11 Notes - Diagnosis and Treatment.pdf

Diagnosis of cancer History:  Exposure (at work place, home, travel): asbestos, pesticides,  Any growths, lumps  Bleeding or blood in sputum, stool, urine  Change in bowel or bladder habits, visible moles  Discharge: breast, vaginal, intestinal  Hoarseness of the voi...

Diagnosis of cancer History:  Exposure (at work place, home, travel): asbestos, pesticides,  Any growths, lumps  Bleeding or blood in sputum, stool, urine  Change in bowel or bladder habits, visible moles  Discharge: breast, vaginal, intestinal  Hoarseness of the voice  Indigestion or difficulty swallowing  Nagging cough or Examination:  Inspection:  Obvious changes in a wart or a mole  Sores that doesn’t heal  Anemia and hypoxia; clubbing nails (fingers)  thromboflebitis in other vessels than leg veins  Ausculatation:  Lung  Abdomen: obstruction  Palpation:  any growth or lump  Lymph nodes at JOINTS  Tissue firmness Laboratory Diagnosis of Cancer  Histological  Cytological sample: Papanicolaou smear  Fine needle aspiration: a thin (23–25 gauge (0.52 to 0.64 mm outer diameter)), hollow needle is inserted into the mass for sampling of cells → stained →microscopic examination (biopsy).  Quick-frozen section: during surgery  Biopsy  Biochemical assays o Prostate specific antigen o Human chorionic gonadotrophin o Catecholeamine metabolites  Receptor analysis  Tumor antigens  Tumor specific antigens o MAGE-1-melanoma associated antigen-1  Tumor associated antigens (for the tissues) Dr M Hossu Notes 165  o Prostate specific antigen o Carcinoembryonic antigen o Alpha-fetoprotein o Virus associated antigens  in most cases transformed cells lose normal antigens and do not necessarily express new ones Treatment of Malignancy  N.B. The treatment of malignancy is not usually an emergency, o so there is usually time to gather information. o A well informed patient is extremely important. o Record all info and keep a journal. o Mental and emotional stress & support needed  Surgery  Radiation  Chemotherapy  Molecular therapies (modern monoclonal antibodies, cytokines)  Alternative immune stimulation o PAMP / TLR o Hyperthermia o miRNA o Spontaneous remission  Cen X., Liu S., Cheng K. The Role of Toll-Like Receptor in Inflammation and Tumor Immunity. Front. Pharmacol. 2018;9:878.  Skitzki JJ, Repasky EA, Evans SS. Hyperthermia as an immunotherapy strategy for cancer. Curr Opin Investig Drugs. 2009 Jun;10(6):550-8.: It has been reported that Hsps are generated from  Okada H, Kohanbash G, Lotze MT. MicroRNAs in immune regulation-- opportunities for cancer immunotherapy. Int J Biochem Cell Biol. 2010 Aug;42(8):1256-61  Vaucheret H, Chupeau Y. Ingested plant miRNAs regulate gene expression in animals. Cell Res. 2012 Jan;22(1):3-5  Leroux C, Chervet ML, German JB. Perspective: Milk microRNAs as Important Players in Infant Physiology and Development. Adv Nutr. 2021 Oct 1;12(5):1625-1635.  Ghatalia P, Morgan CJ, Sonpavde G. Meta-analysis of regression of advanced solid tumors in patients receiving placebo or no anti-cancer therapy in prospective trials. Crit Rev Oncol Hematol. 2016 Feb; 98:122-36 Dr M Hossu Notes 166  Importance for the Doctor of Chiropractic of knowing about neoplasia  Any doctor needs to know the symptoms and signs of neoplasia so that they can recognize them in their patients and be able to diagnose the patient or refer to an appropriate specialist.  Any doctor needs to know about carcinogens and factors causing malignancy so that they can counsel their patients about avoiding them.  A doctor needs to know the conditions that can predispose to the development of malignancy so that they will be aware of those conditions in their patients.  A Doctor of Chiropractic needs to know that palpating soft tissue tone alteration, stiffness and/or adhesions may be a sign of a possible neoplasia.  A Doctor of Chiropractic needs to know that joint areas are also a lymphatic rich areas and any changes palpated there may be associated with a possible neoplasia  A Doctor of Chiropractic needs to know that liver, lung, and brain are common sites of metastasis and any alteration of local tissue tone may decrease the resistance of respecting tissues to implanting metastasis or it may be a sign that metastasis may already be there. Dr M Hossu Notes 167