- Order:
- Duration: 8:19
- Published: 13 May 2009
- Uploaded: 06 May 2011
- Author: IrishCancerSociety
Most commonly, chemotherapy acts by killing cells that divide rapidly, one of the main properties of most cancer cells. This means that it also harms cells that divide rapidly under normal circumstances: cells in the bone marrow, digestive tract and hair follicles; this results in the most common side effects of chemotherapy : myelosuppression (decreased production of blood cells, hence also immunosuppression), mucositis (inflammation of the lining of the digestive tract), and alopecia (hair loss).
Other uses of cytostatic chemotherapy agents (including the ones mentioned below) are the treatment of autoimmune diseases such as multiple sclerosis, dermatomyositis, polymyositis, lupus, rheumatoid arthritis (See DMARDs) and the suppression of transplant rejections (see immunosuppression).
Newer anticancer drugs act directly against abnormal proteins in cancer cells; this is termed targeted therapy.
The use of minerals and plant-based medicines are believed to date back to prehistoric medicine.
The first use of drugs to treat cancer, however, was in the early 20th century, although it was not originally intended for that purpose. Mustard gas was used as a chemical warfare agent during World War I and was studied further during World War II. During a military operation in World War II, a group of people were accidentally exposed to mustard gas and were later found to have very low white blood cell counts. It was reasoned that an agent that damaged the rapidly growing white blood cells might have a similar effect on cancer. Therefore, in the 1940s, several patients with advanced lymphomas (cancers of certain white blood cells) were given the drug by vein, rather than by breathing the irritating gas. Their improvement, although temporary, was remarkable. That experience led researchers to look for other substances that might have similar effects against cancer. As a result, many other drugs have been developed to treat cancer, and drug development since then has exploded into a multibillion-dollar industry, although the principles and limitations of chemotherapy discovered by the early researchers still apply.'''
In the broad sense, most chemotherapeutic drugs work by impairing mitosis (cell division), effectively targeting fast-dividing cells. As these drugs cause damage to cells they are termed cytotoxic. Some drugs cause cells to undergo apoptosis (so-called "self programmed cell death").
Scientists have yet to identify specific features of malignant and immune cells that would make them uniquely targetable (barring some recent examples, such as the Philadelphia chromosome as targeted by imatinib). This means that other fast-dividing cells, such as those responsible for hair growth and for replacement of the intestinal epithelium (lining), are also often affected. However, some drugs have a better side effect profile than others, enabling doctors to adjust treatment regimens to the advantage of patients in certain situations.
As chemotherapy affects cell division, tumors with high growth fractions (such as acute myelogenous leukemia and the aggressive lymphomas, including Hodgkin's disease) are more sensitive to chemotherapy, as a larger proportion of the targeted cells are undergoing cell division at any time. Malignancies with slower growth rates, such as indolent lymphomas, tend to respond to chemotherapy much more modestly.
Drugs affect "younger" tumors (i.e., more differentiated) more effectively, because mechanisms regulating cell growth are usually still preserved. With succeeding generations of tumor cells, differentiation is typically lost, growth becomes less regulated, and tumors become less responsive to most chemotherapeutic agents. Near the center of some solid tumors, cell division has effectively ceased, making them insensitive to chemotherapy. Another problem with solid tumors is the fact that the chemotherapeutic agent often does not reach the core of the tumor. Solutions to this problem include radiation therapy (both brachytherapy and teletherapy) and surgery.
Over time, cancer cells become more resistant to chemotherapy treatments. Recently, scientists have identified small pumps on the surface of cancer cells that actively move chemotherapy from inside the cell to the outside. Research on p-glycoprotein and other such chemotherapy efflux pumps, is currently ongoing. Medications to inhibit the function of p-glycoprotein are undergoing testing as of June, 2007 to enhance the of chemotherapy.
Combined modality chemotherapy is the use of drugs with other cancer treatments, such as radiation therapy or surgery. Most cancers are now treated in this way. Combination chemotherapy is a similar practice that involves treating a patient with a number of different drugs simultaneously. The drugs differ in their mechanism and side effects. The biggest advantage is minimising the chances of resistance developing to any one agent.
In neoadjuvant chemotherapy (preoperative treatment) initial chemotherapy is designed to shrink the primary tumour, thereby rendering local therapy (surgery or radiotherapy) less destructive or more effective.
Adjuvant chemotherapy (postoperative treatment) can be used when there is little evidence of cancer present, but there is risk of recurrence. This can help reduce chances of developing resistance if the tumour does develop. It is also useful in killing any cancerous cells which have spread to other parts of the body. This is often effective as the newly growing tumours are fast-dividing, and therefore very susceptible.
Palliative chemotherapy is given without curative intent, but simply to decrease tumor load and increase life expectancy. For these regimens, a better toxicity profile is generally expected.
All chemotherapy regimens require that the patient be capable of undergoing the treatment. Performance status is often used as a measure to determine whether a patient can receive chemotherapy, or whether dose reduction is required. Because only a fraction of the cells in a tumor die with each treatment (fractional kill), repeated doses must be administered to continue to reduce the size of the tumor. Current chemotherapy regimens apply drug treatment in cycles, with the frequency and duration of treatments limited by toxicity to the patient.
Other agents are mechlorethamine, cyclophosphamide, chlorambucil, ifosfamide. A study of four patients with brain metastases from lung cancer found a three-month regimen of light water "noticeably prolonged" their survival time. A 2010 Hungarian study found significant improvement in the survival times of prostate cancer patients treated with light water.
In most cases, the dose is adjusted for the patient's body surface area, a measure that correlates with blood volume. The BSA is usually calculated with a mathematical formula or a nomogram, using a patient's weight and height, rather than by direct measurement.
Depending on the patient, the cancer, the stage of cancer, the type of chemotherapy, and the dosage, intravenous chemotherapy may be given on either an inpatient or an outpatient basis. For continuous, frequent or prolonged intravenous chemotherapy administration, various systems may be surgically inserted into the vasculature to maintain access. Commonly used systems are the Hickman line, the Port-a-Cath or the PICC line. These have a lower infection risk, are much less prone to phlebitis or extravasation, and abolish the need for repeated insertion of peripheral cannulae.
Harmful and lethal toxicity from chemotherapy limits the dosage of chemotherapy that can be given. Some tumors can be destroyed by sufficiently high doses of chemotherapeutic agents. However, these high doses cannot be given because they would be fatal to the patient.
Depression of the immune system, which can result in potentially fatal infections. Although patients are encouraged to wash their hands, avoid sick people, and to take other infection-reducing steps, about 85% of infections are due to naturally occurring microorganisms in the patient's own gut and skin. This may manifest as systemic infections, such as sepsis, or as localized outbreaks, such as shingles. Sometimes, chemotherapy treatments are postponed because the immune system is suppressed to a critically low level.
Damage to specific organs may occur, with resultant symptoms:
In very severe myelosuppression, which occurs in some regimens, almost all the bone marrow stem cells (cells that produce white and red blood cells) are destroyed, meaning allogenic or autologous bone marrow cell transplants are necessary. (In autologous BMTs, cells are removed from the patient before the treatment, multiplied and then re-injected afterwards; in allogenic BMTs the source is a donor.) However, some patients still develop diseases because of this interference with bone marrow.
In Japan the government has approved the use of some medicinal mushrooms like Trametes versicolor, to counteract depression of the immune system in patients undergoing chemotherapy. The United States' top-ranked cancer hospital, the MD Anderson, has reported that polysaccharide-K (PSK; an extract from Trametes versicolor) is a "promising candidate for chemoprevention due to the multiple effects on the malignant process, limited side effects and safety of daily oral doses for extended periods of time." PSK is already used in pharmaceuticals designed to complement chemotherapy such as MC-S. The MD Anderson has also reported that there are 40 human studies, 55 animal studies, 37 in vitro studies, and 11 reviews published concerning Trametes versicolor or its extract PSK.
A class of drugs called 5-HT3 antagonists are the most effective antiemetics and constitute the single greatest advance in the management of nausea and vomiting in patients with cancer. These drugs block one or more of the nerve signals that cause nausea and vomiting. During the first 24 hours after chemotherapy, the most effective approach appears to be blocking the 5-HT3 nerve signal. Approved 5-HT3 inhibitors include dolasetron, granisetron, and ondansetron (Zofran). The newest 5-HT3 inhibitor, palonosetron, also prevents delayed nausea and vomiting, which occurs during the 2–5 days after treatment. Since some patients have trouble swallowing pills, these drugs are often available by injection, as orally disintegrating tablets, or as transdermal patchs.
The substance P inhibitor aprepitant, which became available in 2005, is also effective in controlling the nausea of cancer chemotherapy.
Some studies and patient groups say that the use of cannabinoids derived from marijuana during chemotherapy greatly reduces the associated nausea and vomiting, and enables the patient to eat. Some synthetic derivatives of the active substance in marijuana (Tetrahydrocannabinol or THC) such as Marinol may be practical for this application. Natural marijuana, known as medical cannabis is also used and recommended by some oncologists, though its use is regulated and not legal everywhere.
Less common side effects include pain, red skin (erythema), dry skin, damaged fingernails, a dry mouth (xerostomia), water retention, and sexual impotence. Some medications can trigger allergic or pseudoallergic reactions.
Some patients report fatigue or non-specific neurocognitive problems, such as an inability to concentrate; this is sometimes called post-chemotherapy cognitive impairment, referred to as "chemo brain" by patients' groups.
Specific chemotherapeutic agents are associated with organ-specific toxicities, including cardiovascular disease (e.g., doxorubicin), interstitial lung disease (e.g., bleomycin) and occasionally secondary neoplasm (e.g., MOPP therapy for Hodgkin's disease).
This text is licensed under the Creative Commons CC-BY-SA License. This text was originally published on Wikipedia and was developed by the Wikipedia community.
Name | James Randi |
---|---|
Birth name | Randall James Hamilton Zwinge |
Birth date | August 07, 1928 |
Birth place | Toronto, Ontario, Canada |
Occupation | Magician, writer, skeptic |
Website | www.randi.org |
Nationality | Canadian-American |
Religion | Atheist |
Although often referred to as a "debunker," Randi rejects that title owing to its perceived bias, instead describing himself as an "investigator." He has written about the paranormal, skepticism, and the history of magic. He was a frequent guest on The Tonight Show Starring Johnny Carson and is occasionally featured on the television program . The JREF sponsors The One Million Dollar Paranormal Challenge offering a prize of US$1,000,000 to eligible applicants who can demonstrate evidence of any paranormal, supernatural or occult power or event under test conditions agreed to by both parties.
Randi was the host of The Amazing Randi Show on New York radio station WOR in the mid 1960s. This radio show, which filled Long John Nebel's old slot with similar content after Nebel went to WNBC in 1962, had frequent pro-paranormal guests, including Randi's then friend James Moseley. Randi, in turn, spoke at Moseley's 1967 Fourth Congress of Scientific Ufologists in New York City, stating, "Let's not fool ourselves. There are some garden variety liars involved in all this. But in among all the trash and nonsense perpetrated in the name of Ufology, I think there is a small grain of truth."
Randi also hosted numerous television specials and went on several world tours. Then Randi appeared as "The Amazing Randi" on a television show titled Wonderama from 1967 to 1972, and as host of a failed revival of the 1950s children's show The Magic Clown in 1970. In the February 2, 1974, issue of Abracadabra (a British conjuring magazine), Randi defined the magic community, saying, "I know of no calling which depends so much upon mutual trust and faith as does ours." In the December 2003 issue of The Linking Ring, the monthly publication of The International Brotherhood of Magicians, Points to Ponder: Another Matter of Ethics, p. 97, it is stated, "Perhaps Randi's ethics are what make him Amazing" and "The Amazing Randi not only talks the talk, he walks the walk."
During Alice Cooper's 1973–1974 tour, Randi performed as the dentist and executioner on stage. Also, Randi had designed and built several of the stage props, including the guillotine. Shortly after, in February 1975, Randi escaped from a straitjacket while suspended upside-down over Niagara Falls in the winter on the Canadian TV program World of Wizards.
Randi was once accused of actually using "psychic powers" to perform acts such as spoon bending. James Alcock relates this incident, which occurred at a meeting where Randi was duplicating the performances of Uri Geller: A professor from the University at Buffalo shouted out that Randi was a fraud. Randi said, "Yes, indeed, I'm a trickster, I'm a cheat, I'm a charlatan, that's what I do for a living. Everything I've done here was by trickery." The professor shouted back: "That's not what I mean. You're a fraud because you're pretending to do these things through trickery, but you're actually using psychic powers and misleading us by not admitting it." The famous author and believer in spiritualism Arthur Conan Doyle had years earlier made a similar accusation against the magician Harry Houdini. A similar event involved Senator Claiborne Pell. Pell believed in psychic phenomena. When Randi demonstrated viewing a hidden drawing by using trickery, Pell refused to believe that it was a trick, saying, "I think Randi may be a psychic and doesn't realize it."
Randi entered the international spotlight in 1972 when he publicly challenged the claims of Uri Geller. Randi accused Geller of being nothing more than a charlatan and a fraud who used standard magic tricks to accomplish his allegedly paranormal feats, and he supported his claims in the book The Truth About Uri Geller. Geller unsuccessfully sued Randi for $15 million in 1991. Geller's suit against the Committee for Scientific Investigation of Claims of the Paranormal (CSICOP) was thrown out in 1995, and he was ordered to pay $120,000 for filing a frivolous lawsuit.
Randi was a founding fellow and prominent member of CSICOP. During the period when Geller was filing numerous civil suits against him, CSICOP's leadership, wanting to avoid becoming a target of Geller's litigation, requested that Randi refrain from commenting on Geller. Randi refused and resigned. However, he still maintains a respectful relationship with the group and frequently writes articles for its magazine.
Randi has gone on to write several books criticizing beliefs and claims regarding the paranormal. He has also demonstrated flaws in studies suggesting the existence of paranormal phenomena; in his Project Alpha hoax, Randi revealed that he had been able to orchestrate a three-year-long compromise of a privately funded psychic research experiment. The hoax became a scandal and demonstrated the shortcomings of many paranormal research projects at the university level.
Randi has appeared on numerous TV shows, sometimes to directly debunk the claimed abilities of fellow guests. In a 1981 appearance on That's My Line, Randi appeared opposite psychic James Hydrick, who claimed that he could move things with his mind and demonstrated this ability on live television by apparently turning a page in a telephone book without touching it. Randi, having determined that Hydrick was surreptitiously blowing on the book, arranged packaging peanuts (polystyrene foam shapes) on the table in front of the telephone book for the demonstration, preventing Hydrick from demonstrating his abilities, which would have been exposed when the blowing moved the packaging. Many years later, Hydrick admitted his fraud.
Randi was awarded a MacArthur Foundation Genius award in 1986. The money was used for Randi's comprehensive exposé of faith healers, including Peter Popoff, W.V. Grant and Ernest Angley. When Popoff was exposed, he was forced to declare bankruptcy within the year.
In 1988, Randi tested the gullibility of the media by perpetrating a fraud of his own. By teaming up with Australia's 60 Minutes program and by releasing a fake press package, he built up publicity for a spirit channeler named Carlos who was actually artist Jose Alvarez, a friend of Randi's. Randi would tell him what to say through sophisticated radio equipment. The media and the public were taken in, as no reporter bothered to check Carlos's credentials and history, which were all fabricated. The hoax was exposed on 60 Minutes; Carlos and Randi explained how they pulled it off.
In the book The Faith Healers, Randi explains his anger and relentlessness as arising out of compassion for the helpless victims of frauds. Randi has also been critical of João de Deus (John of God), a self-proclaimed psychic surgeon who has received international attention. Randi observed, referring to psychic surgery, "To any experienced conjurer, the methods by which these seeming miracles are produced are very obvious."
In 1982, Randi verified the abilities of Arthur Lintgen, a Philadelphia physician who is able to determine the classical music recorded on a vinyl LP solely by examining the grooves on the record. However, Lintgen does not claim to have any paranormal ability, merely knowledge of the way that the grooves form patterns on particular recordings.
James Randi stated that Daniel Dunglas Home was caught cheating on a few occasions, but the episodes were never made public, and that the accordion Home is supposed to have played without touching it was a one-octave mouth organ that Home concealed under his large moustache. James Randi writes that one-octave mouth organs were found in Home's belongings after his death. According to Randi 'around 1960' William Lindsay Gresham told Randi he had seen these mouth organs in the Home collection at the Society for Psychical Research. Eric Dingwall who catalogued Home's collection on its arrival at the SPR does not record the presence of the mouth organs. According to Peter Lamont, the author of an extensive Home biography, "It is unlikely Dingwall would have missed these or did not make them public."
He has regularly featured on many podcasts that can be found online, including The Skeptics Society's official podcast Skepticality and the Center for Inquiry's official podcast Point of Inquiry. From September 2006 onwards, he has occasionally contributed to The Skeptics' Guide to the Universe podcast with a column titled "Randi Speaks." In addition, "The Amazing Show" is a podcast in which Randi shares various anecdotes in an interview format.
On Larry King Live, March 6, 2001, Larry King asked Sylvia Browne if she would take the challenge and she agreed. Then Randi appeared with Browne on Larry King Live on September 3, 2001, and she again accepted the challenge. However, she has refused to be tested and Randi keeps a clock on his website recording the number of weeks that have passed since Browne accepted the challenge without following through. During Larry King Live on June 5, 2001, Randi challenged Rosemary Altea to undergo testing for the million dollars. However, Altea would not even address the question. Instead Altea, in part, replied "I agree with what he says, that there are many, many people who claim to be spiritual mediums, they claim to talk to the dead. There are many people, we all know this. There are cheats and charlatans everywhere."
Starting on April 1, 2007, only those with an already existing media profile and the backing of a reputable academic were allowed to apply for the challenge. The resources freed up by not having to test obscure and possibly mentally ill claimants will then be used to more aggressively challenge notorious high-profile alleged psychics and mediums such as Sylvia Browne, Allison DuBois and John Edward with a campaign in the media.
Late in 1996, Randi launched a libel suit against a Toronto-area psychic named Earl Gordon Curley. Curley had made multiple objectionable comments about Randi on Usenet. Despite prodding Randi via Usenet to sue (Curley's comments had implied that if Randi did not sue, then his allegations must be true), Curley seemed entirely surprised when Randi actually retained Toronto's largest law firm and initiated legal proceedings. The suit was eventually dropped in 1998 when Earl Curley died at the age of 51.
Sniffex, producer of a dowsing bomb detection device, unsuccessfully sued Randi and the JREF in 2007. Sniffex sued Randi for his comments regarding a government test in which the Sniffex device failed. The company was later investigated and charged with fraud. Randi has said that one reason he became an American citizen was an incident while on tour with Alice Cooper where the Royal Canadian Mounted Police searched the band's lockers during a performance. Nothing was found, yet the RCMP trashed the room.
In February 2006, Randi underwent coronary artery bypass surgery. In early February 2006, he was declared to be in stable condition and "receiving excellent care" with his recovery proceeding well. The weekly commentary updates to his website were made by guests while he was hospitalized. Randi recovered after his surgery and was able to help organize and attend the 2007 Amazing Meeting in Las Vegas, Nevada (an annual convention of scientists, magicians, skeptics, atheists and freethinkers).
Randi was diagnosed with intestinal cancer in June 2009. He had a ping pong ball-sized tumor removed from his intestines during laparoscopic surgery. He announced this a week later at the July 2009 The Amazing Meeting as well as the fact that he was scheduled to begin chemotherapy in the following weeks. He also said at the conference: "One day, I'm gonna die. That's all there is to it. Hey, it's too bad, but I've got to make room. I'm using a lot of oxygen and such—I think it's good use of oxygen myself, but of course, I'm a little prejudiced on the matter."
Official
Supportive
Media
Transcripts (Sylvia Browne and Randi) (Sylvia Browne's manager and Randi) (Altea and James Randi) (Rosemary Altea and Randi) (Sylvia Browne and Randi)
Criticism
Category:1928 births Category:Living people Category:American atheists Category:American magicians Category:American people of Canadian descent Category:American people of German descent Category:American skeptics Category:Canadian atheists Category:Canadian immigrants to the United States Category:Canadian magicians Category:Canadian people of German descent Category:Canadian skeptics Category:Cancer patients Category:Gay writers Category:LGBT writers from Canada Category:LGBT writers from the United States Category:MacArthur Fellows Category:Naturalized citizens of the United States Category:People from Toronto Category:Professional magicians Category:American humanists
This text is licensed under the Creative Commons CC-BY-SA License. This text was originally published on Wikipedia and was developed by the Wikipedia community.
Playername | Dániel Hauser |
---|---|
Fullname | Dániel Hauser |
Height | 182 cm |
Dateofbirth | August 22, 1986 |
Cityofbirth | Budapest |
Countryofbirth | Hungary |
Currentclub | MTK Hungária FC |
Clubnumber | 3 |
Position | Midfielder |
Years | 2005– 2006–2008 2008– |
Clubs | MTK Hungária FC → Soroksár SC (loan) → MTK Budapest FC II |
Caps(goals) | 5 (0) 56 (0) 29 (0) |
Nationalyears | 2002–2003 |
Nationalteam | Hungary U-17 |
Nationalcaps(goals) | 15 (0) |
Pcupdate | 27 March 2010 |
Dániel Hauser (born August 22, 1986) is a Hungarian football player who currently plays for MTK Hungária FC.
In the 2002/03 season, he was a member of the Hungary under -17 squad that reach the 2003 UEFA European Under-17 Football Championship.
Category:1986 births Category:Living people Category:People from Budapest Category:Hungarian footballers Category:Association football midfielders Category:MTK Hungária FC footballers Category:Soroksári TE footballers
This text is licensed under the Creative Commons CC-BY-SA License. This text was originally published on Wikipedia and was developed by the Wikipedia community.