Electrochemotherapy is a new modality of treating skin metastases. I discuss here the indications and patient selection and success rates of other institutions.
Electrochemotherapy : principles, sessions, case studies, and machines.leroybiotech
Electrochemotherapy is a recent cutaneous tumors treatment for any type of animals.
In the 80s, specific electrical conditions that increase membrane cell permeability in vitro have been defined: principle of “electroporation” was born. The concept was developed and improved effectiveness of certain chemotherapeutic agents has been validated by early clinical studies in human and veterinary medicine in 1991 (Mir et al. 1991).
Thanks to a European project on human patients from 2006, named ESOPE (European Standard Operating Procedures of Electrochemotherapy), the technique of electrochemotherapy was standardized (Mir et al. 2006)
CARCINOMA COLON - Dr. ZAHID IQBAL MIR
Dr. Zahid Iqbal Mir, MBBS MS (General Surgery), DNB (General Surgery) has done his MBBS and masters in General Surgery from the prestigious Govt Medical College Jammu and DNB in General Surgery from NBEMS New Delhi. He is a passionate surgeon, earlier practising at Government Medical College, Jammu as Registrar in Department of General Surgery. Nowadays working as Senior Resident in Department of General Surgery, Government Medical College & Hospital, Sector 32, Chandigarh and a rising name in field of surgery.
He is an enthusiastic, enigmatic and dedicated teacher as well. He is not just a resolute learner, but also an awe inspiring guiding light for his juniors, which makes him the most loveable and respected senior.
Currently he is running “LOVE FOR SCALPEL” for PGMEE aspirants on most of the social platforms, which is gaining immense popularity among residents, medical graduates and undergraduates.
Electrochemotherapy : principles, sessions, case studies, and machines.leroybiotech
Electrochemotherapy is a recent cutaneous tumors treatment for any type of animals.
In the 80s, specific electrical conditions that increase membrane cell permeability in vitro have been defined: principle of “electroporation” was born. The concept was developed and improved effectiveness of certain chemotherapeutic agents has been validated by early clinical studies in human and veterinary medicine in 1991 (Mir et al. 1991).
Thanks to a European project on human patients from 2006, named ESOPE (European Standard Operating Procedures of Electrochemotherapy), the technique of electrochemotherapy was standardized (Mir et al. 2006)
CARCINOMA COLON - Dr. ZAHID IQBAL MIR
Dr. Zahid Iqbal Mir, MBBS MS (General Surgery), DNB (General Surgery) has done his MBBS and masters in General Surgery from the prestigious Govt Medical College Jammu and DNB in General Surgery from NBEMS New Delhi. He is a passionate surgeon, earlier practising at Government Medical College, Jammu as Registrar in Department of General Surgery. Nowadays working as Senior Resident in Department of General Surgery, Government Medical College & Hospital, Sector 32, Chandigarh and a rising name in field of surgery.
He is an enthusiastic, enigmatic and dedicated teacher as well. He is not just a resolute learner, but also an awe inspiring guiding light for his juniors, which makes him the most loveable and respected senior.
Currently he is running “LOVE FOR SCALPEL” for PGMEE aspirants on most of the social platforms, which is gaining immense popularity among residents, medical graduates and undergraduates.
Report Back from SGO: What’s the Latest in Uterine Cancer?bkling
Dr. Jeannine Villella, Chief of Gynecologic Oncology at Lenox Hill Hospital, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Villella breaks down what the research presented at the conference means for you and discusses new developments.
Please see the Creative Commons License on the second slide. This slide deck is for medical education uses only and does not constitute medical advice. Please consult with your own health care provider.
We live in an age of a new unpreceded wonders. The wonders of the world are not seven any more. The inanimate talk to us. We are flying in the air. More than 65,000-Ton can float over the water in an iron vessel. The Robotic Doctor is already a reality. Reviewing the history of mankind's cumulative experience starting with the ancient very primitive trials and ending with the presence of Robotic and Telesurgery
Clearly show that the major and rapid advances in the whole mankind's life occur only in the last few decades especially the last 10 years ? .
Opportunities for Immune Therapy and Preventionbkling
Dr. Margaret Gatti-Mays of the National Cancer Institute, a Staff Clinician of Laboratory of Tumor Immunology and Biology and the Co-Director of the Clinical Trial Group, explores the future of immunotherapy in breast cancer treatment.
Rectum cancer surgery. Standards of Surgical practice for resectable rectal c...Tariq Khan
Rectum cancer treatment is changing day by day. The current standards of surgical treatment is discussed here. We practice in Shaheed Suhrawardy Medical College, Dhaka and BRB Hospitals Ltd, Dhaka
This document provides information on the Electro Cancer Therapy as used by the Budwig Center in Spain. We have so far experienced some excellent results using this particular treatment with various forms of cancer including prostate, cervical, lung, breast and skin cancers. Visit us at http://www.budwigcenter.com for more information.
Report Back from SGO: What’s the Latest in Uterine Cancer?bkling
Dr. Jeannine Villella, Chief of Gynecologic Oncology at Lenox Hill Hospital, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Villella breaks down what the research presented at the conference means for you and discusses new developments.
Please see the Creative Commons License on the second slide. This slide deck is for medical education uses only and does not constitute medical advice. Please consult with your own health care provider.
We live in an age of a new unpreceded wonders. The wonders of the world are not seven any more. The inanimate talk to us. We are flying in the air. More than 65,000-Ton can float over the water in an iron vessel. The Robotic Doctor is already a reality. Reviewing the history of mankind's cumulative experience starting with the ancient very primitive trials and ending with the presence of Robotic and Telesurgery
Clearly show that the major and rapid advances in the whole mankind's life occur only in the last few decades especially the last 10 years ? .
Opportunities for Immune Therapy and Preventionbkling
Dr. Margaret Gatti-Mays of the National Cancer Institute, a Staff Clinician of Laboratory of Tumor Immunology and Biology and the Co-Director of the Clinical Trial Group, explores the future of immunotherapy in breast cancer treatment.
Rectum cancer surgery. Standards of Surgical practice for resectable rectal c...Tariq Khan
Rectum cancer treatment is changing day by day. The current standards of surgical treatment is discussed here. We practice in Shaheed Suhrawardy Medical College, Dhaka and BRB Hospitals Ltd, Dhaka
This document provides information on the Electro Cancer Therapy as used by the Budwig Center in Spain. We have so far experienced some excellent results using this particular treatment with various forms of cancer including prostate, cervical, lung, breast and skin cancers. Visit us at http://www.budwigcenter.com for more information.
Acute and Late Radiation Related Side Effects and their Management in Pelvic ...Dr Kartik Kadia
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using physiotherapy modalities for improve the healing of wound specially for bed ulcer, vascular ulcer , post infected surgical wound , diabetic foot ulcers
There are many types of cancer treatment. The types of treatment that patient receive will depend on the type of cancer, stage of cancer and how advanced it is.
Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy.
Radiation Treatment of Rectal and Colon Cancer :: July 2017 #CRCWebinarFight Colorectal Cancer
Michael Bassetti, MD, Ph.D. from the University of Wisconsin Carbone Cancer Center discusses all you need to know about radiation. Dr. Bassetti will talk about what radiation treatment is, how it’s used for rectal and colon cancer patients, how to prepare for treatment, how to manage side effects and more.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
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2. Outline
• Skin Metastases
• Electrochemotherapy (ECT) for Skin Metastases
• Fundamentals
• Technical Requirements
• Chemotherapy Used
• Recent Evidence for ECT
3. Skin Metastases
• Generally, skin metastases are encountered in 0.7 –
10% of all patients with cancer.1
• Usually occur in the body region near the primary
tumor.2
• Tumors with propensity for skin metastasis3
• Melanoma 45%
• Breast Cancer 30%
• Nasal sinus 20%
• Larynx 16%
• Oral cavity 12%
• Other organs: lungs, uterus,
stomach, colon, kidney, sarcoma
1Hussein MR 2010. J Cutan Pathol.
2Bienvento 2012
3Medscape 2017
4. Skin Metastases
• Most common primary
cancer that develop skin
metastases4:
• MEN Lung cancer
(anterior chest), head and
neck cancer
• WOMEN Breast cancer
(anterior chest and
abdomen)
• Can mimic specific
dermatological conditions
such as a cutaneous cyst,
pyogenic granuloma,
cellulitis, and even an
infection (herpes zoster,
abscess, etc)
4Hussein MR 2010. J Cutan Pathol.
5. Skin Metastases
• Often a preterminal event that heralds a poor outcome
Hussein MR 2010. J Cutan Pathol.
Lung CA
Breast CA
Oral Cavity CA
6. Skin Metastases
• Greatly affect quality of life
• Lead to ulceration, bleeding,
and pain
• Challenge to treat!
• Supportive
• Chemotherapy, RT, surgery
• Ablation (laser, excision, etc..)
8. • As electroporation is limited to the tumour-affected
area, there is MINIMAL or NO INCREASE in systemic
toxicity resulting in a good tolerability of this method.
Dynamic Electro-enhanced Chemotherapy
(DEECT) : Fundamentals
11. Side Effects of Bleomycin
Most Serious:
• Pulmonary fibrosis – rare;
dose-related (in those
receiving >400 units total
dose); age-related (the older
grp)
• Anaphylaxis usually in 1st or
2nd dose
12. Head-Neck Skin Metastases
• Head-Neck cancers eventually develop ulcerating skin
lesions, resistant to both local and systemic treatments,
often painful and with strong odours due to infection.
14. Response from ECT, Skin Mets from HNCa
Mevio N, et al. Tu mo ri, 98: 308-313, 2012
15. Breast Cutaneous Metastases
• Cutaneous metastases from breast cancer occur in
about 2% of patients and account for only 1% of all
metastases from this type of malignancy.
• However, breast cancer metastases to the skin represent 51%
of all of skin metastases.
16. Patient Selection for ECT
Banerjee, et al. Arch Breast Cancer 2016; Vol. 3, No. 4: 108-117
17. RR, ECT on BrCa skin lesions: Evidence from Literature
Banerjee, et al. Arch Breast Cancer 2016; Vol. 3, No. 4: 108-117
18. Response from ECT (Skin Mets Various Ca):
Evidence from Literature
MATTHIESSEN LW, et al. Acta Oncologica, 2011; 50: 621–629
19. Predictive Factors for response from ECT (Skin Mets
BrCa): Evidence from Literature
Banerjee, et al. Arch Breast Cancer 2016; Vol. 3, No. 4: 108-117
20. ELECTROCHEMOTHERAPY
Advantages
• Suitable for patients :
• with severe comorbidity
• advanced age
• already exhausted all other
treatments.
• ECT can be used to treat painful, bleeding
and weeping metastases, as well as large
lesions up to a depth of 4 cm.
• Can be done outpatient.
• Side effects are minor. Muscular
fasciculation in terms of muscle aches is
rare.
• Local tumour control is possible
• Repeatability is possible
Disadvantages
• If GA used - can have common anaesthesia
related risks.
• Use of IV bleomycin can result in pulmonary
fibrosis, particularly as this treatment is
administered to patients who have previously
received radiation therapy and who are
comorbid, older, etc.
• The electrode used during ECT is a disposable
instrument which is not particularly inexpensive.
• In the case of ECT of large lesions in particular,
the formation of large ulcers is possible due to
increased tumour decomposition.
• As the use of ECT is not curative but palliative,
it is very likely that the treatment will have to be
repeated, as the metastases become
progressive over time.