Most anti-cancer drugs can affect the cardiac pumping function

Cancer therapy has been at receiving end for quite some time now. A few years ago, a British doctor shot to fame when he refused to accept modern medicare for his cancer treatment. He opted to die of cancer than suffer from the adverse effects of its therapy. Recently, a lady who claimed to have found a cure for cancer in fruits and vegetables died of cancer, too. A film actor and director managed to stall a government proposal to start a cancer center in central Kerala, out of his conviction that modern medicine has no cure for cancer and cancer drugs if dumped is capable of killing the entire fish population of the Arabian Sea. Not just that, someone even put a fake post in the name of a celebrated oncologist on Facebook promoting alternative therapy for cancer, which was then shared widely. 

Why is cancer treatment alone is singled out by the public and lamented at? Why do those who have no basic training in medicine call the shots in cancer care? Why are oncologists and others involved in cancer care taken for granted as agents of multinational drug firms trying to sell expensive concoctions to unsuspecting cancer victims?

Statistics tell us that cancer survival rate has improved by over sixty per cent during the last 40 years, owing to advances in chemotherapy, oncosurgery, radiation, oncology, imaging sciences and other supportive specialties including oncocardiology. Cancers like nasopharyngeal cancer, pancreatic cancer and cancers among young adults have less impressive cure rates. Breast and prostate cancer are curable. These patients when diagnosed and treated appropriately, do not die of cancer, but of other illnesses. Evidence-based medicine has proved beyond doubt that alternative therapies and nature cure is not effective for treatment of cancer.

Why do people expect a cure for cancer like a common cold, malaria, or an infective diarhoea? Anti-cancer drugs have significant side effects and sensitive dose ranges. Most anticancer drugs can potentially affect the heart, especially cardiac pumping function leading to heart failure. Some can cause elevation of blood pressure, cardiac rhythm abnormalities, heart attacks, venous thromboembolism and even new cancers. Reports show that immunotherapy too can cause fulminant heart failure. 

A pertinent question arises here. If these medications cause such damage, why they should ever be used? Reason: They cure cancer. We see more and more people with adverse effects because patients survive cancer and live longer. If they were dead, you won’t get to see adverse events too. More patients are alive with cancer, so you see more relics of cancer.As life expectancy improves, and population survives infectious diseases out of better living standards, antibiotics, vaccination and social engineering, lifestyle disorders and cardiovascular disease by improvement in physical activities, diet modifications, medications, other interventions and conquer death out of it, then it is a biological plausibility that most of us will catch cancer or degenerative disorders in due course of time. Unlike many doomsayers scream, life expectancy is improving all over the globe, including in some of the most underprivileged societies.

This is a reality. When population ages, natural conditions like cardiac illnesses, cancer, kidney failure and degenerative diseases will be on the rise.We will have to live with all of these maladies. Scientific approach to issues are critical and government policies will be crucial. Radical changes in health care delivery systems will become the need of the hour, hospices will become more relevant that can accommodate and care for people who need attention, short of hospitalisation. We will have to promote research; improve social infrastructure, public conveyances, and social security. That is the way population will live longer, healthier and better. 

Can you imagine even someone like Steve Jobs was a fan of alternate therapies for cancer and died out of an eminently treatable form of cancer of the pancreas denying us more advanced iPhones, iMacs, and iscreens?

The author is an Interventional Cardiologist, with a special interest in cardiac involvement in cancer therapies. He was a fellow in cancer biology and therapeutics.

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Exercise boosts tumour-fighting ability of chemotherapy

Scientists have found that combining exercise with chemotherapy may shrink tumours more than chemotherapy alone.

Researchers from the University of Pennsylvania found that exercise may benefit cancer patients undergoing chemotherapy.

Joseph Libonati, an associate professor in the School of Nursing and director of the Laboratory of Innovative and Translational Nursing Research, senior author on the study, and colleagues were particularly interested in testing whether exercise could protect against the negative cardiac-related side effects of the common cancer drug doxorubicin.

Though effective at treating a variety of types of cancer, doxorubicin has is known to damage heart cells, which could lead to heart failure in the long-term.

"The immediate concern for these patients is, of course, the cancer, and they'll do whatever it takes to get rid of it," Libonati said.

"But then when you get over that hump you have to deal with the long-term elevated risk of cardiovascular disease," Libonati said.

Previous studies had shown that an exercise regime prior to receiving chemotherapy could protect heart cells from the toxic effects of doxorubicin, but few had looked to see whether an exercise regimen during chemotherapy could be beneficial.

Libonati's team set up an experiment with four groups of mice. All were given an injection of melanoma cells in the scruffs of their neck.

During the next two weeks, two of the groups received doxorubicin in two doses while the other two groups received placebo injections.

Mice in one of the treated groups and one of the placebo groups were put on exercise regimens, walking 45 minutes five days a week on mouse-sized treadmills, while the rest of the mice remained sedentary.

After the two-week trial, the researchers examined the animals' hearts using echo-cardiogram and tissue analysis.

As expected, doxorubicin was found to reduce the heart's function and size and increased fibrosis - a damaging thickening of tissue. Mice that exercised were not protected from this damage.

"We looked, and the exercise didn't do anything to the heart - it didn't worsen it, it didn't help it," Libonati said.

But the mice that both received chemotherapy and exercised had significantly smaller tumours after two weeks than mice that only received doxorubicin.

Further studies will investigate exactly how exercise enhances the effect of doxorubicin, but the team believes it could be in part because exercise increases blood flow to the tumour, bringing with it more of the drug in the bloodstream.

The study appears in the American Journal of Physiology.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.








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Scientists have found that combining exercise with chemotherapy may shrink tumours more than chemotherapy alone.

Researchers from the University of Pennsylvania found that exercise may benefit cancer patients undergoing chemotherapy.

Read more at:
http://economictimes.indiatimes.com/articleshow/42981559.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

Scientists have found that combining exercise with chemotherapy may shrink tumours more than chemotherapy alone.

Researchers from the University of Pennsylvania found that exercise may benefit cancer patients undergoing chemotherapy.

Joseph Libonati, an associate professor in the School of Nursing and director of the Laboratory of Innovative and Translational Nursing Research, senior author on the study, and colleagues were particularly interested in testing whether exercise co ..

Read more at:
http://economictimes.indiatimes.com/articleshow/42981559.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

Indian-origin scientist develops leadless pacemaker

The world's first wireless pacemaker, developed by an Indian-origin scientist, has shown promising results after one year of human trials.

The device, resembling a tiny, metal silver tube and smaller than a triple-A battery, is only a few centimeters in length, making it less than ten per cent the size of a traditional pacemaker. "This is the first time we've seen one-year follow-up data for this innovative, wireless cardiac pacing technology and our results show the leadless pacemaker is comparable to traditional pacemakers," said Dr Vivek Reddy, Director of Arrhythmia Services at The Mount Sinai Hospital here, who is the study's co-investigator. 

In comparison to a conventional pacemaker, the new-age leadless pacemaker eliminates the need for a surgical pocket and no visible pacemaker device under a patient's chest skin, no incision scar on the chest, no connector wires or leads, and no restrictions on a patient's daily activities. The device's benefits may also allow for less patient discomfort, infections, and device complications and dysfunction. "Our latest findings further support the promising performance and safety of this minimally-invasive, non-surgical pacing device. More long-term follow-up of these LEADLESS study patients will further our understanding of the potential advantages, benefits, and complication risks of leadless pacemaker technology, along with additional ongoing, larger trials," Dr Reddy said.

The study's long-term follow-up has evaluated 32 patients with a slowed heartbeat, bradycardia at two hospitals in Prague and one in Amsterdam, the hospital said in a statement. The miniature, leadless cardiac pacemaker is placed directly inside a patient's heart without surgery during a catheter-guided procedure through the groin via the femoral vein. 

It works by closely monitoring the heart's electrical rhythms and if the heart beat is too slow it provides electrical stimulation therapy to regulate it. The findings, which assessed device performance and patient outcomes through 12-months of follow-up, show pacing thresholds (0.43 volts) and sensing (10.32 mV) of the leadless pacemaker device are equivalent to those in traditional pacemakers. 

Reddy presented the one-year LEADLESS study data findings during his late-breaking clinical trial presentation on May 9 at Heart Rhythm 2014, the Heart Rhythm Society's 35th Annual Scientific Sessions in San Francisco. Reddy was the first to implant the leadless pacemaker in the United States at The Mount Sinai Hospital launching the multicenter clinical trial LEADLESS II which aims to further test the leadless pacemaker more widely for safety and efficacy in 670 patients at 50 centers across the US and Canada. 

More than 4 million patients globally have a pacemaker, and 700,000 new patients receive one each year, the hospital said.

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I'll be away

Hi All

have a great festive season ahead. I'm likely to be away for some days, was already in n out of hospital during the last few days. First thought just acute attack of asthma, then pulmonary embolism was ruled out with CT, now it is thought to be cardiac problem, as 2 years back I did have a heart attack, was in CCU for 19 days with oxygen 24x 7, as there was too much of pericardium fluid around heart n lungs. Only after it was all drained out, totally almost 1 litre, I was able to breathe on my own.

So, just keep your fingers crossed that it is nothing serious, so, I'm back to blogging soon. As now, having chest pain, even with little walking, breathlessness, too much pressure in my chest. Dr. wants to do an angio on Thursday, sad part is my little grandson, just 1 year old is coming to visit me & I'll be in the hospital, miss my time with my son n his family.

Take care all of you out there. Good health, keep smiling.

Happy Diwali, Halloween etc to all around the world.

Heart: Heal thyself

Scientists have made a breakthrough towards treatment for heart attack, by instructing the injured heart in mice to heal by triggering cardiovascular regeneration that is driven by native heart stem cells.

The study,  shows that there was an effect on driving the formation of a small number of new cardiac muscle cells.

A Prof., said that this is the beginning of using the heart as a factory to produce growth factors for specific families of cardiovascular stem cells, and suggests that it may be possible to generate new heart parts without delivering any new cells to the heart itself.

The study is based upon another recent discovery in a lab, which was published in Cell Research.

The study, performed in mice, shows that only a single administration of a short pulse of expression of VEGFA is required, if it can be delivered to the exact region where the heart progenitors reside.

The therapeutic effect is long term, as shown by markedly improved survival following myocardial infarction with a single administration of the synthetic mRNA when given within 48 hours after the heart attack.

The long-term effect appears to be based on changing the fate of the native heart stem cells from contributing to cardiac fibrotic scar tissue and towards cardiovascular tissue.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.

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Cardiac Sarcoidosis:

Sarcoidosis is a poorly understood disease that most commonly affects the lungs but can also involve almost every part of the body including the heart. Cardiac sarcoidosis (CS) is estimated to be present in 10-25 percent of patients with sarcoidosis.

Sarcoidosis is characterized by the presence of granulomas, which are ball-like collections of white blood cells that cluster around and react to a foreign substance. The inflammation associated with granulomas can damage virtually every part of the heart, including the electrical system, muscle, valves, arteries, and surrounding tissue called the pericardium. It is important to remember CS can precede, follow, or occur simultaneously with other non-cardiac forms of sarcoid.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.

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Genetic mutation linked to congenital heart disease identified

A new study led by a researcher has found that a mutation in a gene crucial to normal heart development plays a role in some types of congenital heart disease.

The findings, could help narrow the search for genes that contribute to this defect, which affects as many as 40,000 newborns a year.

Several hundred genes have been implicated in the formation of the heart, and a mutation in any of them could potentially contribute to a cardiac defect.

Identifying which of these genes is involved in human congenital heart disease has been a challenge for scientists in the field.

"We have to ask ourselves, what subset of the more than 20,000 genes that make up the human genome are contributing to congenital heart disease?" he said.

"Right now, we don`t know enough about a lot of those genes, so this study provides another piece of the puzzle," he said.  That piece is FOXP1, a member of a large gene family that helps regulate tissues throughout the body, including in the heart, lungs and brain.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.


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