Tuesday, August 30, 2011

Symptoms and Treatments of Leukemia

The goal of treatment for leukemia is to destroy the leukemia cells and allow normal cells to form in your bone marrow. Treatment decisions are based on the type and subtype of leukemia you have, its stage, and your age and general health.

Treatment for acute leukemia

Chemotherapy is the use of drugs to fight cancer. It is the usual treatment for acute leukemia. For most people, that means receiving drugs in three stages:
  • Induction. The goal of this stage is remission. Remission is a period in which the leukemia cells have been destroyed and are replaced with healthy cells. Induction is done with high doses of powerful drugs which may be given over a period of time from about a week to a month, depending on the type of leukemia. Then it takes several weeks for your body to start growing new blood cells. You probably will stay in the hospital during this time. This can take a month or longer.
  • Consolidation. Even when tests show no leukemia cells can be found, there may still be some left. The goal of consolidation is to kill any cells that are left. Consolidation often involves the same drugs given in the induction stage, but the schedule and doses may be different. For example, you may receive the drugs in one or two 5-day cycles spread over 1 to 3 months.
  • Maintenance. The goal of this stage is to prevent leukemia cells from growing back. During maintenance you are given lower doses of drugs over the course of 2 to 3 years. If your type of leukemia has a high risk of coming back (relapse), this stage might include a stem cell transplant. The maintenance stage is not used for all types of leukemia, but is a common part of treatment for acute lymphoblastic leukemia (ALL).
Some types of acute leukemia spread to the brain and spinal cord. Regular chemotherapy cannot reach those areas, because your body puts up a special barrier to protect them. A different way of giving chemotherapy, called intrathecal chemotherapy, treats these areas by injecting the drugs directly into your spinal canal to attack any leukemia cells there. Radiation is also used to treat acute leukemia that has spread to the brain and spinal cord.
Stem cell transplant is often used as an initial treatment for people with high-risk acute leukemia. Most stem cell transplants for leukemia are allogeneic, meaning the stem cells are donated by someone else. The goal of a transplant is to destroy all the cells in your bone marrow, including the leukemia cells, and replace them with new, normal cells.
Treatment if acute leukemia gets worse
Sometimes leukemia gets worse in spite of treatments. Sometimes it gets better, or "goes into remission." Sometimes it comes back, or "relapses." Even when that happens, there are several treatments that may help to cure the leukemia or help you live longer:
  • Clinical trials. People who have leukemia may enter a research program when they first start treatment or if the leukemia is not getting better. These programs test new ways to treat the disease. For more information, see www.cancer.gov/clinical_trials/ or http://clinicaltrials.gov.
  • Stem cell transplant. Donated cells from a "matched" donor can rebuild your supply of normal blood cells and your immune system. (A matched donor is usually a family member. But many people have family members whose stem cells are not a close enough match.) Stem cells can be from bone marrow, from the bloodstream, or from umbilical cord blood. If you have a matched donor, drugs and radiation are used to destroy the cells in your bone marrow and make room for donated cells. If you have a relapse after a transplant, a transfusion of more of your donor's white blood cells may put you back into remission.
  • Drugs. Sometimes different drugs or different doses than those that were used during your initial chemotherapy can help.
  • Repeating the induction stage. Sometimes the same drugs that put leukemia into remission in the first place will work again.

Treatment of chronic leukemia

Unlike acute leukemia, chronic leukemia is not always treated right away. It usually gets worse more slowly than acute leukemia. This is especially true for chronic lymphocytic leukemia (CLL).
Treatment choices for chronic leukemia include:
  • Watchful waiting. Treatment is often not needed in the early stages of CLL. CLL usually gets worse very slowly, and you may have no symptoms for some time. You and your doctor may decide to hold off on treatment for a while. During this time your doctor will watch you carefully. It is estimated that 1 in 3 people who have CLL never need treatment.7
  • Stem cell transplant. Most stem cell transplants for leukemia are allogeneic, meaning the stem cells are donated by someone else. The goal of a transplant is to destroy all the cells in your bone marrow, including the leukemia cells, and replace them with new, normal cells.
  • Biological therapy. This is the use of special drugs that improve your body's natural defenses against cancer. One such drug that doctors often use to treat CLL is a monoclonal antibody.
  • Radiation therapy. Radiation may be used to destroy cancer cells. It also may be used to shrink swollen lymph nodes or a swollen spleen. Sometimes radiation is used on the whole body to prepare for a bone marrow transplant or to treat CLL.
  • The first treatment used for chronic myelogenous leukemia (CML) is the medicine imatinib (Gleevec).
  • Clinical trials, which are used to find out whether a medicine or treatment is safe and effective. People who have chronic leukemia are often referred to clinical trials for their treatment. For more information, see www.cancer.gov/clinical_trials/ or http://clinicaltrials.gov.
  • Chemotherapy. Chemotherapy is the use of drugs that attack cancer cells. A variety of drugs is available to fight leukemia and help you live longer.
  • Treatment of infections. When you have chronic leukemia, your body is not able to fight infections very well. You and your doctor need to watch for any signs of infections, such as pneumonia, yeast infections, and shingles. Early treatment of these and other infections will help you live longer. You can sometimes prevent certain infections or keep from getting very sick by getting a flu shot or a pneumonia vaccine. Your doctor also may give you antibiotics to prevent infection while you are being treated for leukemia.
If you have chronic lymphocytic leukemia (CLL), your doctor may want to check you regularly for other types of cancer. People who have CLL have a higher chance than normal of getting a second cancer.
Treatment if chronic leukemia gets worse
If you have chronic myelogenous leukemia (CML) that gets worse or relapses, there is still much hope. Imatinib (Gleevec) may be combined with other drugs to treat the disease. A new drug called dasatinib (Sprycel) is now available for people whose CML is not helped by imatinib. Other new drugs are also being tested in clinical trials.
If you have a relapse after a bone marrow transplant, a transfusion of more of your donor's white blood cells may put you back into remission.

Palliative care

If leukemia gets worse, you may want to think about focusing on palliative care for your treatment. Palliative care is a kind of care for people who have illnesses that do not go away and often get worse over time. It is different from treatment to cure your illness, called curative treatment. Palliative care focuses on improving your quality of life—not just in your body but also in your mind and spirit.
Palliative care may help you manage symptoms or side effects from treatment. It could also help you cope with your feelings about living with a long-term illness, make future plans around your medical care, or help your family better understand your illness and how to support you.
If you are interested in palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.
For more information, see the topic Palliative Care.

End-of-life issues

Even if your treatment is going well, it's a good idea to plan ahead. Talk to your family and your doctor about health care and other legal issues that arise near the end of life. Put your health care choices in writing (with an advance directive or living will). This is important, if a time comes when you can't make and communicate these decisions. Think about your treatment options and which kind of treatment will be best for you. You may also want to choose a health care agent to make and carry out decisions about your care if you become unable to speak for yourself.
For more information, see the topics Writing an Advance Directive and Choosing a Health Care Agent.
A time may come when your goals may change from treating an illness to maintaining your comfort and dignity. Your doctor can address questions or concerns about maintaining your comfort when cure is no longer an option. Hospice care professionals can provide palliative care in the comfortable surroundings of your own home.
For more information, see the topics Palliative Care, Hospice Care and Care at the End of Life.

Pallative Care of Leukemia

alliative care for leukemia focuses on relieving symptoms, improving quality of life and supporting the patient throughout treatment for leukemia. Palliative care demands are different for different types of leukemia. For example, acute leukemia palliative care differs from chronic leukemia care. Palliative care is different from treatment designed to cure a disease. Instead, the goal of palliative care is to improve a patient's quality of life and relieve suffering by focusing on physical and emotional wellbeing.

Palliative Care vs. Hospice Care

Palliative care is often confused with hospice care, or end-of-life care. Hospice care includes palliative care by necessity, but palliative care alone doesn't mean that treatment for leukemia has failed. Instead, palliative care provides support in a number of areas, including:
  • Education
  • Emotional support
  • Pain management
  • Treatment complications.

Pain Management and Treatment for Leukemia

Leukemia can cause pain, including joint and bone pain due to accumulations of leukemia cells. Chronic leukemia may result in an enlarged spleen that places pressure on surrounding tissue, causing discomfort and pain. Infection of lymph nodes by leukemia cells can cause painful swelling.
Treatment for leukemia, including chemotherapy and radiation therapy, can also cause pain. In addition to treatment itself, causes of pain may include multiple needle sticks due to chemotherapy administration and blood sample and bone marrow collections.
Pain medication may be prescribed to manage leukemia pain. Pain caused by chemotherapy injection can be mitigated with central venous catheterization, a surgical procedure where a temporary catheter is inserted into a vein for administration of chemotherapy drugs.
Other strategies for managing leukemia pain may include:
  • Acupuncture
  • Counseling
  • Exercise therapy
  • Massage
  • Meditation
  • Relaxation or breathing techniques
  • Stress management techniques.

Prevention of Leukemia Treatment Problems

Prevention of treatment complications is an important part of palliative care for various types of leukemia. Chemotherapy and radiation therapy weaken the immune system, especially when given in the doses required for stem cell transplantation.
Prophylactic antibiotics may be provided to lower the risk of infection during treatment for leukemia. If necessary, antifungal and antiviral medications are employed. The patient may also receive nutritional advice from a dietician on how best to eat during leukemia treatment.

Emotional Support for Leukemia Patients

Acute leukemia symptoms develop rapidly, and chronic leukemia may not be detected until the disease is advanced. The transition from feeling healthy to facing a life-threatening illness is rapid and abrupt for many leukemia patients.
The emotional toll of leukemia on patients should not be understated. Palliative care may include counseling and support for both the patient and her family.

Patient Education and Palliative Care

Palliative care may also include educating the patient on his disease and offering suggestions on how to live with leukemia. Chronic lymphocytic leukemia, for instance, is often not treated in its early stages, unlike other types of leukemia. Instead, doctors typically recommend "watchful waiting," or monitoring the patient for chronic leukemia symptoms. Palliative care may include educating the patient on what signs to look for and report to medical professionals.

Once diagnosis is made, the goal of the leukemia team is to prevent complications such as bleeding, electrolyte abnormalities and infections that can potentially lead to death.
Biren Saraiya, MD
Biren Saraiya
Initially, the complications are due to the leukemia and later they are due to the chemotherapy. Usually the period of time patients spend in the hospital is in weeks. This long duration of the hospitalization allows the medical team, the patient and family to really get to know each other well.
The medical team’s focus is not only on the patient, but also on the family. Typically, patients are readmitted to the hospital for subsequent therapies as well, and again this potentially allows for a continued relationship between the medical team and the patient and family.
Though not formally called palliative care, the therapy typically involves prevention and treatment of complications. Antibacterial, antiviral and antifungal medications are used to prevent and treat infections; transfusions are used for the treatment of bone marrow dysfunction; and treatment with pain medications and parenteral nutrition for mucositis. Historically, the improvement in outcome of therapy has been due to these supportive measures as they have allowed for increasingly toxic therapy aimed at curing the cancer.
The traditional leukemia team typically includes physicians including the attending oncologist, house staff and consultants, but also nurses, a social worker, a physical therapist, a nutritionist and a pharmacist.
The traditional model of palliative care also involves a team of medical professionals including physicians, nurses, a social worker, a physical therapist, a nutritionist, a pharmacist, and a psychologist or psychiatrist.
Despite having similar goals and similar team members there is a disconnect. In my estimation, there are at least two factors for this disconnect. One is of perception. Many nonleukemia professionals (and in my case my house staff) have the perception that leukemia doctors push patients too hard (even give chemotherapy in the ICU!), while many leukemia doctors may feel that the patient population they serve, even the elderly, can benefit from very aggressive therapy. This may be related to the differences in potential outcomes. With leukemia, the other “c” word, cure, is possible even in the poor-risk group. In the case of a typical solid tumor patient, the goal of therapy becomes palliative in nature once the cancer is metastatic.
The other disconnect is of time — by the nature of the disease, all decisions for therapy are made in a very short amount of time as compared to other solid tumor malignancies. This obviously creates a situation where a patient who until very recently had been feeling well needs to make a decision regarding therapy in a relatively short period of time or they could potentially die. In my limited experience, that is not much of a choice.
Unlike patients with solid tumor malignancy where there is gradual onset of symptoms such as dyspnea, pain and decrease in performance status, leukemia may have a very acute onset.
In a 2001 editorial in Leukemia Research, Mary Laudon Thomas, MD, called for integration of both palliative care and leukemia therapy. And if one looks at the similarities between the two, it makes perfect sense. The outcomes for patients receiving the aggressive chemotherapy are improved with better symptom control. The primary team has many concerns to deal with besides the symptoms. We know from previous research that when there is a specific person or a team focused on symptoms, the symptom control is improved. Shouldn’t then it be standard of care to have a team member focused solely on patient’s symptoms?

Nepal Cancer Relif Society in Nepal

What we do and how

Nepal cancer relief society is playing a leading role in both preventive and curative programs against cancer. Besides the cancer prevention and tobacco control projects supported by international and national donor organizations, NCRS every year conducts its own cancer control programs nationwide. NRCS has its branches in 40 districts of Nepal. One of its major activities includes Mobile Cancer Screening Programs that are conducted throughout the year in the remote outskirts of Nepal, where both cancer screening and health education are undertaken. NCRS also provides scholarships for health practitioners (doctors/nurses) for higher studies. Apart from this, NCRS also conducts various other preventive & curative programs. NCRS is contributing nation by providing better cancer treatment facilities in country.

Preventive Program

NCRS conducts preventive programs for Cancer in mainly 3 ways, working with Educational Institutions, Community & with Professional Organization. NCRS organizes workshops, seminars, symposia to educate Nepalese public on various aspects of cancers, reorient the health workers in the various issues of cancer, educate people against the use of carcinogens and methods of detecting it at its signs of cancer, advice patients to visit proper centers for treatment at slightest doubt of having cancer.

1. Working With Education Institution.

Cancer Education Program (for prevention and early detection)
Creating awareness about cancer, its early symptoms and screening for early detection are the major preventive activities of NCRS. As awareness about the cancer and its early symptoms is major way from preventing cancer. Under this program NCRS conduct cancer awareness programs including classes in varieties of sectors like educational institutions, community organizations, women groups, rehabilitation centers and many other sectors of rural and urban regions of the country through its 40 district branches. NCRS provide awareness raising materials (Brochures of all cancer, breast self examination leaflets, oral cancer examination leaflets, tobacco related brochures etc). NCRS also shows cancer awareness documentary. Directly it approaches to different educational institutions, women groups, rehabilitation centers and local community. Indirectly NCRS collaborates with several professional and nongovernmental organizations to conduct cancer education program including tobacco control. Various researches in tobacco sector have also been conducted by NCRS.
Cancer screening for early detection is another preventive activity of NCRS.

2. Community Based Programs.

Tobacco Control Program
Creating awareness about tobacco products is another preventive activity of NCRS. "Tobacco products is the major cause of all cancers", with this fact NCRS has been conducting several activities.
Achievements of Organization in “Advocacy for Tobacco Control”
Advocacy and awareness for tobacco control is one of the major preventive activities of NCRS because it has been proved that tobacco is one of the major causes of all cancers. The person who takes tobacco can be suffered from breast cancer, cervical cancer, oral cancer, blood cancer, lung cancer and many other types of cancer.  Here are some activities of the organization in the sector of tobacco control.
  • In 1998 the organization motivated the people to protest against the advertisement of tobacco in the electronic media. The organization received the signature of 1, 00,000 people from different socio economic level and it was submitted to the Prime Minister of Nepal. As a result the government of Nepal in the electronic media from the year 1999 has prevented the publicity of tobacco and its products.
  • NCRS has played a desirable role for the ratification of the FCTC treaty by pressing the government through special bill decision. NCRS has also dispatched request letter to all municipalities in Nepal to ban tobacco and its products advertisement through billboards and hoarding.
  • NCRS is actively working and negotiating for the effective implementation of policies of FCTC treaty by pressing the law implementing agencies and house of parliament. Remarkable number of seminars has already been conducted by NCRS for this regard.
  • NCRS is going to conduct a national alliance movement against tobacco by establishing a network of more than 10 different organizations working in the sector of tobacco control. The name of the networking organization will be Tobacco-Free Initiative Nepal. NCRS is actively working out for this purpose and trying to bring outstanding revolution for tobacco control.
  • NCRS has been providing a TOBACCO QUIT LINE service for counseling people who wants to quit tobacco products as a part of rehabilitation.

3. Working with Professional organization

Volunteer Support Program (V.S.P.)
Cancer is a disease which not only disturbs person’s health physically but also mentally, psychologically .In such hard times cancer patients requires backup from other people whether from family members or friends. If the support giver is one of the survivors from cancer, then the cancer patients will have more trust and confidence towards that person and will take shorter time when he/she is physically as well as psychologically stressed.
Counseling from others in difficult situations gives hints of hope and sense of happiness in the face of the patients. It has been proved as one of the effective methods to support the cancer patients. Their happiness can be seen on their faces when counselors share their feelings with them. The patients feel glad that people have time to talk with them and who are ready to listen to their feelings, sometimes it's harder for the cancer patients to speak up openly with their family members. In those circumstances, they share their matters with the counselor. Occasionally counselor acts as a mediator between the cancer patients and their family members.
With the objective to help cancer patients and their family members V.S.P has been launched. The program was launched two years ago and through this program many patients have successfully received counseling service which they were in need of.

4. Others

Tobacco Quit Line Program
'' Tobacco Quit-Line telephone counseling service “ is a counseling service aimed to help tobacco users who want to quit tobacco related products .It is especially intended for those, who are in need of proper counseling regarding tobacco use and its effects on their health. For the first time in Nepal, this telephone counseling service was started by NCRS on May 31st,marking World No Tobacco Day 2005,which  was inaugurated by Vice President of the Ministry of Council and Minister of Population and Health Ministry Honorable Kritinidhi Bista.
This telephone counseling service since then has become an easy and convenient way for those who wanted to get counseling on quitting tobacco products .Addicts who were searching for an appropriate place where they can share their feelings regarding their addiction were really contented to get suggestion and instructions through this service.
More than 400 callers have dialed to this service and more than 100 of the callers have benefited through this service that are now staying as a non smoker.
Tobacco quit line counselling service number is : 977-01-5201200 (from 11:00 am-5:00Pm)

Curative Programs:
NCRS is directly supporting the community by providing curative facilities for the cancer patients suffering from cancer who don't have the money for the treatment. It is a well known fact that cancer is a very dangerous and expensive to cure. There are large numbers of poor people in Nepal suffering from cancer without treatment. NCRS helps them by providing medical facilities. For achieving this goal, NCRS is running a Bhaktapur Cancer Hospital (BCH) in collaboration with Rotary International, local community and Nepal Government's Ministry of Health in 1992. Patients are referred to BCH from other territory centers in the region for proper counseling and treatment. Presently, BCH is a 72-bedded hospital that provides chemotherapy, radiotherapy, brachyotherapy and surgical services including palliative care and pain management services. About 10,000 new cancer patients, both children and adults, are treated every year. Doctors treat cancers of the lung, cervix, breast and ovary as well as leukemia. The patients diagnosed during cancer screening programs are referred to the Bhaktapur Cancer Hospital and other cancer hospitals inside the country or abroad if necessary.
Every year the incoming of new cancer patients are increasing in Bhaktapur Cancer Hospital. The patients increasing data shows that it has become very important to uplift the cancer control programs both in preventive as well as curative aspects.
Similarly the cancer treatment facility is also provided by other cancer hospitals of Nepal. B.P Koirala Memorial Cancer Hospital is one of them.  Similarly, Bir Hospital and T.U Teaching hospital is also providing cancer treatment facility to some extent. Kanti Children Hospital is giving medical facilities for treating child cancer.

Fund Raising Programs
Financial status is the major part of every organization. For the non government organizations like NCRS, it has always become a big challenge to sustain and conduct its activities. There are several fundraising aspects of NCRS. They are categorized into following subheadings.
  • Fund collected from international organizations under small grants programs by submitting proposals.
  • Annual Donor Program of NCRS.
  • Fund Raising Events conducted by NCRS.
Small Grants awarded by International Cancer Organizations is a major part of the financial status of NCRS. Every year in special occasions like World Cancer Day, World No Tobacco Day the International Organizations support small grant awards for the organizations like NCRS working in the sector of cancer and tobacco control.
NCRS has its Annual Donor Program- another fund raising program. Under this program NCRS makes annual members, who annually donate certain amount of money. NCRS send them vote of thanks and reports of all the activities where the donations have been utilized.
Every year NCRS conducts several fund raising entertaining events. The events not only help to raise funds but also help in creating awareness about cancer and tobacco. The programs help to make general public, community people a part of cancer control. NCRS also organizes concerts, folk songs competitions and shows to raise fund for cancer patients and to conduct cancer control activities.
Some Fund Raising Events are:
  • Good Morning Tea
  • Walkathon
  • Run For Cure
  • Relay for Life
  • Garage Sale
  • Nurse of the Year
  • Dress Down Day
  • Raffal
  • Concert
  • Movie nights

Bhaktapur Cancer Hospital that Providing Leukemia Treatment

ancer is one of the growing menaces which needs to be addressed soon to give the Nepalese people a better life. The number of these patients is increasing and more and more people are suffering from these disease. Unfortunately, most of the patients come late in their disease process, so that the doctors cannot even think of curing them. Thus, we need a centre where this disease is treated in a holistic manner, such that best prevention, diagnosis, treatment, palliative care are all available in one centre. This is the only way, we can treat all Nepalese who come with this disease in whatever stage, and nobody is sent away because of lack of anything, especially facilities and manpower.

There are two cancer hospitals in Nepal. The Bharatpur cancer hospital is doing a good job, but they still cannot compete with the facilities and the number of specialties able to give service to these unfortunate patients. Similarly, Bhaktapur cancer hospital has the same problem but compounded due to its small size. TUTH with its all its resources can be of great help to give the state of the art cancer management through Suresh Wagle Cancer Center. Thus, Nepal Government has budgeted as a priority a building of a cancer center in TUTH.

The need of Suresh Wagle Cancer Center in Tribhuvan University Teaching Hospital (TUTH) is that cancer encompasses all specialties in its management, from state of art diagnostic centre to best surgical, medical, gynaecology, psychiatry, physiotherapy and many more specialities. Cancer can occur in any part or organ of the body and at this time in Nepal, TUTH is the only institute with all the facilities and the specialties that can manage any cancer in any part of the body.

Research is another important division to help in giving a state of the art management to the cancer patient. Institute of Medicine (IOM) with its international recognition and its academic facilities, such as Medical Education Department and Research Department can be a very good place for research. These departments are supported by a Department of Information Technology. Thus, the good research that can be done in Suresh Wagle Cancer Center can bring international recognition as well as support. Further more it will ultimately help in providing better service to the cancer patients.

Having all this in one compound will help in avoiding spending large amount of money in building and developing these facilities and specialties in a new place. Thus, the Suresh Wagle Cancer Center in the same compound as TUTH can use all these facilities and specialties and concentrate in oncological service while providing a holistic treatment to any cancer patients.


Cancer Cure Gives Life Back to Young Boy

Supnil Bhandari is an eight year old with a great fighting spirit and a ready smile. Thanks to Dr Baral, Director
of Bhaktapur Cancer Hospital Nepal and his great team, Supnil is now in remission from Cancer and looking forward to going home.
The Bhaktapur Cancer Hospital is the only charitable hospital in Nepal and in a country where cancer treatment is economically beyond the reach of most people, it’s Dr Baral and his team who often provide the difference between life and death.
“The medical team provided such good care and love for my son” said Mr Bhandari. “We travelled by bus for 350km to come to the hospital to treat my son, I was worried for him, but the doctors reassured me that they would do everything possible for Supnil, they save my son’s life and I am so happy”.
Supnil is one of the luckiest ones to survive but unfortunately there are many more like Supnil who need your help. 

Acute Coronary Syndrome

With his continual leukemia now in full remission, Bryan Baker kicked off his 2011 campaign with a bang Saturday, dropping Joe Riggs with a small hook to gain a spot in Bellator Fighting Championships’ 5th-season middleweight tournament.
“My heart was ready. I coached my mind. I knew my body would follow,” Baker said at the Bellator Forty Three post-fight announcements event. “I was Hundred per cent certain. I finished game plan. My coach, Thomas Denny, put together a splendid game plan, and I carried out it.”
Baker castigated the UFC veteran with knees in the clinch before ending Riggs’ night with a left hand at 3:53 of the second round.
Following his triumph, Baker took center cage once more, though that time there would be no fight. The middleweight as a option dropped to a knee and suggested wedding to his girl friend, Megan Vargas, who approved in front of the crowd at the First Council Casino in Newkirk, Okla.
“My heart is just doing back-flips right now,” said Baker. “I could’t express how much that young woman looks after me and how much I love her. I wanna give planet to her. That cage is hers to the amount that it is my own. We’re going to overcome it together. There are tons of fine things in shop for us.”
With the triumph, Baker moves one step nearer to a shot at Bellator’s middleweight title. The California-based “Beast” has knocked on that door before, as he fought his way to the finals of the promotion’s Season Two tournament, finally losing to Alexander Shlemenko in their June 2010 ultimate.
Baker can get a possibility to avenge that loss, as Shlemenko may in addition uncover his way in the forthcoming tournament if he is apt to navigate Brett Cooper at Bellator Forty Four on May Fourteen. Bellator Season Five is anticipated to kick off Sept. Seventeen at Bellator Forty Nine. Till then, Baker will have to focus on different things, like setting a date for his marriage.

Leukemia in Nepal in Ayurveda

We can successfully treat : A -Adrenocortical CarcinomaAcute Lymphoblastic Leukemia, Adult Acute Lymphoblastic Leukemia, ChildhoodAcute Myeloid Leukemia, AdultAcute Myeloid Leukemia, ChildhoodAdrenocortical Carcinoma, ChildhoodAIDS-Related CancersAIDS-Related LymphomaAppendix CancerAstrocytomas, ChildhoodAtypical Teratoid/Rhabdoid Tumor, Childhood, CentrAnal Cancer- B -Basal Cell Carcinoma, see Skin Cancer (NonmelanomaBile Duct Cancer, ExtrahepaticBladder CancerBladder Cancer ChildhoodBone Cancer, Osteosarcoma and Malignant Fibrous HiBrain Stem Glioma, ChildhoodBrain Tumor, AdultBrain Tumor, Brain Stem Glioma, ChildhoodBrain Tumor, Central Nervous System Atypical TeratBrain Tumor, Central Nervous System Embryonal TumorBrain Tumor, Astrocytomas, ChildhoodBrain Tumor, Craniopharyngioma, ChildhoodBrain Tumor, Astrocytomas, ChildhoodBrain Tumor, Cerebellar Astrocytoma, ChildhoodBrain Tumor, Cerebral Astrocytoma, ChildhoodBrain Tumor, Ependymoma, ChildhoodBrain Tumor, Medulloblastoma, ChildhoodBrain Tumor, Supratentorial Primitive Neuroectodermal and Pineal Tumors, ChildhoodBrain and Spinal Cord Tumors, Childhood (Other)Breast CancerBreast Cancer and Pregnancy Breast Cancer, ChildhoodBreast Cancer, MaleBronchial Tumors, ChildhoodBurkitt Lymphoma- C -Carcinoid Tumor, ChildhoodCarcinoid Tumor,GastrointestinalCarcinoma of Unknown PrimaryCentral Nervous System Atypical Teratoid/RhabdoidCentral Nervous System Embryonal Tumors, ChildhoodCervical CancerCervical Cancer, ChildhoodChordoma, ChildhoodChronic Lymphocytic LeukemiaChronic Myelogenous LeukemiaChronic Myeloproliferative DisordersColon CancerColorectal Cancer, ChildhoodCraniopharyngioma, ChildhoodCutaneous T-Cell Lymphoma, see Mycosis Fungoides a- E -Embryonal Tumors, Central Nervous System, Childhoo/a>Endometrial CancerEpendymoblastoma, ChildhoodEpendymoma, ChildhoodEsophageal CancerEsophageal Cancer, ChildhoodEwing Family of TumorsExtracranial Germ Cell Tumor, ChildhoodExtragonadal Germ Cell TumorExtrahepatic Bile Duct CancerEye Cancer, Intraocular MelanomaEye Cancer, Retinoblastoma- G -Gallbladder CancerGastric Cancer (Stomach)Gastric (Stomach) Cancer, ChildhoodGastrointestinal Carcinoid TumorGastrointestinal Stromal Tumor (GIST) Gastrointestinal Stromal Cell Tumor, ChildhoodGerm Cell Tumor, Extracranial, ChildhoodGerm Cell Tumor, OvarianGestational Trophoblastic TumorGlioma, AdultGlioma, Childhood Brain Stem- H -Hairy Cell LeukemiaHead and Neck CancerHepatocellular (Liver) Cancer, Adult (Primary)Hepatocellular (Liver) Cancer, Childhood (Primary)Histiocytosis, Langerhans CellHodgkin Lymphoma, ChildhoodHypopharyngeal CancerHypopharyngeal Cancer- I -Intraocular Melanoma Islet Cell Carcinoma- K -Kaposi SarcomaKidney (Renal Cell) CancerKidney Cancer, Childhood- L -Langerhans Cell HistiocytosisLaryngeal CancerLaryngeal Cancer, ChildhoodLeukemia, Acute Lymphoblastic, AdultLeukemia, Acute Lymphoblastic, ChildhoodtLeukemia, Acute Myeloid, AdultLeukemia, Acute Myeloid, ChildhoodLeukemia, Chronic LymphocyticLeukemia, Chronic MyelogenousLeukemia, Hairy CellLip and Oral Cavity CancerLiver Cancer, Adult (Primary)Liver Cancer, Childhood (Primary)Lung Cancer, Non-Small CellLung Cancer, Small CellLymphoma, AIDS-RelatedLymphoma, Central Nervous System (Primary)Lymphoma, Cutaneous T-CellLymphoma, Hodgkin's Disease, AdultLymphoma, Hodgkin's Disease, ChildhoodLymphoma, Non-Hodgkin's Disease, AdultLymphoma, Non-Hodgkin's Disease, ChildhoodLymphoma, Primary Central Nervous System- M -Macroglobulinemia, WaldenströmMalignant Fibrous Histiocytoma of Bone and OsteosaMedulloblastoma, ChildhoodMedulloepithelioma, ChildhoodMelanomaMesothelioma, Adult MalignantMesothelioma, ChildhoodMetastatic Squamous Neck Cancer with Occult PrimarMouth CancerMultiple Endocrine Neoplasia Syndrome, ChildhoodMultiple Myeloma/Plasma Cell NeoplasmMyelodysplastic SyndromeMyelodysplastic/Myeloproliferative DiseasesMyelogenous Leukemia, ChronicMyeloid Leukemia, Adult AcuteMyeloid Leukemia, Childhood AcuteMyeloma, MultipleMyeloproliferative Disorders, ChronicMyeloproliferative Disorders, ChronicMyeloproliferative Disorders, ChronicMyeloproliferative Disorders, Chronic- N -Nasal Cavity and Paranasal Sinus CancerNasopharyngeal CancerNasopharyngeal Cancer, ChildhoodNeuroblastomaNon-Hodgkin Lymphoma, AdultNon-Hodgkin Lymphoma, ChildhoodNon-Small Cell Lung Cancer- O -Oral Cancer, ChildhoodOral Cavity Cancer, Lip andOropharyngeal CancerOsteosarcoma and Malignant Fibrous Histiocytoma ofOvarian Cancer, ChildhoodOvarian Epithelial CancerOvarian Germ Cell TumorOvarian Low Malignant Potential Tumor- P -Pancreatic CancerPancreatic Cancer, ChildhoodPancreatic Cancer, Islet Cell TumorsPapillomatosis, ChildhoodParanasal Sinus and Nasal Cavity CancerParathyroid CancerPenile CancerPharyngeal CancerPineal Parenchymal Tumors of Intermediate Differen Pineoblastoma and Supratentorial Primitive NeuroecPituitary TumorPlasma Cell Neoplasm/Multiple MyelomaPleuropulmonary BlastomaPregnancy and Breast CancerPrimary Central Nervous System LymphomaProstate Cancer- R -Rectal CancerRenal Cell (Kidney) CancerRenal Cell (Kidney) Cancer, ChildhoodRenal Pelvis and Ureter, Transitional Cell CancerRespiratory Tract Carcinoma Involving the NUT GeneRetinoblastoma Rhabdomyosarcoma, Childhood- S -Salivary Gland CancerSalivary Gland Cancer, ChildhoodSarcoma, Ewing Family of TumorsSarcoma, KaposiSarcoma, Soft Tissue, AdultSarcoma, Soft Tissue, ChildhoodSarcoma, UterineSézary SyndromeSkin Cancer (Nonmelanoma) Skin Cancer, ChildhoodSkin Cancer (Melanoma)Skin Cancer (Melanoma)Small Cell Lung CancerSmall Intestine CancerSoft Tissue Sarcoma, AdultSoft Tissue Sarcoma, ChildhoodSquamous Cell Carcinoma, see Skin Cancer (NonmelanSquamous Neck Cancer with Occult Primary, MetastatStomach (Gastric) CancerStomach (Gastric) Cancer, ChildhoodSupratentorial Primitive Neuroectodermal Tumors- T -T-Cell Lymphoma, Cutaneous, see Mycosis FungoidesTesticular CancerThroat Cancer Thymoma and Thymic CarcinomaThymoma and Thymic Carcinoma, ChildhoodThyroid CancerThyroid Cancer, ChildhoodTransitional Cell Cancer of the Renal Pelvis and UTrophoblastic Tumor, Gestational- U -Unknown Primary Site, Carcinoma of, AdultUnknown Primary Site, Cancer of, ChildhoodUnusual Cancers of Childhood Ureter and Renal Pelvis, Transitional Cell CancerUrethral CancerUterine Cancer, EndometrialUterine Sarcoma- V -Vaginal CancerVaginal Cancer, ChildhoodVulvar Cancer- W -Waldenström MacroglobulinemiaWilms' TumorWomen's Cancers
about 12 months ago

Treatment of Leukemia then and now

Treatment of Leukemia -- Then and Now


The Woburn trial focused on a suspected childhood leukemia cancer cluster and the connection to toxic pollutants TCE and PCE in the municipal water supply. This webpage includes background information on the treatment of childhood leukemia.

Childhood Leukemia Treatment

Between the late 1960s and now, the treatment of leukemia has changed significantly. In the 1950s, nearly all children with leukemia died. The survival rate for children today is about 75 percent and childhood leukemia is one of the most successfully treated cancers.

Survival Rates for Childhood Leukemia Patients

History of Leukemia Treatment

In the 1940s and 1950s treatment of leukemia was based on single agent chemotherapy. In the 1960s multi-agent chemotherapy began and dramatically increased survivorship (Kersey 1997 ). In the 1970s and 1980s pre-symptomatic therapy for central nervous system leukemia also improved treatment. In addition, alternative combinations and timings of chemotherapy improved treatment.
Unfortunately, many leukemias developed drug resistance to chemotherapy when a patient relapsed. One solution was more intensive chemotherapy and total body irradiation followed by bone marrow transplantation. Bone marrow transplants were introduced in the 1970s for use when drug treatments did not work. In newer approaches, bone marrow is removed during remission and re-transplanted if the patient relapses.
In the early 1970s brain and spinal column radiation (cranospinal radiation) was used to prevent central nervous system leukemia. This treatment reduced the rate of relapse from 50 to less than 10 percent. However, many survivors developed cognitive dysfunction that becomes apparent 2 to 5 years after treatment. This is called "late effects" (Kersey 1997 ).

Current Leukemia Treatment

Currently, ALL leukemia is treated by chemotherapy, radiation therapy, or bone marrow or cord blood transplantation.

  • Chemotherapy: Drugs are used to destroy cancer cells or stop them from growing. Typically, some form of chemotherapy will be part of the treatment plan for all patients with ALL.

  • Radiation therapy: Children who have signs of disease in the central nervous system (brain and spinal cord) or have a high risk of the disease spreading to this area may receive radiation therapy to the brain. This type of therapy is not common.

  • Bone marrow or cord blood transplant (also called a BMT): This is used for patients who are less likely to go in to remission with chemotherapy, as transplants can have serious risks.