Category Archives: Cancer Supportive Care/Palliative Care

Ginger to Lessen Chemotherapy Nausea

The medical abstract below provides a rather technical overview of how ginger root helps lessen chemotherapy induced  nausea. Organic ginger root tea is helpful.

Neurogastroenterol Motil. 2013 May;25(5):439-47,
Ginger and its pungent constituents non-competitively inhibit activation of human recombinant and native 5-HT3 receptors of enteric neurons.
Walstab J, Krüger D, Stark T, Hofmann T
1Department of Human Molecular Genetics, Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany.

Beneficial effects of ginger in the treatment of gastrointestinal (GI) problems and chemotherapy-induced nausea and vomiting are well accepted. In rodents, the action of ginger seems to be mediated by the inhibition of 5-HT3 receptors, which are established targets to combat emesis and irritable bowel syndrome.

Heterologously expressed human 5-HT3 A or 5-HT3 AB receptors were characterized by means of Ca(2+) influx studies using HEK293 cells. Complementing Ca(2+) measurements in Fluo-4-AM-stained whole-mount preparations of the human submucous plexus were carried out. Furthermore, [3H]GR65630 binding assays were performed to reveal the mode of action of ginger and its pungent compounds.

We show for the first time that ginger extracts and its pungent arylalkane constituents concentration-dependently inhibit activation of human 5-HT3 receptors. Ginger extracts inhibited both receptors with increasing content of pungent compounds, confirming that these are part of ginger’s active principle. Inhibition potencies of the arylalkanes 6-gingerol and 6-shogaol on both receptors were in the low micromolar range. A lipophilic ginger extract and 6-gingerol had no influence on 5-HT potency, but reduced the 5-HT maximum effect, indicating non-competitive inhibition. The non-competitive action was confirmed by [(3) H]GR65630 binding, showing that the ginger extract did not displace the radioligand from 5-HT3 A and 5-HT3 AB receptors. The potential relevance of the inhibitory action of ginger on native 5-HT3 receptors in the gut was confirmed in whole-mount preparations of the human submucous plexus. While a general neurotoxic effect of 6-gingerol was ruled out, it inhibited the 2-methyl-5-HT-mediated activation of 5-HT3 receptors residing on enteric neurons.

Our findings may encourage the use of ginger extracts to alleviate nausea in cancer patients receiving chemotherapy and to treat functional GI disorders.

Is Palliative Care The Same As Hospice?

Palliative Care addresses pain and symptom management, and is often given alongside a curative treatment plan. Hospice Services are limited to those patients with a life limiting illness, nearing end of life, when curative treatment is no longer sought. The focus of hospice is symptom relief and comfort.
Palliative Care can be provided at any stage of a serious illness, whether that illness is curable, chronic or life threatening. Anyone with a serious or chronic condition can benefit from palliative care.
Palliative Care is an interdisciplinary approach that includes pain management, symptom management, and emotional support as a patient copes with serious illness.
Both Palliative Care and Hospice Services focus on the patient as a whole person, addressing body, mind and spirit.
Both Palliative Care and Hospice Services can be provided in the hospital, in outpatient settings, in skilled nursing homes and in home.

Palliative Care and Hospice Services provide comfort and dignity for the person enduring serious illness.


What is Integrative Medicine

The Consortium of Academic Health Centers For Integrative Medicine website states Integrative Medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.
The Consortium office is located on the Twin Cities campus of the University of Minnesota.  

Additionally . . .
Dr. Andrew Weil’s website defines Integrative medicine as healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.
The Principles of Integrative Medicine:

• A partnership between patient and practitioner in the healing process

• Appropriate use of conventional and alternative methods to facilitate the body’s innate healing response

• Consideration of all factors that influence health, wellness and disease, including mind, spirit and community as well as body

• A philosophy that neither rejects conventional medicine nor accepts alternative therapies uncritically

• Recognition that good medicine should be based in good science, be inquiry driven, and be open to new paradigms

• Use of natural, effective, less-invasive interventions whenever possible

• Use of the broader concepts of promotion of health and the prevention of illness as well as the treatment of disease

• Training of practitioners to be models of health and healing, committed to the process of self-exploration and self-development


Skin Rash Due To Cancer Treatment

The National Comprehensive Cancer Network (NCCN), is a not-for-profit alliance of 21 of the world’s leading cancer centers. The NCCN is dedicated to improving the quality and effectiveness of care provided to patients with cancer. The following NCCN information regards skin rashes due to epidermal growth factor receptor inhibitor cancer treatment.

Certain drugs used in cancer treatment can cause skin rash, dry skin, or hair or nail problems. Drugs called EGFR inhibitors (epidermal growth factor receptor) are often prescribed for patients with colon, head and neck, pancreatic, non–small cell lung, and breast cancers. These drugs include cetuximab (Erbitux), panitumumab (Vectibix), erlotinib (Tarceva), gefitinib (Iressa), and lapatinib (Tykerb/Tyverb).  This class of cancer drugs is associated with a number of side effects, but skin rash is the most common. Approximately 90% of patients undergoing treatment with EGFR inhibitors experience this side effect. The rash can cause significant discomfort and can also affect a patient’s appearance, which may contribute to a negative body image and depression. Patients affected by these negative effects, however, can take actions to reduce the severity of this unpleasant experience.

Rash Characteristics
The rashes associated with these drugs can be severe and may affect the face, scalp, neck, upper chest, and back. This rash often resembles acne, although it has distinct qualities that make it more troublesome than classic acne. Patients often complain of tenderness, irritation, burning, and stinging.

Although this rash is an unwanted and uncomfortable side effect of treatment, patients should realize that the rash and its severity mean that the treatment is working. It is also important to realize that the rash is not an allergic reaction and it generally resolves after treatment is stopped. However, because the more severe the rash, the better the treatment is working, doctors will treat the rash rather than lower the dose or stop treatment.

Protecting the Skin
Because the rash can sometimes be triggered by ultraviolet light, patients receiving any of the drugs listed above should consider using sunscreen to protect their skin from the sunlight. Sunscreens without alcohol are less irritating. Although both fair- and dark-skinned patients can experience the rash, it is more likely to be severe in people with light skin.

Although most of these skin rashes do not cause scarring, patients may see darkening of the skin after the redness and inflammation have resolved. This darkening usually fades within 3 weeks after treatment is stopped. Patients who develop significant skin rashes during treatment may be more sensitive to sunlight even after treatment, so it is important to continue protective measures.

As with all side-effects from cancer treatment, patients should inform their cancer care team if they develop a rash during cancer treatment. Early intervention is important for proper management, so patients should tell their health care providers about any skin changes as soon as possible. Patients should not try to diagnose or treat themselves to avoid worsening the condition.

For example, although the rash resembles acne, common anti acne medications, such as topical retinoids and benzoyl peroxide, should not be used for treatment because they are drying and can increase the burning and irritation. Further, they have not been shown to improve the symptoms. For mild rashes, topical creams such as hydrocortisone can be used to relieve symptoms. For rash that is moderate to severe, the doctor may consider oral antibiotics such as doxycycline. Although the rash is not an infection, the affected area can get infected from scratching. Therefore, it is important for patients to take antibiotics if they are prescribed. Oral or topical antihistamines may also be recommended to relieve itching.

In addition to taking any prescribed mediation, there are some things patients can do to help reduce their discomfort with the rash:

Apply alcohol-free, fragrance-free, hypoallergenic moisturizer daily and on feet and hands at bedtime
Drink plenty of fluids (at least 2 liters a day) to stay hydrated, and avoid caffeine
 Apply PABA free sunscreen of at least SPF 30 and wear protective clothing when in sunlight
 Avoid hot showers, walking barefoot, and wearing tight fitting footwear
Wear only hypoallergenic makeup
Use mild detergents and skin cleansers
Avoid over-the-counter anti acne medications

Patients should also contact their health care provider if the symptoms get worse or the rash spreads.

Sourced From: – National Comprehensive Cancer Network.

Chemotherapy Skin Rash

Skin changes associated with chemotherapy drugs can have a wide variety of sign and symptoms including rashes, dermatitis, hyperpigmentation (excess darkening of the skin), urticaria (hives), photosensitivity, nail changes, alopecia (hair loss), and radiation recall.

Hand Foot Syndrome
Also know as palmar-plantar erythrodysesthesia, involves dry, painful, erythematous, hyperpigmented skin conditions commonly associated with continuous infusion of fluorouracil (5-FU); liposomal preparations, such as liposomal doxorubicin; or prolonged therapy with hydrea or high-dose methotrexate.

Infusion of carmustine (BCNU), cytarabine (Ara-C), gemcitabine (Gemzar), asparaginase (Elspar), and procarbazine (Matulane) can cause temporary rashes. These are often responsive to diphenhydramine or steroids.

Mitomycin, 5-FU, methotrexate, vinblastine, and dacarbazine (DTIC) can induce photosensitivity.

Nail changes
A variety of nail changes can result from chemotherapy. Usually, changes in nail pigmentation are noted, with banding and streaks starting at the base of the nail as it grows out. Cyclophosphamide, doxorubicin, and 5-FU cause nail pigment changes. Bleomycin and more recently the weekly administration of taxanes have been noted to produce excessive nail brittleness and nail loss.

Skin hyperpigmentation can occur with a variety of drugs, most notably, busulfan, bleomycin, thiotepa, 5-FU, and methotrexate.

Radiation recall is a phenomenon in which a skin reaction is observed after chemotherapy administration in areas that were previously irradiated. DTIC and doxorubicin are the usual agents associated with radiation recall. Methotrexate and 5-FU can also cause this effect.


Skin Toxicity Associated With Chemotherapy

BACKGROUND: New chemotherapic agents and new protocols in oncology have led to an increasing survival rate in patients affected by tumors. However, this increased use has been accompanied by a growth in the incidence of cutaneous (dermatologic) side effects and a worsening of patients’ quality of life. Appropriate management of skin toxicity associated with chemotherapic agents is therefore necessary for suitable drug administration and to improve quality of life and clinical outcomes.
METHODS: We have clinically examined 100 patients affected by cancer, determining type, frequency, treatment, and evolution of side effects related to chemotherapy.
RESULTS: The prevalent cutaneous side effects in patients undergoing chemotherapy are skin rash, xerosis, pruritus, paronychia, hair abnormality, and mucositis. The clinical cases are reported in detail.
CONCLUSION: Oncological therapies have become more selective and have low systemic toxicity because of their high specificity, but cutaneous side effects are common and may worsen the quality of life of these patients.

Source: J Exp Clin Cancer Res. 2012 May 28
Chemotherapy and Skin Reactions.
Fabbrocini G, Cameli N, Romano MC, Mariano M, Panariello L, Bianca D, Monfrecola G.
Division of Clinical Dermatology, Department of Systematic Pathology, University of Naples Federico II, Naples, Italy.


Chemotherapy Side Effects Skin



Over the last two decades, a number of new chemotherapeutic agents have been used for the treatment of cancer. These drugs may be classified according to their mechanism of action: signal transduction inhibitors (epidermal growth factor receptor EGFR antagonists and multikinase inhibitors), proteasome inhibitors, spindle inhibitors (xaxanes and vinca alkaloids), antimetabolites (purine analogs and pyrimidine analogs), genotoxic agents.

Chemotherapeutic agents have significant side effects. Although skin toxicity is rarely life-threatening it often worsens the patients’ quality of life.

It is well known that, cytotoxic agents like Cyclophosphamide, Chlorambucil, Busulfan, Procarbazine can cause side-effects to hair and nails (alopecia, paronychia, melanonychia, and other abnormalities), on skin barrier (skin rash, skin dryness, hyperpigmentation) and on mucose (Steven-Johnson Syndrome and toxic epidermic necrolysis).

In recent years, targeted therapy has considerably increased survival rate in patients affected by important solid tumors of kidney, lungs, colon-rectum, breast and liver. Among the innovative therapeutic strategies in chemotherapy, the EGFR inhibitors (Cetuximab, Panitumumab, Erlotinib, Gefitinib) approved for lung and colon-rectum tumors showed an increasing skin toxicity, causing widespread skin dryness (in more than 90% of patients) and a follicular rash which can be complicated by pruritus, pain and infections.

Despite the benefits of all these chemotherapic agents, toxic effects on the skin may eventually result in poor compliance of patients and interruptions or discontinuation of antineoplastic therapy. Such toxic effects of the skin may also significantly reduce the quality of life of oncological patients.

Sourced from: Chemotherapy and Skin Reactions
Journal of Experimental & Clinical Cancer Research 2012
Gabriella Fabbrocini, Norma Cameli

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Katha Tibet DaSomá Skin Ointment and Therapeutic Lip Balm are manufactured and distributed by Kathá Soma Consumer Healthcare USA.  Kathá Soma therapeutics are formulated to help people living with cancer, chronic disease or slow cell renewal due to aging, minimize their signs & symptoms, achieve daily comfort and maintain quality of life.