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Showing posts with label Cancer. Show all posts
Showing posts with label Cancer. Show all posts

Sep 4, 2011

An Evidence Based Study On Stomach, Gall Bladder, Pancreatic, and Liver Cancers

Research Article

Psorinum Therapy in Treating Stomach, Gall Bladder, Pancreatic, and Liver Cancers: A Prospective Clinical Study

Aradeep Chatterjee,1 Jaydip Biswas,2 Ashim Chatterjee,1 Sudin Bhattacharya,2 Bishnu Mukhopadhyay,3 and Syamsundar Mandal2

1 Critical Cancer Management Research Centre & Clinic, 381 S K Deb Road, West Bengal, Kolkata 700 048,  India
2 Chittaranjan National Cancer Institute, Kolkata 700 026,  India
3 National Institute of Technology, Durgapur 713209,  India

Received 27 November 2009; Revised 14 October 2010; Accepted 27 October 2010

Copyright © 2011 Aradeep Chatterjee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We prospectively studied the clinical efficacy of an alternative cancer treatment “Psorinum Therapy” in treating stomach, gall bladder, pancreatic and liver cancers. Our study was observational, open level and single arm. The participants' eligibility criteria included histopathology/cytopathology confirmation of malignancy, inoperable tumor, and no prior chemotherapy or radiation therapy. The primary outcome measures of the study were (i) to assess the radiological tumor response (ii) to find out how many participants survived at least 1 year, 2 years, 3 years, 4 years and finally 5 years after the beginning of the study considering each type of cancer. Psorinum-6x was administered orally to all the participants up to 0.02 ml/Kg body weight as a single dose in empty stomach per day for 2 years along with allopathic and homeopathic supportive cares. 158 participants (42 of stomach, 40 of gall bladder, 44 of pancreatic, 32 of liver) were included in the final analysis of the study. Complete tumor response occurred in 28 (17.72%) cases and partial tumor response occurred in 56 (35.44%) cases. Double-blind randomized controlled clinical trial should be conducted for further scientific exploration of this alternative cancer treatment.

1. Introduction

Although, great advances have been made in the treatment of some forms of cancer and new advances in surgery, radiotherapy, and chemotherapy leading to an increase in cure rates have been achieved, such interventions are often too much expensive and beyond the reach of many cancer patients of the developing  as well as of the developed countries [1–3]. In developing countries, majority of the cancer patients have inadequate access to the mainstream cancer treatments due to lack of proper medical infrastructures, skills, and above all limited financial resources [4, 5]. Some types of cancer (i.e., liver, gall bladder, pancreatic, and stomach) are still associated with poor prognosis to conventional cancer treatments [6–9]. Side effects of the chemotherapy and radiation therapy are also intolerable to many cancer patients [10–12]. In most of the situations, elderly cancer patients cannot be provided with conventional cancer treatments because of old age-related problems [13, 14]. As a result, alternative cancer treatments have become an important feature of oncology regardless of geographic region and they appear to exist in greater abundance through out the world. Many alternative cancer therapeutic modalities are now being practiced in India, and one of them which has gained significant popularity is called Psorinum Therapy [15–17]. The investigational anticancer drug used in this alternative cancer therapy is “Psorinum” which is derived from the sphere of homeopathy. The supportive treatments of Psorinum Therapy are adopted both from the spheres of allopathy and homeopathy. Psorinum is an alcoholic extract of the scabies, slough, and pus cells. According to the pre-clinical data, “Psorinum-6x” (“x” stands for decimal potency of homeopathy) activates different immune effector cells (e.g., T cells, and accessory cells like, macrophages, dendritic cells, and natural killer cells) which can trigger a complex antitumor immune response [18, 19]. In a rat model study, daily oral administration of  Psorinum 6x at doses up to 0.5 ml/Kg body weight/day for 2 weeks resulted in no adverse side effect [19]. Published retrospective and prospective studies also support the efficacy of Psorinum Therapy in treating patients with various malignancies [20–28]. The prospective observational clinical trial, reported here, was conducted to evaluate the efficacy of the Psorinum Therapy in treating stomach, gall bladder, pancreatic, and liver cancers and to assess  the side effects of the drug Psorinum if any [29].

2. Materials and Methods

2.1. Settings

The study was conducted by the Critical Cancer Management Research Centre and Clinic (CCMRCC) situated in Kolkata of West Bengal, India. The study started from June 2001 and completed in July 2009. The study protocol was approved by the Institutional Review Board (IRB approval Number: 2001–05) of the CCMRCC in conformity with the World Medical Association (WMA) declaration of Helsinki and it is subsequent amendments and the ethical guidelines of the Indian Council of Medical Research (ICMR) for the biomedical research on human participants.

2.2. Study Design

The study was prospective, observational, open level, and single arm.

2.3. Inclusion and Exclusion Criteria

Only the patients of confirmed malignancy (by histopathological examination of endoscopic biopsy, cytopathological exam of CT guided FNAC) involving stomach, gall bladder, pancreatic, and liver cancers of both sexes were enrolled. The participants’ eligibility criteria included (i) histopathology/cytopathology confirmation of malignancy, (ii) inoperable tumors, and (iii) no prior chemotherapy or radiation therapy. The lower age limit was 18 years and there was no upper age limit for the eligibility. Patients who were unable to understand English, Hindi, or Bengali or resided outside India were excluded from the study. The patients who reported the cancer centre from the period of June 2001 to November 2003 and fulfilled the eligibility criteria were recruited. Written informed signed consent was taken from each patient before starting the study.

2.4. Intervention

Psorinum-6x was administered orally to all the participants up to 0.02 ml/Kg body weight as a single dose in empty stomach per day for complete course duration of 2 years.

2.5. Supportive Treatments

In this study, the supportive cares were taken both from the spheres of allopathy and homeopathy. Supportive cares for control of infection, pain, electrolytic balance, bleeding, nutritional deficiencies were taken, and blood transfusion, abdominal or plural paracentesis, analgesic, bronchodilator, stenting of the hepato-pancreato-biliary system, and bypass were done as and when required  to  improve the survival and the quality of life of the participants.  The frequently used homeopathic medicines for the purpose of the supportive cares were Chelidonium majus, Carduus marianus, Baryta carbonica, Conium maculatum, Carbo animalis, Bryonia alba, Medorrhinum, Thuja occidentalis, Cholesterinum, and Lycopodium clavatum (Table 1). Less frequently used homeopathic medicines for the purpose of the supportive cares were mother tincture of the Berberis vulgaris, mother tincture of the Calendula officinalis, mother tincture of the Hamamelis virginiana, mother tincture of the Symphytum officianale, mother tincture of the Syzygium jambolanum, Gelsemium 200c, Cantharides 200c, Sulphur 200c, Arsenicum album 200c, and Causticum 200c.

Table 1: Details of the frequently used homeopathic medicines for the purpose of the supportive cares.

 2.6. Outcome Measures

Primary outcome measures of the study were (i) to assess the radiological tumor response and (ii) to find out in each type of cancer how many participants survived at least 1 year, 2 years, 3 years, 4 years, and finally, after 5 years since the beginning of the study. To assess the radiological tumor response, CT Scans were done at the beginning of the study, repeated every 3–6 months during the 1st year of the study and repeated every 6–8 months during the next 2 years of the study. Radiological tumor response was defined by Response Evaluation Criteria in Solid Tumors (RECIST). A complete response was defined as complete disappearance of all targeted lesions without disease progression or any new lesion, and a partial response was defined as at least 30% regression in the sum of the longest diameter of the targeted lesions as reference to the baseline sum LD without disease progression or any new lesion. To assess the survival, the investigators followed up the participants via personal meetings, phone calls, and mails at least for 5 years (where applicable) after the study began. Secondary outcome measure of the study was to assess the side effects of the Psorinum. The investigators asked the participants and also examined them clinically to assess if they had any side effect. Apart from these, participants were also followed up to know if they were taking any other conventional or investigational cancer treatments.

3. Results

10 (5.95%) participants were dropped out from the study as they opted for conventional cancer treatments, among them 4 of stomach, 2 of gall bladder, 3 of pancreatic, and 1 of liver cancers. 158 participants (42 of stomach, 40 of gall bladder, 44 of pancreatic, and 32 of liver) were included in the final analysis at the end of the study. In these participants, the diagnosis of malignancies was confirmed by histopathological examination of endoscopic biopsies and cytopathological examination of CT-guided FNAC. In case of stomach, gall bladder, and pancreatic cancers, the histology type was adenocarcinoma, and in case of liver cancer the histology type was hepato cellular carcinoma (HCC). Among the 158 participants, 84 (53.16%) were male and 74 (46.84%) were female. According to the AJCC TNM staging system, 39 (24.68%) were diagnosed at stage-III, and 112 (70.89%) were diagnosed at stage-IV. The participants’ Karnofsky status was between 40–70%, and Eastern Cooperative Oncology Group (ECOG) status was between 2-3.  Among the 39 participants (24.68%) who were diagnosed at stage-III, 13 (33.33%) had complete response and 16 (41.03%) had radiological partial response. Among the 112 (70.89%) participants who were diagnosed at stage-IV, 12 (10.71%) had radiological complete response and 38 (33.93%) had radiological partial response (Tables 2 and 3, Figures 1, 2, and 3). In this study, no adverse side effects were observed from the drug Psorinum. However, very few patients reported to have mild oral irritation and skin itching which were successfully controlled by the supportive cares. Psorinum Therapy was also effective in improving the disease symptoms and the quality of life of the participants. At least 60% participants of stage-III and at least 45% participants of stage-IV reported that the therapy was effective in reducing their cancer-related pain, cough, dysponea, nausea and vomiting, fatigue, constipation and improving appetite, and weakness. These were also confirmed after examining the participants clinically. Improvements were also observed in the lab investigations like Complete Blood Count (CBC), Liver Function Test (LFT), Kidney function test, AFP level, and CA 19.9. These lab investigations were done as a part of their routine clinical check ups. Among the 158 participants,  98 (62.03%) were aged 65 years or more. Better outcomes were observed among the participants below 65 years of age than the participants who were over the age of 65. The outcomes did not vary significantly while considering gender. Figures 4(a) and 4(b) show complete tumor response in one stomach and one gall bladder cancer patients, respectively, who were treated through Psorinum Therapy.


Table 2: TNM Staging, partial and complete tumor response in each cancer type.

Table 3: Survival outcomes in each cancer type.

Figure 1: Distribution of partial and complete tumor response rates in different cancer types.

Figure 2: Lorenz Analysis: Distribution of tumor response in different cancer types.

Figure 3: Kaplan Meier survival analysis in different cancer types.

Figure 4: (a) Showing complete tumor response of a stomach cancer patient who underwent Psorinum Therapy. (b) Showing complete tumor response of a gall bladder cancer patient who underwent 
PsorinumTherapy.

4. Discussion and Conclusion

Many studies were published on the role of complementary and alternative medicines in treating cancer patients. Some studies support the CAM therapies to be beneficial for palliative cancer cares [30–35]. However, very few of the published reports support their efficacy with regard to the primary care of cancer. According to our knowledge, the clinical study, reported here, is the only prospective study that intrigued a fair number of complete and partial tumor responses along with impressive survival outcomes in treating patients with stomach, gall bladder, pancreatic, and liver cancers through psorinum therapy. Previously, interviews were conducted on 300 biopsy-proved cancer patients of Psorinum Therapy. The primary purpose of the study was to ascertain the patients’ and/or their caregivers’ view on this CAM therapy. The survey showed the patients had tried Psorinum Therapy mainly due to no other available treatment options, financial constraints, frustration with the conventional cancer treatments, and belief in the efficacy of the Psorinum Therapy. According to the survey, among the 300 cancer patients, 195 (65%) had consulted their oncologists before trying the therapy [17]. This therapy can be easily replicated by other practitioners in different clinical centers due to the following advantages.

The reagent to prepare the drug Psorinum is available. The specific dosing and the medicinal power are established. The medicine administration technique is easy as it can be taken orally. 

The supportive treatments are adopted from the allopathic streams. The supportive treatments with homeopathic medicines are done by specific ailment versus specific medicine concept instead of the concept of specific patient versus specific medicine, making the homeopathic supportive cares easier to replicate. In a nutshell, we should remember that, 158 participants of histopathology or cytopathology confirmed stomach, gall bladder, pancreatic, and liver cancers were included in the final analysis at the end of the study. According to the AJCC TNM staging system, 39 (24.68%) were diagnosed at stage-III and 112 (70.89%) were diagnosed at stage-IV. The participants Karnofsky status was between 30–60% and ECOGstatus was between 2-3. The participants received the drug Psorinum along with allopathic and homeopathic supportive treatments without trying conventional or any other investigational cancer treatments. According to the RECIST criteria, radiological complete response occurred in 28 (17.72%) and partial response occurred in 56 (35.44%) participants. The limitation of this study is that it did not have any placebo or treatment control arm; therefore, it cannot be concluded that Psorinum Therapy is effective in improving the survival and the quality of life of the participants due to the academic rigours of the scientific clinical trials. This study also cannot rule out the effects of the implemented allopathic and homeopathic supportive measures in the observed results. However, the results of the study showed a fair number of complete and partial tumor responses along with impressive survival outcomes in difficult to treat cancer types. Therefore, randomized double-blind clinical trial, detailed molecular, pharmacokinetics, and pharmacodynamics studies should be conducted for further scientific exploration of this alternative cancer treatment to determine if it can be integrated into the mainstream oncology.

Funding

Dr. Rabindranath Chatterjee Memorial Cancer Trust provided funding for this study.

Conflict of Interests

The authors declare that they have no conflict of interests.

Acknowledgments

The authors would like to acknowledge the cooperation rendered by the pathologists, radiologists, oncologists, gastroenterologists, general physicians, nurses, and other technical and nontechnical persons to carry out the study. The statistical analysis was done by Ms. Moumita Mukherjee and Ms. Rituparna Mukherjee of CCMRCC. The whole study was presented at the 2009 Annual Meeting of the American Society of Clinical  Oncology (ASCO).




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This Article Published in

Evidence-Based Complementary and Alternative Medicine
Volume 2011 (2011), Article ID 724743, 7 pages
doi:10.1155/2011/724743

To read this Article Click Here


Jun 26, 2008

Breast Cancer: Facts and Risk

Facts About cancer:

1. 7.4 million (74,00,000) people died of cancer in 2004. And 83.2 million ( 8,32,00,000) people will die of cancer by 2015.
2. In women Breast cancer is was the most common cause of cancer mortality , 16% women death by cancer were caused by breast cancer.
3. Only 22% women of age group 50-69 year ,surveyed in 66 countries, had undergone a mammogram. In india less then 5% women of this group underwent for a Mammogram.
4. In India breast cancer is most common form cancer in women.
5. 1 in 26 women in India are expected to be diagnosed with breast cancer in their lifetime.
6. WHO( world health organistaion) predicts that by 2020, India will be on a par with US and Europe in the incidence of breast cancer - one in every seven women.
7. If breast cancer detected in Stage 1 ,chances of survival are 80% while in stage 3 chances of survival are 20%.
8. At present ,an estimated 100,000 women get diagnosed with breast cancer every year in India.
9. 1 in 10 women diagnosed with cancer in one breast will develop the cancer in the other breast as well.
10. Around 30,000 women die of breast cancer annually.
11. In India ,about 50% patients of breast cancer get diagnosed only at stage 3.
12. In the last 40 years, breast cancer cases have gone up by 30-40% across Indain metros.
13. A 3% per year rise in breast cancer cases in India is predicted.
14. By 2015 there will be approximately 2.5 lakh (2,50,000) new cases of breast cancer in India.


What is good :

Mortality of Breast cancer ,cervical cancer, colorectal cancer, oral cancer can be reduced by screening.


MAMMOGRAPHY:

1. Screening Mammography is an X-Ray examination of the brestes in a woman who is asymptomatic ( Has no symptoms of breast cancer).
2. It's goal is to detect cancer when the cancerous lump is still too small to be felt by a woman or her physician.
3. Mammography can find 90% of breast cancers in women over 50 years and can discover a lump up to two years before it can even be felt.
4. Early detection of small breast cancers improves a woman's chances of successful treatment.
5. Screening mammography is recommended every one or two years for women once they reach age of 40 and every year once they reach age of 50 years.
6. Physicians sometimes begin screening mammography before age 40 in patients who have a strong family history of breast cancer.

Jan 17, 2008

Tobacco :Effects on Health

Tobacco :Effects on Health

Facts


1. Avoiding tobacco may add 20 years to the life of the teenager.About half of the teenagers who use tobacco will eventually be killed by it-about a quarter in middle age and a quarter in old age.
2. In India 9,00,000 peoples die due to tobacco related diseases per year.
3.India has the largest number of Oral Cancer in the world which is due to Tobacco.
4.In India the tobacco contributes to 56.4% and 44.9% of cancer cases in the world which is due to tobacco.
5.Tobacco smoking accounts for 82% of chronic obstructive lung disease in India.
6. It is estimated that India as compared to any other country will have the fastest rise in tobacco related deaths each year.

Types of Tobacco used in India and worldwide

Smokeless Tobacco used in India(used for chewing):

Pan-betel quid with tobacco
Pan Masala
Tobacco
Tobacco and slaked lime (khaini)
Chewing tobacco
Suns
Mishri
Gul
Bajjar
Gudhaku
Creamy snuff
Tobacco Water

Smoked Tobacco

Beedis
Cigarettes
Cigars
Cheroots
Chuttas
Reverse chutta smoking
Dhumti
Reverse Dhumti smoking
Pipe
Hooklis
Chillum
Hookah

Effects of Tobacco Consumption

Tobacco is responsible for cancer at many sites:

Lungs, mouth, pharynx, larynx, stomach, urinary bladder, gall Bladder, penis (and possibly other organs of body).

Oral cancers (cancer of the cheek), stomach cancers, kidney cancers.


Tobacco leads to :

1.Heart and blood vessel disease, myocardial Infraction (Heart Attack), Angina (Chest Pain), sudden Cardiac Death (Unheralded sudden death), stroke (Brain Attack), peripheral Vascular Disease (Gangrene of legs).
2. There is 'one' tobacco related death every 8 seconds.
3.Smokers/tobacco consumers are 2 to 3 times more likely to develop heart disease and paralysis than non-smokers.
4. Smoking causes more than 90% of lung cancers and other lung diseases (chronic bronchitis, emphysema).
5.Smoking / tobacco consumption is a cause of impotence in men.
6. Smoking / tobacco consumption decreases estrogen levels in women. Menopause occurs earlier.
7.Smoking / tobacco consumption decreases ability of physical activity and decreases physical endurance.
8. Women who smoke and take birth control pills are at a greatly increased risk of a stroke.
9. Pregnant women, who smoke, have a greater chance of losing the baby, or having a baby with a low birth weight, or babies with developmental problems, or sudden infant deaths.
10. Smoking / tobacco suddenly raises the blood pressure and reduces the blood flow to the heart. It also decreases the flow of blood to the feet and can cause gangrene of the legs.
11.Tobacco damages the lining of the arteries all over the body.
12. Smoking causes health problems for children and other family members (due to second-hand smoke).
13. A non-smoker living with two packs per day smoker, smokes passively equivalent of three cigarettes per day according to unit nicotine levels.
14. It has also been found that smoking/tobacco consumption increases the risk of diabetes.
15.Higher the good cholesterol in the blood the better it is. Lower the good cholesterol in the blood higher is the threat. Tobacco lowers the good cholesterol in the blood.

Why give up tobacco?

Tobacco is a heart breaker and a body breaker as tobacco mainly kills through heart disease and cancers.

Nicotine addiction ensures life-long customers not long-life customers

It's never too late to give it up!

Stopping smoking/tobacco even in middle age before having cancer or some other serious disease avoids most of the later excess risk of death from tobacco. The benefits of stopping at earlier ages are even greater.Once you give up tobacco the risk of heart attacks normalized to that of a non-smoker in 3 years.

Benefits of Quitting Tobacco:

Quitting smoking lowers many health risks very quickly. If you quit, here are only a few of the benefits:

The Physical benefits of quitting tobacco:

1. Your risk of cancer and heart disease will go down.
2. Stress on your heart will be reduced.
3. Your loved ones will not be harmed by your smoke.
4. Your smoker's cough (persistent cough and phlegm) will most probably disappear.
5. Your teeth will become whiter and cleaner.

The Social benefits of quitting tobacco:

1. You will be the one in control - cigarettes will no longer control you.
2. Your self-image and self-confidence will improve.
3. You'll be a healthier parent for your children, now and in the future.
4. You'll have more money to spend on other things.

Tips to Quit Smoking /Tobacco

1. Hide ash trays, cigarettes, paan, jarda. Out of sight, out of mind. A simple, yet helpful endeavor.
2. Don't let cigarettes, paan and jarda be easily available. Keep cigarettes/ jarda, paans in a place where you have to make a real effort to get them for example, another room of the house, places where you don't go to very often, locked in a cupboard etc. Every time you have to smoke/eat jarda/paan, you should have to make a conscious effort, get up, walk and get it.
3. Figure out your "triggers" to smoke, or consume paan/jarda and ways to cope with them. Is it the company of people who smoke/eat jarda/paan? Try in the initial period to be away from smokers/paan eaters/ jarda eaters or rather when they smoke or eat pan/jarda. Do you consume tobacco when you are tense, or when you are working late, to pep you up and to give that extra energy? For that try to put something in the mouth, like chewinggums, sweets, peppermints, lozenges etc. and practice deep breathing
4. Whenever you have that craving, try deep breathing when either standing or sitting. Having a glass of water and exercising also helps to decrease the craving.
5. When you feel like taking tobacco, think of your children and the effect on their future if you develop any of the dangerous diseases caused by tobacco.
6. Set a stop date.
7. Find a support person.
8. Make plans for your first day without cigarettes/ paan/jarda.
9. Use the 4 D's when the craving for smoking/tobacco hits you:
* Do something else
* Delay smoking/tobacco consumption the next cigarette
* Deep breathing
* Drink water
10. Use positive self-talk.
11. Reward yourself.
12. Practice relaxation techniques (yoga, walking, meditation, dancing, music etc.) every day.
13. Limit the intake of caffeine and alcohol.

Further, be active, and eat a healthy diet!

What Homeopathy can do for quitting Smoking



1.Homeopathic medicines help you to not to crave for smoking.

2.Homeopathic medicines improves the withdrawal symptoms after you quit.
3.Homeopathy save your health from side effects of long term smoking and chewing tobacco.
4.Homeopathy helps to remove irritating cough and phlegm discharges due to smoking.