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On April 4, visitors to www.Turnto10.com discussed cancer treatments online with Fred Schiffman, MD, director of cancer services at Lifespan. Below are excerpts from the chat. Moderator: Welcome to the NBC 10 chat. Our guest today is Fred Schiffman, MD, and he will be discussing cancer treatments. Cynthia: How do you feel about so-called "natural" cancer treatments? Dr. Schiffman: While many such treatments may have merit usually they have not undergone rigorous testing. One should always check with one's physician to make certain that such treatments do not interfere with proven standard therapies. Moderator: Dr. Schiffman, what about that natural breast cancer treatment we have heard about recently that Suzanne Somers mentioned? Dr. Schiffman: I'm not directly familiar with that form of therapy but the use of ginko biloba by many people can cause a bleeding tendency if combined with standard cancer therapies which might tend to lower platelets-the cells which clot blood. All patients should inform their physicians if they are using any natural or non-prescription therapies. While some might be quite helpful, there is a potential for negative interactions with other medications. Moderator: Dr. Schiffman, what is the most exciting mainstream cancer treatment that has emerged in the past year or so? Dr. Schiffman: Rather than considering cancer as one disease, it should be considered as many diseases-each of which does share some common characteristics. There are many encouraging developments on several fronts, many of which have developed from our understanding of molecular biology and immunology. For example, certain growth factors which are associated with leukemia can be blocked by the use of specific interfering medications. Dr. Schiffman: Also, the immune system can be stimulated to fight off the intrusion and development of cancerous tissues if it is approached in the correct way. Additionally, information from the human genome project will be exploited to develop new medical treatments. We are also learning how best to combine surgical techniques, radiation techniques, and chemotherapeutic techniques, in order to provide the least toxicity and greatest benefit to our patients. Jess: Once somebody is already being treated for cancer, is it still beneficial to begin taking preventive measures, such as improving diet and exercise to help fight their current disease or perhaps inhibit future cases? Dr. Schiffman: Jess, the answer is yes, because one's general health is important in fighting the disease. However, one's physician should be checked with to make certain that no additional stresses come from too vigorous an exercise program and that dietary considerations are in harmony with the specific therapies administered. FDog: Do you think any cancer can be treated by starving the tumor? Dr. Schiffman: FDog, actually, a therapy has been developed which starves the tumor by interfering with new blood vessel growth which would otherwise feed the tumor. This phenomenon which is called "tumor angiogenesis" has been described by physicians in Boston and medications are currently being tested which would block this new blood vessel growth and thereby "starve" the tumor. Annie: I have one question; after you are treated for HPV cervical cancer can you get it again-are you ever cured of the virus? Dr. Schiffman: Early stage (not widely spread) cervical cancer is likely to be cured with appropriate therapy. However, widespread cervical cancer, whether associated with HPV or not, has a poorer prognosis. Some scientists who are studying cervical cancer have reported that any tumors containing HPV have a poorer prognosis than those which do not contain the virus. Mercedes: While I realize that there is no such thing as a safe suntan, is the light from tanning beds much worse for your skin than natural sunlight? Dr. Schiffman: Mercedes, in general, any ultraviolet light exposure has the potential to stimulate the growth of certain skin cancers. Specifically, actinic keratoses and malignant melanoma are associated with ultraviolet light exposure. The American Cancer Society and the Skin Cancer Foundation recommend that the general population employ "sun smart" practices. This includes the avoidance of direct midday sun exposures between the hours of 10 a.m. and 4 p.m. and the use of sunscreens, protective clothing and appropriate shade. Any blistering sunburn, especially in the young, has the potential of inducing skin cancer, specifically melanoma. Any ultra-violet light strong enough to induce tanning has the potential to cause skin cancer Giacob: Can a person with end-stage cancer be treated pain free? Mercedes: Thank you very much, Dr. Schiffman. Dr. Schiffman: Giacob, one of the important developments over the last several years has been the education of cancer physicians about the importance of quality of life and pain management. Fortunately, today there are many medications which can reduce pain and not interfere with activities of daily living. One's physician and other health care workers, such as hospice nurses, can be extremely helpful in addressing specific concerns about pain. Denise: What can you tell me about Gemzar to treat a Liomyosarcoma? Dr. Schiffman: Denise, Gemzar is one of the newer cancer agents which is being used for a variety of malignancies. Liomyosarcoma can be difficult to treat and doxorubicin and ifosfamide have shown some activity in the treatment of certain patients with Liomyosarcoma. Gemzar is currently being studied in order to address its usefulness in this tumor as well. Giacob: Is pancreatic cancer hereditary? Dr. Schiffman: Currently, it is estimated that possibly as many as 5 to 8 percent of pancreatic cancer cases are associated with familiar predisposition. Several hereditary disorders may predispose persons to certain forms of pancreatic cancer. Docrock: My father was treated for prostate cancer with radiation and then developed non-Hodgkin's lymphoma and went through seven chemotherapies. He was 79 at the time. Subsequent to these treatments I have noticed that he does not think as clearly as he use to; he seems to have a little dementia. Is it possible for this to be a result of the treatments? Dr. Schiffman: Dementia has many causes. Neither radiation therapy for prostate cancer nor standard chemotherapy for Hodgkin's disease are commonly associated with dementia. Since there are some reversible causes of dementia, your father's primary physician and oncologist should be consulted about this problem. Dr. Schiffman: Mercedes, to follow up on your question about the tanning salon, several studies show that the excessive use of tanning salons is associated with an increased risk of developing melanoma. No study demonstrates that tanning is protective against subsequent sunburns or melanoma. Long-term use of tanning salons is associated with premature skin aging, cataract and other forms of skin cancer. Prevention strategies should discourage the use of tanning salons. Mercedes: Thanks for that additional information. I'll pass it along to friends! Diane: Are there any new treatments for multiple myeloma? What is the best treatment for breast cancer? I saw that Suzanne Somers is using a European drug? What have you heard about it? Dr. Schiffman: Diane, in certain patients, bone marrow transplantation has been used to improve survival. There are several centers which are utilizing this technique, such as Dr. Kenneth Miller's center at New England Medical Center, that may be helpful in providing more information about this technique for multiple myeloma. Denise: My mom has already been through 6 rounds of doxorubicin and at this time her tumors are stable. Is ifosfamide in the same group of medications as Adryomicin? Dr. Schiffman: Ifosfamide is a different class of drug. Denise: Thank you, Dr. Schiffman. Does ifosfamide have as many side effects as the adryomicin? Dr. Schiffman: It has different side effects but your physician or oncologist should be consulted about risks and benefits in your particular situation Denise: Thank you again. Good-bye Diane: Thanks so much. Dr. Schiffman: You are welcome. If you have specific questions about cancer, the George Clinic at Rhode Island Hospital (401-444-5434) or the Fain Clinic at The Miriam Hospital (401-793-2920) may be helpful in addressing your concerns. Fergus: I know ovarian cancer is a slow-growing cancer, but if it metastasizes does the "new" cancer exhibit the same type of slow-growing cells or does it change? Dr. Schiffman: Fergus, this is a very good question, but it is impossible to predict in individual cases how rapidly metastatic devices will grow. Some patients demonstrate slow growth and others rapid growth of their metastatic cells. Dr. Schiffman: For those of you who asked about Suzanne Somers, the medication she is using is apparently called "Iscador," a derivative of the mistletoe plant. It has been used in Europe to treat HIV patients and in some patients with solid tumors. It may act by improving the immune system, however, to my knowledge its benefit is not proved and before recommending its use most oncologists would want to know the results of multi-center, randomized, controlled trials. Moderator: Dr. Schiffman and Lifespan would like to thank all of you for joining us today. Find out more: |
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