1. How sophisticated is our understanding of cancer?
As a former oncology nurse....the understanding of cancer is sophisticated in the area of molecular research r/t the following current research and treatment modalities:
Western model for what causes cancer: The prevailing model for cancer development is that mutations in genes for tumor suppressors and oncogenes lead to cancer. In addition, many viruses infect humans only a few viruses are known to promote human cancer. These include both DNA viruses and retroviruses a type of RNA virus.
TX focus: Direct annihilation of the cancer cells using aggressive therapies.
From a molecular perspective cancer compromises at least 100 different diseases and all cancer cells share one characteristic: identified abnormal cells in which the processes regulating normal cell division are disrupted. These changes are often a result of inherited mutations or acquired via environmental factors. Cancer results from a series of molecular events that alter the normal properties of cells. These altered cells divide and grow in the presence of signals that normally inhibit cell growth. As these cells grow they develop new characteristics, including changes in cell structure, decreased cell adhesion, and production of new enzymes. Its cell progeny divide and grow which eventually invade other tissues. Only a small number of approx. 35,000 genes in the human genome have been associated with cancer. These malfunctioning genes are known as proto-oncogenes, producing products that normally enhance cell division or inhibit normal cell death. The mutated forms of these genes are called oncogenes. Another group called tumor suppressors make proteins that normally prevent cell division or cause cell death. The third group contain DNA repair genes which help prevent mutations that lead to cancer.
Cancer cells do not stop dividing so research attempts to understand what stops a normal cell from dividing? In terms of cell division normal cells differ from cancer cells in at least four ways-
1- normal cells require external growth factor to divide. When synthesis of these growth factors is inhibited by normal cell regulation the cells stop dividing. Cancer cells have lost the need for positive growth factors so they divide whether or not these factors are present.
2- Normal cells show contact inhibition; that is, they respond to contact with other cells by ceasing cell division. This characteristic is lost in cancer cells which continue to grow after they touch other cells which continue to grow after they touch other cells causing a large mass of cells to form.
3- Normal cells age and die- and are replaced in a controlled and orderly manner by new cells. Apoptosis is the normal programmed death of cells. Telomerase is activated in cancer cells allowing an unlimited of cell division...
4-Normal cells cease to divide and die when there is DNA damage or when cell division is abnormal. Cancer cells continue to divide even when there is a large amount of damage to DNA or when the cells are abnormal.
Detection and DX:
-Imaging techniques, MRI, X-rays, CT, ultrasound, endoscopy to biopsy tissue to be sent to a pathologist= which then looks for abnormalities in the cells in terms of their shape, size, structure, borders of tumors, and developmental stage of tumor, diagnosis can involve removal and examination of lymph nodes to determine whether the cancer cells have spread.
-tumor markers
Tx: Treatment depends on the type of cancer, its location and state of advancement.
1-surgery- remove solid tumors
2-radiation- kills cancer cells with high energy rays targeted directly to the tumor damaging the DNA ad preventing its replication.
3-Chemotherapy- drugs are toxic compounds that target rapidly growing cells. Newer drugs target signal transduction pathways such as receptors, growth factors or kinases. Examples of Drugs that enhance immune system and work with hormonal system such as : Tamoxifen, Raloxifen, spindle inhibitors, endostantin, angiostatin, interluken 2, alpha interferon, Herceptin.
4- Hormones therapy- some cancer cells require hormones for growth so drugs that block the activity of the hormone are utilized.
5-Chemoimmunotherapy- attaches chemotherapy drugs to antibodies that are specific for cancer cells.
Prevention:
-Cancer appears to result from a combination of genetic mutations and environmental factors. The National Cancer Institute recommends a diet with large amounts antioxidants and other nutrients that may help to prevent cancer: Vitamin A,C,E, phytochemicals which are found in plants, vegetables , and fruits.
-Screening, genetic testing, and counseling: early DX and TX: detection of BRCA1 and BRCA2- genes associated with early development of breast cancer for women.
2. TCM approach to cancer how does it differ?
TCM approach emphasize the importance of the body-mind communication network. The development of cancer is viewed as a part of the presenting features of a syndrome representing an imbalance of the whole body-mind network. Thus, cancer is a systemic DX from the start and the
rebalance of the body-mind network will be restored and this will help resolve the cancer.
-In TCM herbs are used to enhance innate immunity and in combinations are used to enhance their benefits while reducing their side effects: extracts for anti-cancer therapy include and not limited to: anemarrhena, asphodeloides, atremisia argyi, commiphora myrrha, duchesnea indica, gleditsia sinensis, rubia cordifolia salvia chinensis.. these herbs contain a variety of chemicals that may act synergistically to inhibit tumor cell division, increase tumor cell death , increase the proportion of immune cells within the tumor and increase blood flow through the tumor.
-Acupuncture- an immune modulating effect- is utilized as a technique which modulates neurotransmitters, cytokines, and neuropeptides through electrophysiological changes in the nervous system.
TCM role in cancer supportive care:
-modification of biological response to improve therapeutic gain
-improve psycho-neuro immunological response
-enhancement of sx control
-psychospiritual integration synergistically
TCM cancer tx/prevention-
- appropriate nutrition- the use of green tea and panax ginseng
-sx control- residual tx of residual effects such as fatigue and depression- spleen and stomach qi are supported by the use of appropriate formulas.
-Qi gong and tai chi and awareness meditation which are used to change electromagnetic changes that may represent the flow of qi.
-balancing the 5 elements associated with psycho-spiritual concepts through herbs and acupuncture
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