Acne has become a major problem for patients with colon cancer since the introduction of Erbitux and Vectibix. These drugs target EGFR not only in the tumor but the basal layers of the skin and cause a skin acne rash which can cover significant part of the head, chest, and back.

Most physician prescribe topical or oral antibiotics particular when there are a lot of pus-filled pustules. Bristol Myers Squibb which distributes Erbitux® (cetuximab) has developed a skin care kit, including liquid bandages and lotion to treat the skin. Most of my patients love it.

Patients always ask what else they can do, so I searched for remedies against acne and found interesting, promising ways to treat acne. Read the rest of this entry »

Heartburn is a common symptom for patients and family members. Recent reports show that home remedies can help to treat heartburn.

Patients who ever had severe heartburn or women who are pregnant know how bad this pain can be. If you have heartburn for the first time, you may end up in the emergency room because it is such a burning chest pain that is can look like a heart attack. In fact, one of the differential diagnoses of chest pain is heartburn. Read the rest of this entry »

Most of us love cocktails. . .Manhattan, gin and tonic etc. We know, depending on what we use and how they are mixed, they may taste different.

Well, for the treatment of colon cancer patients we have different cocktails to choose from such as FOLFOX and FOLFIRI. Both are combinations of 5-FU and leucovorin and either irinotecan or oxaliplatin. Both regimens have similar efficacy and similar extent of side effects, with oxaliplatin having more neurotoxicity and irinotecan more diarrhea.

However, depending how you mix and deliver the three drugs you may have significant differences in toxicity. It is amazing what differences exist among oncologists in how they mix up their chemotherapeutic cocktails. Not only the doses but also the timing of administration can differ dramatically, which can result in differences in toxicities for patients.

Read the rest of this entry »

Many patients with metastatic disease ask how long we should do chemotherapy. This is astonishing since when we are diagnosed with diabetes or hypertension we usually would not ask the same question. Of course, for patients with metastatic disease we continue as long the chemotherapy works.

A lot of patients ask whether you can take a break from chemotherapy, particularly around the holidays or vacation times. Do you take a break from insulin or your high blood pressure medication? In the last two years, clinical trials have been conducted to answer exactly this question.
Read the rest of this entry »

Last week I had a consultation with an older gentleman who is 84 years old. Interestingly, the role of age in the treatment of colon cancer has changed. During my training in Germany in the nineteen eighties when someone came in with metastatic cancer and was older than 65, we rarely gave chemotherapy because we were afraid to make those patients sicker than cancer did.

We have a perception that when someone is old we should be much more gentle and we should adapt treatment not only using less aggressive chemotherapy cocktails but also lower doses.. These perceptions go back to the history of chemotherapy when chemotherapy drugs made most patients very sick and weak. With less toxic chemotherapeutic therapies and much better drugs against nausea and vomiting, our perception needs to be reevaluated. Read the rest of this entry »