In accordance with the company’s ongoing efforts to censor all truth while promoting only establishment fake news on its platform, social media giant Facebook has decided to launch full-scale war against online free speech about vaccines.
Pandering to the demands by California Democrat Adam Schiff, Mark Zuckerberg and his team recently announced that they are now “exploring additional measures to best combat the problem” of Facebook users discussing and sharing information about how vaccines are harming and killing children via social media.
According to an official statement released by Facebook, the Bay Area-based corporation is planning to implement some changes to the platform in the very near future that may include “reducing or removing this type of content from recommendations, including Groups You Should Join, and demoting it in search results, while also ensuring that higher quality and more authoritative information is available.”
In other words, the only acceptable form of online speech pertaining to vaccines that will be allowed on Facebook is speech that conforms to whatever the U.S. Centers for Disease Control and Prevention (CDC) says is “accurate” and “scientific.” Anything else, even if it comes from scientific authorities with a differing viewpoint, will be classified as false by Facebook, and consequently demoted or removed.
Facebook’s censorship tactics are becoming more nefarious by the day. To keep up with the latest news, be sure to check out Censorship.news.
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Facebook is quickly becoming the American government’s ministry of propaganda
Facebook’s rationale, of course, is that it’s simply looking out for the best interests of users who might be “misled” by information shared in Facebook groups suggesting that the MMR vaccine for measles, mumps, and rubella, as one example, isn’t nearly as safe as government health authorities claim.
And that’s just it: There are many things that the government is wrong about, but that have been officially sanctioned as “truth” by government propagandists. If Facebook bows down to these government hacks with regards to vaccines, there’s no telling what the company will try to ban from its platform in the future.
Not only did the government deny young Cassandra the right to make her own medical decisions, but it also overrode the will of her parents, who also opposed taking the chemotherapy route. In essence, the government forced Cassandra to undergo chemotherapy at gunpoint, and now it’s trying to do the exact same thing with Facebook.
If little Adam Schiff is successful at forcing Facebook to only allow information on its platform that conforms with the official government position on vaccines, the next step will be to outlaw the sharing of information on the platform about the dangers of chemotherapy, as well as the dangers of fluoride, pesticides, and other deadly chemicals that the government has deemed as “safe and effective.”
Soon there won’t be any free speech at all on Facebook, assuming the social media giant actually obeys this latest prompting by the government to steamroll people’s First Amendment rights online. And where will it end?
“These radical Leftists are domestic terrorists and suicidal cultists … they are the Stasi, the SS, the KGB and the Maoists rolled all into one. They absolutely will not stop until America as founded is completely ripped to shreds and replaced with an authoritarian communist-leaning regime run by the very same tyrants who tried to carry out an illegal political coup against President Trump.”
Chemotherapy has long been a mainstay of cancer treatment. But a lot has changed since Sidney Farber, MD, the founder of Dana-Farber Cancer Institute, achieved the first remissions for pediatric leukemia using chemotherapy in the 1940s.
Today, in the era of precision cancer medicine, there are newer treatments and chemotherapy that can more specifically target cancer cells. Researchers have also discovered the effectiveness of using chemotherapy drugs in conjunction with other drugs to pack a more powerful punch. To put it simply: Chemo is a lot better today than it used to be.
Still, there’s a lot of misinformation surrounding this kind of cancer treatment. In this episode, we explore some of the most common myths and misconceptions with Clare Sullivan, MPH, BSN, clinical program manager for Patient Education at Dana-Farber.
MEGAN RIESZ: So, first, can you just kind of explain generally what chemotherapy is and how it’s commonly administered?
CLARE SULLIVAN, NPH, BSN: Sure. Think about what the body does. The body is made up of cells that normally divide and grow and are replaced. Think about how your fingernails grow. Chemotherapy (or chemo, for short) is a group of medicines or drugs that treat cancer and other diseases. Cancer also divides and replicates.
Different chemotherapy drugs act in various ways. Some chemotherapy drugs can kill the cancer as they divide at critical times during the cell cycle, something that we learned way back in high school. Some chemotherapy can target the cancer’s food supply and kill important hormones and other nutrients it needs to grow. And then some chemotherapies can target the cancer’s genes and prevent it from growing. Then, one of the other interesting areas is that some chemotherapy can prevent the tumor from growing new blood vessels that it needs to grow and spread.
There have been many new and exciting developments in the field of cancer care, and when I say this, I mean chemotherapy, whether you add different combinations or other treatments. So, chemotherapy is still a very important tool for treating many cancers today.
MEGAN: Just to be clear, how is chemotherapy different than immunotherapy, which is something that’s talked about a lot today?
SULLIVAN: Well, immunotherapy has received a lot of attention because of new medications discovered that help treat cancer, but immunotherapy is unlike chemotherapy because of the way that it fights cancer.
Let’s start at the beginning. The immune system is a very complex network of cells and organs that defend against foreign substances, like bacteria or viruses.
Think about when you get a cut. The body’s defenses go into action immediately scanning and will recognize any foreign bacteria and then send out the correct army or navy to wipe out that invader. The immune system is so sophisticated that it can remember that invader, and if it comes again, it will recognize it and protect you from that disease. This is very similar to the chicken pox.
MEGAN: And let’s talk about side effects, which can be big considerations for patients. What are some common side effects that patients experience during chemotherapy?
SULLIVAN: The most common side effects for chemotherapy depend on the drug, the manner it’s given, the dose, and how often you get it, but the number one side effect across the board is fatigue. Then there are a few others that I’ll mention: appetite changes, nausea. But again, remember, there’s a lot of anti-nausea medications that are very effective now. A weakened immune system where you might get bruising or bleeding, and this is because of the way the chemotherapy goes after the cell cycle—it decreases the red blood cell and the white blood cell. Constipation and diarrhea are also another side effect, but again, there are a lot of good medications that are very effective. Then, mouth care—mouth care is really important to prevent mouth sores.
I want to go back to my first symptom, which was fatigue. Fatigue is real. Think about it as tiredness that doesn’t go away with rest. If you take a nap and wake up, you should ordinarily feel refreshed, but fatigue is when you wake up and really feel just as tired as when you went to sleep. So, during your treatment, of course, there will be times that you need to rest, but when possible, the best way to offset a host of issues that can happen when you lay in bed all day is to stay active.
Here are some tips. First, I want to think about those days that you’re most tired, really struggling with fatigue and really just around the house. Every time that you get up to the bathroom, try to move around. Move from the bathroom to the couch for a few minutes to a chair, and then move back to bed and continue that cycle as you get up to the bathroom. Just keep moving. Keep walking, even if it’s around the dining room table and in the middle of the night. If you can carry something like a laundry basket, put some weight in it. If you can carry a carton of milk around the dining room table…something just to help you move. Do some arm or leg stretches when you’re in or out of bed. A tip is that if you’re watching TV, put the exercise channel on and follow along in bed.
On a good day, you’re going to want to put your coat on right over that bathrobe, walk around the block, get a good pair of slippers with some comfortable soles, and you don’t even need to change your shoes.
The tip here for you is that you will find your energy perks up a few days before your next chemotherapy treatment. Use this time wisely. This is when you can really get out of the house. Maybe you might work a half a day. Maybe someone would drive you to work. Maybe you could work around the house. Walk a little further than just around the block. Walk with a little bit of speed. Use your arms. Get off a stop earlier on the train. Take the stairs at work. Take the stairs during your hospital visit. Take the dog for a walk. On your way back, pull a few weeds in the lawn.
If you’re in the hospital and you’re getting your chemotherapy in the hospital, work with the nursing staff on the floor. Measure how many laps it would take around the unit to equal a mile. We have many units over at the Brigham with signs of encouragement for lap walking.
MEGAN: So, patients often wonder if they will lose their hair during chemotherapy. Can you talk about this as well?
SULLIVAN: Sure. There are many other side effects that are specific to the drugs, and the one that I have not mentioned, as you have brought up, is hair loss. Many people associate hair loss with chemotherapy from movies or TV, but this is not as common anymore. When you enter the infusion clinic, you might be surprised to see that many patients have hair. This is not to say that some chemotherapy still causes hair loss, but it is not as common as people think.
MEGAN: So, chemotherapy can be used in a few different ways—curatively or palliative, for example. Can you talk about this?
SULLIVAN: Yes, Megan. What you’re referring to are the three goals of cancer treatment. There are actually three. You may see one of these terms on your initial chemotherapy consent, but most importantly, you may want to confirm with your cancer team what the strategy is for your treatment plan. Starting out on the same page with your team is very important. Remember, this can change as information about your cancer is understood over time by your team.
The three strategies to cancer treatment are cure, control, and palliation. Cure is when the cancer is completely removed, and the intent is that the cancer will not come back. Control would be the second strategy. That’s when disease cannot be fully removed from the body, but the team can keep it in check for long periods of time. Then the third strategy is what we call palliation. The disease here cannot be successfully removed and may not be controlled for long, but the team is confident that they can minimize any symptoms to help you feel more comfortable.
The word “palliation” can be confusing and even turn some people off from the medical specialty of palliative medicine. Palliative care is a specialized medical care for any cancer patient. It helps patients get relief from pain, symptoms, and the stress of having a serious illness. It can help improve their quality of life, no matter what treatment goal there is. Palliative care can help with fatigue, pain, nausea, shortness of breath, and a whole host of other symptoms that you may have during treatment, where the goal of palliative care is to help you feel more comfortable during your treatment, preserve your dignity, and better communicate with your family and caregivers.
Palliative care can be helpful through all stages of cancer care. Early on, it can help make the treatment more tolerable. Later, it can help you with daily life, can assist you in planning your care, and provide you with an additional layer of support. Think of it as a superhero. Think of it as the superheroes of cancer care.
Often, people mix up the word “palliative care” and “hospice care.” Palliative care is available to any patient with any stage of cancer at any age. Hospice care is for patients also receiving palliative care, but hospice care is typically only given during the final months of life.
MEGAN: Is there anything else you might like to convey to patients who are starting chemotherapy?
SULLIVAN: Sure. There are some tips here that I’d really like to share with you today. For those people who might be going to an infusion clinic or going even to a hospital, it’s OK to ask for a tour. Go and visit the infusion area, or even walk through the hospital ward, just to get familiar with the surroundings. Bring a friend and stay active.
If you don’t understand something that the doctor or nurse says, please ask them to repeat. It’s very important that you understand. Know who to call and when. Keep that information near you at all times, whether it be on your refrigerator, in your wallet, or type it right away in your phone contacts the minute that you get it. Make sure family members have it or close friends know where this information is kept.
Men with early stage testicular cancer can safely receive one course of chemotherapy or radiotherapy after surgery without it having a long-term effect on their sperm count, according to a study published in the leading cancer journal Annals of Oncology  on February 25.
Although it is known already that several rounds of chemotherapy or high doses of radiotherapy given to men with more advanced testicular cancer can reduce sperm count and concentration, it has been unclear whether a single cycle of chemotherapy or radiotherapy would have a similar effect in men with stage I disease.
Dr, Kristina Weibring, a cancer doctor at the Hospital in Stockholm, Sweden, who led the study, said: “We wanted to examine in more detail if postoperative treatment, given to decrease the risk of recurrence after the removal of the tumorous testicle, would affect the sperm count and sperm concentration long term in testicular cancer patients with no spread of the disease. To our knowledge, no such study has been done before.
“This is important to find out, since treatment with one course of postoperative chemotherapy has been shown to decrease the risk of relapse substantially, thereby reducing the number of patients having to be treated with several courses of chemotherapy.”
Testicular cancer is the most common cancer in young men between the ages of 15 and 40. When it is diagnosed, all patients have the testicle containing the tumour removed, a surgical procedure called orchiectomy.
In this study, 182 men aged between 18 and 50, diagnosed with stage I testicular cancer and who had had an orchiectomy within the past five years, took part in the study between 2001 and 2006. They were treated either in Stockholm or Lund. After surgery, they received radiotherapy (14 fractions of 1.8 Gy each, up to a total dose of 25 Gy) or one course of chemotherapy, or were managed by surveillance, meaning there was no postoperative treatment. They provided semen samples after orchiectomy but before further treatment, and then six months, one year, two years, three years and five years thereafter. From 2006 onward, radiotherapy was no longer used as a standard treatment in Sweden because of the risk of causing secondary cancer.
“We found no clinically significant detrimental long-term effect in either total sperm number or sperm concentration, irrespective of the type of postoperative treatment received,” said Dr Weibring. “Among men who received radiotherapy, there was a distinct decrease in average sperm number and concentration six months after treatment, though not in those who received chemotherapy. However, sperm number and concentration recovered in the radiotherapy group after six months, and continued to increase in all groups up to five years after treatment.
“I am very excited to see these results as I wasn’t expecting sperm to recover so well after postoperative treatment. I didn’t expect as negative an effect as if the patient had received many courses of chemotherapy, since it is much more toxic, but I was not sure how much the sperm would be affected by one course.
“With the results of this study we can give the patients more adequate information on potential side effects from postoperative treatment. Testicular cancer patients are often young men wanting to father children at some point, and we find, in many cases, that the patients are afraid of the potential risk of infertility caused by chemotherapeutic treatment. These findings should provide some reassurance to them.”
A well-known problem for men diagnosed with testicular cancer is an impaired ability to create sperm. A condition called testicular dysgenesis syndrome, characterized by poor semen quality among other things, may play a role in this and is also associated with a higher risk of developing testicular cancer. In addition, the orchiectomy and the cancer itself may also affect sperm quality. The removal of one testicle does not necessarily affect a man’s sperm count and concentration as the remaining testicle can compensate.
Dr Weibring concluded: “Our results are promising but more studies are needed, and we still recommend sperm banking before orchiectomy as a number of patients may have low sperm counts at the time of diagnosis that persists after postoperative treatment. In addition, the type of testicular cancer and whether or not it will need further treatments are unknown factors before the orchiectomy. Assisted reproductive measures may be necessary for these patients regardless of any treatment given.”
Editor-in-chief of Annals of Oncology, Professor Fabrice André, Professor in the Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France, commented: “This study, together with other research efforts, explores the paths to recovering a normal life after cancer. The finding that one course of chemotherapy has minimal impact on sperm count offers hope for thousands of patients worldwide, but we all must keep in mind that these data are preliminary and will require validation before we can use them in clinics. The next step will be to establish how to predict the toxic effects on sperm count of different chemotherapy regimens.”
 “Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment”, by Kristina Weibring et al. Annals of Oncology. doi:10.1093/annonc/mdz017
The research was supported by grants from the Swedish Government Funding for Clinical Research, the Swedish Cancer Society, Gunnar Nilsson’s Cancer Fund, Malmo University Hospital Foundation for Cancer Research and Foundation for Urological Research, and King Gustaf V’s Jubilee Fund for Cancer Research.
Up until recently, chemotherapy and radiation have been the only two approved treatment methods for treating cancer by mainstream medicine, but as more research emerges, light is being shed on just how damaging these treatment methods can be and how often they are the cause of death and not the cancer itself. Upon this discovery, many doctors are starting to see how this is not always the best treatment method.
Researchers from Public Health England and Cancer Research UK recently performed a groundbreaking study, which examined the number of cancer patients who died within 30 days of beginning chemotherapy showing how the treatment, and not the cancer itself, was the cause of death.
When looking at those death rates across hospitals in the U.K., the researchers found an alarming mortality rate that was directly associated with the chemotherapy treatment.
“England around 8.4 per cent of patients with lung cancer, and 2.4 per cent of breast cancer patients died within a month,” the Telegraphreported.
“But in some hospitals the figure was far higher. In Milton Keynes the death rate for lung cancer treatment was 50.9 per cent, although it was based on a very small number of patients.”
Results of the study showed the one-month mortality rate at Lancashire Teaching Hospitals for those undergoing palliative, rather than curative chemotherapy was 28%. One in five patients receiving palliative care for breast cancer at Cambridge University Hospitals died from treatment.
In other areas including, Blackpool, Coventry, Derby, South Tyneside, Surrey, and Sussex, saw that deaths from lung cancer patients receiving chemotherapy were much higher than the national average.
Cancer Lead for Public Health England, Dr. Jem Rashbass, requested the study and said, according to the Telegraph: “Chemotherapy is a vital part of cancer treatment and is a large reason behind the improved survival rates over the last four decades.”
“However, it is powerful medication with significant side effects and often getting the balance right on which patients to treat aggressively can be hard.”
“Those hospitals whose death rates are outside the expected range have had the findings shared with them and we have asked them to review their practice and data.”
“All women with breast cancer and all men and women with lung cancer residing in England, who were 24 years older and who started a cycle” of chemotherapy in 2014 were included in the analysis by the researchers of the study.
Could This Signify The End Of Chemo?
Finally, chemotherapy has been looked at with a skeptical eye, had this been studied sooner, it is easy to see how this method of treatment cannot distinguish between healthy cells and cancerous cells, therefore there are more ideal patients for this method of treatment and less ideal patients. The study published by the Lancet shows how the cell destroying property of chemo can eventually lead to death as there aren’t enough healthy cells to survive.
Because of these important findings, researchers have now advised physicians to exercise more caution in the process of vetting which patients should in fact receive chemotherapy and which, ideally should not. Older, infirm patients could potentially be better off without receiving palliative care.
“The statistics don’t suggest bad practice overall but there are some outliers,” noted Professor David Dodwell of the Institute of Oncology at St. James Hospital in Leeds.
“It could be data problems, and figures skewed because of just a few deaths, but nevertheless it could also be down to problems with clinical practice,” he continued.
“I think it’s important to make patients aware that there are potentially life threatening downsides to chemotherapy. And doctors should be more careful about who they treat with chemotherapy.”
It’s important to realize that doctors aren’t intending to harm their patients by prescribing this method of treatment, this is what they have been taught during their extensive years of schooling and education, this is the curriculum, so it’s the widely accepted treatment method for cancer even though it often doesn’t help at all and can make things worse as mentioned above.
The hospitals involved maintain their stance, after reviewing the information that chemotherapy is safe, with the caveat patient selection for the treatment should be more discretionary. Chemo does seem to work for many, but there is a more ideal patient for this method and it shouldn’t be prescribed to every cancer patient that walks through the door.
Professor David Cameron of the Edinburgh Cancer Centre at West General Hospital in Edinburgh, Scotland, noted,
“The concern is that with some of the patients dying within 30 days of being given chemo probably shouldn’t have been given the chemo. But how many? There is no easy way to answer that, but perhaps looking at those places/hospitals where the death rate was higher might help. Furthermore, if we give less chemo then some patients will die because they didn’t get enough chemo. It’s a fine balance and the more data we have the better we can be t making sure we get the balance right. “
U.S. Doctors, Take Note
Unfortunately, in the United States many patients are forced to undergo chemotherapy despite what they want for themselves. This has happened with many children whose parents are opting to seek out alternative cancer treatments.
One example involves, 17-year-old Cassandra C., who has Hodgkin lymphoma, has been denied her desire to pursue alternative treatment methods when it comes to her cancer treatment. The Connecticut Supreme Court ruled, on January 8th, that Cassandra (who declined chemotherapy treatment) will be forced to undergo the treatment anyway. She cited chemotherapy’s adverse health effects as her main reason for refusing.
Cassandra expressed that being forced into surgery and chemo has traumatized her, that it should be a given human right to decide what you want and don’t want for your own body.
The most frustrating part about this whole thing is that there are in fact many alternative methods to treating cancer that are not recognized, accepted or provided with enough funding for thorough studies to be considered as an option in the first place.
Successful alternative methods that have been used to treat cancer is an entirely separate topic that involves a lot of research, but success has been reported using vegan methods, fasting methods, and more. Clinical trials have been conducted in these areas, but we don’t hear much about it. The science on this that’s emerging is fascinating, and we encourage all who are interested to look into it a little deeper if interested.
Below is a great clip from The THRIVE movement that gives us all something to thing about.
Patients treated with chemotherapy have disturbed sleep-wake activity, a prospective study from Hong Kong and Australia confirms.
“The first administration of adjuvant chemotherapy is associated with sleep disturbance and sleep-wake activity rhythm disruption among breast cancer patients, while the disturbance and disruption during the last cycle are less severe,” the researchers write in Sleep, online December 14.
“Nevertheless, repeated administration of chemotherapy results in progressive impairment of nocturnal melatonin production,” they add.
Dr. Lap Ah Tse of the Jockey Club School of Public Health and Primary Care of the Chinese University of Hong Kong and colleagues investigated the patterns of sleep, sleep-wake activity rhythm, and first morning void urinary melatonin levels in 180 patients undergoing adjuvant chemotherapy for stage I-III primary breast cancer.
At baseline, the median participant age was 53, and most were married with high school or higher education; 76% reported sleep disturbance (Pittsburgh Sleep Quality Index (PSQI) 5 or higher); 85% had good performance status; and 72% had undergone mastectomy.
Guided by their disease condition and preference, patients received one of three adjuvant chemotherapy regimens: six cycles of FEC-T (5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel; 44% received this), four cycles of doxorubicin plus cyclophosphamide (29%), or four cycles of docetaxel plus cyclophosphamide (27%).
Participants completed a baseline questionnaire about sociodemographics and lifestyle, including age, education level, family income, marital status, and drinking history; they completed the PSQI to evaluate their subjective sleep quality; and the researchers reviewed their medical records.
The patients wore wrist actigraph monitors GENEActiv Original (Activinsights Company, UK) on the non-dominant hand for a week before chemotherapy, and during the first week of the first cycle. Afterwards, those treated with doxorubicin plus cyclophosphamide or with docetaxel plus cyclophosphamide wore the monitor during the first week of the fourth cycle (end of chemotherapy), and those on FEC-T wore the monitor during the first week of the third cycle (end of FEC). They collected their first morning void urine samples before treatment as well as during their first and the last cycle.
The actigraphy data were extracted to determine sleep efficiency, sleep duration, total nighttime wake time, percent rhythm, F-statistic, amplitude, mesor, and acrophase.
Researchers also assessed urinary 6-sulfatoxymelatonin (aMT6s) levels.
Linear mixed-effects models were used to calculate the changes in actigraphy values as well as first morning urinary aMT6s before and during chemotherapy, and univariable and multivariable models were used for all actigraphy values and urinary aMT6s. The multivariable linear mixed-effects models were adjusted for cancer stage; age; body mass index; menopausal status; performance status; surgery type; comorbidities; corticosteroid use; sociodemographics; alcohol consumption; and chemotherapy.
Compared with baseline, sleep efficiency during the first and last cycle decreased by 10% and 5%, respectively; rhythm decreased by 27% during the first cycle and 21% during the last cycle; and during the first and last cycles, aMT6s levels decreased by 11% and 15%, respectively, compared to baseline.
“This study provides the first epidemiological evidence that nocturnal melatonin secretion is progressively impaired over the course of chemotherapy in breast cancer patients receiving chemotherapy,” the authors write.
The authors note that disturbed sleep with weak sleep-wake activity rhythm is a common problem among breast cancer survivors who have chemotherapy.
“This longitudinal study suggests that sleep, sleep-wake activity rhythm, and nocturnal melatonin production are rapidly disrupted after the administration of the first cycle of adjuvant chemotherapy in breast cancer patients,” they write.
“Sleep disturbance is associated with poor quality of life, fatigue, and depression in breast cancer patients. Weak sleep-wake activity rhythm is evident to be a prognostic risk factor associated with poor survival of cancer patients and the side effects of anti-cancer treatment,” they add. “Furthermore, disruptions in sleep and sleep-wake activity rhythm may disrupt the production of nocturnal melatonin, which is an endogenous hormone playing a pivotal role in alleviating oxidative stress and regulating the immune and hematological system.”
Pancreatic cancer is a lethal disease with a very poor prognosis. In contrast to treatments for many other tumor types, cytotoxic agents are still the first-line drugs for pancreatic cancer in both the palliative and adjuvant settings. Some progress has been made in recent years, but most large phase 3 studies have not shown significant improvements in survival. Because the available drugs and regimens are limited in both type and effect, the selection of chemotherapy based on clinicopathologic characteristics may be consequential for pancreatic cancer. In the present report, we focused on 7 landmark clinical trials for pancreatic cancer. We observed that FOLFIRINOX (oxaliplatin, irinotecan, fluorouracil, and leucovorin) and NG (nab-paclitaxel and gemcitabine), 2 first-line regimens, exerted opposite effects on metastatic pancreatic cancer patients with different baseline carbohydrate antigen 19-9 (CA19-9) levels. This suggested that not only the performance status but possibly also CA19-9 levels should be considered when making a therapeutic choice for patients with advanced pancreatic cancer. Moreover, we found that patients with a diagnosis of pancreatic cancer who have undergone a surgical resection with a negative margin (R0) may benefit more from fluorouracil and/or oral prodrugs of fluorouracil-based adjuvant therapy than from gemcitabine. Conversely, gemcitabine or gemcitabine-based regimens may be more effective for patients with a positive resection margin (R1). Based on these findings, we propose flowcharts for selecting chemotherapy for both advanced and resected pancreatic cancer. Furthermore, we present possible mechanisms and interpretations underlying the selection of chemotherapy for pancreatic cancer and propose the tumor burden as a key variable in this process. Regardless of the possible bias and exact treatment selection process, this study offers an opportunity to improve patient outcomes by using agents currently used in the therapy of pancreatic cancer. Although these conclusions are based on indirect evidence, we provide insights and possibilities to drive the selection of chemotherapy for pancreatic cancer.
Chemotherapy is any treatment involving the use of drugs to kill cancer cells – A Doctor outlines what you need to know.
Cancer chemotherapy may consist of single drugs or combinations of drugs, and can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment.
More than half of all people diagnosed with cancer receive chemotherapy. For millions of people who have cancers that respond well to chemotherapy, this approach helps treat their cancer effectively, enabling them to enjoy full, productive lives. Furthermore, many side effects once associated with chemotherapy are now easily prevented or controlled, allowing many people to work, travel, and participate in many of their other normal activities while receiving chemotherapy.
Being informed about chemotherapy and its potential side effects can help you to proactively manage your own care and optimize your treatment and outcome.
How is chemotherapy delivered?
There are a variety of schedules and techniques used to deliver chemotherapy and yours will depend on which treatment your doctor prescribes. Cancer chemotherapy may consist of a single drug or combinations of drugs that are delivered in cycles. A cycle consists of treatment with one or more drugs followed by a period of rest.
Chemotherapy can be administered orally in the form of a pill, into a vein (intravenous), injected into a body cavity (such as the bladder), into a muscle (intramuscular), or into the spinal fluid (intrathecal). Currently, most chemotherapy is administered intravenously; however, oral chemotherapy drugs are gaining wider use. In some cases, it may be beneficial to administer IV chemotherapy through a venous access device (VAD), which is inserted into a major vein in the body and can remain in place for a long period of time. Not every chemotherapy patient requires a VAD. However, for those that are undergoing frequent treatment, blood tests, and nutritional support, a VAD is beneficial by reducing the number of needle sticks and associated discomfort.
How often will I receive chemotherapy?
Chemotherapy drugs are typically given in cycles. The cycle consists of the day(s) the drug is administered followed by a rest and recovery period. A cycle usually lasts one to four weeks and is then repeated, which means a treatment is administered every one to four weeks. Each course of chemotherapy is different, but generally consists of four to six cycles. The actual administration of some chemotherapy drugs may take only seconds or minutes, while others may take hours or even days.
What are the advantages and disadvantages of oral chemotherapy drugs?
In the past, chemotherapy drugs were mainly administered into a vein (intravenous). Recently, oral chemotherapy drugs are being developed. Oral drugs may provide greater ease of administration since patients can take them at home rather than going to a clinic or hospital for treatments. Not all chemotherapy drugs are available in oral form. Furthermore, intravenous (IV) administration is sometimes preferable because the doctor can be more certain that the patient received the appropriate dose as scheduled and they can monitor the patient during administration.
What is a venous access device (VAD) and what types are used for cancer patients?
A VAD is a surgically implanted device that provides long-term access to a major vein. Although there are several different types of VADs, the two most commonly used for cancer treatment and taking blood samples are:
Tunneled external catheters (Hickman® catheter), or
Subcutaneous implanted ports (port-a-cath).
Both a Hickman® catheter and a port-a-cath are surgically implanted into a major vein. For the Hickman® catheter, the plastic tube or catheter is attached to a major vein and then comes out of the body for external access. A port-a-cath is implanted completely beneath the skin into a major vein under the collarbone. The port may then be accessed by a special needle through the skin to deliver chemotherapy, hydration, transfusions, and for taking blood samples.
The following are some key features that distinguish these two types of VADs:
Easier insertion, removal, and access
Higher flow capacity due to single, double, or triple lumen (channel)
Fewer device-related infections
Fewer activity restrictions
Less day-to-day maintenance
Lower flow capacity due to only single or double lumen (channel)
Patients undergoing very demanding therapies that require frequent treatment, blood transfusions, and nutritional support—such as a stem cell transplant—may be required a Hickman® catheter instead of a port.
Who needs a VAD?
Not every chemotherapy patient requires a VAD. For some chemotherapy treatment plans, the inconvenience of implanting and accessing a VAD may outweigh the benefits. You may wish to ask your doctor if a VAD is an appropriate option for you, especially if you experience any of the following:
You are extremely anxious about having needles inserted.
Your veins are difficult to access or become inaccessible.
You must have alternative veins in your foot or hand accessed, which may be associated with more discomfort.
You are undergoing continuous infusion chemotherapy (over an hour).
You anticipate many months of chemotherapy treatments.
You are receiving intravenous chemotherapy that requires multiple needle sticks.
Your treatment requires frequent drawing of blood samples.
Your treatment strategy involves chemotherapy agents that may cause “vein pain” when administered through the arm.
You have a physician or nurse who recommend a vascular access device.
What special precautions are necessary with a VAD?
Your VAD must be flushed in order for it to work properly. Flushing your VAD requires placing a needle in your port and flushing it out with heparin. Heparin is a blood thinner prevents the catheter (plastic tube) from becoming occluded (clogged). While you are on treatment, your VAD will be flushed after each treatment. When you are no longer on treatment you must still remember to have your VAD flushed regularly. This procedure needs to be done every 4-6 weeks. It is your responsibility to make the appointment to have your VAD flushed.
Additional things about chemotherapy you may need to know include the following topics:
The development of any of the following symptoms during your chemotherapy treatment may indicate a serious condition. If you experience any of the following throughout your cancer treatment, please inform your doctor.
Fever higher than 101º F
Vomiting that continues 48 hours after treatment
Bleeding or bruising
Shortness of breath/chest pain
Severe constipation or diarrhea
Painful or frequent urination
Blood in the urine or stool
Soreness, redness, swelling, pus, or drainage at your VAD site
Irregular or rapid heart beat
Pain in a new place.
Pain that is not relieved by your pain medication.
Headache that is not relieved by Tylenol®
Inability to eat and continued weight loss
Nasal congestion, drainage, cough
One or more of the following symptoms in conjunction with repetitive diarrhea or vomiting (signs of dehydration):
Dry, cracked lips
Dry, sticky tongue
Increased pulse rate
Dizziness/lightheadedness (especially when rising to a standing position)
Doctors answers to the most frequently asked questions about chemotherapy
Chemotherapy kills rapidly-dividing cells in a variety of ways, depending on the drug. Since there are many different types of cancers that all grow differently, many chemotherapy drugs have been developed to target these various growth patterns. Each drug has a different way of working and is effective at a specific time in the life cycle of the cell it targets. For example, some chemotherapy drugs work by:
Preventing cells from dividing, or
Disrupting cellular metabolism or other critical functions.
How is chemotherapy given?
Chemotherapy can be given:
By mouth in the form of a pill,
With a shot (injection), or
By intrathecal and intraventricular injection (meaning into the spinal fluid surrounding the spinal cord or brain).
Many types of chemotherapy can be given at home. Through instruction, you and your family members can learn how to administer chemotherapy in pill form or by injection with small syringes and needles similar to those that people with diabetes use to administer insulin. In some cases, a nurse will administer chemotherapy in an outpatient clinic. In other cases, it may be necessary to go to the hospital to receive treatment.
Chemotherapy is typically given in cycles, which is a treatment followed by a period of rest. A cycle can last one or more days, but is usually one, two, three, or four weeks long. A course of chemotherapy is comprised of multiple cycles. Each course is different, but generally consists of four to six cycles. It may take a relatively short period of time to receive some chemotherapy drugs, while others take hours. It all depends on the treatment regimen that your doctor recommends.
If your chemotherapy is given through an IV, your doctor may suggest an implanted venous access device (VAD) such as a Hickman® catheter or Port-a-Cath. VADs are surgically placed in a large vein near the heart and can stay in place for long periods of time. By using a VAD, you will not have to have smaller catheters repeatedly placed in your arm veins.
How often will I receive chemotherapy?
Generally, treatments are given daily, weekly, or monthly. How often you receive chemotherapy depends on the type of cancer and which drug or combination of drugs you receive. Your doctor will help you determine the most effective treatment schedule for you. Chemotherapy is usually given in cycles with rest periods between each administration.
Chemotherapy may be used in combination with surgery. When chemotherapy is given before surgery it is referred to as neoadjuvant chemotherapy. The goal of neoadjuvant chemotherapy is to shrink the cancer before it is surgically removed. If the chemotherapy is given after surgery, it is referred to as adjuvant chemotherapy. The goal of adjuvant chemotherapy is to kill any cancer cells left in the body after surgery. Regardless of whether it is given before or after surgery, chemotherapy will still be administered in cycles that depend on the type of cancer and which drug or combination of drugs.
What chemotherapy will I receive?
You will receive chemotherapy that is best suited to achieve your goals of therapy. When selecting a treatment or treatments, your doctor will consider:
How far along your cancer is in its development
The expected behavior of the cancer
Where the cancer originated
Other medical problems you may have
Any potential side effects from the treatment.
How is my chemotherapy scheduled?
Chemotherapy is typically given in cycles, which is a treatment followed by a period of rest. A cycle can last one or more days, but is usually one, two, three or four weeks long. A course of chemotherapy is comprised of multiple cycles. Each course is different, but generally consists of four to six cycles. The actual administration of the chemotherapy drugs may take minutes to several hours, depending on the drug or drugs given.
If your chemotherapy is given through an IV, your doctor may suggest an implanted venous access device (VAD) or Port-a-Cath. VADs are surgically placed in a large vein near the heart and can stay in place for long periods of time. By using a VAD you will not have to have smaller catheters repeatedly placed in arm veins.
What are the side effects of chemotherapy?
Chemotherapy works by destroying cancer cells; unfortunately, it cannot tell the difference between a cancer cell and a healthy cell. The delivery of cancer therapy often affects the body’s normal tissues or organs that are not affected by cancer. Side effects, or complications of treatment are the undesired consequence of affecting normal cells.
Side effects of treatment may cause inconvenience, discomfort, and occasionally even fatality to patients. Additionally and perhaps more importantly, side effects may prevent delivery of thefull dose of chemotherapy on schedule. This is extremely important to understand since your expected outcome from chemotherapy is based on delivering treatment at the full dose and schedule prescribed in the treatment plan Because the expected outcome from therapy is based on delivering treatment at the prescribed dose and schedule, a change from the treatment plan may reduce your chance of achieving an optimal outcome. . This is extremely important to understand. In other words, side effects not only cause discomfort and unpleasantness, but may also compromise your chance of cure by preventing the delivery of therapy at its optimal dose and time.
The most common side effects of chemotherapy are low blood counts, nausea, vomiting, hair loss, and fatigue. Some side effects may be temporary and merely annoying. Others, such as infection or a low white blood count, can be life-threatening. For example, one of the most serious potential side effects of chemotherapy is a low white blood cell count – a condition called neutropenia (new-truh-pee-nee-ah) – which can put you at risk for severe infections or treatment interruptions.
Fortunately, last 20 years has brought a great deal of progress in the development of treatments to help prevent and control the side effects of cancer therapy. These developments have
Led to vast improvements in the management of symptoms associated with cancer treatment
Allowed for greater accuracy and consistency concerning the administration of cancer treatment
Made many cancer treatments more widely available to patients throughout the world.
Why am I so tired?
Many people who receive chemotherapy experience fatigue. Fatigue has many causes but frequently occurs because of anemia caused by the chemotherapy. Your daily activities should be planned according to how you feel, and you should take rest periods throughout the day as often as you feel necessary. Anemia can be effectively treated. To learn more, go to fatigue.
Will my chemotherapy make me sick?
Without receiving special anti-nausea medications, most patients will experience some nausea after treatment with chemotherapy. Nausea and vomiting may last 24-48 hours. The severity of nausea and vomiting mainly depends on which chemotherapy drugs were used. A number of very effective medications called anti-emetics or anti-nausea drugs are now available to help lessen or prevent nausea and vomiting. These medications may be given to you intravenously during your chemotherapy, or you may be given a prescription medication to take at home. To learn more, go to nausea and vomiting.
What tests will be performed?
Your doctor determines what kinds of tests are needed. If you are receiving chemotherapy, you may have blood work done anywhere from the day of or up to 7 days before your scheduled treatment. This blood work will include a complete blood count (CBC), chemistry profile, and any necessary cancer markers. A blood sample for a complete blood count (CBC) will also be collected seven to fourteen days following your chemotherapy. It is important to be aware of possible symptoms of reduced red blood cell (RBC), white blood cell (WBC), or platelet (PLT) production. Be sure to report any of the following:
Fever (over 101º F), congestion, or a cold.
A rash, blister, easily bruised skin, signs of bleeding, an infected cut, itching or burning in the genital area.
Weakness, fatigue, or shortness of breath.
Why is my complete blood count (CBC) tested after treatment?
Chemotherapy destroys rapidly dividing cells, a characteristic of cancer cells. However, red blood cells, white blood cells, and platelets also divide rapidly and are frequently damaged by chemotherapy. Your red blood cell count, white blood cell count, and platelet count may all go down. Your doctor monitors these counts to determine the toxicity of treatment and to predict your risk for complications, as well as to plan future therapy. For more information, see section on Understanding and Monitoring Your Blood Counts.
Will I lose my hair because of my treatment?
Hair loss occurs with some, but not all, chemotherapy drugs. The amount of hair loss varies from a slight thinning to complete baldness and affects the scalp, eyelashes and eyebrows, legs, armpits, and pubic area.
Hair loss will typically begin two or three weeks after your first treatment. The amount of hair that you lose will depend on the type of chemotherapy drug you are taking. Hair typically begins to grow back approximately 2-3 weeks after treatment is finished. The hair may grow back differently than it was before treatment. For example color or texture (curly or straight) may be different.
Remember that hair loss associated with chemotherapy is temporary and the hair WILL grow back. In the meantime, here are a few tips to help you cope with the loss:
You may wish to cut your hair before it starts falling out. The experience of losing the hair is sometimes worse than dealing with it once it’s gone. If you expect to lose all or a lot of your hair, cutting it first may be easier to cope with.
Plan ahead; shop for a wig before your hair is gone, especially if you wish to match your natural color. Or, take this opportunity to try something different.
Try hats or head scarves; these are good alternatives or a compliment to a wig.
Remember to cover your head or use sunscreen on your scalp. Skin that has been covered with hair may be particularly sensitive to UV rays of the sun.
Ask your insurance company if they cover the cost of the wig.
Treat your new hair gently once it grows back. Avoid chemicals, bleach, peroxide, or colors.
The U.S. Food and Drug Administration today approved Daurismo (glasdegib) tablets to be used in combination with low-dose cytarabine (LDAC), a type of chemotherapy, for the treatment of newly-diagnosed acute myeloid leukemia (AML) in adults who are 75 years of age or older or who have other chronic health conditions or diseases (comorbidities) that may preclude the use of intensive chemotherapy.
“Intensive chemotherapy is usually used to control AML, but many adults with AML are unable to have intensive chemotherapy because of its toxicities. Today’s approval gives health care providers another tool to use in the treatment of AML patients with various, unique needs. Clinical trials showed that overall survival was improved using Daurismo in combination with LDAC compared to LDAC alone for patients who would not tolerate intensive chemotherapy,” said Richard Pazdur, M.D., director of the FDA’s Oncology Center of Excellence and acting director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research.
AML is a rapidly progressing cancer that forms in the bone marrow and results in an increased number of abnormal white blood cells in the bloodstream and bone marrow. The National Cancer Institute at the National Institutes of Health estimates that in 2018, approximately 19,520 people will be diagnosed with AML and approximately 10,670 patients with AML will die of the disease. Almost half of the adults diagnosed with AML are not treated with intensive chemotherapy because of comorbidities and chemotherapy related toxicities.
The efficacy of Daurismo was studied in a randomized clinical trial in which 111 adult patients with newly diagnosed AML were treated with either Daurismo in combination with LDAC or LDAC alone. The trial measured overall survival (OS) from the date of randomization to death from any cause. Results demonstrated a significant improvement in OS in patients treated with Daurismo. The median OS was 8.3 months for patients treated with Daurismo plus LDAC compared with 4.3 months for patients treated with LDAC only.
Common side effects reported by patients receiving Daurismo in clinical trials include low red blood cell count (anemia), tiredness (fatigue), bleeding (hemorrhage), fever with low white blood cell count (febrile neutropenia), muscle pain, nausea, swelling of the arms or legs (edema), low platelet counts (thrombocytopenia), shortness of breath (dyspnea), decreased appetite, distorted taste (dysgeusia), pain or sores in the mouth or throat (mucositis), constipation and rash.
The prescribing information for Daurismo includes a Boxed Warning to advise health care professionals and patients about the risk of embryo-fetal death or severe birth defects. Daurismo should not be used during pregnancy or while breastfeeding. Pregnancy testing should be conducted in females of reproductive age prior to initiation of Daurismo treatment and effective contraception should be used during treatment and for at least 30 days after the last dose. The Boxed Warning also advises male patients of the potential risk of drug exposure through semen and to use condoms with a pregnant partner or a female partner that could become pregnant both during treatment and for at least 30 days after the last dose. Daurismo must be dispensed with a patient Medication Guide that describes important information about the drug’s uses and risks. Patients should also be advised not to donate blood or blood products during treatment. Health care providers should also monitor patients for changes in the electrical activity of the heart, called QT prolongation.
The FDA granted this application Priority Review designation. Daurismo also received Orphan Drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases.
The FDA granted the approval of Daurismo to Pfizer.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
If you’ve heard that high doses of vitamin C can kill cancer, there’s a good chance you’ve also heard some official-sounding organizations claiming that there is no science to back this up. However, new research shows that high doses of vitamin C can indeed fight cancer, underscoring the findings of countless other studies like it that are widely ignored by the medical industry.
Detractors choose to focus on those studies that showed it didn’t work, conveniently ignoring the fact that many of the studies that were inconclusive in this regard simply weren’t testing big enough doses to unlock its effectiveness.
Research carried out at the University of Iowa confirms that vitamin C does kill cancer cells selectively without damaging normal cells. One study showed that the vitamins can reduce mutations that cause cancer in mice, while another study showed it can kill as much as 50 percent of human lymphoma cells.
Another study, this one from the Perlmutter Cancer Center, found that injecting mice with high doses of vitamin C stopped leukemia cancer stem cells from humans from growing, probably by telling the faulty stem cells in bone marrow to die. A different study found that adding vitamin C via IV to typical chemotherapy drugs extended the average survival times of pancreatic cancer patients from 5.65 months to 12 months.
Then there’s the University of Kansas study that injected high doses of vitamin C into ovarian cells from humans. They found that the vitamin targeted the ovarian cancer cells without harming healthy cells, and they went on to repeat the study on mice and human subjects.
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These findings wouldn’t be surprising to the researchers who worked on a review that was published in the Puerto Rico Health Sciences Journal in 2008. After looking at studies that used extremely higher amounts of vitamin C intravenously, they concluded that it can be effective against tumors, although they said that its efficacy could not be judged when it was administered orally.
Even though the authors called for further research into vitamin C’s cancer-fighting power, nothing was done about it at the time. After all, chemotherapy has been so profitable for the medical and pharmaceutical industries, and it would be hard to profit off of something as cheap, widely available, and unpatentable as vitamin C .
IV may not be the only way to deliver high doses of vitamin C
Some people have been getting these treatments on their own at alternative cancer clinics, but it’s not widely accepted. In addition, those who are wary of IVs find it extremely difficult to get the high blood concentration needed for this treatment to work its magic when they take it orally.
Now, however, there is a new form of vitamin C that could change everything. Liposomal vitamin C can create vitamin C levels in the blood that are 100 to 500 times greater than those normally achieved by oral ingestion, making it easier for people to fight cancer.
Liposomal vitamin C is encapsulated in lecithin, which shields it from digestive enzymes that would normally break it down. It makes its way through the digestive system with ease and is absorbed by the intestines before being transported into the liver, where it is released into the bloodstream.
This approach does away with the waste and gastric upset seen with conventional vitamin C tablets while maintaining high blood concentrations. Whether it will one day make its way into the mainstream and give riskier treatments like chemotherapy a run for their money remains to be seen, however.