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Fighting cancer with immunotherapy: Signaling molecule causes regression of blood vessels

Immunotherapy with T-cells offers great hope to people suffering from cancer. Some initial successes have already been made in treating blood cancer, but treating solid tumors remains a major challenge. The signaling molecule interferon gamma, which is produced by T-cells, plays a key role in the therapy. It cuts off the blood supply to tumors, as a new study reveals.

A microscopic image of tumor tissue under the influence of TNF (left) and IFN- ? (right). Red blood cells are pictured in a magenta color. TNF bursts the blood vessels and releases large amounts of blood cells, whereas IFN-? lets vessels retreat.
Credit: Christian Friese / MDC

Immunotherapy with T-cells offers great hope to people suffering from cancer. Some initial successes have already been made in treating blood cancer, but treating solid tumors remains a major challenge. The signaling molecule interferon gamma, which is produced by T-cells, plays a key role in the therapy. It cuts off the blood supply to tumors, as a new study in the journal Nature reveals.

The immune system is the body’s most powerful weapon against diseases. So what if it were possible to use the immune system to fight cancer? For a long time now, researchers have been trying to do just that — for example, by employing a special kind of immune cell called T-cells. They are „special mobile forces“ that — after undergoing training — patrol the body, and can seek out and kill cancer cells. This strategy has been successful in initial clinical trials — but mostly just in the treatment of cancers that do not form tumors, such as blood cancer.

Good at fighting blood cancer, but not so effective against solid tumors

Large solid tumors, on the other hand, sometimes pose big problems for T-cells. Though adept at targeting cancer cells swimming in the bloodstream, they have difficulty attacking compact tumors. The tumor weakens the aggressors through the delivery of inhibiting signals.

The scientists working with Dr. Thomas Kammertöns, Prof. Thomas Blankenstein, Prof. Hans Schreiber and Christian Friese are searching for solutions with their research team at Charité — Universitätsmedizin Berlin, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Institute of Health (BIH) and the Einstein Foundation.

In a study published in the journal Nature, they investigated how the signaling molecules of T-cells affect the immediate tumor environment, which includes the connective tissue as well as the blood vessels that supply the tumor.

T-cells produce not only tumor necrosis factor (TNF) but also the molecule interferon gamma (IFN-γ). Until now, however, there has been little understanding about how IFN-γ really works. „We knew that IFN-γ attacks cancer cells via the tumor microenvironment,“ says Kammertöns. „We now wanted to find out exactly which cells are targeted by the signaling molecules.“

Blood vessel regression is induced

The researchers generated genetically modified mice and used a clinically relevant cancer model. This included animals in which only blood vessel cells were susceptible to the signaling molecule.

In this mouse model IFN-γ pruned back the blood vessels in the tumors, thus shutting down the supply of oxygen and nutrients and killing the tumors. The researchers were able to observe this process microscopically in living mice in fine detail. They found that the blood vessel cells alone responded to the signaling molecule. When the researchers targeted other types of cells with IFN-γ, the tumors continued their growth.

These findings provided an explanation for the molecule’s powerful properties, which were already well known. „IFN-γ is one of the most important weapons in the T-cells‘ arsenal,“ says Thomas Kammertöns.

Thomas Blankenstein, lead investigator of the study, says: „The two together — IFN-γ and tumor necrosis factor — are a powerful team. TNF bursts tumor blood vessels, thus opening up the tissue, while IFN-γ cuts off the blood supply and keeps the tumor at bay over the long term.“

Optimizing T-cell therapy

The study offered the researchers clues on how to improve T-cell therapy for solid cancer tumors. Thomas Blankenstein explains: „We want to understand exactly how T-cells target tumors. Destroying a tumor’s infrastructure is probably more effective than killing individual cancer cells.“

„Our findings are significant beyond tumor therapy,“ says Thomas Kammertöns. „Interestingly, the mechanism used by IFN-γ to eliminate solid tumors resembles the physiological regression of blood vessels during development. It also disrupts wound healing.“

„IFN-γ might also affect the formation of new blood vessels after strokes or heart attacks. That’s why we want to find out more about the molecular processes behind all of this.“


Story Source:

Materials provided by Max Delbrück Center for Molecular Medicine in the Helmholtz Association. Note: Content may be edited for style and length.


Journal Reference:

  1. Thomas Kammertoens, Christian Friese, Ainhoa Arina, Christian Idel, Dana Briesemeister, Michael Rothe, Andranik Ivanov, Anna Szymborska, Giannino Patone, Severine Kunz, Daniel Sommermeyer, Boris Engels, Matthias Leisegang, Ana Textor, Hans Joerg Fehling, Marcus Fruttiger, Michael Lohoff, Andreas Herrmann, Hua Yu, Ralph Weichselbaum, Wolfgang Uckert, Norbert Hübner, Holger Gerhardt, Dieter Beule, Hans Schreiber, Thomas Blankenstein. Tumour ischaemia by interferon-γ resembles physiological blood vessel regression. Nature, 2017; DOI: 10.1038/nature22311

Max Delbrück Center for Molecular Medicine in the Helmholtz Association. „Fighting cancer with immunotherapy: Signaling molecule causes regression of blood vessels.“ ScienceDaily. ScienceDaily, 26 April 2017. <www.sciencedaily.com/releases/2017/04/170426131018.htm>

Quelle: Fighting cancer with immunotherapy: Signaling molecule causes regression of blood vessels


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Tests To Help With Breast Cancer Treatment Decisions

Herzlichen Dank an The Breast Cancer Authority!

When you’ve just received a diagnosis of breast cancer, you are faced with many different treatment options. Your mind is in a whirl with fear, confusion, and disbelief. While none of these feelings help decision making, there are some tests that can help: Oncotype DX and Mammaprint. 

These tests are genomic tests that analyze the activity of specific genes in the breast tumor. They can help you determine if your risk of breast cancer coming back is high or low, which can help you in making a decision about whether to have chemotherapy, radiation, or other therapies to reduce risk after surgery.

There are two main types of tests – Oncotype DX and Mammaprint.

Oncotype Dx has two tests for breast cancer – one for Ductal Carcinoma in situ (DCIS) – Oncotype DX DCIS and one for invasive breast cancer – Oncotype DX.  Mammaprint has one test for invasive breast cancer. Let’s look at these in greater detail.

What are genomic tests?

Genomic tests look at specific genes in your individual tumor and try to determine what is driving its growth. This is different from genetic tests which look at your inherited risk or predisposition for cancer. Genomic tests provide information that can help tailor your treatment plan to you as an individual. They are a type of personalized medicine. This is really important, because not all breast cancers are the same and, in fact, some breast cancers might have more in common with a prostate cancer than they do with another type of breast cancer. One size treatment definitely does not fit all.

Oncotype DX DCIS

This test is only for people diagnosed with DCIS or, as it is often called, “stage zero” breast cancer. In addition to general information such as tumor size, margins, and grade, Oncotype DX DCIS helps determine the likelihood of DCIS recurring or invasive breast cancer occurring within the next 10 years.

It examines a sample of the tumor tissue that has already been removed during the lumpectomy for DCIS. By looking at the expression of 21 different genes in the tumor, it provides a DCIS score of between 0-100. The lower the score, the lower the risk of recurrence. Two scores are given, one to determine the risk of recurrence of DCIS and another for the risk of occurrence of an invasive breast cancer.

Knowing the DCIS score can help you decide whether to have radiation treatment  following the lumpectomy. If your risk of recurrence is low, then maybe you can spare yourself further treatment and the possible side effects that go with it.

To be eligible for Oncotype DX DCIS, you need to have recently been diagnosed with DCIS and had lumpectomy surgery. The decision should be made in discussion with your doctor/oncologist.

In the US, insurance might cover the cost of this test; the testing company will help you determine if this is the case and provide information to your insurers, as necessary. In the UK, these tests can be conducted under the NHS or privately.

Many oncologists are now familiar with these tests for invasive breast cancer; sadly, the Oncotype DX DCIS test does not appear to be known by all oncologists, so it’s good for you to be proactive and start the discussion. Here is a link to the validation work done on the test that you can forward to your oncologist, and further links are given at the bottom of this post:

Clinical validation of oncotype DX DCIS

I definitely think it is worth having a discussion with your oncologist, sharing the references as necessary, and if you don’t get anywhere with the oncologist, talk to your family doctor or surgeon.

Oncotype DX and Mammaprint

Both Oncotype DX and Mammaprint are genomic tests suitable for early stage invasive breast cancer. They both predict the benefit of chemotherapy or other types of treatment, as well as the likelihood of 10 year recurrence.

They are similar tests but have some differences, as outlined below:

Comparison of oncotype DX and mammaprint for invasive breast cancer

Looking at this table can help determine if you are eligible for either of these tests.

As with Oncotype DX DCIS, some insurance companies in the US will pay for these tests whereas some don’t include them in coverage. Both testing companies offer financial assistance or guidance, so it’s worth calling them to discuss if you are interested and want to check coverage. In the UK, these tests can be conducted under the NHS or privately.

These tests are important because some of the cancer treatments, like chemotherapy, can have many side effects and are hard to get through. If there is little to no benefit in these treatments for you as an individual, then these genomic tests give you the confidence to not have a treatment that has greater potential for risk than for benefit.

Obviously the decision of further treatment is based on more than just these results. It involves detailed discussion with your oncologist, but also personal consideration of what you want and how you feel. Remember, you can take your time over treatment decisions. You might feel rushed, but take adequate time until you feel comfortable that you are making the right personal decision. These tests can go a long way in giving you confidence in your decision, but it is still a personal choice that needs to be right for you as an individual based on your mind and spirit, as well as your body.

Here are links to each of these three tests for more information

Patient information on Oncotype DX DCIS

Oncologist information on Oncotype DX DCIS

Patient information on Oncotype DX

Oncologist information on Oncotype DX

Patient information on Mammaprint

Oncologist information on Mammaprint

Let me know if you’ve had any of these tests and how they helped you.

Ruth BaillieRuth Baillie is originally from the UK and now lives most of the year in Northern California. She holds two Master’s degrees, one in Personalized Nutrition (distinction), and another in Health Psychology. She is a Registered Nutritional Therapist, Certified Professional Cancer Coach, and Cancer Guide, and has undertaken considerable post-graduate studies in integrative naturopathic oncology. She is the author of “Choices in mind-body medicine for cancer patients in Sonoma County, California” and her research has been published in peer-reviewed journals.

 

Tests To Help With Breast Cancer Treatment Decisions


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Lymphedema After Mastectomy Breathing Exercises & Restorative Yoga

It is not unusual for a woman to develop lymphedema after a mastectomy. Lymphedema is a sometimes-painful swelling in the soft tissues.  This can be due to the removal of lymph nodes, scar tissue, strictures, and other factors.

Manual lymph drainage massage is the usual recommended technique to treat this swelling.  It may be surprising to know that another therapy that benefits lymphedema is yoga, especially restorative yoga. When the lymphatic system is at its optimum, it is like a free flowing river, running without obstacles.  However, when the lymph nodes are removed or damaged, that same river meets obstacles and begins to slow down and this creates a pooling of fluids.  This build up in the tissues can cause swelling and inflammation and reduce oxygen in the lymphatic tissues. The white blood cells, or immune soldiers of the body, can be impaired in their function in this situation.  This may increase the risk of infection and create a possible permanent disability.  Edema is often found in the arms and legs, but can be found in other parts of the body.

Knowing how important it is to keep this fluid running like a free flowing river, we need to foster relaxation and gentle movements that encourage its increased flow.  This is especially important after breast surgery or removal of nodes, when it is paramount to undertake new activities to increase impaired lymphatic function.

The need to develop a deeper state of relaxation to counter the mental and physical stress of illness and its treatment is critically important to our health and well-being.

Practicing yoga, especially Restorative Yoga which targets the pectoral area, keeps the fluid moving through the body rather than slowing down and creating a back up.  This benefits the breasts by promoting drainage and healing and creating a sense of safety when expanding the chest.

Practicing Restorative Yoga daily will undo the harmful effects of too much sitting or inactivity.  Starting yoga practice with a knowledgeable Restorative Yoga teacher is as important as wearing a bandage or support garment.

An important thing to understand in your practice of Restorative Yoga is that you must to slow down enough to listen to what your body is telling you.  Any time you overwork your muscles or strain your healing tissues,  you run the risk of fluid build up.

Let this be the yoga practice of self-understanding.

More Great Articles

  1. How Breathing Exercises Can Raise Energy Levels For Breast Cancer Patients
  2. Breathing, Yoga and Cancer
  3. Breast Cancer Breathing Guidelines & Techniques During Exercise
  4. Diaphragmatic Breathing for Cancer Survivors
  5. Learn Natural Breath Breathing Exercise For Breast Cancer Treatment
  6. Yoga Pose for Breast Cancer – Root Lock KRIYA Breathing
  7. 4 Benefits of Breathing Exercises For Breast Cancer Treatment
  8. Why Start A Breathing Practice For Breast Cancer Recovery? Good Health!

Dawn Breast CancerAbout Dawn Bradford Lange:  Co-founder of Breast Cancer Yoga. Dawn is making a difference with Breast Cancer Yoga therapeutic products designed to support you emotionally and physically during breast cancer . We want to give you the attention and personal service you need so please email us at info@breastcanceryoga.com if you have questions.

Lymphedema After Mastectomy Breathing Exercises & Restorative Yoga


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A little known side effect with a huge impact

A little known side effect with a huge impact

Lymphedema affects millions of cancer patients, yet many don’t know their risk and treatment is not always covered
Sept. 3, 2015

https://www.fredhutch.org/en/news/center-news/2015/09/lymphedema-cancer-treatment-side-effect.html

Breast cancer survivor Rebecca Thomas

Breast cancer survivor Rebecca Thomas began experiencing symptoms of lymphedema several years after her treatment. Custom compression sleeves are a common treatment for lymphedema but Medicare and many other insurance companies don’t cover them. Thomas, who couldn’t afford the out-of-pocket expense, said she simply „learned to live with it.“

Photo by Robert Hood / Fred Hutch News Service

First, there was achiness, a pain that never went away. Then, her right arm and hand began to swell, a little at first and then a lot. Then Rebecca Thomas, a breast cancer survivor five years out from surgery, chemo and radiation, was hospitalized with a raging infection.

“The swelling wasn’t bad at first and I didn’t think much of it,” said the 65-year-old food service worker from Seattle, who was diagnosed with cancer in 1988. “But I got a [cut] on my finger and bacteria got in there and I ended up with a very bad case of cellulitis. It got at least three times the normal size, my whole hand and arm. After that is when the trouble really set in.”

Thomas’ “trouble” was lymphedema, a condition that impacts millions of U.S. cancer survivors every year, particularly patients who undergo lymph node dissection as part of their treatment, like actress and “lymphedema ambassador” Kathy Bates.

The National Cancer Institute calls lymphedema “one of the most poorly understood, relatively underestimated, and least researched complications of cancer or its treatment.” Others refer to it as cancer’s “dirty little secret” since patients often don’t know they’re at risk for it, general practitioners may not know how to diagnose or treat it and the condition can be so fickle that even cancer care providers can’t predict who will get it or when. Pain, swelling and related infections can happen months, years or even decades after surgery and treatment.

And while early treatment with compression garments can vastly improve patients’ quality of life by keeping the swelling in check, Medicare and other insurers often don’t cover them, forcing many to live with a painful, debilitating, embarrassing and costly condition – sometimes for years.

Breast cancer oncologist and health economist Dr. Gary Lyman

Breast cancer oncologist and health economist Dr. Gary Lyman said there is „absolutely no reason“ why the Centers for Medicare & Medicaid Services should not cover the cost of compression sleeves for patients diagnosed with lymphedema.

Photo by Robert Hood / Fred Hutch News Service

How cancer treatment impacts lymph nodes

Lymphedema is tied to the body’s cell waste disposal system, which acts a bit like a garbage pickup service. Cells create waste (bacteria and proteins) that are picked up and shuttled along by the lymphatic system and then processed by the lymph nodes, which act as the garbage and recycling plants in the bustling city that is your body.

Unfortunately, when these lymph nodes (or processing plants) are blocked or damaged or removed thanks to a tumor, surgery or radiation, our cell’s “garbage” starts to pile up and the limbs begin to swell. If left untreated, lymphedema can trigger a chain reaction of complications, most notably sudden, serious and recurrent infections brought on by unchecked bacteria that thrive in the trapped lymph fluid.

“Any patient who has a tumor or surgery that disrupts the lymphatics under the arm or adjacent to the neck or in the groin may end up with edema of the extremities,” said Dr. Gary Lyman, researcher and breast cancer oncologist with Fred Hutchinson Cancer Research Center and its treatment arm, Seattle Cancer Care Alliance.

“It can be relatively mild to quite severe,” he said. “It’s unsightly, puts patients at increased risk of recurrent infections and pain and quality of life can be dramatically affected.  Most breast cancer patients today don’t develop severe lymphedema but it still occurs and when it does, it’s a major life event and a lifelong event.”

Fortunately, lymphedema isn’t all that hard to manage if caught early.

Experts say those at risk should first and foremost protect their skin from cuts and scratches, i.e., don’t go blackberry picking without long sleeves, use bug spray so you don’t get insect bites and don’t try to pet the cranky neighborhood cat. If it’s really hot out and you’re having a “flare” – your arm starts to feel hot and tight and somehow bigger – avoid anything that would aggravate it further like strenuous gardening or pushups.

In other words, listen to your body and learn the subtle symptoms so you can nip the condition in the bud. If you notice any signs of swelling, contact a lymphedema therapist.

Seattle Cancer Care Alliance physical therapist Carol Baltaxe

SCCA physical therapist Carol Baltaxe said if patients don’t have compression, the lymphedema will „slowly get worse over time.“ Baltaxe and her colleagues try to connect patients whose insurance doesn’t cover compression garments with additional resources. Patients can also get assistance through the National Lymphedema Network.

Photo courtesy of Carol Baltaxe

Subtle symptoms

Lymphedema usually starts with an arm or leg simply feeling “heavy” or “tight.” As it progresses, the arm or leg (or hand/foot) will slowly swell, rings or watches may suddenly seem too small and shoes may not fit. The limb may also ache, become less flexible or even itch. Without treatment, the swelling will become more pronounced and the chance of infection from even a small cut or scrape will skyrocket.

Red, blotchy skin; pain in the lymphedema limb, and fever and chills are all signs of infection. And bacteria can enter the bloodstream from anywhere in the body and travel to the lymphedema area, say experts.

“We had a patient who was getting infections every three months and we discovered she was getting dental work done and bacteria were being introduced through her gum line,” said Sue Frohreich, a physical therapist with SCCA. “She started doing a preventive prophylactic antibiotic the morning of her dental appointments and never had an infection again to my knowledge.”

Anywhere from 6 to 63 percent of breast cancer patients develop lymphedema (depending on the study you read), most as a result of radiation and/or the surgical removal of lymph nodes (obesity exacerbates the condition possibly due to excess inflammation). A joint Fred Hutch/NCI study that followed breast cancer patients for 10 years found 29 percent went on to develop lymphedema anywhere from two weeks to 11 years post diagnosis.

As for other cancers, a 2010 meta-analysis found that the overall incidence of lymphedema was 30 percent in sarcomas; 20 percent in gynecologic cancers; 16 percent in melanomas; 10 percent in genitourinary cancers and 4 percent in head/neck cancers.

“Anyone who has had lymph nodes removed or radiated should be seen by a lymphedema therapist even if they don’t have swelling to get educated about the signs and symptoms and the things they can do to reduce the risk of getting it,” said physical therapist Carol Baltaxe, also with SCCA.

Treatment options include lymphatic drainage massage, compression and, more recently, surgery. Exercise – done correctly (patients should discuss this with a physical therapist or other lymphedema expert) – is another effective way to manage symptoms.

“Being active can actually help stimulate the lymphatic system,” said Frohreich. “As long as they do slow progression, it doesn’t increase their incidence of lymphedema.”

Cervical cancer survivor Cindy Alsobrook

Cindy Alsobrook developed lymphedema in her left leg shortly after going through surgery, chemo and radiation for cervical cancer. „I used to walk three to five miles a day. Now, walking four to five blocks to the grocery store is about all I can do.“

Photo courtesy of Cindy Alsobrook

Rude stares and repeated infections

Seattle cancer survivor Cindy Alsobrook, 42, developed lymphedema in her left leg shortly after she finished surgery, chemo and radiation for cervical cancer in December 2013.

“I had surgery to remove my ovaries and Fallopian tubes and they took 32 lymph nodes because they were looking cancery,” she said. “So my lymph system had quite a few nodes removed and then the radiation went in and fried what I had left. “

As a result Alsobrook’s left leg has doubled and even tripled in size and she’s suffered repeated cellulitis infections and one hospitalization.

And those are only the physical symptoms. The condition also carries a heavy psychological burden.

A former preschool teacher who’d just launched a new career in retail, Alsobrook was forced to give up her job. She routinely deals with stares and rude comments from strangers. Thanks to lymphedema, she can’t exercise, wear her favorite clothes or even go for a walk without feeling its effects.

“I spend a lot of time lying on the couch watching movies or reading now,” she said. “I used to go roller skating. I used to walk three to five miles a day. Now, walking four to five blocks to the grocery store is about all I can do. And I’m much slower than I used to be. I’m getting lapped by grandmas with their walkers. I miss skinny jeans and cute shoes something terrible. Even things like yoga pants can be difficult. To get the big leg to fit, the skinny leg is swimming.”

Lymphedema infographic

Delayed diagnosis

While Alsobrook was warned about lymphedema both before and after surgery and radiation, experts say this isn’t always the case.

“There are definitely information gaps out there in the medical community,” said Sam Roth, patient and outreach coordinator with the National Lymphedema Network, based in San Francisco. “People come out of cancer therapy or surgery with very moderate lymphedema and if they’re not educated on basic risk reduction and practices, they can exacerbate it.”

Those at risk, for instance, may want to avoid the heat, wear a compression sleeve when flying and avoid putting extra weight, strain or constriction on their affected limbs, he said. (For more tips, click here.)

Cancer patients should also be aware that lymphedema is commonly misdiagnosed by general practitioners.

“I remember one patient who kept hearing the diagnosis that she was retaining water,” said Roth. “This happens to a lot of patients. Unfortunately, she was misdiagnosed for years. She was in tears when she finally talked to us. The swelling in her legs had gotten so bad that part of her skin was hanging down like an extra appendage.”

The earlier you catch it, the more manageable it is, Roth stressed, “but just getting a diagnosis and getting recognition of it is difficult.”

A new process at SCCA should make diagnosis easier.

“We’re going to start doing pre-surgical baseline arm measurements in breast cancer patients so we’ll know when we start to see signs of swelling earlier,” said Baltaxe.

Lymphedema and the law

But even if lymphedema is diagnosed early, treatment may not be covered by insurance.

Both Thomas and Alsobrook went without custom compression garments for years (and in Thomas’ case, decades) because they couldn’t afford the out-of-pocket costs. Thomas’ one custom-made sleeve and glove cost $1,000 (she wore it out years ago and never replaced it) and the single custom leg compression garment Alsobrook saved for months to buy ran $1,700 (most patients require a pair of compression garments every six months for each affected limb).

Without compression, the lymphedema flourished.

“I feel like the insurance could have saved a lot of trouble and money if they would have just given me custom compression garment from the beginning,” said Alsobrook, who is on Medicaid. “I feel like I would have been able to return to work if it hadn’t gotten to the stage it is now. I’ve got permanent tissue damage going on now and I can only get it to go down so far.”

Baltaxe, who often chases down resources for patients like Alsobrook, said the current lack of coverage for compression garments “doesn’t make any financial sense,” pointing to a 2009 study that showed women with breast cancer-related lymphedema (BCRL) incurred an average of $7,000 more in health care costs per year than those without BCRL.

“[Compression] is a minimal cost for an insurance company,” she said. “And it’s a lot cheaper to have a patient in a compression garment than to pay for the cost of IV antibiotics or hospitalization.”

A bill known as the Lymphedema Treatment Act, sponsored by Washington State Rep. Dave Reichert may help change that. The bill, a patient-driven grassroots effort, is under consideration by two House committees.  Its aim, according to the LTA website, is to “improve coverage for the treatment of lymphedema from any cause by amending Medicare statute to allow for coverage of compression supplies.” Changing the Medicare law could set a precedent for Medicaid and private insurers to follow..

Lyman, co-director of Fred Hutch’s HICOR group, which helps to identify the best value in cancer care, said the proposed change in law is a “no-brainer.”

“There is absolutely no reason why the Centers for Medicare & Medicaid Services should not reimburse the cost of a sleeve for any patient with lymphedema,” he said. “It’s controlling the symptoms, it’s non-toxic and it’s not expensive.  I don’t understand any rationale for not reimbursing for compression. It only takes a few patients with a $100,000 hospital bill to more than offset what they view as cost savings by not preventing infections with a compression sleeve.”

Thomas, who knows others who’ve been diagnosed with breast cancer and lymphedema, said compression makes all the difference.

“It would have been a different story if I had not gotten the cellulitis,” she said. “[A family member] has breast cancer and she got a sleeve recently. I can hardly see the swelling, but I know they can tell when there’s lymphedema there. I’m really grateful she got it taken care of so soon. It’s not going to be as bad an issue for her.”

HOW TO TREAT IT:

  • Manual lymphatic drainage: This specialized type of skin massage mobilizes and moves built-up fluid to areas of the body where it can be absorbed.
  • Good skin care: Maintaining healthy skin through scar care, moisturizing and careful shaving is important for avoiding infections. Even a small cut or scrape can potentially lead to problems because of an inefficient lymphatic system.
  • Exercise: Some patients believe if they don’t move, they won’t swell, but the opposite is true. We move fluid by pumping our muscles, so being active is very, very important. Precautionary steps must be taken to not aggravate lymphedema, but the benefits outweigh the risks.
  • Compression: If limbs are swollen, they must be compressed. Special types of bandages are initially used in physical therapy to reduce swelling and then patients are fitted with a compression garment to maintain reductions. Compression is an important key for treating lymphedema.
  • Surgery: In recent years, new surgical procedures such as lymph node transfer have been developed that provide relief from swelling and discomfort and generally make lymphedema easier to manage.

We encourage all cancer survivors to be proactive in learning about this condition. With help, you can learn strategies to be able to manage it on your own.

From “Coping with lymphedema,“by Lexi Harlow and Sue Frohreich, Seattle Cancer Care Alliance Physical Therapy Clinic

Has lymphedema affected your life? Tell us about it on Facebook.

Solid tumors, such as those of the breast, are the focus of Solid Tumor Translational Research, a network comprised of Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Cancer Care Alliance. STTR is bridging laboratory sciences and patient care to provide the most precise treatment options for patients with solid tumor cancers.

Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she also writes the breast cancer blog doublewhammied.com. Reach her at dmapes@fredhutch.org.


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What Happens When Cancerous Cells Move Into Your Lymph System?

What Happens When Cancerous Cells Move into your Lymph System?

 

https://breastcanceryogablog.com/

When cancer cells break away from the main tumor, there’s a great possibility that they will become stuck to nearby lymph nodes. This is why doctors usually check the lymph nodes first when figuring out how far cancer has grown or spread.

When the cancerous cells make contact with the lymph node, they may divide and perform a tumor at the site of the lymph node. When doctors examine the lymph nodes and find evidence of metastases (especially in lymph nodes near the primary tumor), this is an indicator that metastasis exists in distant organs and often helps doctors make prognoses.

Proper lymph drainage lowers your risk of developing cancer, as it ensures proper removal of abnormal, cancerous cells and prevents metastasis.

The Key Takeaway: When cancer cells break away from the main tumor, they can travel through other parts of the body via the lymph system. When transported via the lymph system, cancerous cells may end up in your lymph nodes, where most are killed but one or two may settle and grow into new tumors, leading to metastasis.

So, before I move into how you can strengthen your lymph system and slow down the spread of cancer, time for a quick review!

You now know:

  1. The lymph system is critical for your body’s defense against harmful toxins and bacteria.
  2. Cancerous cells can move through your body via the lymph system, leading to the possibility of metastasis.
  3. Proper lymph drainage ensures cancer prevention and prevention of the spread of cancerous cells, or metastasis.

Now, from point 3 above, it should follow that a healthy, well-functioning lymph system is crucial for cancer prevention and metastasis.

Let’s go into how you can boost and invigorate your lymph system so that it is on top of its game when you need it.

How Can you Boost your Lymphatic System?

There are three ways you can boost your lymph system:
1.) Proper Nutrition Boosts your Lymph SystemProper Nutrition Boosts your Lymph System

  • Certain foods can improve lymphatic flow, including:
  • Citrus fruits such as limes, lemons, tangerines, oranges, and grapefruit
  • Berries, specifically cranberries
  • Sunflower and pumpkin seeds
  • Chia, hemp, and flax
  • Herbs and spices such as black pepper, cardamom, coriander, cinnamon, ginger, and turmeric
  • Seaweed and algae

There are also foods that you should avoid, including:

  • Dairy foods
  • Processed foods
  • Sugary foods
  • Oily foods

2.) Development of Positive Habits for a Healthy Lymph SystemDevelopment of Positive Habits for a Healthy Lymph System

There are some habits that can produce a positive impact on your lymph system (and prevent the development and spread of cancer):

  • Wear bras less frequently (very important for breast cancer) – Clothing that constricts body parts can interfere with lymph flow and drainage
  • Get regular massages – Massages are great for stimulating lymph drainage
  • Properly hydrate your body – Drinking water helps your lymph flow along with flow in other major bodily systems. Forget the eight glasses of water everyday rule. Shoot for drinking half of your body weight in ounces of water per day. So, if you weigh two hundred pounds, drink one hundred ounces of water.
  • Breathe deep! – Fill your lungs completely and don’t move your shoulders
  • Swish oil in your mouth – Swishing a tablespoon of oil in your mouth clears your sinuses which helps with lymph flow
  • Attain proper alignment in your body with chiropractic care – Proper alignment in your body helps with better drainage of fluid
  • Take advantage of regular spa days – Time in a sauna is a great way to remove toxins from your body, which revs up your lymph system, too
  • Enjoy a clay bath – Clay baths provide a great way for you to detox and enjoy a thorough skin cleanse, both of which are helpful for your lymph system
  • Hold your liver sacred – your liver produces lymph, which is critical for the rest of your lymph system
  • Experiment with dry skin brushing – rubbing a dry brush across your body opens up skin pores and, as a result, stimulates your lymph system.

3.) The most important habit you can adopt? Get moving and exercise! Your lymph system doesn’t have a pump to stimulate lymph movement; therefore, you have to get that lymph moving manually. The best way to do this is via exercise, but not just any exercise.

Learn more below:

Get Moving to Boost your Lymph Flow

Any vertically oriented exercise is best for your lymph system. So, your go to exercises should be downward dogs, jumping jacks, or headstands. Certain physical limitations, however, can make these types of exercises uncomfortable, painful, or even impossible. For these reasons, bouncing on a trampoline, or rebounding, is the most effective workout you can give your lymph system. Check out the next section to learn why.

The Best Exercise for your Lymphatic System: Rebounding!

What is Rebounding? Rebounding increases the flow of oxygen to all cells in your body, and the exercise can help you become healthier, stronger, and help your body become more capable of effectively fighting disease.The Best Exercise for your Lymphatic System- Rebounding!

What Equipment is Needed to Rebound? All you need is a high quality rebounder trampoline, or exercise trampoline, to rebound! If you need more stability during your bounces, you can also purchase a stability bar with most rebounder models. For more info on what to look for when shopping for a rebounder, check out this detailed rebounder trampoline buyer’s guide.

How do I Use the Rebounder During my Workouts? There are several rebounding workouts you can enjoy, depending on your fitness level. These are the four most popular rebounder workouts:

The Sitting Bounce

If you don’t have a very high level of fitness due to injury, illness, or advanced age, the sitting bounce might be best for you. You will need one other person to properly perform the sitting bounce. First, sit on the rebounder. Second, your partner should stand directly behind you and gently bounce up and down, which will help you bounce up and down. To further develop your core strength with the sitting bounce, try leaning back, extending your arms, or using your arms to help you bounce.

 

Check out this video to see the sitting bounce in action:

Leonard Parker, Owner of RebounderZoneIf you are ready to start a new, refreshing stage in your battle against breast cancer, start rebounding today with these high quality rebounders. Use discount code VICTORY for 10% off all products in our store.

A life of better health awaits you.

Author: Leonard Parker, Owner of RebounderZone 

 

 

 

Breast Cancer Authority

What Happens When Cancerous Cells Move into your Lymph System?When cancer cells break away from the main tumor, there’s a great possibility that they will become stuck to nearby lymph nodes. This is why doctors usually check the lymph nodes first when figuring out how far cancer has grown or spread.

When the cancerous cells make contact with the lymph node, they may divide and perform a tumor at the site of the lymph node. When doctors examine the lymph nodes and find evidence of metastases (especially in lymph nodes near the primary tumor), this is an indicator that metastasis exists in distant organs and often helps doctors make prognoses.

Proper lymph drainage lowers your risk of developing cancer, as it ensures proper removal of abnormal, cancerous cells and prevents metastasis.

The Key Takeaway: When cancer cells break away from the main tumor, they can travel through other parts of the body via the lymph system. When transported via…

Ursprünglichen Post anzeigen 919 weitere Wörter


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How is your Lymphatic System Connected with Cancer?

 

How is your Lymphatic System Connected with Cancer?

How is your Lymphatic System Connected with Cancer?

 

Are you living with or at high risk for breast cancer? Did you know there are certain habits and exercises you can use to strengthen your body’s response to breast cancer? Not only will these habits and exercises help prevent and self treat breast cancer, but they will also benefit your health in a myriad of other ways.

In this article, I will detail exactly what these habits and exercise are. But, before I go that far, let’s start with the base: your lymphatic system.

What is the Lymphatic System?

Why your Lymphatic System is Critical to your Overall HealthThe lymph system is a network of nodes, organs, and lymph vessels. Your lymph system consists of your adenoids, liver, lymph fluid, lymph nodes, lymphatic vessels, spleen, thymus, thoracic duct,  and tonsils. Working in harmony, your lymph system’s components absorb excess fluid from the body and return that fluid to your bloodstream. These components also absorb fat in your small intestine and boost your immune system.

Why your Lymphatic System is Critical to your Overall Health

A healthy, well-functioning lymph system serves several critical functions for your health and wellness, including:

    • Balance of proteins in your tissues’ fluids
    • Diffusion and circulation of nutrients such as Vitamin A, Vitamin D, Vitamin E, and Vitamin K from your red blood cells.
    • Regulation of your blood pressure

The most important reason to have a healthy lymph system?: A strong lymph system provides protection from harmful toxins and bacteria.

Now that you understand the importance of your lymph system, let’s explore how it is connected with cancer.

How is your Lymphatic System Connected with Cancer?

As mentioned above, your lymph system serves as a critical line of defense for your body’s immunity. In this defense, your lymphatic system destroys old or abnormal cells, such as cancer cells.

Details on How your Lymph System Removes Cancerous Cells

This is a high level overview on how cancerous cells are removed from your body:

Blood circulates throughout your body.

      1. As your blood flows, fluid leaks from your blood vessels to your body tissues.
      2. This excess fluid delivers food to your cells and forms tissue fluid with your body’s tissues.
      3. At this point, this excess fluid picks up bacteria, waste products, and damaged or abnormal cells, including cancerous cells.
      4. After this “garbage collection”, the fluid drains into your lymph vessels.

Next, your lymph fluid flows through your lymph vessels and lymph glands, filtering out those nasty cancerous cells along the way.

The most important habit you can adopt? Get moving and exercise! Your lymph system doesn’t have a pump to stimulate lymph movement; therefore, you have to get that lymph moving manually. The best way to do this is via exercise, but not just any exercise.

Learn more below:

Get Moving to Boost your Lymph Flow

Any vertically oriented exercise is best for your lymph system. So, your go to exercises should be downward dogs, jumping jacks, or headstands. Certain physical limitations, however, can make these types of exercises uncomfortable, painful, or even impossible. For these reasons, bouncing on a trampoline, or rebounding, is the most effective workout you can give your lymph system. Check out the next section to learn why.

The Best Exercise for your Lymphatic System: Rebounding!

The Best Exercise for your Lymphatic System- Rebounding!What is Rebounding? Rebounding is a great exercise that helps you satisfy all four essential elements of exercise: aerobic capacity, endurance, flexibility, and strength. Rebounding increases the flow of oxygen to all cells in your body, and the exercise can help you become healthier, stronger, and help your body become more capable of effectively fighting disease.

What Equipment is Needed to Rebound?All you need is a high quality rebounder trampoline, or exercise trampoline, to rebound! If you need more stability during your bounces, you can also purchase a stability bar with most rebounder models. For more info on what to look for when shopping for a rebounder,check out this detailed rebounder trampoline buyer’s guide.

Even if you rebound regularly, you still need to maintain a balanced, nutritious diet, get proper rest, avoid negative behaviors such as drug use, and get proper treatment for states detrimental to your health such as stress, anxiety, and depression.

Due to its positive impact on not only your lymph system but a variety of other bodily systems, rebounding is the best exercise to invigorate your body’s lymph flow.

Leonard Parker, Owner of RebounderZoneIf you are ready to start a new, refreshing stage in your battle against breast cancer, start rebounding today with these high quality rebounders. Use discount code VICTORY for 10% off all products in our store.

A life of better health awaits you.

Author: Leonard Parker, Owner of RebounderZone 

 

 

How is your Lymphatic System Connected with Cancer?


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Palm Tree Standing Yoga Pose For Breast Cancer Related Lymphedema — Breast Cancer Authority

Palm Tree Yoga Pose is a great standing pose for breast cancer recovery and lymphedema management. This pose helps with stiffness or tightness in the chest area or the armpit (axilla) area that comes after either surgery, radiation therapy and lymphedema flare ups. Depending on the symptoms, your physician will select the best treatment for […]

über Palm Tree Standing Yoga Pose For Breast Cancer Related Lymphedema — Breast Cancer Authority


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Artikel – Selen erobert sich festen Platz in der Onkologie

Einen schönen guten Tag wünsche ich euch. In letzter Zeit habe ich recht viele Mails bekommen wegen Selen. Wir ihr wisst glaube ich das die Selen nicht nur positives tun für unser Immunsystem sondern auch gegen unsere Lymphödeme, Wirkung und positive Eigenschaften habe ich schon auf meinem Blog öfters angeschnitten. Per Zufall habe ich einen Artikel gefunden der auch auf den positiven Eigenschaften eingeht für Krebs Patienten.

Herzlichen Dank an http://www.gesundheit.com !

„Selen erobert sich festen Platz in der Onkologie

Das essentielle Spurenelement Selen erfüllt im menschlichen Körper vielfältige Funktionen: Als Bestandteil körpereigener Redoxsysteme – allen voran der spezi-fischen Seleno-Enzyme Glutathionperoxidase und Thioredoxinreduktase – übernimmt es wichtige oxidative Schutzfunktionen, verbessert die Immunkompetenz und ist daran beteiligt, in Tumorzellen ein Selbstmordprogramm (Apoptose) auszulösen. Zahlreiche pharmakologische, tierexperimentelle und klinische Daten sprechen dafür, dass sich die genannten Fähigkeiten des Spurenelements zur Vorbeugung und Behandlung von Krebserkrankungen nutzen lassen.

Krebserkrankungen vorbeugen …
Die tumorpräventiven Wirkung von Selen kann heute nicht mehr ernsthaft in Zweifel gezogen werden. Studiendaten aus 30 Jahren belegen eindeutig den Zusammen-hang zwischen schlechter Selenversorgung und erhöhter Krebsinzidenz. So zeigen etwa große prospektive Studien der 80er und 90er Jahre, dass ein niedriger Selen-Status mit einem zwei- bis sechsfach erhöhten Krebsrisiko einhergeht. Interventions-studien aus China belegen, dass die Krebsinzidenz ? in diesem Fall die des hepatozellulären Karzinoms ? deutlich reduziert wird, wenn die Nahrung mit Selen in Form von Natriumselenit supplementiert wird. Die aussagekräftigste Studie zur tumorpräventiven Wirkung von Selen ist die 1996 veröffentlichte Clark-Studie. In der plazebokontrollierten Doppelblindstudie an 1300 Patienten mit behandeltem Nichtmelanom-Hautkrebs konnte gezeigt werden, dass eine Supplementation von 200 µg Selen pro Tag die Gesamt-Krebsinzidenz ebenso wie die Krebsmortalität dramatisch zu senken vermag. Experten wie die britische Ernährungswissen-schaftlerin Margret Rayman schließen aus diesen Ergebnissen, dass gerade in Selen-Mangelgebieten wie Deutschland besonders sorgfältig auf eine gute Selen-versorgung der Bevölkerung geachtet werden sollte (Lancet, 2000). Durch Supple-mentation des Spurenelements könne malignen Erkrankungen auf einfache Weise vorgebeugt werden.

… und Krebs therapieren 
Auch in der Behandlung manifester Krebserkrankungen hat Selen einen hohen Stellenwert. Mittlerweile ist die Selentherapie integraler Bestandteil einer ganzheitlichen supportiven Onkotherapie. Die antitumorale Wirksamkeit des Spurenelements konnte mittlerweile am Tiermodell, aber auch beim Menschen vielfach belegt werden. So zeigt eine multizentrische Anwendungsbeobachtung an 570 Tumorpatienten, dass die tägliche Einnahme von 200 µg Natriumselenit (Cefasel® 100 µg) bei knapp 70 Prozent der Patienten zu einer deutlichen Verbesserung der Beschwerden oder gar zur Symptomfreiheit führte.

In die gleiche Richtung weist ein mehrjähriges Modellprojekt, das in einer onkolo-gisch geführten Praxis und Tagesklinik in Düsseldorf durchgeführt wurde. Das Projekt zeigt, dass Natriumselenit, eingebettet in ein komplexes Therapiekonzept aus Spurenelementen, Vitaminen und proteolytischen Enzymen, das Leben von Krebs-patienten verlängert und deren Lebensqualität verbessert. Im Rahmen der Unter-suchung hatten 417 Patienten unterschiedlicher Krebsentitäten zusätzlich zur konventionellen Behandlung eine Basistherapie aus Natriumselenit (Cefasel® 100 µg, normale Dosis 100 µg täglich, in Belastungssituationen wie Operation, Chemo- oder Strahlentherapie 300 µg täglich), Vitaminen, Spurenelementen und proteoly-tischen Enzymen erhalten. Die Zwischenauswertung der Untersuchung nach 36 Monaten ergab im Vergleich zu einer historischen Kontrolle konventionell behandel-ter Patienten (Saarländer Krebsregister) einen deutlichen Trend hin zu einer verlän-gerten Überlebenszeit und einer besseren Lebensqualität. Angesichts dieser Daten ist Selen für Studienleiterin Dr. Elsbeth Rethfeldt „ein Muss in der Therapie und Prävention von Krebserkrankungen“. Die Ärztin sieht die therapeutischen Einsatz-gebiete von Selen vor allem prä- und postoperativ im Sinne einer Ödemverringerung und Metastasenprophylaxe sowie begleitend zu einer Strahlen- und/oder Chemo-therapie. Aus heutiger Sicht würde die Ärztin ihren Patienten in Belastungs-situationen wie der Chemotherapie allerdings eine höhere Tages-Selendosis – nämlich 1000 µg – verabreichen.

Wirkmechanismen sind heute gut verstanden 
Dass Selen Krebszellen auf effektive Weise den Kampf ansagt ? das ist klinisch eindeutig belegt. Wie diese Wirksamkeit allerdings auf zellulärer und molekularer Ebene zustande kommt, war lange Zeit nur ansatzweise verstanden. Heute sieht man in dieser Hinsicht klarer: Anhand von Literaturdaten lassen sich heute ver-schiedene Wirkmechanismen des Spurenelements belegen, die allesamt eine Krebs-therapie günstig beinflussen können. Interessant ist dabei, dass die Effekte von Selen in der Onkotherapie zwar zum großen Teil auf seiner viel diskutierten Wirk-samkeit als Radikalfänger beruhen, jedoch über die reine Interaktion mit antioxi-dativen Schutzsystemen hinausgehen.

Gesichert ist, dass Selen

  • antioxidative Schutzsysteme unterstützt
  • Immunmechanismen stabilisiert
  • DNA-Reparaturmechanismen beeinflusst
  • Oberflächenmoleküle auf Tumorzellen „down-reguliert“ und dadurch deren invasives Potential vermindert
  • an der Induktion des programmierten Zelltods (Apoptose) in Tumorzellen mitwirkt und
  • Metaboliten bildet, die direkt die Tumorigenese beeinflussen.

Eine simultane Aktivierung all dieser Mechanismen durch Selen bewirkt, dass der Organismus auf mehreren Ebenen ? quasi im Rahmen einer konzertierten Aktion ? gegen die Krebszellen vorgehen kann.

Supportive Selentherapie schützt vor Zytostatika- und Strahlenschäden 
Doch Selen ist offenbar viel mehr als ein antitumoral wirksames Spurenelement. Denn Selen, so weiß man heute, geht nicht nur gegen Tumorzellen vor, sondern schützt gleichzeitig gesunde Körperzellen vor Schäden durch eine konventionelle Krebstherapie demzufolge profitieren Krebspatienten, die begleitend zu einer Strahlen- oder Chemotherapie Natriumselenit erhalten, nicht nur von der Anti-Krebs-Wirkung des Spurenelements, sondern auch von dessen Schutzeffekt gegenüber Radiatio und Chemotherapie. Die Erklärung für dieses Phänomen: Aufgrund seines antioxidativen Potentials unterstützt Selen den Organismus bei Entsorgung freier Radikale, die unter einer Chemo- oder Strahlentherapie in großer Menge gebildet werden.

Der chemoprotektive Effekt des Spurenelements ist mittlerweile durch zahlreiche in vitro- und in vivo-Untersuchungen belegt. So konnte beispielsweise Sieja (1998) zeigen, dass Frauen mit Ovarialkarzinom, die unter einer Chemotherapie standen, von der täglichen Gabe von 200 µg Selen profitierten. Erfahrungen aus der klinischen Praxis bestätigen die selenbedingte Schutzwirkung von Körperzellen gegenüber Zytostatika auch bei anderen Krebsarten. Untersuchungen am Tiermodell belegen ebenfalls, dass eine gezielte Vorbehandlung der Tiere mit Natriumselenit uner-wünschte Nebenwirkungen bestimmter Chemotherapeutika wie Adriamycin (Kardio-toxizität) oder Cisplatin (Nephrotoxizität) deutlich vermindert.

Auch Krebspatienten, die unter einer Radiotherapie stehen, profitieren von der zusätzlichen Verabreichung von Selen. Zahlreiche in vitro- und in vivo-Daten belegen den radioprotektiven Effekt des Spurenelements. So behandelten etwa Hehr et al. (1997) Patienten mit fortgeschrittenem Rektumkarzinom, die unter einer Radio-chemotherapie standen, zusätzlich mit Selen. Nach jedem Zyklus der Chemotherapie mit Fluorouracil erhielten die Patienten täglich 2000 und nach jeder Bestrahlung des Tumors und der Lymphknoten 400 µg Natriumselenit. Einmal wöchentlich wurde untersucht, ob sich die Selenbehandlung positiv auf die Lebensqualität der Patienten auswirkte. Von besonderem Interesse waren dabei die Parameter Durchfall, Dysurie, Hunger Appetit, Übelkeit und Erbrechen. Die Autoren kamen in ihrer Untersuchung (die nach eigenen Angaben noch vorläufigen Charakter hat) zu dem Ergebnis, dass sich ein radioprotektiver Effekt von Selen sowohl auf in vivo- als auch auf in vitro-Ebene belegen lässt.

Rodemann et al. setzten 1999 die Studien über die Radioprotektion von Selen fort. Die Wissenschaftler führten in vitro-Experimente an kultivierten Plattenepithel-karzinom-Zellen und normalen Haut-Fibroblasten durch. Sie bestrahlten beide Zelltypen in Anwesenheit von Natriumselenit nach einem bestimmten zeitlichen Schema.

Dabei stellte sich heraus, dass die Fibroblasten unter dem Einfluss des antioxidativ wirksamen Spurenelements vor den Auswirkungen der Strahlung geschützt waren, nicht jedoch die Krebszellen. Auch Schleicher et al. konnten 1999 an kultivierten Zellen zeigen, dass Natriumselenit die strahleninduzierte Wachstums-hemmung humaner Endothelzellen praktisch aufhob, während Tumorzellen durch das Spurenelement nicht vor Strahlenschäden geschützt wurden.

Diese Ergebnisse sind von großer Bedeutung für die komplementäre Onkotherapie. Denn sie entkräften die lange gehegte Befürchtung, Antioxidantien wie Selen schützten auf der einen Seite zwar Körperzellen vor Radikalschäden, machten auf der anderen Seite aber gleichzeitig die Wirkung konventioneller Therapien zunichte (die ja ihre zelltoxische Wirkung in der Regel ebenfalls über eine Bildung freier Radikale entfalten können). Die Daten von Rodemann et al. und Schleicher et al. belegen jedoch, dass der radioprotektive Effekt des Selens sich allein auf normale, nicht maligne veränderte Zellen beschränkt. Mit anderen Worten: Strahlenschäden an Krebszellen, die therapeutisch erwünscht sind, werden durch die Anwesenheit von Selen nicht vereitelt.

Selen macht Tumorzellen empfänglicher für eine Chemotherapie
In jüngster Zeit mehren sich die Hinweise darauf, dass Selen die tumordestruktive Kraft konventioneller Therapien sogar noch effektiver machen kann. Aktuellen Untersuchungen zufolge kann die frühzeitige Gabe von Selen verhindern, dass sich Resistenzen gegenüber Zytostatika ausbilden. Selbst wenn sich die Resistenz bereits ausgebildet hat, vermag Selen die Tumorzellen wieder gegen das Chemo-therapeutikum zu resensibilisieren. Dabei kommt offensichtlich ein dualer Wirk-mechanismus des Spurenelementes zum Tragen. Einerseits übt Selen einen hemmenden Einfluss auf das Enzym Glutathion-S-Transferase aus, welches bei resistenten Krebszellen übermäßig aktiv und offenbar direkt an der Resistenz-entwicklung beteiligt ist. Andererseits bildet Selen mit freiem reduzierten Glutathion, das bei resistenten Tumorzellen ebenfalls im Übermaß vorhanden ist, die Verbindung Selenodiglutathion (GS-Se-SG). Das führt dazu, dass in der resistenten Krebszelle die Menge an freiem reduziertem Glutathion permanent vermindert wird ? und zwar so lange, bis die oxidative Abwehr der Zelle zusammenbricht. Schließlich wird in der bereits vorgeschädigten Tumorzelle der programmierte Zelltod ausgelöst ? was ihr endgültig den Todesstoß versetzt.“

©Red. gcom/J.M-W./Foto: Cefak

http://www.gesundheit.com/gc_detail_7_gc01070218.html

http://www.gesundheit.com/


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Lymphödem: Die Krankheit nach dem Krebs , SPIEGEL ONLINE

Lymphdrainage: Wichtiger Bestandteil der Therapie eines LymphödemsZur Großansicht

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Lymphdrainage: Wichtiger Bestandteil der Therapie eines Lymphödems

Eine Krebstherapie kann ein Lymphödem auslösen, bei dem sich große Mengen Flüssigkeit in Armen oder Beinen sammeln. Es muss schnell behandelt werden, sonst drohen unumkehrbare Schäden.

Die Operation ist überstanden, in den Nachsorgeuntersuchungen wurden keine neuen Krebszellen gefunden. Doch dann wird der Arm auf der Seite der betroffenen Brust schwer und schwillt langsam an. Typische Symptome für ein sekundäres Lymphödem.

Das ist eine krankhafte Veränderung, bei der sich Lymphflüssigkeit im Gewebe und in den Gewebezwischenräumen anstaut, weil der Lymphabfluss gestört ist“, sagt Susanne Weg-Remers, Leiterin des Krebsinformationsdienstes beim Deutschen Krebsforschungszentrum (DKFZ). Das erworbene (sekundäre) Lymphödem tritt deutlich häufiger auf als das angeborene (primäre) Lymphödem, bei dem die Lymphabflusswege nicht richtig angelegt sind. Wichtigste Ursache sind Weg-Remers zufolge Krebserkrankungen und -behandlungen.Operationen, bei denen Lymphknoten und angrenzendes Gewebe entfernt werden, Strahlentherapie oder Lymphknotenmetastasen können Abflusswege zerstören. Am häufigsten treten Lymphödeme an den Gliedmaßen auf: nach Brustkrebsoperationen typischerweise am Arm, nach Operationen am Unterleib, etwa bei Prostata- oder Gebärmutterkrebs, an den Beinen.

20 bis 30 Prozent der Brustkrebspatientinnen betroffen

Etwa zwei bis drei von zehn Brustkrebspatientinnen sind von sekundären Lymphödemen betroffen, erklärt Weg-Remers. Weil zunehmend schonender operiert werde, sei die Fallzahl bei Krebspatienten aber insgesamt rückläufig, sagt Oliver Rick, Sprecher der Arbeitsgruppe Onkologische Rehabilitation der Deutschen Krebsgesellschaft (DKG).

Schwere, Spannungsgefühl, Schmerzen und eine beginnende Schwellung können die ersten Symptome eines Lymphödems sein. Sie treten meist erst Wochen oder Monate nach einer Krebsoperation auf. „Das kann auch nach 15 oder 20 Jahren noch passieren“, erklärt Rick. Das Tückische: Hat sich erst einmal ein Lymphödem gebildet, geht es nicht von allein wieder weg, sondern verschlimmert sich stetig.

Bei Flüssigkeitsansammlungen im Gewebe produziert der Körper sogenanntes Proteoglykan. Es kann sehr viel Flüssigkeit aufzunehmen. Sammelt sich durch den gestörten Lymphabfluss aber immer mehr an, kehrt sich der eigentlich positive Regulierungseffekt ins Negative um, erklärt Manuel E. Cornely, Chefarzt der CG Lympha Praxisklinik für Operative Lymphologie in Köln. „Das Proteoglykan lagert sich als schwammartige Masse ab.“ Gleichzeitig werde immer mehr davon gebildet.

Ohne Behandlung gibt es irreversible Schäden

Wird das Lymphödem nicht behandelt, nimmt der betroffene Körperteil an Umfang zu, das Gewebe verändert sich. Die Schwellung, die sich anfangs noch eindrücken und verschieben lässt, wird hart. „Das ist dann ein Stadium, das mit den verfügbaren Therapien schwer oder gar nicht mehr zu beseitigen ist“, so Rick.

Die Beeinträchtigungen, die sich im Zuge dessen ergeben können, sind nicht nur optisch und psychisch massiv. Arm oder Bein können ihre Beweglichkeit verlieren, Betroffene werden eventuell berufsunfähig oder sind auf Pflege angewiesen. Erste Anzeichen eines sekundären Lymphödems sollte daher ein Arzt untersuchen.

Betroffene benötigen eine sogenannte komplexe physikalische Entstauungstherapie (KPE). „Das ist ein umfassendes Therapieprogramm aus mehreren Komponenten“, sagt Rick. Zum einen ist das eine manuelle Lymphdrainage, zum anderen die Kompressionsbehandlung mit Bandagen und Kompressionsstrümpfen. So sollen die gestaute eiweißreiche Flüssigkeit abgeleitet und Gewebsveränderungen verhindert werden.

In der ersten Entstauungsphase, die etwa vier bis sechs Wochen dauert, muss die Lymphdrainage in hoher Frequenz erfolgen, oft sogar täglich. Das Anlegen von Kompressionsbandagen im Anschluss verhindert, dass sich erneut ein Ödem bilden kann. Ärzte, Therapeuten und das Sanitätshaus, das die Kompressionsbekleidung anfertigt, müssen dabei eng zusammenarbeiten.

„Ein gut funktionierendes Netzwerk ist Voraussetzung, dass die Behandlung auch ambulant gut laufen kann“, sagt Rick. Ist dies nicht gegeben oder kommt es trotzdem zu Verschlechterungen, rät der Mediziner dazu, die Behandlungen stationär durchzuführen.

Lebenslanges Tragen von Kompressionsbekleidung

Ein sekundäres Lymphödem verlangt in der Regel eine dauerhafte Therapie. „Das bedeutet ein lebenslanges Tragen der Kompressionsbestrumpfung, manchmal ergänzt durch eine Erhaltungslymphdrainage“, sagt Rick. „Wenn man die Therapievorgaben nicht beachtet, kann man schnell an den Punkt kommen, ab dem die Schädigungen irreversibel sind.“Operationen, die versuchen, den unterbrochenen Lymphabfluss durch einen Bypass ähnlich wie bei Herz-OPs wiederherzustellen, sind kompliziert. Die Lymphgefäße sind so fein wie ein Haar, und wenn sich das Gewebe schon verändert hat, helfen Operationen nicht, erklärt Cornely.

Eine mögliche Alternative ist das Absaugen des Proteoglykan-Gewebes. „Wir können dem Kreislauf der vermehrten Flüssigkeitsansammlung entgegenwirken und damit die notwendigen Lymphdrainagen und Kompressionsbehandlungen deutlich reduzieren“, erklärt Cornely. Patienten, die sich dafür entscheiden, müssen die Kosten allerdings selbst tragen. Und: „Die wissenschaftliche Datenlage zur Wirksamkeit operativer Verfahren ist bisher dünn“, sagt Weg-Remers.

http://www.spiegel.de/gesundheit/diagnose/lymphoedem-die-krankheit-nach-dem-krebs-a-1008939.html


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A Psychologist’s Guide To Meaningful Conversation During Cancer Treatments

It is time to talk about the “C” word as we move our way through the alphabet. It might seem no surprise to you if I chose the word cancer for the C word. However, I am choosing the word Conversati…

Quelle: A Psychologist’s Guide To Meaningful Conversation During Cancer Treatments