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 »

Errors in giving chemotherapy and associated medicines were found in over seven percent of adult outpatient visits and nearly twenty percent of children’s visits in a recent study. Most often, mistakes were made when changes were made to the original prescription on the day chemo was administered.  For children, about a third of mistakes happened when medicines were given at home.

Over nine months and nearly 1,400 visits, researchers found 112 medication errors.  Sixty-four of them had a the potential to harm the patient, and 15 actually did.  About 5 percent of the time, someone discovered the mistake before the medicine was actually given. Read the rest of this entry »

Ginger root

Although ginger is often recommended as a simple remedy for chemotherapy nausea, ginger capsules don’t seem to work any better than a sugar pill to improve the effects of standard nausea drugs.

In a randomized study, 162 patients received either ginger capsules or a placebo for chemotherapy-induced nausea and vomiting. Neither the patients or their doctors knew which they were getting.  All patients were already receiving an 5-HT₃ inhibitor such as Zofran® or Kytril®.  Some were also being treated with Emend® (aprepitant).

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Continuing Avastin® (bevacizumab) beyond the time when advanced colorectal cancer gets worse helps patients, according to new study reports.  Patients who continued to receive Avastin with a new chemotherapy regimen after their cancer first progressed lived almost 12 months longer than patients who got more chemo but stopped Avastin.  Both groups did better than those who had no further treatment at all.

BRiTE (Bevacizumab Regimens: Investigation of Treatment Effects and Safety) observed progress of three groups of patients when their cancer got worse after their first chemotherapy treatments.  All patients had Avastin as part of the first chemo, some continued it beyond that first cancer progression. Read the rest of this entry »

Oncologists often recommend that patients on chemotherapy avoid antioxidant supplements including vitamin C.  Now basic research shows that vitamin C reduces the activity of several different chemotherapy drugs, both in cancer cell lines and in experimental mice.

Vitamin C appears to protect the cell against death during chemotherapy by restoring its mitochondria.  Mitochondria power cells, converting nutrients to energy.  When mitochondria are damaged they force the cell to die — the goal of chemotherapy.  By revitalizing damaged mitochondria, the vitamin reduced the effectiveness of all the chemo drugs tested, by as much as 70 percent for some. Read the rest of this entry »