1,721,021 research outputs found
Surprising results of a supportive integrated therapy in myelofibrosis
No full textObjectives: Myelofibrosis (MF) is characterized by shortened survival and a greatly compromised quality of life. Weight loss and cachexia seem to be the most important factors influencing survival in patients with MF. The aim of this study was to assess the efficacy of an integrated supportive therapy in improving cachexia and MF-related symptoms. Methods: We reported on a case of a patient with MF who presented with weight loss and cachexia associated with severe anemia, fatigue, fever, and bone pain. The circulating levels of inflammatory, oxidative stress parameters, hepcidin, and erythropoietin were evaluated and were above normal ranges. The patient was treated with a multitargeted approach specifically developed for cachexia including oral l-carnitine, celecoxib, curcumin, lactoferrin, and subcutaneous recombinant human erythropoietin (EPO)-α. Results: Surprisingly, after 1y, cachexia features improved, all MF symptoms were in remission, and inflammatory and oxidative stress parameters, hepcidin, and EPO were reduced. Conclusions: Because our protocol was targeted at inflammation and the metabolic state, its effectiveness may emphasize the role of inflammation in the pathogenesis of MF symptoms and demonstrates a need for the study of new integrated therapeutic strategies
A multitargeted treatment approach for anemia and cachexia in metastatic castration-resistant prostate cancer
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Advances in pharmacologic strategies for cancer cachexia
No full textIntroduction: Cancer cachexia is a severe inflammatory metabolic syndrome
accounting for fatigue, an impairment of normal activities and, eventually,
death. The loss of muscle mass associated with body weight loss is the main
feature of this syndrome.
Areas covered: The present review aims to describe the advances in the
pharmacological approaches for cancer cachexia, highlighting the impact on
weight loss, muscle wasting and related outcomes.
Expert opinion: Among the pharmacological agents, attention should yet be
given to the currently most widely studied drugs, such as progestogens and
NSAIDs. Emerging drugs, such as ghrelin and selective androgen receptor
modulators, have obtained promising results in recent randomized clinical
trials. Larger sample sizes and more robust data on the effectiveness of anticytokine
agents are needed. Any pharmacological approach to counteract
cancer cachexia should always be associated with an adequate caloric intake,
obtained by diet or through enteral or parenteral supplementation, if indicated.
Finally, we can currently state that a combined approach that simultaneously
targets the fundamental pathways involved in the pathogenesis of
cancer cachexia is likely to be the most effective in terms of improvements
in body weight as well as muscle wasting, function, physical performance
and quality of lif
Ovarian hyperstimulation in premenopausal women during adjuvant tamoxifen treatment for endocrine-dependent breast cancer: A report of two cases
No full textAdjuvant endocrine therapy is an integral component of care for endocrine-dependent breast cancer. The aim of this type of therapy is to counteract the production and the action of estrogens. The ovary is the primary site of estrogen production in premenopausal women, whereas, in postmenopausal women, the main source of estrogens is adipose tissue. Therefore, ovarian function suppression is an effective adjuvant strategy in premenopausal estrogen-dependent breast cancer. Similarly, the inhibition of estrogen action at the receptor site by tamoxifen has proven to be effective. To date, international consensus statements recommend tamoxifen (20 mg/day) for five years as the standard adjuvant endocrine therapy for premenopausal women. It should be noted that tamoxifen is a potent inducer of ovarian function and consequent hyperestrogenism in premenopausal women. In the present study, we report two cases of ovarian cyst formation with very high estrogen levels and endometrial hyperplasia during the administration of tamoxifen alone as adjuvant treatment for estrogen receptor-positive breast cancer in premenopausal women. These cases suggest that in young premenopausal patients with estrogen-dependent breast cancer, ovarian suppression is an essential prerequisite for an adjuvant endocrine therapy with tamoxifen. In this context, luteinizing hormone-releasing hormone agonist treatment by suppressing effective ovarian function may lead to a hypoestrogenic status that may positively impact breast cancer prognosis and prevent the effects of tamoxifen at the gynecological level. It is important to reconsider the action of tamoxifen on ovarian function and include these specific effects of tamoxifen in the informed consent of premenopausal patients who are candidates for tamoxifen alone as adjuvant endocrine treatment
MESNA (2-mercaptoethane sulfonate) is effective in inducing lymphocyte progression through cell cycle in patients with advanced cancer of different sites
No full textPrevention of oxidative stress and cachexia in cancer patients with antioxidants, both in the diet and supplemented, plus an integrated treatment approach
No full textTHE 'COMPREHENSIVE GERIATRIC ASSESSMENT' EVALUATION: A SELECTION OF INFORMATIVE QUESTIONNAIRES FOR ESSENTIAL PARAMETERS. PRELIMINARY EXPERIENCE BY A SINGLE INSTITUTION
No full textRole of inflammation and oxidative stress in post-menopausal oestrogen-dependent breast cancer
Full text linkWeight gain and obesity are among the most important risk factors for post-menopausal oestrogen-dependent breast cancer (EDBC). Weight gain is associated with oxidative stress, which in turn promotes breast cancer progression. We carried out a prospective study in 216 consecutive post-menopausal breast cancer patients aiming to examine the correlations between traditional prognostic factors (tumour size, T, nodal, N, grading, G, and metastasis status, M), and body mass index (BMI), leptin, pro-inflammatory cytokines (Interleukin, IL,-6 and tumour necrosis factor-alpha, TNF-α), and oxidative stress (reactive oxygen species, ROS, glutathione peroxidase, GPx, superoxide dismutase, SOD) among patients with oestrogen receptor (ER)+ and ER- breast cancers. Distribution of T, N and M categories did not differ between ER+ and ER- breast cancer patients. ER- patients showed a higher incidence of G3 tumours. Weight, BMI, leptin, IL-6 and ROS were higher in ER+ compared with ER- patients. Among ER+ patients, BMI, leptin, IL-6 and ROS correlated with T and M. Leptin, IL-6 and ROS were positively correlated also with N. Among ER- patients, BMI and leptin did not correlate with any of prognostic parameters, whereas a positive correlation between IL-6, ROS and M was found. Multivariate regression analysis showed that BMI, leptin, IL-6 and ROS were predictive for T, N and M in ER+ patients. Weight gain, inflammation and oxidative stress are involved in EDBC prognosis. Their modulation through antidiabetic, anti-inflammatory and antioxidants drugs combined with endocrine therapy may constitute a targeted approach in post-menopausal EDBC
Antioxidant agents alpha lipoic acid, N-Acetyl cysteine and MESNA (2-mercaptoethane sulfonate) are effective in inducing lymphocyte progression through cell cycle in advanced cancer patients
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