The top 5 Advances in Modern Oncology

What would you consider to be the top recent advances in the world of cancer?

As part of the 50th anniversary celebrations at the American Society of Clinical Oncology (ASCO), the society prepared a list of the most significant clinical cancer advances in modern oncology.

It then invited physicians, patients, and the public to vote for what they considered to be the top 5 advances in the last 50 years. The votes are now in. Take a moment and reflect, what would you have chosen???

Well, this week we go Out on a Limb once more and reveal what ASCO decided they are, but first





        Thought for the day


                The future begins today


                       Wayne Gerard Trotman
                       British filmmaker, writer





So here they are. The American Society of Clinical Oncology has revealed what it describes as the "Top 5 Advances in Modern Oncology.”

1. Chemotherapy cures advanced Hodgkin lymphoma
In 1965 came the first chemotherapy breakthrough for advanced cancer in adults, when a 4-drug combination chemotherapy regimen (cyclophosphamide, vincristine, mechlorethamine, and prednisone, known as MOPP) induced long-term remissions in more than half of patients with aggressive Hodgkin lymphoma.

This regimen quickly became standard treatment, but in the 1970s, a different 4-drug combination (doxorubicin, bleomycin, vinblastine, and dacarbazine, known as ABVD) proved even more effective, curing about 70% of patients with advanced Hodgkin lymphoma. The ABVD combination remains a mainstay of treatment today, ASCO comments.

It adds that the 1965 discovery of MOPP "sparked the first hope that advanced cancers could be cured with drug treatment, and paved the way for 90% cure rates for patients with this disease (Hodgkin lymphoma) today."

2. HPV vaccine approved to prevent cervical cancer
In 2006, the Food and Drug Administration (FDA) approved the first human papillomavirus (HPV) vaccine, Gardasil, which protects against the two strains of HPV (16 and 18) known to cause 70% of cervical cancers, as well as two other HPV strains (6 and 11) associated with genital warts.

Another HPV vaccine, Ceravix, which protects against the 2 strains linked to cervical cancer (16 and 18), was approved in 2009. Gardasil was first approved for the prevention of HPV-related cervical cancer, but this later expanded to include prevention of additional HPV-related diseases, including vaginal, vulvar, and anal cancers in women, and anal cancer and genital warts in men.

ASCO adds that studies have also linked HPV infection to head and neck cancers, suggesting that the vaccine may help prevent these cancers as well. "Widespread vaccination, if fully implemented, stands to drive dramatic reductions in cervical and other HPV-related cancers in the US and worldwide," it adds.

3. Targeted drug transforms treatment of chronic myelogenous leukemia
In 2001, the rapid FDA review and approval of imatinib (Gleevec) dramatically changed the treatment of patients with chronic myelogenous leukemia (CML).

This easy-to-take daily pill ― which targets a molecular defect (the Philadephia chromosome) present in nearly all patients with CML ― turned a disease with almost no long-term survivors into one with 5-year survival rates of 90%, ASCO comments. It also ushered in a new era of successful research on molecularly targeted treatments for many more cancers.

4. Chemotherapy cures men with testicular cancer
In 1977 came the pivotal trial showing that the 3-drug chemotherapy regimen known as PVB
(cisplatin, vinblastine, and bleomycin) produced complete remissions and some cures for more than 70% of men with advanced testicular cancer. Earlier chemotherapy treatments worked in just 5% of men, ASCO notes.

This combination regimen, coupled with later surgery, radiation, and chemotherapy advances, has made testicular cancer "one of the most curable cancers and one of oncology's biggest success stories."

5. Powerful antinausea drugs dramatically improve many patients' quality of life
In 1991, the FDA approval of the antinausea drug ondansetron (Zofran), as well as other supportive-care drugs in the following years, have together dramatically changed the experience of cancer treatment, bringing unprecedented improvements to patients' quality of life, ASCO comments.

Ondansetron, a 5HT3 receptor antagonist, works by deactivating the nervous system's natural trigger for vomiting, and other similar drugs were also soon approved, including granisetron (Kytril), dolasetron (Anzemet) and palonosetron (Aloxi).

These and other antinausea drugs, like aprepitant (Emend), which is a substance P/neurokinin 1 antagonist, allow most cancer patients to receive chemotherapy in an outpatient setting, with minimal disruption to their daily routines, ASCO commented.

"These drugs not only bring relief from intense, treatment-induced nausea, but make it possible for patients to avoid once-routine hospital stays, complete their full course of treatment, and live longer and better lives," it added.

Editor’s comment
Nothing here directly related to any of the most common cancers – breast, prostate, lung, bowel etc; and nothing from recent years. No studies on long-term survivors. No recognition of any Lifestyle Medicine benefits (nutrition, power of the mind, meditation, exercise etc).

Ever wonder how well all those research dollars are really being spent ? Or is this a sample that reflects a bias? What do you think?  What would be in your top 5? Add a comment below....

Reference: Click here

NOTICEBOARD

Details of all coming programs Ruth and I will be presenting are on our website: www.iangawler.com/events, and here are the next few:

NEXT MEDITATION RETREAT
Meditation Under the Long White Cloud   24 - 30 October 2015

7 day retreat at Mana Retreat Centre, Coromandel Peninsula, New Zealand

                 Take time out from the busyness of everyday life; spend time with your self
           Slow down, reflect, contemplate – regain perspective, vitality, balance and clarity
      Deepen your understanding and experience of mindfulness, contemplation and meditation

Full details, CLICK HERE


SPECIFIC CANCER RESIDENTIAL PROGRAMS

CANCER and BEYOND     October  2015     Monday 12th to Friday 16th 

Finding peace in the Healing Process

Five Day Residential Follow-up Program at the Gawler Foundation in the Yarra Valley

FULL DETAILS Click here 



MIND-BODY MEDICINE and CANCER    November  2015    Tuesday 10th to Saturday 14th

Five day Residential program in the beautiful surrounds of Wanaka, New Zealand
- an easy drive from Queenstown airport and very accessible for Australians

FULL DETAILS Click here

A volatile mix - stress, epigenetics and alcohol

Know anyone prone to drinking more alcohol when under stress? Talks about how the alcohol relieves the pressure? Just feels better after a glass or two?

May seem innocent enough, but this week we examine new research that demonstrates how the combination of stress and alcohol can lead to genetic changes that in turn explain how some people tip over into alcoholism, but first


               Thought for the day

         If we could read the secret history of our enemies,

        We should find in each man's life 
        Sorrow and suffering enough to disarm all hostility.

                      Henry Wadsworth Longfellow 





We all know that stress, whether acute or chronic does not feel good.

We also know that if the stress we are under exceeds our capacity to cope; then that type of stress can lead to alterations in mood and increased anxiety that may eventually result in the development of stress-related mental and physical disorders.

Dysphoria is a medical term that describes “a state of unease or generalized dissatisfaction with life”. Dysphoria is what many people feel when over-run with stress or anxiety.

Now, here is the thing. Alcohol is known to temporarily relieve feelings of dysphoria for many people. Some call this “self medication” and alcohol certainly works to that effect. But while on the surface, this self medication might seem harmless enough - having a quiet drink to settle the mind – there is a deeper and more sinister issue.

It turns out that the relationship between stress and alcohol consumption is meditated in part by brain-derived neurotrophic factor (BDNF). BDNF is a protein that regulates both the structure and function of nerve synapses - the point where two nerve cells interact and exchange nerve signals, and numerous other physiological processes. BDNF itself is regulated by genes that in turn can be affected by alcohol consumption.



Apparently, when alcohol is drunk with the intention of alleviating the unpleasant feelings of dysphoria, it causes epigenetic changes that in turn affect the complex control of BDNF.

The more alcohol that is drunk, the less functional BDNF becomes and so the need develops to drink more alcohol to achieve the same level of relief from dysphoria.

This can tip the unwary into a vicious cycle that can lead to alcoholism.

When talking of epigenetics here, we are describing the regulation of genetic information without modification of the core DNA sequence. Epigenetics in this situation can affect the complex control of BDNF signalling and synaptic plasticity - for example, by modifying the structure of the DNA–protein complexes such as chromatin, that make up the chromosomes and thereby modulate the expression of certain genes.

While these studies that are clarifying the mechanisms behind the epigenetic control of BDNF signalling and synaptic plasticity are offering some real insight into the mechanisms mediating the interaction between stress and alcoholism, they clearly come with a warning.



The body is so extra-ordinary, and so packed with its own wisdom.

While alcohol may relieve those early feelings of discomfort that come from stress and anxiety, clearly it comes with a very real risk; as shown here, a slippery slope type of risk.

Happily, given the chance, the body – and the mind - can learn to manage stress and anxiety much more effectively.

Another great reason to meditate regularly!

And more evidence of epigenetics - how your genes are not static, but are directly affected by the environment they are placed in - with positive or negative effects depending upon that interaction between the genes you were given and the environment created for them.

Primary Reference 
Moonat,S., and Pandey, SC. Stress, Epigenetics, and Alcoholism; Alcohol Research: Current Reviews, Volume 34, Issue Number 4

NOTICEBOARD
COMING RESIDENTIAL PROGRAMS
Currently, Ruth and I are concentrating much of our working time on preparing and presenting residential programs.

MEDITATION RETREATS
We lead meditation retreats for anyone interested in a more immersive experience of meditation. Whether as a beginner or an experienced meditator, there is nothing like taking time out from the busyness of daily life, receiving some instruction, being guided into meditation and then having a solid period of time to develop and deepen your own practice.

These programs can be well suited to people who teach meditation and want to learn more, or for those aspiring to become meditation teachers. Attending our meditation retreats may count towards the requirements to become qualified as a member of the Meditation Association of Australia (the re-named ATMA), please check for the specific program you are interested in.

CANCER PROGRAMS
We also lead more specific programs for people dealing with cancer. Again, whether you are dealing with cancer personally, or are supporting someone going through cancer, it can be invaluable to take the uninterrupted opportunity that a residential program offers to learn and experience what can be done through your own combined efforts.

All the important Lifestyle Medicine factors are addressed in depth – accelerated healing, therapeutic nutrition, suitable types of exercise, healthy, healing emotions, the power of the mind and of course, meditation, mindfulness and guided imagery.

Two types of cancer programs are presented. The first are open to everyone affected by cancer and are held in New Zealand. These programs are comprehensive in that they cover the full program and are suitable for people new to this approach or the more experienced. There is an 8 day and a 5 day version of this program to choose from.

Then there are more specific follow-up programs that we present for the Gawler Cancer Foundation in the Yarra Valley. These are tailor-made to meet the needs of people who have attended a previous “Gawler” program, either at the Foundation itself, with Ruth or myself, or one of the groups linked with the Foundation that is presenting its style of program.

THE VENUES
We have gone to some lengths to ensure that all these residential programs can be presented in beautiful environments, where the amenities are suitable and where the food is consistent with our principles and prepared lovingly with great taste. As we know, healthy food is not only good for you, but can taste terrific!

Details of the programs coming up in the not-to-distant future are below, while more comprehensive details are on the website: www.iangawler.com/events

NEXT MEDITATION RETREAT
Meditation Under the Long White Cloud   24 - 30 October 2015

7 day retreat at Mana Retreat Centre, Coromandel Peninsula, New Zealand

                 Take time out from the busyness of everyday life; spend time with your self
           Slow down, reflect, contemplate – regain perspective, vitality, balance and clarity
      Deepen your understanding and experience of mindfulness, contemplation and meditation

Full details, CLICK HERE


SPECIFIC CANCER RESIDENTIAL PROGRAMS

CANCER and BEYOND     October  2015     Monday 12th to Friday 16th 

Finding peace in the Healing Process

Five Day Residential Follow-up Program at the Gawler Foundation in the Yarra Valley

This program is specifically designed for those with cancer along with their support people who have attended a previous Gawler Cancer Foundation program or equivalent such as with Sabina Rabold, CSWA, Cancer Care SA, CanLive NZ, or with the Gawlers themselves.

A unique opportunity to meet with like-minded people once again, to consolidate what you already know, to learn more from the combined knowledge, experience and wisdom of Ian and Ruth, to reaffirm your good intentions, and to go home refreshed and revitalised.

FULL DETAILS Click here 

MIND-BODY MEDICINE and CANCER    November  2015    Tuesday 10th to Saturday 14th

Five day Residential program in the beautiful surrounds of Wanaka, New Zealand
- an easy drive from Queenstown airport and very accessible for Australians

This program is open to anyone affected by cancer. Health professionals interested to learn more of this work are also welcome to attend.

While the focus of this program is on therapeutic meditation and nutrition, the power of the mind and emotional health, ample time will be given to answering any questions you may have relating to the Gawler program - exercise, positive thinking, healing, balancing medical options, successful ways of dealing with setbacks, sustaining your good intentions and the relevance of finding meaning in life to healing and recovery.

FULL DETAILS Click here