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Posts tagged ‘chemotherapy’

Light Replaces Chemo

From Technology Review. Published by MIT

Biomedicine
Light-Based Therapy Destroys Cancer Cells

The new approach, which features a heat-sensitive fluorescent dye, could eventually replace standard chemotherapy.

Tuesday, November 8, 2011
By Erica Westly

For more than two decades, researchers have tried to develop a light-activated cancer therapy that could replace standard chemotherapy, which is effective but causes serious negative side effects. Despite those efforts, they’ve struggled to come up with a light-activated approach that would target only cancer cells.

Now scientists at the National Cancer Institute have developed a possible solution that involves pairing cancer-specific antibodies with a heat-sensitive fluorescent dye. The dye is nontoxic on its own, but when it comes into contact with near-infrared light, it heats up and essentially burns a small hole in the cell membrane it has attached to, killing the cell.

To target the tumor cells, the researchers used antibodies that bind to proteins that are overexpressed in cancer cells. “Normal cells may have a hundred copies of these antibodies, but cancer cells have millions of copies. That’s a big difference,” says Hisataka Kobayashi, a molecular imaging researcher at the National Cancer Institute and the lead author of the new study, published this week in Nature Medicine. The result is that only cancer cells are vulnerable to the light-activated cascade.

The researchers tested the new treatment in mice and found that it reduced tumor growth and prolonged survival.
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There are a few kinks to work out before the system can be adapted for humans, though. For instance, the researchers couldn’t test the treatment’s effect on large tumors, since killing off too many cells at once caused cardiovascular problems in the mice. Finding the right cancer-cell markers to pair with the dye may also prove difficult. For example, HER-2, one of the proteins targeted in the study, is only expressed in 40 percent of breast-cancer cells in humans.

Read complete article at Technology Reivew

The Barking Seal Admiration Society

Story from Saint Catherine’s Baby by Gabriel Constans

The Barking Seal Admiration Society – Part 1

My sister Joanne had come, for respite, from our hometown of Modesto, a land-locked metropolis eviscerated in the the scorching Sacramento Valley in Northern California. We were spending the afternoon on the wharf in Santa Cruz, a city on the edge of the Monterey Bay, just a touch south of San Francisco by way of Highway One; a scenic, precarious strip of pavement, hugging the coast like a black snake.

I’ve lived in Santa Cruz for twenty odd years, but you wouldn’t know it by the looks of me. My usual slacks, short-sleeved dress shirt and wide-brimmed Fedora, to cover my receding brown hair and shade my ever paling skin, stands in stark contrast to the shorts, wet suits, Hawaiian prints and Birkenstocks worn by most of the tanned, beach-faring home grown crowd. I don’t surf, the ocean’s much too cold for my liking; and I hate it when sand gets in my socks and shoes, grating roughly against my skin. To top off the oxymoron of my seaside existence, my work with an advertising agency in San Jose, though personally rewarding is not something I flaunt in this liberal college town.

Holding her floppy white straw hat, Joanne skipped down the old wooden peer, her right arm swinging freely. The pier stood on creaking stilts of old oak pylons that had been driven into the sea floor at the start of the last century. A space in the middle of the pier had been created for tourists to feed the seals. Joanne stopped at the railed opening to see the gluttonous sea creatures lounging on the braces below. As I caught up, she barked, clapped and laughed loudly, imitating the chubby, sumo-wrestling otters’ boisterous demands for food.

She was laughing like she had when we were two little toe heads. I remembered the times she interrupted my Lone Ranger play, as I made serious sound effects of guns firing and bullets ricocheting past my head. I wore my plastic red cowboy hat and holster and she’d be outfitted as a petite ballerina; her blond pigtails held to the side by bright pink, silk ribbons.

“Get out of the way!” I’d yell, pointing my six-shooter at the bad guys. She danced closer. “Stop it Jo!” I’d yelled again, using the form of Joanne she hated. She danced closer still, twirling, curtseying, falling and playing dead; her square-toed, laced ballet shoes sticking straight into the air. Everyone knows ballerinas and cowboys don’t mix, but she would keep jumping up and falling down, giggling and laughing, with total disregard for my need to save the land from desperados. Unable to keep a straight face, I’d holster my guns and clap at her performance, just like I’d seen our mother do before she’d died of cancer.

Joanne was still barking at the seals when a skinny woman wearing a blue-green scarf joined in. Momentarily startled, Joanne stopped and stared. Realizing the stranger wasn’t any crazier than herself; she smiled, laughed and resumed her barking and clapping. hey were like mimicking mimes imitating an innocent bystander.

The new addition to the barking seal admiration society turned and clapped towards Joanne, who eagerly returned her applause. They both bowed, barely avoiding knocking each other in the head. The woman’s scarf slipped forward and fell, revealing a shiny hairless scalp. She grabbed the cloth by the corner before it hit the pier. She stood grinning with the brilliance of a sparkler and quickly wrapped and tied her silk scarf. Joanne took off her hat and briskly rubbed her short soft brown curly tufts.

Feeling somehow drawn to this barking skeleton with no hair, I moved closer and listened to the enraptured duo, as the lady pointed at Joanne and said, “Chemo?”

Joanne nodded. They hollered, squealed and embraced; as if they were long lost sisters.

“Robin,” the woman exclaimed, bowing slightly.

“Joanne.” She curtsied.

They hugged again. Joanne, holding the sleeve of Robin’s full length, blue print dress, turned her in my direction. “This is my big brother Rueben; my great protector and occasional pain in the butt,” she snickered. “This is Rob . . .”

“Robin,” I interjected. “I heard.”

Dispensing with my usual reserve, I took Robin’s hand, knelt on the wood planks and kissed the back of her thin wrist. “It’s a pleasure, Ms. Robin.”

She bent her knees and bowed her head formally. “The pleasure is all mine Sir Rueben.”

I stood, offering my hands as their princely escort. Joanne, on my left, placed her right hand on mine, as Robin did the same on my right. With her free hand Robin lifted her dress a few inches, as Joanne pretended to do likewise, though she wore pants. We walked regally towards the bench at the end of the pier, with our noses turned theatrically skyward.

I brushed off the bench, pretended to place a cloth upon it and invited them to sit on their royal throne. They sat, squished comfortably together, as I descended onto the thick weathered wood next to Robin.

“Come closer,” she said, grabbing my pant leg and pulling. “It’s chilly out here.”

I snuggled closer. The waves thumped against the pilings below. We watched the surfers, as they drifted around the rising swells, waiting for the crest of a perfect wave. When their experienced eyes saw nature’s roller-coaster approaching, they began paddling and stood bravely on their miniscule pieces of wood; daring the foamy, curling blood of the sea to give them a thrill before extinguishing itself on the sandy shore. I thought about trying it once or twice, but the idea of swimming in freezing water, sharks, stinging salt-water in my eyes and the possibility of drowning; made my fledgling desire vanish faster than a crowd of punk rockers exiting the concert of a polka playing accordion band.

“Was it breast cancer?” Joanne asked, breaking the comfortable silence.

“Still is,” Robin said, matter-of-factly. “It’s such a happy camper, it’s decided to pitch tent.”

“I’m sorry,” Joanne said; her face transformed into a Japanese Kabuki mask of sorrow.

“Not your fault,” Robin replied dreamily, looking past the horizon. “Not anybody’s fault.”

“What a rotten deal,” I said.

“Yep, a rotten deal,” she said softly and exclaimed, “I’m starved.” She stood, took hold of our hands and tried pulling us off the bench. Her grip was surprisingly strong. “Sir Rueben,” she bowed. “Lady Joanne,” she bowed again, “Queen of the barking seals. Let us partake of some fine delicacies at the great dining hall of fish and chips.”

Turning our backs to the sea; Robin promenaded, with her two newly aggrieved squires, past the barking seals and tourists snapping pictures, towards the castle of greasy potatoes and dead fish meat.

After finishing a second order of fried breaded cod at Barcello’s Fish Fry and stacking the grease stained, white and red checkered throwaway containers in a heap; Robin grimaced and lurched forward.

“I think I’m going to be sick!” she covered her mouth.

The waitress behind the counter, who was as worn and painted over as the pier itself, noticed Robin’s distress and came as fast as her arthritic knees would allow.

“You OK?” she barked, with an urgency that implied, “You better be.”

Robin put her hand on the spotted Formica top and rolled her head from side to side. I placed my hand between her shoulder blades, moved my fingers up her spine and massaged her neck. Leaning closer, I heard her laughing under her breath. She looked at me and smiled, then jerked upright, “Just kidding!”

Joanne rolled her eyes with relief. The waitress was not amused. “Ha. Ha,” she scowled, lumbering back to the other end of the counter, muttering silent obscenities.

“Why’d you do that?” Joanne admonished, “It wasn’t funny.”

“Hey,” Robin replied, “When did you turn into the queen of pathos?”

Joanne’s frown turned into a smile, as she pushed Robin’s shoulder.

“Ouch!” Robin yelped, clasping her shoulder and grimacing with pain.

“Oh no,” Joanne’s face contorted once again. “I’m so sorry.” She looked at Robin with alarm. “Are you OK?”

Robin’s mischievous grin returned. She winked, letting Joanne know the joke was on her.

“Why . . . you!” Joanne waved Robin off good naturally and pushed her on the shoulder again as Robin renewed her painful grimace, then laughed hysterically, almost spitting with pleasure.

Robin turned discreetly in my direction and whispered, “I’ll act sick more often, if you promise to rub my back like that again.” I started to look away but couldn’t. She took my hand like a precious jewel and stroked it as gently as a soft kitten. “You have beautiful hands,” she purred. I glanced over her shoulder and saw Joanne watching out of the corner of her eye.

As we headed towards the car to pay the meter, not wanting to pay thirty-five dollars for a two-hour stroll, because of a parking ticket, it seemed as if the three of us had been together all day.

Reluctantly, we took our leave, as Joanne was driving back to Modesto that afternoon and offered Robin a ride.

“I’ll walk. Thanks,” she said, looking admiringly at the sky then back at me. “It’s such a beautiful day. I don’t live far.”

Joanne gave her a long hug. “Thank you,” she said.

“For what?” Robin asked.

“For reminding me how good it feels to laugh.”

“What else is there?”

They held each other’s hands, one on top of the other. Robin gently extracted her fingers from Joanne’s and turned her luminous eyes on mine. I wasn’t sure what to say or how. It felt like I’d known this woman all my life.

“Let’s go Rueben,” Joanne broke in. “I’ve got to get packed.”

My lips parted and crackled a stifled, “Goodbye.”

Robin stood quietly, nodding farewell. I started to walk away, when a desperate surge of adrenaline turned me around. Robin hadn’t budged. I hurried back.

“Could we . . . ah . . . get together sometime?” I said.

“I thought you’d never ask,” she smiled suggestively, reaching into her shimmering dress pocket and handing me a card.

Lowering my hat against the sun’s glare, I read. “Robin Magnolia. Consultant.”

“Consultant for what?” I wondered out loud.

“Surfing,” she replied, taking my hand in hers and kissing me on the cheek.

“Surfing?”

“Life surfing,” she whispered. Call me.”

“I will.”

Joanne shouted, “Come on Rueben! I’ve got to go.”

“See ya,” I said, letting her hand drop and heading towards the car. It took all my strength to not spin around and take her in my arms.

Part 2 (Conclusion) Tomorrow

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Health Care’s Invisible Glue

I once had the opportunity of developing intimate relationships with people of all ages and from all walks of life. They and their loved ones often shared deep secrets and lifetime memories. Challenges arose daily, imploring me to make an individual more comfortable or free of pain or to help someone deal with an emotional crisis. As the years progressed, I found that a simple touch, deed or word could profoundly affect the people I cared for.

You may be thinking, “You must be a nurse, right?” No. “Oh, then you’re obviously a doctor or an intern?” No, but close.

I’m talking about life as a nursing assistant, better known by the pseudonym “aide,” “orderly” or “attendant.” Their work with elders in convalescent homes is legendary. Legendary because they continue to work in such facilities with little pay, dangerous under staffing and terrible supply shortages. Conditions are frequently better in acute-care hospitals, but even there they are often seen as appendages to doctors and nurses. Rare is the individual or organization that grasps the importance and necessity of their involvement in the health care system. They are the “meat and potatoes” of hands-on medical care in this country, the glue that holds it together.

Nursing assistants make a crucial difference in peoples’ lives. Frequently, they spend more time with patients than nurses and doctors combined. For some, their presence means the difference between fear and loneliness and even life and death. They are there when we hurt, sweat, laugh and cry.

Some individuals (health care professionals and the public) act superior or snobbish to aides, treating them as if they are lacking in brains or have no motivation to “move up” the social ladder of medicine. It’s not overt or cruel prejudice, it is a basic disregard for the job, the training required and the workers involved.

Let me take you inside the world of a nursing assistant for just one 8 ½ hour shift, when I used to work the swing shift on the cancer unit of a local hospital. This is the real stuff, the nuts and bolts of health care and healing. It’s what nurses used to do before they become inundated with paper work, passing medications and running madly to finish all necessary procedures and treatments and to fulfill all the other responsibilities demanded of them.

After receiving my list of assigned patients and finding out which nurse I’m working with, I begin obtaining patients’ vital signs and get an overall picture of how they’re doing.

The gentleman I encounter in the first room needs his oxygen adjusted and some fresh water and towels.

The next patient, Alice, needs an entire bed change. A 73-year old woman with breast cancer, she has become incontinent and soiled her gown and linens. She is embarrassed and painfully apologetic. As I cleaned her up she spoke of her fear that she was beginning to lose control of her life. When I left, Alice said she felt “clean, fresh and renewed.”

The third person I contacted that evening was Charles, a 60-year old man with leukemia. As we conversed, he asked if I was in training to be a nurse. When he found out I wasn’t, he said, “Oh well, this is a good job for you to start out with for your future.” Just then the charge nurse came in with a frantic look on her face and asked if I could get another patient on a gurney to go downstairs for x-rays.

After I located a gurney on another unit and got the patient ready, another nurse requested that I make a trip to the blood bank to pick up some packed cells (blood). When I returned from the lab, I found my team leader (nurse) at the medicine cart.

We sat down and looked over the “care” charts to decipher what protocol was desired for each patient. Some vital signs needed to be taken and some patients needed to walk, be turned, bathed or catheterized (a tube put in the urethra to empty the bladder). Others had doctors’ “orders” that entailed checking blood sugar levels or collecting sputum, urine or stool samples for lab tests. During report, the nurse suddenly stopped, turned excitedly toward me and said, “When are you going to nursing school? You would make a great nurse.” She looked downhearted when I explained that I had no desire to be a registered nurse or to go back to school. She said, “But you’re so intelligent!” I grimaced and said, “Thanks”. Was she implying that that nursing assistant’s are stupid?

When report was over, I finished the remaining vital signs, lifted one patient up in bed, helped another to use the bedpan and took Alice for a walk down the hall. While shuffling along we pretended we were dancing to, “Tea For Two.” Her eyes sparkled when she told me that she and her deceased husband had been prize-winning dancers in the 1940s.

I informed the nurse that a patient’s IV (intravenous bag) was almost dry and that a number of people had requested pain relief and various other medications. The dinner trays arrived and after checking to make sure they all matched each patient’s diet, we passed them out. One of my folks needed help eating (as a result of an old stroke), so I sat by her bed and slowly gave her a few mushy bits of her soft diet, so she wouldn’t choke. Meanwhile, a patient undergoing chemotherapy was throwing up just two doors down the hall. After emptying his emesis basin (vomit container), I went to supper. Believe it or not, I was famished. It had been only two and a half-hours since my shift had started, but it felt like two and a half days!

On the way to dinner, I picked up a magazine which had a feature story entitled, “What Do Nurses Want?” I got my hot, soggy food, set my tray on the table and turned on the television. The channel I selected dramatized the story of a big-city hospital. As usual, the only characters given any airtime were, you guessed it, doctors and an occasional nurse. Everyone else in the show (housekeepers, technicians, secretaries and nurses aides) were shown as auxiliary personnel who did nothing but get in the way of the featured players.

After devouring my food in the allotted half-hour supper break, I returned to the unit and picked up the patients’ dinner trays. As I walked by Room 264, I saw Sam (a patient with advanced renal failure) falling headlong towards the floor. I leaped through the door and grabbed him just in the nick of time. Sometimes I felt like I was in one of those old commercials were people dove to catch a spill before it hit the carpet. Sam was getting more confused and said he had to go get things ready for the rabbit cage. I maneuvered him back to bed and eventually convinced him to stay in his room for the rest of the night. It took another hour before he realized he was in the hospital, after frequent reminders of who, what and where we were.

Then Michael put on his call light and literally screamed for help! Michael was a young man with AIDS who was in the hospital for treatment of a lung infection. Upon entering his room I found him tense, angry and perspiring profusely. He asked various questions about medications, IVs and food. Everything was worrying him. Was this working right? Was that being done on time? Was he getting the proper nourishment? After sitting and listening a few minutes, it was apparent that he was concerned about something other than mere food. At first, I answered his questions, then I asked him if he could tell me what he was really afraid of? He began to cry. He said he was overcome with feelings of abandonment from a dear friend and the emotional loss of some of his family members as a result of his illness. Fifteen minutes later Michael and I were laughing about the absurdity of life and the beauty of loving and sincere friendships. He only rang for assistance one other time that evening, to have someone turn out his light and say goodnight.

I left Michael’s room, made a fresh pot of coffee for family members and staff, fixed someone’s bed and TV and then took Jackie her evening snack of fruit and juice. Jackie and I had known each other for a few years, as she’d had frequent admissions for chemotherapy, such as her present three-day stretch. She always called it her “dose of poison” for the month and described her hospital visits as, “A working, masochistic vacation!” We spoke of her family, hopes for a cure and her latest garden project. Then she asked about my children and work. After a pause, the familiar questions began. “When are you going to go study medicine?” “Isn’t this just a job you’re doing to get through medical school?” Patiently, I said, “No, I’m not going to school right now.” It seemed futile to explain once again that this was my profession.

The remainder of the evening involved collecting and measuring fluid totals from each patient and spending time with the family members of a man who died at 9:00 p.m. His death was not unexpected, but the grief his family experienced was far greater than they had anticipated (as is often the case). We called the doctor, minister and mortuary. I got his body ready by taking out the IVs, putting in his teeth and folding his hands on his chest with as much dignity as possible. I finished charting on all the patients around 11:30 p.m., said goodnight to my co-workers and friends and called it a night.

Another “routine” shift had passed. As I drove home in the darkness, I thought about the perceptions people have of nursing assistants. Our society says it cares about the young and old, yet it places little value on those who care for the sick and aged or teach our children. Such failure to match words with deeds is, at the least, hypocritical. Why don’t people respect and reward those providing the hands-on care of their father or mother as much as they value the doctor who diagnosis the illness or the nurse that starts the IV or hands out the pills? If appreciation for the work nursing assistants’ do is ever acknowledged by good pay, healthy and safe staff to patient ratios and mutual respect, I think I’ll pass out from the shock.

Doctors and nurses are prime assets in delivering good quality health care. Without them, many would flounder and perish. I’ve seen them work long hours with great heart and dedication. But they are not the sole providers of care, nor do they have an exclusive patent on providing expert and passionate service. They do not work in a vacuum devoid of others’ energy and skills. Without secretaries, housekeepers, laundry workers, department managers, volunteers and countless other technicians, assistants and personnel, the health care system would find it impossible to function, let alone provide adequate or quality care.

Life tends to go in circles. Who will be there when you are feeling sick and miserable or someone in your family is? A nurse, maybe. A doctor, perhaps. Most likely, it will be one of my colleagues, a nursing assistant.

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