel okay and not have to go to the hospital every other week or month, it’s a lot easier to live your life more fully. Advanced heart failure is tough—it’s always exciting to see that science continues to find ways to use the tools of nature to help in relatively non-invasive ways.

The Fugitive (Image via RottenTomatoes.com) Tommy Lee Jones confronts Harrison Ford

“How the pharmaceutical companies distort medical knowledge, mislead doctors, and compromise your health.” That’s what it says the book is about. Just started reading Overdosed America, The Broken Promise of American Medicine, by John Abramson, MD.

Dr. Abramson was a family physician for 20-some years. When he knew he had to write this book he left the practice of medicine. He doesn’t say this, but I’d guess he left because he didn’t want anyone to be able to raise a question about his motives in writing this careful analysis of some seriously negative practices going on in the American medical industry.

Along with his indictments of highly respected medical journals for publishing questionable research conclusions supported by misleading statistical information, he states that billions and billions of American citizens’ dollars are being diverted to the coffers of giant corporations—a la the fictional Devlin MacGregor from the movie The Fugitive .

The first case Dr. Abramson presents concerns Vioxx and Celebrex. He notes two early articles that appeared in the Journal of the American Medical Association from November 24, 1999, touting the supposed beneficial effects of the two drugs for arthritis pain. He then studies the accompanying editorial and notes that it says, in contrast to the articles, there is no statistical benefit of these drugs over older, less expensive drugs. The editorial calculated that preventing a single serious ulcer with either of these medicines would cost the American public $400,000.

And as of 2005, lawsuits were being filed against Merck for misleading people instead about the dangers of Vioxx—an increased risk of heart problems and stroke. Here’s a concise review of how Overdosed America addresses these issues in relation to arthritis patients.

Have personally seen a friend suffering terrible side effects from statins. Dr. Abramson writes about how a patient bullies him into prescribing it for him—despite the doc’s recommendations to the contrary. That’s the next drug he tackles in the book. I’ll let you know what he finds.

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Didn’t it have to be only a matter of time? I’m happy but not surprised to find that heart patients are beginning to benefit from having stem cells injected into their body’s operating plant. So far studies are limited, but they involve human hearts, not mice or pigs, and are yielding some very promising results.

In one case patients who’d had a heart attack had their hearts injected with bone marrow stem cells and experienced stronger healing. Even some scars in heart tissue began to fade. In another study patients battling heart failure after a heart attack benefited from injections of their own cardiac stem cells.

Research indicates that timing and sourcing are important. Using cardiac stem cells seems more effective than those from bone marrow. Injecting stem cells too soon or too late can cut short or even nullify benefits.

All the heart patients today have got to be on pins and needles hoping this research will progress rapidly enough to make a difference for them and those who love them.

Image via Wikipedia

Exercise. Yeah I know. Do you really want to hear about another way exercise is good for you? Well, this appears to be a slightly new take. It’s about how nitric oxide (NO), a short-lived gas produced by the body during exercise, benefits the heart.

A recent study published in the journal, Circulation Research, says that voluntary exercise (as opposed, I guess, to sitting in some machine that moves your body for you) produces nitric oxide which then “turns on chemical pathways that relax blood vessels to increase blood flow and activate survival pathways [emphasis mine].” Exercise was found to boost “levels of an enzyme that produces nitric oxide (eNOS, endothelial nitric oxide synthase).”

So in short, you choose to exercise. Your body produces NO, then the NO is “stored in the bloodstream and heart in the form of nitrite and nitrosothiols,” which are then withdrawn from storage as needed. And even cooler, these reserves remain elevated for a week after exercise has stopped—”unlike other heart enzymes stimulated by exercise”—and don’t return to baseline until four whole weeks after exercise. So it seems we get a lot for a little effort.

I once had a book called Dr. Naglier’s Body Maintenance and Repair Book. He said, emphatically, that even five minutes of movement a day is so much better for your body than nothing, that you should never not do anything because you’re afraid you couldn’t possibly do all the exercise “they” recommend.

Score another big one for nitric oxide. It’s truly a health friend, and it doesn’t take much to put it to work for you.

Image via Wikipedia - Total recorded alcohol per capita consumption (15+) in liters of pure alcohol

Many a drinker felt a burst of hope/support when scientists first began finding connections between genetic makeup and the urge to drink alcohol. The hope was, if you drank too much, they might find a way to “cure” it, just as they have found cures for so many diseases. And hopefully a gentler cure that doesn’t involve making you violently ill when you take a drink.

The search continues. Researchers have previously established that a “neuronal nitric oxide synthase 1 (NOS1) gene promoter polymorphism, EX1f-VNTR (exon 1f-variable number tandem repeats)” (***see note below) influences both impulsivity and psychopathology.

A recent study now says there may be a reverse correlation between one allele (one member of a pair of genes), the short one, and its pair. The short one, associated with psychpathology and impulsivity—long thought to be linked to alcoholism—has been  considered the “risk” gene for alcohol consumption in humans.

The study indicates it’s actually the long allele that’s a marker for starting drinking at an earlier age, drinking more, and experiencing more severe effects of alcohol. And the study results were significant enough for Clinical Psychiatry News to use the headline: Allele Appears Protective Against Alcohol Use. So they’re getting closer to identifying a genetic link—and creating new hope for treating alcoholism more effectively.

*** Looking up the definition of this incredibly long name didn’t enlighten me much, but it led me to an article about it in relation to allergic diseases in the Czech people, and one in relation to Parkinson’s disease in Taiwan…