A Simple Guide to Kidney Cancer
----------------------------------------
What is Kidney Cancer?
------------------------------
Kidney Cancer is a malignant disease of the kidney.
What are the causes of Kidney Cancer?
-----------------------------------------
1.Hereditary- hereditary kidney cancer is related to the Von Lindau syndrome.
2.Smoking. cigarettes smoke chemicals has been known to damage the Kidney cells
3.Uncontrolled hypertension-damage to kidney cells may contribute to Kidney cancer
4.Obesity has been found to have some causal effect
5.Age - more common in in 50-70 age group
6.Long term dialysis for kidney failure.
What are the symptoms and signs of Kidney Cancer?
-------------------------------------------------------
Symptoms - non-specific and silent.
In the early stage there is no symptoms.
By the the time the symptoms appeared, the cancer is usually in the advanced stage.
1.painless hematuria or blood in urine
2.pain in the renal flanks
3.Fever
4.weight loss
Signs:
1.tenderness in renal area of backs
2.palpable mass in the side of abdomen
How do you diagnose Kidney Cancer?
----------------------------------------------
Diagnosis can usually be made by :
History
-----------
1.hematuria
2.Renal flank pain
3.Weight loss
Liver function tests
---------------------
may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, SGGT and alkaline phosphatase levels) in the absence of liver disease.
Ultrasound or abdominal CT
------------------------------
may be used to identify tumors.
Kidney Biopsy
---------------
biopsy of kidney may be done to determine types of Kidney cancer:
Clear Cell Type: 75%
Papillary type: 20%
Chromophole type: 4%
Others: 1%
What is the treatment of Kidney Cancer?
------------------------------------------------
Treatment of Kidney cancer can be
surgery
chemotherapy
radiotherapy
immunotherapy
biological targeted therapy
depending on the stage of the cancer.
Surgery
--------------
If the cancer is localized within the kidney , then it is surgically resectable and curable.
No treatment after surgery has been proven to prevent recurrence.
Depending on the size of the cancer, the recurrence rate varies from
10% in Stage I
60% in Stage III
Once recurrence occur then the cancer is considered as a Stage IV cancer and therefore incurable.
The aim of treatment then is palliative with emphasis to improve overall survival rates and quality of life.
Immunotherapy
-----------------
High dose immunotherapy such as interleukin may be able to cure less than 5% of the kidney cancer patients.
It is however toxic and potentially life threatening and is used for patients not suitable for surgery.
Low dose immunotherapy such as interferon is better in that it can relieve symptoms and improve quality of life for an average of 3-6 month in 15% of cases treated.
Despite its low dose the side effects can also affects the treatment of the patients such as fever, chills and loss of appetite.
Biological targeted therapy
-------------------------------------
These drugs target the growth of the cancer cells by suppressing the cellular pathways which stimulates the growth of the abnormal tumor blood vessels and the tumor cells .
These treatments have been proven to better in terms of better response and length of the disease control compared to interferon and interleukin.
There has also being an improved overall survival rate with a reduced risk of death by 28%.
Side effects are hypertension, ischemia of heart, fatigue, loss of appetite, diarrhea and loss of weight.
The approved drugs are sorafenib, sumitinib and tensirolimus.
Chemotherapy and radiotherapy
-----------------------------
Chemotherapy and radiotherapy have been found to be ineffective for renal cancer treatment.
What is the Prognosis of Kidney cancer?
-------------------------------------------------
The prognosis of Kidney cancer is poor
1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.
2.Median survival from diagnosis is around 1 year
3.5-year survival is lower than 5%.
4.Kidney cancer has one of the highest mortality of all the cancers.
How to prevent Kidney cancer?
------------------------------------
Avoid smoking
Reduce weight in obese patients
Control high blood pressure to prevent damage to the kidney
Avoid taking toxic substances which may damage or injure the cells of the kidney.
Showing posts with label immunotherapy. Show all posts
Showing posts with label immunotherapy. Show all posts
Thursday, November 13, 2008
Tuesday, August 28, 2007
A Simple Guide to Vasomotor rhinitis
A Simple Guide to Vasomotor rhinitis
--------------------------------------
What is Vasomotor Rhinitis?
-----------------------------
Vasomotor Rhinitis is a condition which consists of a group of symptoms that include a runny nose, itchiness and sneezing, that are caused by irritation and congestion in the nose. It is brought about by changes in vascular tone and permeability.
What are the symptoms of Vasomotor rhinitis?
--------------------------------------------------
The symptoms of Vasomotor rhinitis include:
Recurring nasal inflammation
Sneezing
Runny nose
Profuse watery nasal discharge
Nasal membrane swelling
What causes Vasomotor rhinitis?
---------------------------------------
Vasomotor rhinitis occurs as a result of a response of the nasal membrane to
1.irritants such as smoke,
2.temperature changes and
3.stress.
Other causes of chronic rhinitis are blockage in the nose e.g. nasal polyps, enlarged adenoids and a deviated septum that impede mucus drainage and restrict air flow. Medications can cause rhinitis or worsen it in people with allergies, vasomotor rhinitis or a deviated septum.
Prolonged use of nasal decongestants can worsen rhinitis.
Some blood pressure medications such as beta blockers and vasodilators can cause rhinitis.
What is the difference between Allergic rhinitis and Vasomotor Rhinitis?
--------------------------------------------------------------------------------------
Allergic rhinitis could be seasonal or perennial (year round).
Seasonal rhinitis is due to pollen or mould spores.
Perennial rhinitis are due to allergens such as house dust mites, animal dander or moulds found on carpets or furniture upholstery and even some foods.
Non-allergic rhinitis can also be triggered by cigarette smoke and many other air pollutants, strong odours, exposure to cold and alcohol. Smoking and air pollution may also cause symptoms by damaging the cilia (hair cells) which moves mucus through the air passages.
Hormonal changes in pregnancy cause "Rhinitis in Pregnancy". The expecting mother will recover once the baby is delivered.
What treatments are available for Vasomotor rhinitis?
----------------------------------------------------------------
Treatments for Vasomotor rhinitis include:
Non-medical:
----------------
Avoid dry air
Keeping air moist
Vapourisers
Nasal Decongestant sprays are not recommended for treatment of vasomotor rhinitis
Complete avoidance of environmental allergens may be impossible but it can be minimised for example removing carpets and pets.
Use a pollen mask when mowing the grass or cleaning the house
Install an air purifier
Change the air filters monthly in heating and air conditioning systems
use cotton or synthetic materials such as Dacron in pillows and bedding
enclose mattress in plastic
keep windows closed during high pollen times
eliminate house plants
bathe pets frequently or even give away dander–producing pets.
Avoid Nasal irritants which can cause typical immune response seen with classical allergies. Examples include cigarette smoke, perfume, aerosol sprays, smoke, and smog and car exhaust
Nasal irrigation utilizing a buffered hyper tonic saline solution helps to reduce swollen and congested nasal and sinus tissues.
It also washes out thickened nasal secretions, irritants (smog, pollens, etc.), bacteria, and crusts from the nose and sinuses.
While irrigating the nose, it is best to stand over the sink and irrigate each side of your nose.
Aim the stream toward the back of your head, not at the top of your head.
For young children, the salt water can be put into a small spray container which can be squirted many times into each side of the nose.
Medical:
---------
Anti-histamines provide good relief for mild to moderate symptoms.
Newer antihistamines that are long-acting and less likely to cause drowsiness have been found to be useful.
Decongestants such as pseudoephedrine can help to shrink the swollen tissues caused by irritants and other causes. However decongestant nasal sprays are not advised because they cause a a rebound effect on nasal tissues(initially the nasal tissue shrinks but later they become more swollen)
Corticosteroids in the form of nasal spray reduce the immune response and may be prescribed to reduce severe symptoms.
These drugs are highly effective in allergic patients; but there is a potential for serious side effects when used over time. They are best used for the short term management of allergic problems, and their use must always be monitored by a physician.
Nasalcrom (cromolyn sodium): This spray helps to stabilize allergy cells (mast cells) by preventing release of allergy mediators, like histamine.
Immunotherapy:Allergy shots interfere with the allergic response. After identification of an allergen, small amounts of it are given back to the sensitive patient. Over time the patient will develop blocking antibodies to the allergen, and they become less sensitive and less reactive to the substance causing allergic symptoms. This is the best treatment provided the allergen is correctly identified.
Surgery:Nasal polyps, enlarged adenoids and deviated septums can be corrected with surgery. Obviously this should be done only after more conservative measures have been tried. Surgery is not a replacement for good allergy control and treatment.
--------------------------------------
What is Vasomotor Rhinitis?
-----------------------------
Vasomotor Rhinitis is a condition which consists of a group of symptoms that include a runny nose, itchiness and sneezing, that are caused by irritation and congestion in the nose. It is brought about by changes in vascular tone and permeability.
What are the symptoms of Vasomotor rhinitis?
--------------------------------------------------
The symptoms of Vasomotor rhinitis include:
Recurring nasal inflammation
Sneezing
Runny nose
Profuse watery nasal discharge
Nasal membrane swelling
What causes Vasomotor rhinitis?
---------------------------------------
Vasomotor rhinitis occurs as a result of a response of the nasal membrane to
1.irritants such as smoke,
2.temperature changes and
3.stress.
Other causes of chronic rhinitis are blockage in the nose e.g. nasal polyps, enlarged adenoids and a deviated septum that impede mucus drainage and restrict air flow. Medications can cause rhinitis or worsen it in people with allergies, vasomotor rhinitis or a deviated septum.
Prolonged use of nasal decongestants can worsen rhinitis.
Some blood pressure medications such as beta blockers and vasodilators can cause rhinitis.
What is the difference between Allergic rhinitis and Vasomotor Rhinitis?
--------------------------------------------------------------------------------------
Allergic rhinitis could be seasonal or perennial (year round).
Seasonal rhinitis is due to pollen or mould spores.
Perennial rhinitis are due to allergens such as house dust mites, animal dander or moulds found on carpets or furniture upholstery and even some foods.
Non-allergic rhinitis can also be triggered by cigarette smoke and many other air pollutants, strong odours, exposure to cold and alcohol. Smoking and air pollution may also cause symptoms by damaging the cilia (hair cells) which moves mucus through the air passages.
Hormonal changes in pregnancy cause "Rhinitis in Pregnancy". The expecting mother will recover once the baby is delivered.
What treatments are available for Vasomotor rhinitis?
----------------------------------------------------------------
Treatments for Vasomotor rhinitis include:
Non-medical:
----------------
Avoid dry air
Keeping air moist
Vapourisers
Nasal Decongestant sprays are not recommended for treatment of vasomotor rhinitis
Complete avoidance of environmental allergens may be impossible but it can be minimised for example removing carpets and pets.
Use a pollen mask when mowing the grass or cleaning the house
Install an air purifier
Change the air filters monthly in heating and air conditioning systems
use cotton or synthetic materials such as Dacron in pillows and bedding
enclose mattress in plastic
keep windows closed during high pollen times
eliminate house plants
bathe pets frequently or even give away dander–producing pets.
Avoid Nasal irritants which can cause typical immune response seen with classical allergies. Examples include cigarette smoke, perfume, aerosol sprays, smoke, and smog and car exhaust
Nasal irrigation utilizing a buffered hyper tonic saline solution helps to reduce swollen and congested nasal and sinus tissues.
It also washes out thickened nasal secretions, irritants (smog, pollens, etc.), bacteria, and crusts from the nose and sinuses.
While irrigating the nose, it is best to stand over the sink and irrigate each side of your nose.
Aim the stream toward the back of your head, not at the top of your head.
For young children, the salt water can be put into a small spray container which can be squirted many times into each side of the nose.
Medical:
---------
Anti-histamines provide good relief for mild to moderate symptoms.
Newer antihistamines that are long-acting and less likely to cause drowsiness have been found to be useful.
Decongestants such as pseudoephedrine can help to shrink the swollen tissues caused by irritants and other causes. However decongestant nasal sprays are not advised because they cause a a rebound effect on nasal tissues(initially the nasal tissue shrinks but later they become more swollen)
Corticosteroids in the form of nasal spray reduce the immune response and may be prescribed to reduce severe symptoms.
These drugs are highly effective in allergic patients; but there is a potential for serious side effects when used over time. They are best used for the short term management of allergic problems, and their use must always be monitored by a physician.
Nasalcrom (cromolyn sodium): This spray helps to stabilize allergy cells (mast cells) by preventing release of allergy mediators, like histamine.
Immunotherapy:Allergy shots interfere with the allergic response. After identification of an allergen, small amounts of it are given back to the sensitive patient. Over time the patient will develop blocking antibodies to the allergen, and they become less sensitive and less reactive to the substance causing allergic symptoms. This is the best treatment provided the allergen is correctly identified.
Surgery:Nasal polyps, enlarged adenoids and deviated septums can be corrected with surgery. Obviously this should be done only after more conservative measures have been tried. Surgery is not a replacement for good allergy control and treatment.
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