52 patients with bowel cancer and 89 with breast cancer used medicinal mushroom extracts from Myko San company with standard oncological treatments. In this cohort study, lasting from 2005-2010, we analysed the long term effects of using medicinal mushroom products in cancer patients.
While medicinal mushrooms are not 'magic bullets', this study provides unquestionable evidence of the benefits of their use as supportive therapy in cancer patients, leading to significantly improved outcomes.
This work was presented by Neven Jakopovic at the 6th International Medicinal Mushroom Conference in Zagreb, Croatia, in 2011.
Malnutrition is common in cancer patients, affecting 40-80% during their disease course. It negatively impacts treatment outcomes, mortality, and quality of life. Early screening and nutritional interventions can help prevent weight loss and treatment interruptions. A multidisciplinary team approach is needed to address nutritional status from diagnosis onward through cancer treatment. Screening tools help identify at-risk patients who need comprehensive assessment and individualized nutritional support through diet, oral supplements, enteral feeding, or parenteral nutrition as needed. Exercise should also be encouraged to preserve muscle mass. Prioritizing nutritional care represents good clinical practice that can optimize cancer treatment.
1. Resection offers the only chance for cure of pancreatic cancer, but most patients are unresectable at diagnosis. For resectable patients, surgery without delay followed by adjuvant chemotherapy and radiation improves survival compared to surgery alone.
2. For unresectable locally advanced disease, chemoradiation provides a survival benefit over chemotherapy alone. Median survival is approximately 11-12 months with chemoradiation versus 9 months with chemotherapy.
3. Post-operative chemoradiation following pancreatic cancer resection reduces the risk of recurrence and improves long-term survival compared to surgery or chemotherapy alone. The 2-year survival rate is approximately 40-50% with adjuvant chemoradiation versus 20-30
Analysis of Radiation Cystitis and Radiation Proctitis Cases in Patients with...Premier Publishers
Carcinoma cervix is commonly seen in India and is mostly diagnosed at an advanced stage where radiation therapy forms the basis of its treatment. Radiation cystitis and proctitis are commonly seen in these patients and contribute to increased morbidity and mortality. The aim of our study was to analyze the factors associated with radiation cystitis and proctitis in treated patients of carcinoma cervix. A retrospective observational study. All treated patients of carcinoma cervix from 2012 to 2017 with radiation induced cystitis and proctitis attending GOPD were analyzed. Descriptive statistics applied using SPSS software (Version 16). Chi square test and Fischer t test applied for calculating significance values. 100 cases were analyzed in toto. 89% belonged to radiation proctitis group and 11% to radiation cystitis group. All patients received external beam radiotherapy either in the form of conventional (90%) or IMRT technique (10%). Prevalence of radiation proctitis and cystitis in conventional radiotherapy group was 10.4% and 1.31% respectively and in IMRT group was 6.29% and 0.69% respectively. The patients were followed up after treatment for a minimum of 6 months. 100% cystitis cases were cured. But, 15.7% of proctitis cases did not get relieved of their symptoms. Radiation proctitis was seen more in patients receiving conventional radiotherapy via LINAC accelerators as compared to IMRT technique. More patient load, lack of adequate packing methods may contribute to increased incidence of RT related complications. Further evaluation of these patients is required to suggest management protocols and also to avoid them.
Pancreatic Cancer Are We Moving Forward Yetfondas vakalis
This summary provides an overview of key findings from studies presented at the 2007 Gastrointestinal Cancers Symposium on treatments for pancreatic cancer:
1) A phase III trial found that adding bevacizumab to gemcitabine did not improve survival for advanced pancreatic cancer.
2) A phase II study showed promising results for cetuximab plus gemcitabine/oxaliplatin, with a high response rate and tolerable toxicity.
3) Population-based analyses found adjuvant radiotherapy after surgery and chemo-radiotherapy improved survival outcomes for pancreatic cancer.
Role of Oral Gefitinib In Recurrent Carcinoma Cervix in Relation to EGFR StatusPremier Publishers
Cervical cancer is among the most commonly diagnosed cancers in women worldwide. it may persist or recur months or years after completion of the primary treatment. Management of the residual /recurrent disease depends on mode of primary treatment and the extent of recurrence. The treatment options for these include chemotherapy, radiotherapy or surgery. The role of chemotherapy in cervical cancer recurrence is palliative only. This was a prospective study conducted in Dr.B.Borooah Cancer Institute, Guwahati, Assam, A grant in aid institute of Department of Atomic Energy, Govt.of India from October 2017 to March 2019. In our study we evaluated the clinical outcome of oral Gefitinib in recurrent carcinoma cervix cases. The main objective was to investigate the correlation of baseline EGFR expression with tumor response and disease control with Gefitinib. 30 patients with recurrent carcinoma cervix were treated with Gefitinib. Out of these 10 patients had progression of disease during the study period. Median PFS was 10 months. Overall progression free survival and median overall survival was 42.6% and 93.3% respectively at the end of study period of 18 months. Gefitinib is a good option as oral chemotherapy having a good PFS with minimal side effects for recurrent carcinoma of cervix in palliative setting.
This document discusses salvage radiotherapy for locally recurrent prostate cancer after primary radiation. It notes that while salvage brachytherapy is commonly used, studies have shown high rates of severe toxicity and disappointing cancer control. New diagnostic techniques like MRI and PET scans, along with improved biopsy methods, now allow localization of recurrent tumors, enabling focal salvage techniques. This is expected to reduce toxicity while maintaining cancer control. The document provides selection criteria for salvage treatment, noting it may benefit carefully selected patients with pathology-proven local recurrence at least 2-3 years after primary treatment and limited tumor presentation.
This document describes the development of a novel intratumoral drug delivery system using interstitial chemotherapy devices. The system aims to deliver chemotherapy drugs directly into solid tumors via implantable polymeric devices to achieve higher drug concentrations and more homogeneous distribution compared to systemic chemotherapy. The document outlines the design of biodegradable polymer implants loaded with cisplatin as a model drug. In vitro studies show sustained release of cisplatin from the implants over 1 month in a rate dependent on drug loading. The system has the potential for localized treatment with fewer systemic side effects.
The document discusses adjuvant chemotherapy for resected non-small cell lung cancer (NSCLC). It summarizes that the recognition of adjuvant chemotherapy improving survival after surgery for NSCLC was a major advancement. Specifically, administration of cisplatin-based doublet chemotherapy after complete resection of NSCLC stages I-IIIA has been associated with a 5-year survival increase. The most important meta-analysis, the LACE analysis, found that cisplatin-based doublet chemotherapy increased 5-year survival rates from 64%-67% for stage IB NSCLC, from 39%-49% for stage II, and from 26%-39% for stage III.
Malnutrition is common in cancer patients, affecting 40-80% during their disease course. It negatively impacts treatment outcomes, mortality, and quality of life. Early screening and nutritional interventions can help prevent weight loss and treatment interruptions. A multidisciplinary team approach is needed to address nutritional status from diagnosis onward through cancer treatment. Screening tools help identify at-risk patients who need comprehensive assessment and individualized nutritional support through diet, oral supplements, enteral feeding, or parenteral nutrition as needed. Exercise should also be encouraged to preserve muscle mass. Prioritizing nutritional care represents good clinical practice that can optimize cancer treatment.
1. Resection offers the only chance for cure of pancreatic cancer, but most patients are unresectable at diagnosis. For resectable patients, surgery without delay followed by adjuvant chemotherapy and radiation improves survival compared to surgery alone.
2. For unresectable locally advanced disease, chemoradiation provides a survival benefit over chemotherapy alone. Median survival is approximately 11-12 months with chemoradiation versus 9 months with chemotherapy.
3. Post-operative chemoradiation following pancreatic cancer resection reduces the risk of recurrence and improves long-term survival compared to surgery or chemotherapy alone. The 2-year survival rate is approximately 40-50% with adjuvant chemoradiation versus 20-30
Analysis of Radiation Cystitis and Radiation Proctitis Cases in Patients with...Premier Publishers
Carcinoma cervix is commonly seen in India and is mostly diagnosed at an advanced stage where radiation therapy forms the basis of its treatment. Radiation cystitis and proctitis are commonly seen in these patients and contribute to increased morbidity and mortality. The aim of our study was to analyze the factors associated with radiation cystitis and proctitis in treated patients of carcinoma cervix. A retrospective observational study. All treated patients of carcinoma cervix from 2012 to 2017 with radiation induced cystitis and proctitis attending GOPD were analyzed. Descriptive statistics applied using SPSS software (Version 16). Chi square test and Fischer t test applied for calculating significance values. 100 cases were analyzed in toto. 89% belonged to radiation proctitis group and 11% to radiation cystitis group. All patients received external beam radiotherapy either in the form of conventional (90%) or IMRT technique (10%). Prevalence of radiation proctitis and cystitis in conventional radiotherapy group was 10.4% and 1.31% respectively and in IMRT group was 6.29% and 0.69% respectively. The patients were followed up after treatment for a minimum of 6 months. 100% cystitis cases were cured. But, 15.7% of proctitis cases did not get relieved of their symptoms. Radiation proctitis was seen more in patients receiving conventional radiotherapy via LINAC accelerators as compared to IMRT technique. More patient load, lack of adequate packing methods may contribute to increased incidence of RT related complications. Further evaluation of these patients is required to suggest management protocols and also to avoid them.
Pancreatic Cancer Are We Moving Forward Yetfondas vakalis
This summary provides an overview of key findings from studies presented at the 2007 Gastrointestinal Cancers Symposium on treatments for pancreatic cancer:
1) A phase III trial found that adding bevacizumab to gemcitabine did not improve survival for advanced pancreatic cancer.
2) A phase II study showed promising results for cetuximab plus gemcitabine/oxaliplatin, with a high response rate and tolerable toxicity.
3) Population-based analyses found adjuvant radiotherapy after surgery and chemo-radiotherapy improved survival outcomes for pancreatic cancer.
Role of Oral Gefitinib In Recurrent Carcinoma Cervix in Relation to EGFR StatusPremier Publishers
Cervical cancer is among the most commonly diagnosed cancers in women worldwide. it may persist or recur months or years after completion of the primary treatment. Management of the residual /recurrent disease depends on mode of primary treatment and the extent of recurrence. The treatment options for these include chemotherapy, radiotherapy or surgery. The role of chemotherapy in cervical cancer recurrence is palliative only. This was a prospective study conducted in Dr.B.Borooah Cancer Institute, Guwahati, Assam, A grant in aid institute of Department of Atomic Energy, Govt.of India from October 2017 to March 2019. In our study we evaluated the clinical outcome of oral Gefitinib in recurrent carcinoma cervix cases. The main objective was to investigate the correlation of baseline EGFR expression with tumor response and disease control with Gefitinib. 30 patients with recurrent carcinoma cervix were treated with Gefitinib. Out of these 10 patients had progression of disease during the study period. Median PFS was 10 months. Overall progression free survival and median overall survival was 42.6% and 93.3% respectively at the end of study period of 18 months. Gefitinib is a good option as oral chemotherapy having a good PFS with minimal side effects for recurrent carcinoma of cervix in palliative setting.
This document discusses salvage radiotherapy for locally recurrent prostate cancer after primary radiation. It notes that while salvage brachytherapy is commonly used, studies have shown high rates of severe toxicity and disappointing cancer control. New diagnostic techniques like MRI and PET scans, along with improved biopsy methods, now allow localization of recurrent tumors, enabling focal salvage techniques. This is expected to reduce toxicity while maintaining cancer control. The document provides selection criteria for salvage treatment, noting it may benefit carefully selected patients with pathology-proven local recurrence at least 2-3 years after primary treatment and limited tumor presentation.
This document describes the development of a novel intratumoral drug delivery system using interstitial chemotherapy devices. The system aims to deliver chemotherapy drugs directly into solid tumors via implantable polymeric devices to achieve higher drug concentrations and more homogeneous distribution compared to systemic chemotherapy. The document outlines the design of biodegradable polymer implants loaded with cisplatin as a model drug. In vitro studies show sustained release of cisplatin from the implants over 1 month in a rate dependent on drug loading. The system has the potential for localized treatment with fewer systemic side effects.
The document discusses adjuvant chemotherapy for resected non-small cell lung cancer (NSCLC). It summarizes that the recognition of adjuvant chemotherapy improving survival after surgery for NSCLC was a major advancement. Specifically, administration of cisplatin-based doublet chemotherapy after complete resection of NSCLC stages I-IIIA has been associated with a 5-year survival increase. The most important meta-analysis, the LACE analysis, found that cisplatin-based doublet chemotherapy increased 5-year survival rates from 64%-67% for stage IB NSCLC, from 39%-49% for stage II, and from 26%-39% for stage III.
Results of Stereotactic Body Radiotherapy (SBRT) for Management of Hepatic Tu...Premier Publishers
PURPOSE: To evaluate early outcomes of hepatic tumors treated with robotic SBRT (cyberknife).
MATERIALS AND METHODS: Between March 2007 and December 2012; 59 patients: 48 Hepatic Metastases (HM), 8 Hepatocellular Carcinoma (HCC), 3 Cholangiocarcinoma (CC).
CTV margin for HCC and CC was 5 mm, PTV margin: 3 mm. no margin for HM.
Median dose: 47.61 Gy in 3 fractions prescribed to 80 % isodose line.
RESULTS: we report 1 grade 3 toxicity.
HCC; overall survival (OS): 41.7% at 1 year, local control (LC): 75% at 1 year.
At 1 and 2 years we report, respectively.
HM; OS: 83.6% and 57%, disease free survival (DFS): 69.5% and 46.1%, LC: 76.3% and 57.9%.
CC; OS: 100% and 50%, DFS and LC: 50% and 0%.
Factors influencing better OS; type of lesion, age < 65 years (p= 0.033), small PTV volume
(p= 0.002), for DFS; dose of 45 Gy (p= 0.001), dose per fraction of 15 Gy (p= 0.001), coverage > 95% for PTV (p= 0.001), For LC; type of lesion, dose to PTV (p= 0.037), coverage > 95% for PTV (p= 0.001).
CONCLUSION: Age, volume of tumor, dose, coverage of target volume are prognostic factors for survival and LC.
- Neoadjuvant therapy, or preoperative therapy, has several advantages over upfront surgery for pancreatic cancer. It guarantees all patients receive non-surgical therapy, helps select patients most suitable for effective surgery based on their response, and allows for early cytotoxic effects on micrometastatic disease.
- Some key benefits are that it ameliorates risks of postoperative complications limiting adjuvant therapy, downstages borderline resectable tumors in about a third of cases, and improves surgical margin clearance and time to local recurrence.
- Treatment decisions should be individualized based on a comprehensive analysis of a patient's tumor anatomy, biology and physiology at each phase to optimize outcomes. Neoadjuvant therapy is an
Author: Dr Christa Maria Joel
Module: Effects of lifestyle on health
Supervisor: Ms Jane Tobias and Dr Daniel Boakye
University of the West of Scotland
This document discusses hypofractionation in the treatment of head and neck cancers. It begins by outlining outcomes for different stages of disease, then discusses how fraction size, total dose, and treatment time impact treatment. Hypofractionation can counter tumor repopulation and improve local control. Studies show hypofractionation is effective for early disease, palliative cases, and can be safely delivered using simultaneous integrated boost with IMRT. Severe toxicity is low while disease control remains high. Extreme hypofractionation with SBRT also provides good local control with acceptable toxicity.
Adjuvant Treatment of Pancreatic Cancer - August 2018Amr Sakr
This document summarizes the history and results of several major clinical trials evaluating different adjuvant treatment strategies for pancreatic cancer after surgical resection. It finds that adjuvant chemotherapy provides a survival benefit compared to observation alone. Specifically, gemcitabine alone and gemcitabine plus capecitabine were found to improve overall and disease-free survival compared to older regimens or observation. Most recently, a modified FOLFIRINOX regimen was shown to provide the longest median and 3-year survival compared to gemcitabine alone, establishing it as the new standard first-line adjuvant treatment for resectable pancreatic cancer when tolerability allows.
1) The PORTEC-1 and PORTEC-2 trials compared pelvic radiotherapy to no additional treatment or vaginal brachytherapy for patients with endometrial carcinoma. PORTEC-1 found pelvic radiotherapy reduced vaginal recurrence while PORTEC-2 found vaginal brachytherapy achieved excellent vaginal control with fewer side effects compared to pelvic radiotherapy.
2) The PORTEC-3 trial randomized 686 patients with high risk endometrial cancer to chemoradiotherapy or radiotherapy alone. It found chemoradiotherapy improved failure-free survival compared to radiotherapy alone, especially for stage III patients, but with increased toxicity.
3)
Metronomic chemotherapy involves the chronic administration of chemotherapy drugs at low, minimally toxic doses on a frequent schedule with no prolonged breaks. This strategy aims to control cancer by targeting tumor vasculature and is an attractive option in resource-limited areas due to its low cost, oral administration, and minimal side effects compared to conventional chemotherapy. Combining metronomic chemotherapy with drug repositioning and targeted therapies may lead to improved cancer control through multi-pronged effects on cancer cells, vasculature, and the immune system. However, determining the optimal biological dose and identifying surrogate markers pose challenges to realizing the full potential of this approach.
The RAPIDO trial tested a new experimental treatment for locally advanced rectal cancer that involved short-course radiotherapy followed by chemotherapy before surgery, compared to the standard treatment of long-course chemoradiotherapy followed by surgery and then chemotherapy. The results showed that the experimental treatment led to a lower rate of disease-related treatment failures and distant metastases, along with a doubled rate of pathologic complete responses, without increasing toxicities or compromising survival rates. This provides evidence that the experimental approach may be a new standard of care for high-risk locally advanced rectal cancer.
This document discusses improving systemic chemotherapy for bladder cancer. It covers the following key points:
1) Neoadjuvant chemotherapy, particularly cisplatin-based regimens like gemcitabine and cisplatin, has become the standard of care for muscle-invasive bladder cancer based on improved survival outcomes shown in clinical trials.
2) Dose-dense regimens are being explored as a way to improve pathologic response rates without increasing toxicity.
3) While no definitive trials provide support, adjuvant chemotherapy after cystectomy may benefit select patients who did not receive neoadjuvant therapy.
The document discusses value assessment frameworks for cancer therapies developed by the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO). It describes ESMO's Magnitude of Clinical Benefit Scale (ESMO-MCBS), which provides a relative ranking of clinical benefit for new cancer drugs. Studies applying the ESMO-MCBS found that it supported treatment decisions and aligned with reimbursement decisions. While the ESMO-MCBS provides standardized benefit assessment, it only applies to comparative studies and cannot assess single-arm trials. Overall, the ESMO-MCBS provides an unbiased and standardized approach to quantify the clinical benefit of new cancer treatments.
The document discusses treatment options for locally advanced cervical cancer. It summarizes several meta-analyses and clinical trials that show concurrent chemoradiation (CCT-RT) is the standard of care, rather than neoadjuvant chemotherapy followed by surgery (NACT+Surgery). While some older trials showed a benefit of NACT+Surgery, most recent evidence suggests it does not provide benefits and adds unnecessary morbidity compared to CCT-RT. The takeaway message is that in clinical practice, only standard guidelines accepted by major organizations like NCCN and NCI should be followed, and experimental treatments belong only in clinical trials.
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
Treatment Of Stage Iii Nsclc The Role Of Radiation Therapyfondas vakalis
1. Chemo-radiotherapy is the standard of care for stage III non-small cell lung cancer (NSCLC) based on randomized clinical trial outcomes, though local control and toxicity remain issues.
2. Advances in radiation therapy techniques like 3D conformal radiation therapy and intensity modulated radiation therapy may help improve local control and reduce toxicity by better sparing healthy tissues.
3. Patient-specific factors like tumor volume, nodal disease extent, co-morbidities, and dosimetry parameters should be considered to select optimal combined modality treatments and minimize risks.
Clinical Experiences of CK/HT in Hepatocellular Carcinomaaccurayexchange
Chul-Seung Kay1,3 , Seok-Hyun Son1, Myung-Soo Kim1, Jung-Hyun Kwon2
Department of Radiation Oncology1 & 2Internal Medicine2
3Catholic Comprehensive Hospital for Advanced Cancer3
Incheon St. Mary Hospital
The Catholic University of Korea
34320294 jak inhibitors more than just glucocorticoids (1)EVELIN LÁZARO
This editorial discusses recent trials investigating immunomodulatory therapies for COVID-19. It finds that treatment with glucocorticoids (dexamethasone) and JAK inhibitors reduces mortality in hospitalized patients receiving supplemental oxygen or ventilation. Combining JAK inhibitors with glucocorticoids may widen the window of benefit compared to either treatment alone. The editorial concludes that anti-inflammatory therapies reduce mortality in COVID-19 patients with moderate to severe disease, and that JAK inhibitors are a particularly promising option due to their oral administration, safety profile, and potential for combination with glucocorticoids.
How the role of radiotherapy has evaluated in pancreatic cancer. Now it has become indispensable for treatment in pancreatic cancer. Radiotherapy can be used in the form of EBRT/SBRT/IORT.
Breast surgery for Metastatic Breast Cancer : Cochrane Analysis Kundan Singh
The document discusses two studies that evaluated the effects of breast surgery plus systemic therapy versus systemic therapy alone for 624 women with metastatic breast cancer. The average age was 49 years. The studies found no evidence of a difference in overall survival between the two treatment groups. Subgroup analysis found no difference in overall survival based on HER2 or estrogen receptor status, or for those with only bone metastases. Breast surgery plus systemic treatment may improve local progression-free survival but result in shorter distant progression-free survival compared to systemic treatment alone. The document calls for prospective trials and guidelines on the expanding role of surgery for stage IV breast cancer.
This document discusses the health benefits of Ganoderma and DXN products. It states that 70% of health problems are caused by diet and an acidic body. It explains common diseases like cancer, diabetes and heart disease are on the rise due to lifestyle factors. The functions of DXN products are described as balancing pH, improving blood circulation, enhancing immunity, increasing oxygen levels and reducing stress. The document recommends DXN GL, RG, Cordyceps and other products can be taken by people of all ages to boost health and prevent disease. It encourages sharing DXN's health benefits with others.
Cytotoxicity of Blended Versus Single Medicinal Mushroom Extracts on Human Ca...Jolene1981
ABSTRACT: The use of mushrooms contributes to human nutrition by providing low lipid content of lipids and high dietary fiber content, as well as significant content of other biologically active compounds such as polysaccharides, minerals, vitamins, and polyphenolic antioxidants. This study aimed to determine the content of polyphenols and polysaccharides, as well as the cytotoxic and antioxidative properties of several medicinal mushroom preparations. The content of total phenols and flavonoids of preparations of blended mushroom extracts (Lentifom, Super Polyporin, Agarikon, Agarikon Plus, Agarikon.1, and Mykoprotect.1) was evaluated quantitatively by using ultraviolet–visible spectroscopy spectrophotometric methods. The antioxidant capacity of the preparations was evaluated using the ABTS (2,2′-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) and ferric reducing/antioxidant power assays. The content of water-soluble polysaccharides was determined using a specific gravimetric method, based on ethanol precipitation. To determine cytotoxic effects of single and blended mushroom extracts, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and neutral red assays were conducted using human small cell lung cancer, lung adenocarcinoma, colon cancer, and brain astrocytoma cancer cells. The obtained results suggest that due to the significant content of beneficial polyphenolic antioxidants and soluble polysaccharides, use of these mushroom preparations is beneficial in maintaining good health, as well as in the prevention and adjuvant biotherapy of various human pathological aberrations. These results reveal that these extracts exhibit different cytotoxic effects on tumor cells originating from different tissues. In addition, the comparison of investigated blended mushroom extracts with three well-known commercial mushroom products derived from single mushroom species or single mushroom compounds shows that blended mushroom extracts exhibit significantly stronger cytotoxic effects on human tumor cell lines.
Ganoderm lucidum reduces obesity in mice by modulating the composition of gut...Nafisa Nawal Islam
I presented a slightly modified version of this paper published on 23 June, 2015 in the journal 'Nature Communications' in the final of my seminar presentation course of Masters (GEB-507).
Results of Stereotactic Body Radiotherapy (SBRT) for Management of Hepatic Tu...Premier Publishers
PURPOSE: To evaluate early outcomes of hepatic tumors treated with robotic SBRT (cyberknife).
MATERIALS AND METHODS: Between March 2007 and December 2012; 59 patients: 48 Hepatic Metastases (HM), 8 Hepatocellular Carcinoma (HCC), 3 Cholangiocarcinoma (CC).
CTV margin for HCC and CC was 5 mm, PTV margin: 3 mm. no margin for HM.
Median dose: 47.61 Gy in 3 fractions prescribed to 80 % isodose line.
RESULTS: we report 1 grade 3 toxicity.
HCC; overall survival (OS): 41.7% at 1 year, local control (LC): 75% at 1 year.
At 1 and 2 years we report, respectively.
HM; OS: 83.6% and 57%, disease free survival (DFS): 69.5% and 46.1%, LC: 76.3% and 57.9%.
CC; OS: 100% and 50%, DFS and LC: 50% and 0%.
Factors influencing better OS; type of lesion, age < 65 years (p= 0.033), small PTV volume
(p= 0.002), for DFS; dose of 45 Gy (p= 0.001), dose per fraction of 15 Gy (p= 0.001), coverage > 95% for PTV (p= 0.001), For LC; type of lesion, dose to PTV (p= 0.037), coverage > 95% for PTV (p= 0.001).
CONCLUSION: Age, volume of tumor, dose, coverage of target volume are prognostic factors for survival and LC.
- Neoadjuvant therapy, or preoperative therapy, has several advantages over upfront surgery for pancreatic cancer. It guarantees all patients receive non-surgical therapy, helps select patients most suitable for effective surgery based on their response, and allows for early cytotoxic effects on micrometastatic disease.
- Some key benefits are that it ameliorates risks of postoperative complications limiting adjuvant therapy, downstages borderline resectable tumors in about a third of cases, and improves surgical margin clearance and time to local recurrence.
- Treatment decisions should be individualized based on a comprehensive analysis of a patient's tumor anatomy, biology and physiology at each phase to optimize outcomes. Neoadjuvant therapy is an
Author: Dr Christa Maria Joel
Module: Effects of lifestyle on health
Supervisor: Ms Jane Tobias and Dr Daniel Boakye
University of the West of Scotland
This document discusses hypofractionation in the treatment of head and neck cancers. It begins by outlining outcomes for different stages of disease, then discusses how fraction size, total dose, and treatment time impact treatment. Hypofractionation can counter tumor repopulation and improve local control. Studies show hypofractionation is effective for early disease, palliative cases, and can be safely delivered using simultaneous integrated boost with IMRT. Severe toxicity is low while disease control remains high. Extreme hypofractionation with SBRT also provides good local control with acceptable toxicity.
Adjuvant Treatment of Pancreatic Cancer - August 2018Amr Sakr
This document summarizes the history and results of several major clinical trials evaluating different adjuvant treatment strategies for pancreatic cancer after surgical resection. It finds that adjuvant chemotherapy provides a survival benefit compared to observation alone. Specifically, gemcitabine alone and gemcitabine plus capecitabine were found to improve overall and disease-free survival compared to older regimens or observation. Most recently, a modified FOLFIRINOX regimen was shown to provide the longest median and 3-year survival compared to gemcitabine alone, establishing it as the new standard first-line adjuvant treatment for resectable pancreatic cancer when tolerability allows.
1) The PORTEC-1 and PORTEC-2 trials compared pelvic radiotherapy to no additional treatment or vaginal brachytherapy for patients with endometrial carcinoma. PORTEC-1 found pelvic radiotherapy reduced vaginal recurrence while PORTEC-2 found vaginal brachytherapy achieved excellent vaginal control with fewer side effects compared to pelvic radiotherapy.
2) The PORTEC-3 trial randomized 686 patients with high risk endometrial cancer to chemoradiotherapy or radiotherapy alone. It found chemoradiotherapy improved failure-free survival compared to radiotherapy alone, especially for stage III patients, but with increased toxicity.
3)
Metronomic chemotherapy involves the chronic administration of chemotherapy drugs at low, minimally toxic doses on a frequent schedule with no prolonged breaks. This strategy aims to control cancer by targeting tumor vasculature and is an attractive option in resource-limited areas due to its low cost, oral administration, and minimal side effects compared to conventional chemotherapy. Combining metronomic chemotherapy with drug repositioning and targeted therapies may lead to improved cancer control through multi-pronged effects on cancer cells, vasculature, and the immune system. However, determining the optimal biological dose and identifying surrogate markers pose challenges to realizing the full potential of this approach.
The RAPIDO trial tested a new experimental treatment for locally advanced rectal cancer that involved short-course radiotherapy followed by chemotherapy before surgery, compared to the standard treatment of long-course chemoradiotherapy followed by surgery and then chemotherapy. The results showed that the experimental treatment led to a lower rate of disease-related treatment failures and distant metastases, along with a doubled rate of pathologic complete responses, without increasing toxicities or compromising survival rates. This provides evidence that the experimental approach may be a new standard of care for high-risk locally advanced rectal cancer.
This document discusses improving systemic chemotherapy for bladder cancer. It covers the following key points:
1) Neoadjuvant chemotherapy, particularly cisplatin-based regimens like gemcitabine and cisplatin, has become the standard of care for muscle-invasive bladder cancer based on improved survival outcomes shown in clinical trials.
2) Dose-dense regimens are being explored as a way to improve pathologic response rates without increasing toxicity.
3) While no definitive trials provide support, adjuvant chemotherapy after cystectomy may benefit select patients who did not receive neoadjuvant therapy.
The document discusses value assessment frameworks for cancer therapies developed by the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO). It describes ESMO's Magnitude of Clinical Benefit Scale (ESMO-MCBS), which provides a relative ranking of clinical benefit for new cancer drugs. Studies applying the ESMO-MCBS found that it supported treatment decisions and aligned with reimbursement decisions. While the ESMO-MCBS provides standardized benefit assessment, it only applies to comparative studies and cannot assess single-arm trials. Overall, the ESMO-MCBS provides an unbiased and standardized approach to quantify the clinical benefit of new cancer treatments.
The document discusses treatment options for locally advanced cervical cancer. It summarizes several meta-analyses and clinical trials that show concurrent chemoradiation (CCT-RT) is the standard of care, rather than neoadjuvant chemotherapy followed by surgery (NACT+Surgery). While some older trials showed a benefit of NACT+Surgery, most recent evidence suggests it does not provide benefits and adds unnecessary morbidity compared to CCT-RT. The takeaway message is that in clinical practice, only standard guidelines accepted by major organizations like NCCN and NCI should be followed, and experimental treatments belong only in clinical trials.
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
Treatment Of Stage Iii Nsclc The Role Of Radiation Therapyfondas vakalis
1. Chemo-radiotherapy is the standard of care for stage III non-small cell lung cancer (NSCLC) based on randomized clinical trial outcomes, though local control and toxicity remain issues.
2. Advances in radiation therapy techniques like 3D conformal radiation therapy and intensity modulated radiation therapy may help improve local control and reduce toxicity by better sparing healthy tissues.
3. Patient-specific factors like tumor volume, nodal disease extent, co-morbidities, and dosimetry parameters should be considered to select optimal combined modality treatments and minimize risks.
Clinical Experiences of CK/HT in Hepatocellular Carcinomaaccurayexchange
Chul-Seung Kay1,3 , Seok-Hyun Son1, Myung-Soo Kim1, Jung-Hyun Kwon2
Department of Radiation Oncology1 & 2Internal Medicine2
3Catholic Comprehensive Hospital for Advanced Cancer3
Incheon St. Mary Hospital
The Catholic University of Korea
34320294 jak inhibitors more than just glucocorticoids (1)EVELIN LÁZARO
This editorial discusses recent trials investigating immunomodulatory therapies for COVID-19. It finds that treatment with glucocorticoids (dexamethasone) and JAK inhibitors reduces mortality in hospitalized patients receiving supplemental oxygen or ventilation. Combining JAK inhibitors with glucocorticoids may widen the window of benefit compared to either treatment alone. The editorial concludes that anti-inflammatory therapies reduce mortality in COVID-19 patients with moderate to severe disease, and that JAK inhibitors are a particularly promising option due to their oral administration, safety profile, and potential for combination with glucocorticoids.
How the role of radiotherapy has evaluated in pancreatic cancer. Now it has become indispensable for treatment in pancreatic cancer. Radiotherapy can be used in the form of EBRT/SBRT/IORT.
Breast surgery for Metastatic Breast Cancer : Cochrane Analysis Kundan Singh
The document discusses two studies that evaluated the effects of breast surgery plus systemic therapy versus systemic therapy alone for 624 women with metastatic breast cancer. The average age was 49 years. The studies found no evidence of a difference in overall survival between the two treatment groups. Subgroup analysis found no difference in overall survival based on HER2 or estrogen receptor status, or for those with only bone metastases. Breast surgery plus systemic treatment may improve local progression-free survival but result in shorter distant progression-free survival compared to systemic treatment alone. The document calls for prospective trials and guidelines on the expanding role of surgery for stage IV breast cancer.
This document discusses the health benefits of Ganoderma and DXN products. It states that 70% of health problems are caused by diet and an acidic body. It explains common diseases like cancer, diabetes and heart disease are on the rise due to lifestyle factors. The functions of DXN products are described as balancing pH, improving blood circulation, enhancing immunity, increasing oxygen levels and reducing stress. The document recommends DXN GL, RG, Cordyceps and other products can be taken by people of all ages to boost health and prevent disease. It encourages sharing DXN's health benefits with others.
Cytotoxicity of Blended Versus Single Medicinal Mushroom Extracts on Human Ca...Jolene1981
ABSTRACT: The use of mushrooms contributes to human nutrition by providing low lipid content of lipids and high dietary fiber content, as well as significant content of other biologically active compounds such as polysaccharides, minerals, vitamins, and polyphenolic antioxidants. This study aimed to determine the content of polyphenols and polysaccharides, as well as the cytotoxic and antioxidative properties of several medicinal mushroom preparations. The content of total phenols and flavonoids of preparations of blended mushroom extracts (Lentifom, Super Polyporin, Agarikon, Agarikon Plus, Agarikon.1, and Mykoprotect.1) was evaluated quantitatively by using ultraviolet–visible spectroscopy spectrophotometric methods. The antioxidant capacity of the preparations was evaluated using the ABTS (2,2′-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) and ferric reducing/antioxidant power assays. The content of water-soluble polysaccharides was determined using a specific gravimetric method, based on ethanol precipitation. To determine cytotoxic effects of single and blended mushroom extracts, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and neutral red assays were conducted using human small cell lung cancer, lung adenocarcinoma, colon cancer, and brain astrocytoma cancer cells. The obtained results suggest that due to the significant content of beneficial polyphenolic antioxidants and soluble polysaccharides, use of these mushroom preparations is beneficial in maintaining good health, as well as in the prevention and adjuvant biotherapy of various human pathological aberrations. These results reveal that these extracts exhibit different cytotoxic effects on tumor cells originating from different tissues. In addition, the comparison of investigated blended mushroom extracts with three well-known commercial mushroom products derived from single mushroom species or single mushroom compounds shows that blended mushroom extracts exhibit significantly stronger cytotoxic effects on human tumor cell lines.
Ganoderm lucidum reduces obesity in mice by modulating the composition of gut...Nafisa Nawal Islam
I presented a slightly modified version of this paper published on 23 June, 2015 in the journal 'Nature Communications' in the final of my seminar presentation course of Masters (GEB-507).
Acadamic council prc work plan for 2012 to 2014drckknair
This document discusses research projects involving the collection, identification, cultivation, and extraction of medicinal mushrooms and plants. Key areas of focus include isolating compounds from extracts and screening them for various bioactivities like anti-inflammatory and anti-cancer properties. Nanoparticle synthesis and applications, as well as the effects of thorium exposure are also mentioned.
This document discusses different types of weight loss including losing weight, maintaining weight, and gaining muscle weight. It mentions that effective weight loss requires a strategy that acknowledges an individual's needs and abilities. It also notes that proper diet and exercise are important to achieve different fitness goals such as losing fat, gaining muscle, or maintaining a certain appearance.
Treating Human Cancers with Medicinal Mushroom Preparations (Croatian Experie...Neven Jakopovic
This scientific presentation details the results of a 3 year human cohort study of 51 cases of colorectal adenocarcinoma and 105 cases of breast cancer, where medicinal mushroom extracts from Myko San company have been used in conjunction with the usual oncological therapy.
The regimen showed clear, dose-dependent benefits to including appropriate medicinal mushroom extracts for improved cancer status, survival and reduction of therapy side effects.
This work was presented by Dr. Ivan Jakopovic at the 4th International Medicinal Mushroom Conference in Ljubljana, Slovenia, in 2007.
Ganotherapy: Prevention and cure with Lingzhi medicinal mushroomGergely Takács
This precise, detailed valuable book is written by world's greatest Ganoderma Lucidum expert, Dato' dr. Lim Siow Jin Ph.D. after many years of dedicated research for the beneficial effect of medicinal mushrooms on human and animal health.
Symptoms of disease, suggestions for prevention and cure and professional description of DXN Reishi: RG, GL can be studied from this essential masterpiece.
Order DXN Ganoderma products here:http://dxnproducts.com/product-category/food-supplements/
Aloe Vera è una pianta efficace e versatile per la nostra vitalità, salute, bellezza e benessere. Si può usare per uso interno come integratore alimentare completo, e per uso esterno: per la pelle, capelli e vari usi per la nostra bellezza e benessere. Scopri cosa può fare questa pianta per te
Shiitake mushrooms strengthen the immune system through compounds like lentinan and help fight diseases and reduce cholesterol. Reishi mushrooms have strong healing powers in Chinese medicine due to unique compounds similar to steroid hormones. Maitake mushrooms boost immunity, support heart health, and lower blood sugar levels to prevent diabetes.
This document summarizes information about Ganoderma lucidum, commonly known as lingzhi or reishi mushroom. It has a long history of use in Chinese medicine to promote health and longevity. The document discusses the mushroom's appearance and names in different cultures. It also summarizes some of the major bioactive components that have been studied, including polysaccharides, peptidoglycans, and triterpenes, and how they have been associated with various health benefits. The taxonomy and identification of G. lucidum species is complex due to high phenotypic plasticity.
Mushroom pharmaceuticals and nutraceuticals A Presentation By Mr Allah Dad Kh...Mr.Allah Dad Khan
Mushrooms provide many nutrients and have potential health benefits. They are low in calories and fat but high in protein, vitamins such as riboflavin and niacin, and minerals like selenium. Mushrooms also contain antioxidants and beta-glucans that may help reduce inflammation. Certain mushrooms like Reishi have been used in nutraceuticals to lower blood pressure and blood sugar levels and as an immune booster. Some mushroom compounds show anti-cancer properties and are being studied as potential pharmaceuticals for treating diseases.
Mushroom cultivation A Presentation By Mr Allah Dad Khan Former Director Gene...Mr.Allah Dad Khan
Mushroom cultivation A Presentation By Mr Allah Dad Khan Former Director General Agriculture Extension KPK Province and Visiting Professor the University of Agriculture Peshawar Pakistan
Ganoderma Lucidum (Red Reishi or Lingzhi mushroom) has been used in traditional Asian medicine for over 2000 years due to its powerful medicinal properties. It contains over 400 nutrients and compounds that provide benefits such as cardiovascular, immune system, blood sugar and liver support. Regular consumption can help restore pH balance and reduce toxins in the body, potentially reversing chronic diseases. Magnesium, not calcium, is the most deficient mineral in the American diet, with 95% of people lacking enough. Magnesium supports over 300 biochemical reactions and is essential for energy production, muscle and nerve function, blood pressure regulation and more. Poor farming methods have reduced mineral content in produce over the last century.
Medicinal musrhooms A Lecture by Mr. Allah Dad Khan Visiting Professor the ...Mr.Allah Dad Khan
Ganoderma lucidum and cordyceps are medicinal mushrooms used in traditional Chinese medicine to boost immunity and health. Maitake, shiitake, and oyster mushrooms may help lower cholesterol and blood pressure, and strengthen the immune system. Research also indicates these mushrooms may help prevent or treat cancer, diabetes, hypertension, and common illnesses. Other medicinal mushrooms discussed include Agaricus, Phellinus, Tremella, Hericium, and Flammulina species which are used for benefits such as preventing blindness, treating tumors, anti-aging effects, and brain health.
Importance of mushroom cultivation A Presentation By Mr Allah Dad khan Form...Mr.Allah Dad Khan
Importance of mushroom cultivation A Presentation By Mr Allah Dad khan Former Director General Agriculture Extension KPK Province and Visiting Professor the University of Agriculture Peshawar Pakistan
Mushrooms- All you need to know about mushroom by Mervin @ www.mokumoku.myMokuMokuDIYMushroomBox
How much you know about mushroom?
What is fascinating about mushroom is that they are neither animal nor plants. They are the members of a larger kingdom called fungi.
Let's explore more about mushroom by going through the slides. Enjoy! =)
a slideshow on what makes an effective teacher. particularly useful to college/school teachers. helps teachers do some quick swot and helps them equip themselves with useful skills.
The document provides tips for designing effective PowerPoint presentations with engaging content and positive delivery. It recommends using simple, visually appealing designs with limited text on slides. Content should be interactive, incorporating media like videos and diagrams to explain complex topics. Presenters should interact with the audience through games and questions to maintain engagement.
Gemcitabine and Cisplatin In Metastatic Carcinoma Gallbladder. A Single Insti...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document provides an overview of epithelial ovarian cancer including epidemiology, risk factors, pathology, clinical presentation, diagnosis, staging, treatment options, and outcomes. It discusses that ovarian cancer is the second most common gynecologic malignancy in Western countries. Seventy percent of patients present with advanced stage disease. Treatment depends on stage but typically involves surgery and platinum-based chemotherapy. Outcomes have improved over time but remain poor for advanced and recurrent disease.
Chemotherapy in ca urinary bladder dr prasanta dashPrasanta Dash
This document discusses chemotherapy options for metastatic bladder cancer. It notes that the prognosis remains poor with a median survival of 14 months. It reviews response rates of single agents like cisplatin, methotrexate, and doxorubicin. It then discusses combination regimens like MVAC (methotrexate, vinblastine, doxorubicin, and cisplatin), noting response rates of around 50% and median survival of approximately 12 months based on several studies. Larger phase 3 trials found MVAC improved median survival compared to cisplatin or cisplatin/cyclophosphamide regimens.
This document discusses radiotherapy techniques for early breast cancer, including:
1) Modern techniques like IMRT and 4D radiotherapy allow for better treatment planning and delivery while avoiding nearby organs.
2) Several randomized clinical trials found that a shorter, hypofractionated course of radiotherapy was not inferior to standard radiotherapy in terms of local recurrence or toxicity.
3) Partial breast irradiation techniques are being studied as a way to further reduce treatment volumes and time for selected low-risk patients.
The document summarizes current standards and next steps in treating gastric cancer. It discusses how adjuvant chemotherapy and neoadjuvant/perioperative chemotherapy have been shown to improve survival rates compared to surgery alone, increasing 5-year survival by 5-10% and 18% risk reduction respectively. However, tolerance of adjuvant treatments is often poor with high rates of delays, reductions and early termination. Neoadjuvant chemotherapy is better tolerated and may improve R0 resection rates and survival, as supported by several randomized clinical trials.
The document summarizes current standards and next steps in treating gastric cancer. It discusses trends showing falling incidence of distal gastric cancer but rising incidence of proximal gastric cancer. It reviews primary staging procedures and treatments for gastric cancer including surgery, adjuvant treatments, and treatments for advanced cases. It provides evidence that adjuvant chemotherapy and perioperative chemotherapy can increase overall survival rates compared to surgery alone.
This document describes a study protocol for a randomized phase III clinical trial comparing neoadjuvant chemoradiation followed by surgery versus surgery alone in patients with adenocarcinoma or squamous cell carcinoma of the esophagus. The trial aims to enroll 350 patients total with 175 patients in each arm. The primary objective is to compare median survival rates and quality of life between the two treatment groups. Secondary objectives include comparing pathological responses, progression-free survival, number of complete resections, treatment toxicity, and costs. The chemoradiation regimen involves weekly paclitaxel and carboplatin chemotherapy with concurrent radiation over 5 weeks. Patients will then undergo surgery and be followed up for survival and quality of life outcomes
Hypofractionated Radiotherapy in Breast Cancer.pptxAsha Arjunan
1) The document outlines studies evaluating hypofractionated whole breast radiotherapy (HF-WBI) for breast cancer treatment. The Ontario Clinical Oncology Group trial found local recurrence rates and overall survival were similar between HF-WBI (42.5 Gy in 16 fractions) and standard WBI (50 Gy in 25 fractions), with lower late toxic effects for HF-WBI.
2) The UK START trials also found similar local recurrence rates between HF-WBI schedules (39-41.6 Gy) and standard WBI (50 Gy), with lower normal tissue effects for HF-WBI. The UK FAST trial found mild/marked breast changes were higher for 30 Gy compared to 50 Gy but not for
The document discusses using intensity-modulated radiation therapy (IMRT) for the treatment of anal cancer. Dosimetric studies and small clinical trials show that IMRT reduces radiation dosing and toxicity to normal tissues compared to conventional radiation therapy, without decreasing treatment effectiveness or local cancer control. Larger clinical trials are still needed to further evaluate IMRT for anal cancer and detect possible small variations in outcomes. The Radiation Therapy Oncology Group is currently conducting a phase II trial to further evaluate dose-painted IMRT for anal cancer.
Tratamento neoadyuvante y adyuvante en cáncer de colonMauricio Lema
Neoadjuvant and adjuvant chemotherapy for colon cancer: clinical trials and possible indications
The document discusses several clinical trials evaluating neoadjuvant and adjuvant chemotherapy for colon cancer. For neoadjuvant chemotherapy, studies show it is feasible and can increase resection rates for locally advanced colon cancers. Studies also evaluate outcomes of neoadjuvant chemotherapy followed by surgery compared to surgery alone. For adjuvant chemotherapy in stage III colon cancer, large trials demonstrated improved disease-free and overall survival when adding oxaliplatin (FOLFOX) to fluorouracil compared to fluorouracil alone. Later trials evaluated capecitabine-based regimens and durations of adjuvant therapy. For stage II colon cancer, adjuvant chemotherapy
This document summarizes key information about ovarian cancer, including epidemiology, staging, treatment milestones, prognostic factors, and recent clinical trials. It notes that the median age of diagnosis is 63 years and discusses improvements in 5-year survival over time. New developments discussed include the role of surgery, chemotherapy regimens, targeted therapies like bevacizumab, and trials in recurrent settings.
While T4 stage, fewer than 12 lymph nodes, and absence of MMR-D are factors considered in deciding adjuvant chemotherapy for Stage II CRC, they are not definitive standards. Currently, there are no established molecular markers that clearly identify patients with high or low risk of recurrence or benefit from chemotherapy for Stage II colon cancer. Researchers are working to develop improved algorithms incorporating clinical, pathological, and emerging molecular markers to better guide treatment decisions.
1. The document discusses the standard treatment for locally advanced cervical cancer, which is concurrent chemoradiotherapy with cisplatin. Several randomized trials from the 1990s showed improved survival with this approach compared to radiotherapy alone.
2. Meta-analyses of these trials demonstrated a 6-8% absolute improvement in survival at 5 years with the addition of chemotherapy to radiotherapy. Cisplatin is the recognized cytotoxic drug used most commonly.
3. The study described in the document investigated the use of ifosfamide and cisplatin with concurrent chemoradiotherapy and consolidation chemotherapy as a potentially improved treatment approach for locally advanced cervical cancer.
Original StudyType of Breast Cancer Diagnosis, Screening,a.docxvannagoforth
Original Study
Type of Breast Cancer Diagnosis, Screening,
and Survival
Carla Cedolini,1 Serena Bertozzi,1 Ambrogio P. Londero,2 Sergio Bernardi,3,4
Luca Seriau,1 Serena Concina,1 Federico Cattin,1 Andrea Risaliti1
Abstract
Organized, invitational breast cancer screening in our population succeeded in detecting early-stage tumors,
which have been consequently treated more frequently with breast and axillary conservative surgery, com-
plementary breast irradiation, and eventual hormonal therapy. The diagnosis of invasive cancer with screening
in our population resulted in a survival gain at 5 years from the diagnosis.
Introduction: Breast cancer screening is known to reduce mortality. In the present study, we analyzed the prevalence
of breast cancers detected through screening, before and after introduction of an organized screening, and we
evaluated the overall survival of these patients in comparison with women with an extrascreening imaging-detected
breast cancer or those with palpable breast cancers. Materials and Methods: We collected data about all women
who underwent a breast operation for cancer in our department between 2001 and 2008, focusing on type of tumor
diagnosis, tumor characteristics, therapies administered, and patient outcome in terms of overall survival, and re-
currences. Data was analyzed by R (version 2.15.2), and P < .05 was considered significant. Results: Among the 2070
cases of invasive breast cancer we considered, 157 were detected by regional mammographic screening (group A),
843 by extrascreening breast imaging (group B: 507 by mammography and 336 by ultrasound), and 1070 by extra-
screening breast objective examination (group C). The 5-year overall survival in groups A, B, and C were, respectively,
99% (95% CI, 98%-100%), 98% (95% CI, 97%-99%), and 91% (95% CI, 90%-93%), with a significant difference
between the first 2 groups and the third (P < .05) and a trend between groups A and B (P ¼ .081). Conclusion: The
diagnosis of invasive breast cancer with screening in our population resulted in a survival gain at 5 years from the
diagnosis, but a longer follow-up is necessary to confirm this data.
Clinical Breast Cancer, Vol. 14, No. 4, 235-40 ª 2014 Elsevier Inc. All rights reserved.
Keywords: Breast cancer, Breast cancer screening, Invasive breast cancer, Mammographic screening, Overall survival
Introduction
Because of the detection of early-stage tumors, breast cancer
screening reduced breast cancer mortality in Europe by 25%-31%
in patients who were invited for screening and by 38%-48% in
those who were actually screened during the last decade of the
twentieth century and the first decade of the twenty-first.1 In our
region of Italy, an organized breast cancer screening was firstly intro-
duced in 2005, but despite the high compliance of invited women
1Clinic of Surgery
2Clinic of Obstetrics and Gynecology
University of Udine, Udine, Italy
3Department of Surgery, Ospedale Civile di Latisana, Udine, Italy
4 ...
This document discusses stereotactic body radiation therapy (SBRT) for head and neck cancers. It provides an overview of SBRT indications, efficacy, toxicity profiles, quality of life outcomes, fractionation schedules, target definition, constraints, and the role of cetuximab. Several studies on SBRT for recurrent head and neck cancers, primary cancers metastatic to the head and neck region, and target volume delineation are summarized. Toxicities are generally low but carotid blowout syndrome remains a concern, especially for tumors adjacent to carotid arteries.
This document summarizes treatment options for ovarian cancer after diagnosis. It discusses that most cases are advanced at presentation and surgery is used to stage and debulk the cancer. Chemotherapy with a taxane and platinum agent is recommended for early and advanced stage disease. For advanced cancer, intraperitoneal chemotherapy may provide a survival benefit compared to intravenous treatment alone. Recurrent cancer can be treated with additional chemotherapy or surgery depending on factors like time since last treatment and extent of recurrence. Future research aims to improve treatment tolerability and identify new targeted therapies.
D2 gastrectomy with a minimal lymph node dissection of 15 nodes provides curative treatment for gastric adenocarcinoma. Laparoscopic gastrectomy can provide equivalent resection and lymphadenectomy to open surgery, with comparable long-term oncologic outcomes and no increase in recurrence. While laparoscopic techniques continue to be refined, D2 gastrectomy remains the standard treatment with minimally invasive approaches serving as a safe alternative to open surgery. More aggressive multimodal approaches may benefit select patients.
The document discusses evidence from randomized controlled trials on the use of postmastectomy radiotherapy (PMRT) for breast cancer patients. The key trials found that PMRT reduces locoregional recurrence rates from 30% to 10% and breast cancer mortality by 5% at 15 years. PMRT improved disease-free and overall survival rates particularly in patients with 4 or more positive lymph nodes. Modern radiotherapy techniques can help reduce risks of complications from PMRT.
Similar to Long Term Effects of Using Medicinal Mushroom Preparations in Human Colorectal and Breast Cancer (20)
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
2. Introduction Colorectal Cancer Breast Cancer Conclusions
1
Index
I. Introduction
Purpose
Methodology
Therapeutic use
II. Colorectal cancer analysis
III. Breast cancer analysis
IV. Conclusions
3. Introduction Colorectal Cancer Breast Cancer Conclusions
P
2
Purpose
A longer time span analysis of a 2007 work ““Effects of Using
Medicinal Mushroom Preparations in Human Colorectal and
Breast Cancer”
2008 Cancer Incidence and Deaths1
Colorectal (3rd most common): 1.235.108 (609.051)
Breast (2nd most common): 1.384.155 (458.503)
Effects of chemotherapy in these cancers: useless or
improves survival only slightly (4% in colorectal, just
1.5% in breast cancer)2,3
Use of medicinal mushroom preparations against cancer,
is scientifically justified, but mostly unknown in the West
1 Globocan 2008 (globocan.iarc.fr)
2 http://www.coloncancerresource.com/colon−cancer−survival−statistics.html
3 Morgan G, Ward R, Barton M (December 2004). "The contribution of cytotoxic chemotherapy
to 5−year survival in adult malignancies".Clin Oncol (R Coll Radiol) 16 (8): 549–
60. PMID 15630849
4. Introduction Colorectal Cancer Breast Cancer Conclusions
M th d l
3
Methodology
demonstrational study looking at effects of using
medicinal mushroom extracts (MT) in adjuvant and as
primary therapy
Consecutive sample − general population of patients
− starting treatment from January 2005 to January 2006
− follow−up until end of December 2010
Data sources: official medical records, cancer registers
Sample models statistical properties of the general
patient population well
Official therapy procedure (ST) done independently of
mycotherapy (MT)
5. Introduction Colorectal Cancer Breast Cancer Conclusions
Th ti f
4
Therapeutic use of
medicinal mushrooms
Mycotherapy used: liquid form extracts from a blend of
medicinal mushrooms (Lentifom – 3 species, Agarikon –
8 species, Agarikon Plus – 10 species) manufactured by
Dr Myko San –– Health from Mushrooms
Lentifom is taken in quantities correlated with body
weight
Mushroom polysaccharides taken daily amount to
approx. 0.1g/kg bodyweight/day
Forte dosages used at the start of MT
(1 Forte dosage lasts 10 days)
All participants in both samples took at least 4 Forte
dosage (40 days)
6. Introduction Colorectal Cancer Breast Cancer Conclusions
5
Index
I. Introduction
II. Colorectal cancer analysis
Sample and status on arrival
Short term regression rates
Metastases reduction effects
Long term survival and dosage−effect relationship
III. Breast cancer analysis
IV. Conclusions
7. Introduction Colorectal Cancer Breast Cancer Conclusions
C l t l l
6
Colorectal cancer sample
Sample size: 52
Most fundamental division based on location: colon and
rectal cancer
While we have looked at colorectal cancer as a single
entity, for completeness we show some data separately
Colon cancer
Sample size: 28
Rectal cancer
Sample size: 24
Colorectal cancer
Sample size: 52
Male/female: 11−17 Male/female: 13−11
Official general Male/female: 24−28
population
Male to female ratio: colon cancer more
frequent in females, rectal in males
8. Introduction Colorectal Cancer Breast Cancer Conclusions
S l t ti l i t t
7
Sample starting oncologic status
The main difference to the general population of patients
(significant negative skew)
More ARM cases (advanced, recurrent,metastatic) in sample
Chemotherapy was found to be more useful for small tumors, so
this sample is less influenced by chemotherapy
More complex cases may be the result of generally
unknown and un−established method of using medicinal
mushrooms in cancer treatment
9. Introduction Colorectal Cancer Breast Cancer Conclusions
8
S l t ti l i t t ( t’’d)
Sample starting oncologic status cont’’The TNM distribution of the sample shows very difficult cases
68% of sample are Stage 4 (most difficult stage, distant
metastases present); 5−Y survival rate for this group is 5−8%
Average stage: 3.6
TNM stage Total Colon Rectal
I 1 0 1
II A 1 0 1
II B 1 0 1
III A 1 0 1
III B 5 4 1
III C 7 3 4
IV 34 19 15
10. Introduction Colorectal Cancer Breast Cancer Conclusions
9
S l Sample t ti starting l i oncologic t t status ( cont’’t’’d)
Disproportionally large number of surgically unresected and
metastatic cases
Status Total Colon Rectal
Resected 17 9 8
Unresectable,
residual 1 0 1
Resected
w/meta 4 4 0
Unresected
w/meta 301 15 15
1 Patients with surgically inoperable, metastatic cancers have an especially bad prognosis
11. Introduction Colorectal Cancer Breast Cancer Conclusions
10
S l Sample t ti starting l i oncologic t t status ( cont’’t’’d)
S l Sample di t ib ti distribution b by St
Stage
I
II A
2%
II B
2% III A
2%
2%
III B
10%
III C
14%
IV
68%
12. Introduction Colorectal Cancer Breast Cancer Conclusions
11
S l Sample t ti starting l i oncologic t t status ( cont’’t’’d)
Sample distribution by surgery/metastatic status
Resected
33%
Unresected w/meta
58%
Unresectable, residual
2%
Resected w/meta
7%
13. Introduction Colorectal Cancer Breast Cancer Conclusions
Sh t t ff t
12
Short term effects
Status at end
of MT Total Colon Rectal
Progression 2 1 1
No change 11 5 6
Regression 13 6 7 Sample: 26/52
These effects have been end of primary MT (official medical
documents)
assessed at the
Short term effects distribution
Progression No change Regression
13
The use of MT is not coinciding with standard
diagnostic procedure and timing, so less data
11
is available;
We can however better distinguish the effects of
2
5
6 6
7
MT and ST since they are related less strongly 1 1
Total Colon Rectal
14. Introduction Colorectal Cancer Breast Cancer Conclusions
Sh t t ff t ( t’’d)
13
Short term effects cont’’Official therapy procedure is independent of, so we can
assess the effects of MT less related to ST
Patients took 4−27 10−day forte dosages – on average
= 7
Though rate of progression of disease is expected to
rise with increased time interval, the patients taking MT
preparations for longer time have an increased
probability of regression
Compared to regression rates of the patients on
standard chemotherapy 11.7 SD away from the mean!,
p<0.0005, sample size 26)
15. Introduction Colorectal Cancer Breast Cancer Conclusions
Sh t t ff t ( t’’d)
14
Short term effects cont’’90
Effects of dosage on regression and no−change rates
80
70
D R i 60
50
ntage
Dose−Regression %
Dose−No change %
4 90 7 43
40
30
Percen
y = 4,90x + 7,43
R² = 0,995
y 3 52x + 73 48
20
10
= −3,52x 73,48
0 R² = 0,973
0 5 10 15 20
Number of Forte Dosages
The dosages were grouped so each subsample had more than 5 users. This enabled an
excellent curve fit.
16. Introduction Colorectal Cancer Breast Cancer Conclusions
Eff t t t ( di t )
15
Effects on metastases medium term)
The metastatic status was collected in August 2007
(medium term)
Most commonly metastases target the liver and are
inoperable
Once metastases have developed rates of survival are greatly
decreased; reduction of nonresectable metastases is a major
goal of chemotherapy (with success rates of up to 16%)1, but it
results in vascular changes (blue liver syndrome) and
steatohepatitis2
1 Bismuth H, Adam R. Reduction of nonresectable liver metastasis from colorectal cancer after
oxaliplatin chemotherapy. Semin Oncol. 1998 Apr;25(2 Suppl 5):40−6, PMID: 9609107
2 A. J. Bilchik, G. Poston, S. A. Curley, S. Strasberg, L. Saltz, R. Adam, B. Nordlinger, P. Rougier, L. S.
Rosen Neoadjuvant Chemotherapy for Metastatic Colon Cancer: A Cautionary Note. Journal of Clinical
Oncology , Vol 23, No 36 (December 20), 2005: pp. 9073−9078, DOI: 10.1200/JCO.2005.03.2334
17. Introduction Colorectal Cancer Breast Cancer Conclusions
Eff t t t ( t’’d)
16
Effects on metastases cont’’ Meta sample size: 27 (10 alive at end of study)
Metastatic reduction was found in 20.0±7.6% of sample
with no hepatotoxicity
Dosage−effect relationship
In metastatic disease (/w unresected tumor), increases in
a number of dosages shows some effect of meta
suppression (slope −0.81, R2=0.68)
This result is not statistically significant – sample size is
too small to make confident statements of dose
dependent results
18. Introduction Colorectal Cancer Breast Cancer Conclusions
L t i l
17
Long term survival
All survival rates are given in absolutes, and not relative
to age−adjusted general population
Due to small sample sizes we are only able to analyze total
survival and survival in stages 3 and 4
American general 5−year survival rates are much better
than rates in Europe (62 vs.43%) 1
5−year survival (only US data available)
Stage 3 (US data2, A−83%, B−64%, C−44%)
Stage 4 (US data3,2, 5−8 %)
Median survival (all stages) with ST (standard therapy):
29.24 months after 1st diagnosis
1 European Journal of Cancer
2 According to American Cancer Society; no
data for Croatia
3 Data from National Cancer Institute
4 US data 2004−6, large jump from 19
months in 2003
19. Introduction Colorectal Cancer Breast Cancer Conclusions
L t i l t’’18
Long term survival ( cont’’d)
Survival is significantly increased in colorectal cancer patients
using mycotherapy
Median survival in MT sample: 38 months, avg. 34.06
(with 96.8% confidence that this result is independent of
ST; outside of confidence interval)
Additionally, the MT sample has a significant skew to the
more difficult cases and was calculated from the start of
MT and not with first diagnosis!
20. Introduction Colorectal Cancer Breast Cancer Conclusions
S i l b t
19
Survival by stage
Cumulative deaths vs. time
Time
(mths) 0−12 12−24 24−36 36−48 48−60 60+ Sample
size
Total 15 22 26 33 33 33 511
Colon 9 12 14 16 16 16 28
Rectal 6 10 12 17 17 17 24
Changes vs vs. time (dark red red=deaths) by TNM Stage
Time
(mths) 0−12 12−24 24−36 36−482 48−60 60+ Sample
size
1 − − − − 1 − 1
2 −− −− −− −− −− 2 2
3 2 2 2 1 2 4 13
4 13 5 2 5 4 5 34
1 Survivors: 18/51 (for 1 person in the sample survival could not be precisely established)
2 1 death in 36−48 months interval is of unknown TNM Stage
21. Introduction Colorectal Cancer Breast Cancer Conclusions
S i l 20
Survival %
per year
5 Y S i l R
100
90
Survival Rates (per year) Survival Rates:
General (Stage avg.
3.6)
80
MT 35.3%
ST Expected 24%
70
60
Rate %
Stage 4
MT 26.5%
ST results 8%
50
40
Survival R
General Survival per Year
30
20
Stage 4 Survival per Year
10
0
0 1 2 3 4 5 6 7
Official 5Y Survival Rate for Stage 4
Official 5Y Survival Expectancy for
S l
Years
Sample
22. Introduction Colorectal Cancer Breast Cancer Conclusions
St 3 d S i l
21
Stage and Survival
From Stage 3, patients with stages B and C were evaluated (5,
7 in sample, respectively)
Averaged weighted sum of USA data on survival for this group
gives expected 5−Y survival of 52.3%
The survival in this group was 7/12 (58.3%), but the result is
not sufficiently significant (p≈0.01)
This study also only measured time from start of MT, not from
the first diagnosis! This will significantly increase the value of
this result.
A larger sample than followed in this study has to be used to
find any statistical significance
23. Introduction Colorectal Cancer Breast Cancer Conclusions
St 4 d S i l
22
Stage and Survival
In our sample, 34 patients were starting in Stage 4
Official 5−Y Survival from 1st diagnosis is 5−8%
(which for this sample amounts to 1.7−2.7/34 survivors)
In our sample, 9/34 have survived >5 years (26.47%)
The result is statistically significant:
(P(x̅=0.2647|H0true)=0.07%, p<0.001)
5−Y survival was measured from the start of MT,
compared with the highest official data for 5−y survival from
the 1st diagnosis (8%),
98.4% confident that the survival in sample is increased by
using MT in Stage 4 cases
This shows that 5−−year survival is significantly increased in
colorectal cancer patients using mycotherapy
24. Introduction Colorectal Cancer Breast Cancer Conclusions
D S i l C l ti
23
Dosage-Survival Correlation
Dosage−Effect
Increased dosage, i.e. total number of forte dosages, is
positively correlated with longer survival
This trend appears smaller because of the positive
correlation between an dosage increase and more
difficult cases
4
Avg. Stage and Dosage taken
3,5
ge Average
dose−stage
3
Stag
More difficult cases used significantly
more forte dosages; this skews the
0 10 20
Total number of forte dosages
results lowering the perceived benefit
25. Introduction Colorectal Cancer Breast Cancer Conclusions
D S i l C l ti
24
Dosage-Survival Correlation
Dosage−Effect
Increased dosage, i.e. total number of forte dosages, is
positively correlated with longer survival
This trend appears smaller because of the positive
correlation between an dosage increase and more
difficult cases
survival
When evaluated up to 10 forte dosages, the correlation is
very strong (R2=0.98)
45
40
35
b f d h
onths)
Dosage effect on 30
Above 10 forte dosages, there
25
seems to be a threshold or a
20
certain number of people
i l d t b fit f nterval (mo
dose−survival time simply do not benefit from
15
increased MT; unfortunately
the sample is not big enough
to establish it (8 patients took
5
10
Survival i
11−27 dosages, stages 3&4) 0
0 10 20
Total number of forte dosages
26. Introduction Colorectal Cancer Breast Cancer Conclusions
D d i l i St 25
Dosage and survival in Stage 4
In Stage 4, dosage and survival were additionally assessed
(separately from other stages)
Stage 4 Dosage−Survival Interval There is a very strong correlation of increased
dosage leading to increased survival interval for up
50
45
40
s)
to10fortedosages
In our sample, more than 11+ dosages did not
lead toimprovements
35
30
25
val (months
p
This sample size was just 7 so other possibilities
h b f
20
15
10
urvival Inter
dose−survival exist – theremay be a certain percentage of non−
responders, irrelevantof thedose
However, there was significant short term
improvement in this particular group
5
0
0 5 10 15 20
Su
A possible negative effect of increasing to 11+
dosages was evaluated with a student t−test,
Total forte dosages
g ,
but no statistically significant influence was
found (p>0.2)
27. Introduction Colorectal Cancer Breast Cancer Conclusions
26
Index
I. Introduction
II. Colorectal cancer analysis
III. Breast cancer analysis
Sample and status on arrival
Short term regression rates
Metastases reduction effects
Long term survival and dosage−effect
relationship
IV. Conclusions
28. Introduction Colorectal Cancer Breast Cancer Conclusions
B t C
27
Breast Cancer
Breast cancer is the most common type of cancer in
women
Effect of chemotherapy is even less powerful than in
colorectal cancer (generally improves survival by just
1.5%)
Primary treatment method is surgery, which may give a
disease−free status and up to 98% 5−year survival rate
in certain cases
Statistics for this cancer type are continually improving;
however, the is mostly caused by stage at presentation (earlier
diagnosis)
Sample size: 89
29. Introduction Colorectal Cancer Breast Cancer Conclusions
O l i l t t t th t t f MT
28
Oncological status at the start of This sample contains a disproportional number of
metastatic cancer, skewing the distribution to more
difficult cases
Treatment of metastatic breast cancer is primarily
palliative, with extremely low rates of improvement
(1.5%)
Status Number in sample
Resected 37
Unresected 1
Resected /w meta 45
Unresected /w meta 5
Unknown 1
30. Introduction Colorectal Cancer Breast Cancer Conclusions
O l i l t t t th t t f MT
29
Oncological status at the start of (cont’’d)
Sample distribution surgery/meta of status
Unresected /w meta
6%
Unknown
1%
Resected
42%
Resected /w meta
50%
Unresected
1%
31. Introduction Colorectal Cancer Breast Cancer Conclusions
Sh t t ff t
30
Short term effects
Short term effect Number in
sample
Short term effects distribution
p
Progression 5
No change 16
16
15
Regression 15
5 Sample size:36/89
These effects have been assessed
at the end of primary MT (official Progression No change Regression
medical documents)
The probability of such regression rates (41.67% of cases) not
being caused by MT (when compared with ST rate of 1.5%) is 19 SD
away fromthemean; literally of the charts, p<<0.0001;
Null hypothesis of no effect on regression beyond ST must be
rejected
32. Introduction Colorectal Cancer Breast Cancer Conclusions
Sh t t ff t ( t’’d)
31
Short term effects cont’’Dosage−effect
Analyzing the complete known sample, there is both some
increase in regression as dosage is increased
and a weaker, statistically non−significant increase in
progression of disease
This reveals an important problem – the influence of
various stages of the disease
We tried looking more specifically:
Resected (10) very small dosage variation , small dosages
(avg. 4.5), 90% no change
Unresected with meta (3), large dosages (avg. 10.67), more
progression, very small sample
33. Introduction Colorectal Cancer Breast Cancer Conclusions
Sh t t ff t ( t’’d)
32
Short term effects cont’’Resected with meta (22), good sample for further analysis
Analysis of this subsample shows a stronger correlation:
increase in dosage increases regression rates and
lowers progression rates
however, neither of these are confident enough to be
used to accurately predicting future outcomes, by this
model
The results are shown in the following graph…
34. Introduction Colorectal Cancer Breast Cancer Conclusions
Sh t t lt
33
Short term results
70
Progression and regression rates vs. dosage
60
eta)
50
40
cted /w me
Progression of Disease
30
mple (resec
g
Regression of Disease
y = −3,013x + 35,497
R² = 0,4317
20
cent in sam
,
y = 1,3584x + 44,632
R² = 0,6704
10
0
Perc
0 5 10 15
Total forte dosages
35. Introduction Colorectal Cancer Breast Cancer Conclusions
M t t ( di t ) ff t
34
Metastases medium term) effects
Assessed at August 2007 (medium term)
Metastases most commonly target bones, lungs, liver, lymph
nodes, and brain
Statistics for this cancer type are continually improving; however,
the most important predictor of mortality variation is caused
by stage at presentation (earlier diagnosis)1
Metastatic breast cancer 5−Y Survival is low (14 %)2
Metastatic breast cancer is usually considered separately from
other stages of breast cancer
1 P. Tai, E. Yu, V. Vinh−Hung, G. Cserni, G. Vlastos. Survival of patients with metastatic breast
cancer: twenty−year data from two SEER registries.; BMC Cancer, v4.; 2004, doi: 10.1186/1471−
2407−4−60
2 M.E. Lippman. Breast Cancer, Harrison’s Principles of Internal Medicine, p.516−523; D. L. Kasper
et al., eds, 16th ed, 2005
36. Introduction Colorectal Cancer Breast Cancer Conclusions
M t t ( di t ) ff t
35
Metastases medium term) effects
Sample status: 50 (21 alive at end of study)
Metastatic reduction was found in 20.0±5.7% of MT sample.
Metastatic breast cancer is treated with palliative chemotherapy –
reduction effects on metastases (1−3%).
This result is statistically significant (p<0.001)
Dosage−effect relationship
Increases in dose show seemingly random variations – there may
be a problem with a lack of a more stable prognostic factor
No definite, statistically significant dose−−effectiveness
relationship found
37. Introduction Colorectal Cancer Breast Cancer Conclusions
N i ifi t t lt
36
Non-significant meta results
35
Effects of dosage on reduction of
metastases
30
Dose–reduction of metastases
effects cannot be established
25
20
ntage
with appropriate confidence
N t ti ti ll i ifi t ff t
15
Effect percen
Dose vs. Meta
Reduction (sample)
No statistically significant effects
can be deduced (max. between
6−8forte)
10
5
E
0
0 5 10 15
Dosage (no. of forte)
38. Introduction Colorectal Cancer Breast Cancer Conclusions
L t i l
37
Long term survival
All survival rates are given in absolutes, and not relative to
age−adjusted general population
General 5−year survival rate during the study was at
85%1; this is time from first diagnosis and with normal
population distribution of disease stages (dependent on
year and location)
5−−year survival rate for Stage 4 is 14%2 in population
from 1st diagnosis
Croatian official results are not available and are likely
worse than the US data quoted above
1 “World Cancer Report”. International Agency for Research on Cancer. 2008
2 Marc E. Lippman,Breast Cancer , HARRISON'S PRINCIPLES OF INTERNAL MEDICINE,
p. 516−523 (D. L. Kasper et al., eds, 16th ed 2005)
39. Introduction Colorectal Cancer Breast Cancer Conclusions
S i l lt i B C l
38
Survival results in BrCa sample
Cumulative deaths in sample; total and metastatic
Time
(mths) 0−12 12−24 24−36 36−48 48−60 60+ Sample
size
Total 28 39 41 49 49 49 89
Metastatic 24 34 35 40 40 40 50
No meta 4 5 6 9 9 9 38
Survivors: 40/89 In 1 case unknown if distant metastases are present
In MT sample: general 5−Y survival was just 44.94%
(sample more difficult than normally distributed in population, but
due to insufficient staging data, we cannot compare it)
Non−metastatic breast cancer 5−Y survival rate was 76.32% (unknown
distribution of stages, not comparable)
Metastatic breast cancer 5−Y survival was 20% (vs. 14 in population)
We have insufficient data to compare the effect of MT use on long term
survival in total and non−metastatic cancer
40. Introduction Colorectal Cancer Breast Cancer Conclusions
S i l 39
Survival %
per year
120
Survival % per Year
100
Total Survival % per Year
80
al %
Metastatic Survival % per Year
Non−metastatic Survival per Year
Official 5Y Metastatic Survival Rate
60
Surviva
Metastatic survival looks
40 increased, but the data is
20
not significant (p≈0.3).
0
It is probable that the time
from the 1st diagnosis
would make it statistically
0 1 2 3 4 5 6
Years
significant
41. Introduction Colorectal Cancer Breast Cancer Conclusions
D S i l R l ti hi
40
Dosage-Survival Relationship
Increased dosage and increased survival are positively
correlated
The results are skewed because more serious cases took
larger dosages
Dosage−Survival Interval The dosage−survival interval
correlation is strongest at the
low end (4−6 dosages; 64
45
40
Dosage Relationship
4 35
patients) of usage (R2=0.885)
30
This suggests a powerful effect
25
of starting MT tart of MT
This skew, caused by increased
dosages in more difficult cases
(i 7+ d j t3/25
20
15
ths since st
Dosage vs. Total
Survival
Dosage vs.
in dosages just 3/cases are
non−metastatic), is a major cause
of the dip in the graph from 6−8
forte dosages
10
5
Mont
Metastatic Survival
0
0 5 10 15
Total number of forte dosages
42. Introduction Colorectal Cancer Breast Cancer Conclusions
D S i l R l ti hi t’’41
Dosage-Survival Relationship ( cont’’d)
Increased dosage and increased survival are positively
correlated
The because more serious cases took
There is a large increase in the ratio of
metastatic cancers between 6−8 dosages!
results are skewed larger dosages
6 100
90
80
Meta % vs. Dosage
70
60
50
Adjusting for the skew (proportions of meta)
we find a strong dose−dependent effect, and
the function is monotonically increasing
40 Meta % vs.
30
20
10
Dosage
Meta 0
0 5 10 15
Forte dosages used
Adjusted
Total Survival vs.
Dose
0 5 10 15
This graph shows % of metastatic breast
cancer in sample vs. MT usage
43. Introduction Colorectal Cancer Breast Cancer Conclusions
Th Bi Pi t O i f lt
42
The Big Picture: Overview of results
With larger dosages (=longer use) the rates of cancer regressions
rise and rates of progression and no−change in status fall
The regression effects are dose−dependent, more strongly so in
colorectal cancer
Metastases reduction is strong in breast cancer, while less intense
in colorectal cancer
Dosage−effect relationship is stronger in colorectal cancer, and
weaker in breast cancer
Survival prolongation is strong in colorectal cancer, likely in
breast cancer (but cannot be confidently established)
Dosage−effect on survival is stronger in colorectal cancer, but
probable in both
Starting MT yields fastest results (there is a point of diminishing
returns; here established at above 100 days use in both cancers)
Larger dosage and longer use is safe (no decrease in survival and
status)
44. Introduction Colorectal Cancer Breast Cancer Conclusions
Th b tt li
43
The bottom line
Did we cure cancer? Did we win?
No.
Mycotherapy results Standard therapy results
Colorectal cancer
Short term regression: 50% of cases
M t d ti Colorectal cancer
Short term regression: 4% of cases
Meta reduction: 20%
M t d ti id ff t
Stage 4 5Y−survival: 26.5%
Meta reduction: 16 % / w side effects
Stage 4 5Y−survival: 8%
Breast cancer
Short term regression: 41.7%
Meta reduction: 20%
Breast cancer
Short term regression: 1.5%
Meta reduction: 1−3%
Stage 4 5Y−survival: 20% Stage 4 5Y−survival: 14%
But the results are greatly improved by introducing mushroom therapy.
45. Introduction Colorectal Cancer Breast Cancer Conclusions
44
Thank you for your attention!
Correspondence:
ivan.jakopovic@inet.hr
neven.jakopovic@gmail.com
mykosan.com
46. Introduction Colorectal Cancer Breast Cancer Conclusions
45
Lessons for the future
For the researchers
The lack of time from 1st diagnosis made a For the patients For the medical personnel
lot of statistics less definite. While it made
the actual probabilities more likely than
calculated here, we lose some of the
comparability value.
Medicinal mushroom preparations
are effective, to a certain degree.
However there are significant
The use of mycotherapy (use of
medicinal mushroom preparations) in
oncological diseases is not harmful, and
may be beneficial if used in proper
The breast cancer needs to be staged better
(this was partly the fault of the non−
affiliated MDs).
However, individual variations, which we
cannot, at our present state of
knowledge, confidently predict.
doses (in this study 0.1 g/kg BW per
day) for40−100days or longer.
The use of higher doses for a longer
The quantities of the preparation used was
dependent on the patient’s status, their
response to therapy and factors beyond the
medicinal. For best results, dosages should
The very first month or two of use
may be crucial in improving short
term survival, metastases reduction
and total survival increase. Shorter
d i i lik l d
g g
period is safe. There is a potential point
of diminished return in MT lasting
longer than 100days.
Th f MT i l l d
, g
be independent of factors disconnected
from the trial.
The data collection was very dependent on
’ d h
duration is not likely to produce a
significant effect.
This could not be determined by
the strength of the tests in this
The use of in colorectal cancer and
breast cancer improved regression rates
and slowed progression of the disease.
The response is highly dose−
patient’s participation and the dependent
thoroughness of their medical personnel.
study and may not be factual, but
MT of 100 days seems ideal. After
The lack of information made it necessary
this period, there is some statistical
to create smaller subsamples While care
indication that there is diminished
dependent.
The use of MT had a strong effect in
reducing metastases. This result is
subsamples. especially interesting in colorectal
was taken that they remain representable of
the population, this made certain statistics
less confident. The initial sample, should,
resources permitting, be even larger than
return for the investment. (while
not detrimental, there was no
significant change in users taking
more)
p y g
cancer, as the effect is without serious
side effects often observed in
chemotherapy treatments.
U f MT i ifi l i
p g, g
used here, to circumvent this difficulty.
Most of this would be resolved naturally in a
full clinical trial.
Use of proper significantly improves
5Y survival rates for colorectal and
breast cancer.