Re: [MOL] belly wash [12744] Medicine On Line


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Re: [MOL] belly wash



I hope this is the information that you are requesting and that it is of help to
the decision your mother needs to make.  I would also suggest that you call NCI
@ 1-800-4-cancer.  Your friend, Lillian






          Volume 8, Number 1
          Winter 1997



                        Working to Prevent Recurrence

            Photodynamic Therapy for Ovarian Cancer

            novel treatment being tested at the
       University of Pennsylvania Medical Center may
       help prevent recurrence of ovarian cancer. The
       treatment, called photodynamic therapy,
       combines two elements - a photosensitizing agent
       and laser light of a specific wavelength - to
       produce a photochemical reaction that destroys
       tumor cells. The trial is being conducted
       exclusively at Penn.
   For reasons that are not completely understood,
normal cells are relatively spared during the treatment. "As
best we can tell, the drug goes into all cells throughout the
body, but normal tissues seem to clear it very quickly, in a
matter of a few hours. Tumor cells appear to retain it for
several days," explained Eli Glatstein, MD, clinical
director of radiation oncology, who is co-investigator.
"This window of time allows us to target the tumor cells."
   Glatstein participated in a Phase I trial for this
treatment while at the National Cancer Institute. Some of
the patients appeared disease-free after the treatment,
despite the fact that they entered the study with advanced
stage malignancies and were not expected to survive.

Trial Protocol
   According to Stephen Hahn, MD, a Penn radiation oncologist who is principal
investigator,
participants in this Phase II trial receive Photofrin II, a photosensitizing
agent, on an outpatient
basis. Two days later, they return for an exploratory laparotomy to remove the
tumor. If the
tumor can be removed sufficiently, the laser light will be administered.
   Because recurrent ovarian cancer often involves widespread peritoneal
seeding, the laser
light needs to penetrate multiple sites throughout the area. To do this, doctors
infuse a common
nutritional substance called Intralipid into the patient's abdomen with a saline
solution during the
laparotomy. Intralipid diffuses the light throughout the solution and the
abdomen.
   "That will account for the nooks and crannies on the surface of the
peritoneum," said
Glatstein. "It literally bathes the contents with light of the appropriate
wavelength."
   After the treatment, all patients remain hospitalized at Penn for four to
seven days with
follow-up care provided jointly by the referring physicians and physicians at
the University of
Pennsylvania Cancer Center.

                                             New Photosensitizing Drugs
                                                The major adverse reaction with
                                             this treatment is enhanced skin
                                             sensitivity to UV light, which can
                                             last as long as 10 weeks. Prolonged

                                             sun exposure can produce swelling
                                             and pain in the skin, said
Glatstein.
                                                Although Photofrin II is the
only
                                             agent approved for clinical use in
                                             this country, newer sensitizing
                                             agents may reduce the problems
                                             encountered thus far. These
                                             synthetic agents are purer,
reducing
                                             the likelihood of adverse
reactions.
                                             They absorb at longer wavelengths,
                                             thus offering better penetration
and
                                             reduce the period of skin
sensitivity
                                             to sunlight from 10 weeks to about
                                             one week. As a result, treatment
                                             can be repeated weekly, rather than

                                             being limited to the single shot
                                             therapy offered with Photofrin.
                                                Despite the potential advantages

                                             of the newer agents, however,
                                             Glatstein explained that "we're
using
                                             Photofrin because of our success in

                                             the Phase I study. We want to
                                             confirm that and show that this
                                             treatment cures patients. Once
that's
                                             done, we can refine it."

Safe Treatment
   Stephen Rubin, MD, director of Penn's Gynecologic Oncology Division, believes
this
treatment is "promising. Currently, patients with recurring ovarian cancer face
treatment with
second and third line chemotherapy regimens, followed by additional surgery.
Nonetheless, few
are cured with this approach."
   The clinical trial at Penn is open to women who have recurrent ovarian cancer
after
receiving first-line treatment of surgery and chemotherapy. Glatstein said he
hopes to enroll
approximately 30-50 patients in the study over the next one to two years.
   "I think it is a very safe treatment, and I believe it will be useful for a
variety of problems that
are, at present, very challenging to us," concludes Glatstein. Other possible
targets include
tumors on the chest wall of patients with breast cancer, prostate cancer,
carcinoma in situ of the
bladder, head and neck tumors, cystic brain tumors, and leukoplakia.


        For physician to physician consultation or referral call PENNLine

          Eli Glatstein, MD
          Stephen Hahn, MD
          Stephen Rubin, MD

        For all other inquiries go to the PENNHealth page










SKnapp1690@aol.com wrote:

> is belly wash more successful than chemotherapy?????????
> sknapp1690@aol.com. My mother-in-law has ovarian cancer and has to face this
> question right for the option of two different types of treatment. I' d like
> your opinion.
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--
MZ


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