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Archive for the ‘Cancer’ Category

Self-regulation IN RHEUMATOID ARTHRITIS

Friday, October 29th, 2010

Sorry, this entry is only available in Russian.

DEFINITIONS OF SOME EXPRESSIONS YOUR DOCTOR MAY USE – PAINKILLERS AND ADDICTION (PART 1)

Monday, May 18th, 2009

It is a fact that many painkillers are addictive. However, it is extremely rare for people who use painkillers as painkillers to become addicted to them. Addiction is much, much more likely to develop in people who take painkillers not for pain relief, but in order to get a lift, escape from reality or for some other such reason. If you take painkillers for pain, you will find that you can stop taking them quite easily if, and when, your pain is relieved by some other means. Provided you stop them gradually over a couple of days, the worst that will happen is that you may get some mild withdrawal symptoms such as temporary restlessness, difficulty in sleeping and a runny nose. If you get these symptoms, it does not mean that you were addicted. It just means that your body had got used to having the drug around and is now readjusting to being without it again.

I know it is not easy to overcome a fear of addiction and just allow yourself to take as much painkiller as you need. Try to rid yourself of the idea that painkillers are things that enslave you unless you constantly struggle to take them as little as possible. Who would you say is the real slave—the person who is so immobilised and preoccupied by pain that life is miserable for themselves and their family and friends or the one who takes enough painkillers to stay relaxed and comfortable? Uncontrolled pain is a much greater tyrant than painkillers taken so that they do relieve pain.

*175/40/1*

RANDOMISED CLINICAL TRIALS – MAIN TECHNIQUE

Friday, May 15th, 2009

The main technique used in this endeavour is the randomised clinical trial. Here doctors select a fairly uniform group of people—all within a certain age range, with similar types and extent of cancer and about the same degree of physical fitness. To further reduce any possible bias, the people in this already fairly uniform group are allotted randomly (by chance) to one or other of the treatments to be compared. This could be done, say, with the flip of a coin: heads = treatment X, tails = treatment Y. Scientifically-trained doctors believe that such random allocation of people to treatment is the best way of making sure that any differences in results are due to the different treatments and not to any other factor. As I have explained, such techniques are only necessary if we are looking for small differences. For example, trials often include hundreds of people in an attempt to make sure that they do not miss differences of five per cent (one in twenty) in remission rates or of a few weeks or months in average length of life—’statistically significant’ differences. Attention is completely concentrated on ways of expressing results that can be accurately measured and subjected to statistical analysis— things like remission rate and length of life.

*141/40/1*

WOMEN’S BODIES: WHAT ARE THE DOWNSIDES TO THE DISCOVERY OF CANCER GENES?

Thursday, March 12th, 2009

A serious danger of these discoveries is that people gain a false sense of security if they are found not to have the gene. Feeling safe, they may forgo measures to prevent and detect early cancer, and they thus risk developing the same type of cancer. No test will become available in the foreseeable future, if ever, that will guarantee freedom from all cancer risk.

If you had, for example, colon cancer, your children could screened for the gene for hereditary nonpolyposis cancer. Even they are found not to harbor this gene, they are still at risk developing colon cancer from one of the many other genes (most still undiscovered) that can cause it. Your children can be born without any genes predisposing them to colon cancer, but с develop abnormalities that lead to cancer because of exposure cancer-causing agents.

The ability to pinpoint people at risk for different types of a cancer will inevitably have a great impact on health care economics and politics, and transform the insurance industry whose fundamental principle is shared risk.

These exciting discoveries can lead to disappointment if t hopes for preventive and curative measures for the type of cane are not fulfilled.

*45/32/5*

AFTER CANCER: PREVENTING NEW CANCERS. VITAMINS, OVER-THE COUNTER PREPARATIONS

Thursday, March 12th, 2009

Are There Any Vitamins or Other Pills I Can Take to Prevent Cancer?

At this time, there is no pill or vitamin that will prevent cancer in general. You can call the Cancer Information Service on 131120 to check whether any clinical trials are investigating a medicine or therapy that will help prevent the recurrence of your type of cancer or the development of another cancer known to be associated with your type. Your oncologist or doctor can keep you informed of these studies, too.

What If I Am Embarrassed to Tell My Doctor about Various Over-the – Co u n t e r Preparations I Am Taking to Prevent Cancer?

Many people take over-the-counter to help prevent cancer or treat other conditions. Too often, people neglect to tell their doctors about these medicines, either intentionally or unintentionally. Doctors are aware that many people self-medicate with nonprescription pills and tonics. The more information your doctor has about you, the better the care you will receive. If you tell doctor about your self-prescribed medications, your doctor

•can take this information into account when evaluating a problem

• can warn you of potential problems or dangers to you

• can advise you about a more effective or safer way to use the over-the-counter medications

•can adjust your prescription medications, if necessary.

*35/32/5*

AFTER CANCER: ROLE OF VISUALIZATION IN HEALING AND IN FIGHTING CANCER

Thursday, March 12th, 2009

The body is an extremely complex organism. Your mind plays a role in how your body functions. Some research-oriented psychologists and psychiatrists, and a few immunologists and other specialists have speculated that you can affect how well your body fights cancer by visualizing the hoped-for results, just as you can affect how accurately you throw a ball by concentrating on the process. No study to date has shown any significant effect on cure
rates or rates of recurrence through visualization. However, visualization in some people does cause measurable improvement in medical problems such as pain, migraine headaches, insomnia and muscle spasm.

Visualization is a wonderful tool for people in whom it helps alleviate physical and emotional symptoms. As for your cancer, visualization can help decrease negative stress and give you some sense of control.

Visualization can hurt you if you feel guilty when you do not do Herb it or feel responsible if you have medical problems despite genuine efforts to visualize. Visualization is not for everybody.

*26/32/5*

AFTER CANCER: DO I HAVE TO PREPARE FOR MY FOLLOW-UP VISITS?

Thursday, March 12th, 2009

Patients often complain that doctors focus right away on the physical problems, ask countless questions, and never have enough time for explanations or for just a normal conversation. Many patients recoil at the idea of preparing a list of questions and problems, feeling that they should not be treated like a car being brought to the shop. Or they worry that a list would make them look like a hypochondriac. Patients understandably want to feel that they are being treated like a whole person.

The purpose of each follow-up visit is for you to get your needs taken care of and for the doctor to be certain that everything is being done to ensure that you do as well as possible. In order for you to receive the best care, you and your doctor must work together as a team. Your job is to describe your problems and explain your concerns as clearly as possible. Most people do this best with some advance preparation.

Like everyone else, doctors face time constraints. What you may interpret as abruptness may be your doctor’s attempt to be organized, so that the information obtained is complete and accurate and so that your most serious problems are addressed. A vague, unstructured discussion or a focus on one issue may make you feel better emotionally but divert your doctor from the important issues.

Your oncologist is trying to understand your medical situation, find the best solutions to your medical problems, and prevent new problems from occurring. Most oncologists truly care as much about your emotional well-being as about your physical well-being, but focus primarily on the physical in order to maximize the chance that you are physically well enough to deal with the emotional. From a practical viewpoint your doctors are the only people who can address the major medical issues (as opposed to nurses, social workers, counselors, and so on). If they do not take care of these questions and problems, no one else can. Also, if oncologists did not maintain some distance and objectivity, they could not make the best medical decisions for you.

At the beginning of each of your visits, you are like a mystery person. Even if your doctor has been taking care of you for years he or she has to figure out what your problems and concerns an that day in order to address them. And, as with any mystery, the more clues you provide, the faster and more accurate will be you doctor’s solutions.

If you just show up for your visit and expect to sort through your problems and questions while your doctor listens, or if you expect your doctor to figure out your problems and question: through doctor-directed questions, you may spend most of the visit just figuring out what your problems are.

It is much easier for everyone if you tell your doctor, “I have had some cramping in my stomach and have noticed some blood in my bowel movements for the past three weeks,” than if the doctor has to keep prodding: “Are there any problems?” “Yes.’ “Can you tell me what the problem is?” “My bowel movements are different.” “How are they different?” “I think there has been some blood in them.” “When did this begin?” “Let me see . . . today is June 12, so it must have been two … no wait, it was about three weeks ago.” “Do you have any pain?” “Yes.” And so on.

There is an old joke about the patient in the emergency room who complains of stomach pain and vomits blood. After the usual series of questions and physical examinations, the emergency room doctor orders an X ray, which shows a razor blade in the stomach, and asks the patient, “Why didn’t you tell me that you swallowed a razor blade?” The patient answers, “Because you didn’t ask me!”

You are not expected to be an expert at describing your symptoms and problems, but it will be less stressful for you if you are prepared to discuss your problems and concerns. You will be better served, too, because the information you provide will be more accurate and more complete. How many times have you left the doctor’s office and realized that you forgot to mention something important?

Your emotional, social, and spiritual concerns and problems are just as important as your medical ones. Your oncologist absolutely needs to be aware of cancer-related sexual difficulties, problems with your children, problems with insurance or your job, and the like. By making your doctor aware of these issues, he or she can better understand your condition, better understand you, and direct you to appropriate people who can help you deal with your problems.

It does not make sense, however, for your oncologist to be counseling you at length, trying to resolve these issues. It is in your best interests if your oncologist directs you to the people who can help you.

Ironically, the more focused and direct the exchange of information at the beginning of your visit, the more time and energy is left to discuss your emotional and social concerns, to relate socially as two people, and for your doctor to offer comfort and support.

You are a person, with feelings and a soul. When you go to your doctor, you are not taking your body to the shop; you are trusting your being to another person. Your doctor can best care for you through a team effort at understanding and solving your problems.

*17/32/5*

AFTER CANCER: MAINTENANCE THERAPY. REMISSION

Thursday, March 12th, 2009

What Is Maintenance Therapy?

Some cancers are not curable but can be held in check with maintenance therapy. This usually consists of lower-dose medication taken indefinitely that

• slows down or stops the growth of the cancer

• is fairly well tolerated

The goals of maintenance therapy are to

•preserve a disease-free state (help prevent recurrence) after remission is achieved

•help prevent progression of persistent cancer when curative therapy is not available

•help prevent progression of persistent cancer and minimize complications from persistent cancer when curative therapy is too risky

• buy time while waiting for more effective or less toxic therapy

• promote physical and psychological comfort

What Is Remission?

Remission is the absence of any detectable sign of your cancer after restaging tests are completed. “Remission” is used synonymously with “complete remission.”

Remission is not the same as cure. Your remission can last for one month, one year, one decade, or the rest of your life. You must remain in complete remission for a length of time specific for your type of cancer to be considered cured. Many people achieve complete remission but are not cured.

What Is a Durable Remission?

A durable remission is one that lasts for a long time. How long “long” is depends on the usual expectations for your type of cancer and is a subjective notion. A durable remission is not the same as a cure.

For example, if you have a type of cancer that usually recurs within five years of achieving remission and you have been in remission for eight years, you are deemed to have a durable remission. If your type of cancer usually recurs within one year of remission and you enjoy three years of remission, this is felt to represent a durable remission.

*6/32/5*