Re: [MOL] A new concern [01180] Medicine On Line


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Re: [MOL] A new concern



Dear Jeanne,

Thank you so very much for your compassionate message. I just learned
that the chances of contracting this secondary condition is about
0.04%   So, this is something that I will place on the backburner, but
if there are symptoms, at least I have been educated. So many have
written to me about this concern and I have let it go. Thank you.

God Bless You,
marty and Barb

Jeanne Kissinger wrote:
> 
> Marty, thanks for the information. It has been my understanding that
> most chemotherapy had side effects other than killing cancer cells. It
> is simply a matter weighing the risks against the benefits. You could
> not have done otherwise with the information you had then. Any person
> who has had a cancer diagnosis and chemotherapy has to be watchful but
> not fearful. You have done very well and we are in awe of your
> dedication to keeping Barb well. We have all benefited from your
> research.  God bless and a big hug to you both, Jeanne
> 
> Martin Auslander wrote:
> >
> > Good Morning All,
> >
> > I just learned this very dreadful and alarming news.  My Barb had 30
> > treatments of Platinum based chemotherapy in 3 plus years and now we
> > learn that this could lead to secondary cancer...leukemia. Now I learn
> > and wonder why we weren't told at the time she was administered. The way
> > to keep an eye on symptoms is to do a cbc (complete blood test) each
> > month and watch for lowering of platelets and white blood cells. I dont
> > believe we can avoid this but maybe nip in the bud if that is the case
> > that one would develop this secondary disease as a result of long term
> > chemotherapy....as had Barb. Pls say your prayers that this does not
> > develop.....G-d willing.
> >
> > http://www.pslgroup.com/dg/e133e.htm
> >
> > God bless All,
> > marty auslander
> >
> >     ---------------------------------------------------------------
> >
> >  [Table Of Contents Global Edition]
> >                                       [Doctor's Guide E-mail Edition, Information]
> >            [Departments]
> >                                      ----------------------------------------------
> >              What's New
> >                                         [Doctor's Guide to Medical & Other News]
> >             Medical News
> >               & Alerts
> >
> >             Conferences                     Platinum-Based        DG Quick Survey
> >              & Meetings                Chemotherapy For Ovarian
> >                                        Cancer Carries Increased     In the past
> >                                            Risk Of Leukemia         month, what
> >              [Editions]                    ----------------        percentage of
> >                                                --------            your patients
> >          [Other Editiions]                                          brought you
> >                                       WASHINGTON, DC -- Feb. 3,   health-related
> >          [Patient's Guide]            1999 -- A report in           information
> >                                       tomorrow’s issue of the      they found on
> >             [Resources]               New England Journal of      the Internet ?
> >                                       Medicine concludes that
> >            Other Medical              women who were treated
> >              Resources                for ovarian cancer with     0%
> >                                       platinum-based              1-5%
> >           [Opportunities]             chemotherapy (cisplatin     6-10%
> >                                       or carboplatin) have a      11-20%
> >              Employment               two to eight times          21-25%
> >            Opportunities              greater chance of           More than 25%
> >                                       developing leukemia.
> >              Partnering
> >            Opportunities              Larger doses and longer
> >                                       treatments resulted in
> >              [Warning]                higher risks of acute        View Results
> >                                       and/or myeloid leukemia.
> >
> >                                       Although a number of
> >                                       small case reports have
> >  ----------------------------------   linked platinum-based       Click here for
> >                                       chemotherapy regimens to    a free medical
> >    [Back to the top of the page]      secondary leukemia, this      newsletter
> >                                       is the first large-scale,
> >                                       multinational study to
> >                                       quantify the risk.
> >                                       Platinum compounds have       E-mail this
> >                                       served as standard               page
> >                                       treatment for ovarian       to a friend or
> >                                       cancer for two decades        colleague!
> >                                       and are also used to
> >                                       treat other cancers,
> >                                       including testicular,        To print, use
> >                                       bladder, lung,               this version
> >                                       endometrial and head and
> >                                       neck cancers.
> >
> >                                       Because platinum drugs
> >                                       are widely used, Lois
> >                                       Travis, M.D., Sc.D., of
> >                                       the National Cancer
> >                                       Institute's division of
> >                                       cancer epidemiology and
> >                                       genetics in Bethesda,
> >                                       MD., and first author of
> >                                       the study, said that the
> >                                       finding may be important
> >                                       for clinicians in other
> >                                       therapeutic settings.
> >                                       But, she emphasised that
> >                                       the risks needed to be
> >                                       weighed against the
> >                                       substantial benefits of
> >                                       the drugs.
> >
> >                                       "Before platinum-based
> >                                       treatment, only about 40
> >                                       percent of patients with
> >                                       advanced ovarian cancer
> >                                       responded to therapy and
> >                                       the median survival was
> >                                       one year," said Travis,
> >                                       citing recently published
> >                                       statistics. "Now with
> >                                       platinum therapies, the
> >                                       clinical response rate is
> >                                       between 60 percent and 70
> >                                       percent, with a five-year
> >                                       survival of up to 20
> >                                       percent to 30 percent.
> >
> >                                       “It's clear that the
> >                                       significant improvements
> >                                       in patient survival far
> >                                       outweigh the relatively
> >                                       small excess risk of
> >                                       secondary leukemia."
> >
> >                                       Travis also believes that
> >                                       the study may have
> >                                       important implications
> >                                       for clinicians who are
> >                                       considering the optimal
> >                                       dose of platinum to treat
> >                                       ovarian cancer. The
> >                                       researchers were able to
> >                                       evaluate the risk of
> >                                       leukemia over a wide
> >                                       range of platinum doses
> >                                       and found a clear
> >                                       relationship between risk
> >                                       and dose. At cumulative
> >                                       doses less than 500 mg,
> >                                       women were almost twice
> >                                       as likely to develop
> >                                       leukemia whereas at doses
> >                                       of 1,000 mg or more, the
> >                                       risk was between seven to
> >                                       eight times greater than
> >                                       patients who did not
> >                                       receive platinum agents.
> >
> >                                       "If these findings are
> >                                       confirmed in other
> >                                       studies it is very
> >                                       important that any
> >                                       therapeutic benefit from
> >                                       increasing amounts of
> >                                       platinum be carefully
> >                                       weighed against the
> >                                       corresponding risk of
> >                                       subsequent leukemia,"
> >                                       Travis said.
> >
> >                                       The risk of leukemia was
> >                                       calculated by following
> >                                       over 28,000 women in
> >                                       North America
> >                                       (Connecticut, Iowa, New
> >                                       Jersey and Ontario) and
> >                                       Europe (Denmark, Finland
> >                                       and Sweden) who were
> >                                       diagnosed with ovarian
> >                                       cancer between 1980 and
> >                                       1993. Leukemia developed
> >                                       in 96 women who were then
> >                                       matched with 272 control
> >                                       patients. Most were
> >                                       diagnosed with acute
> >                                       myeloid leukemia or
> >                                       myelodysplastic syndrome.
> >                                       The average time to
> >                                       develop leukemia was four
> >                                       years. The median
> >                                       survival time after
> >                                       diagnosis of secondary
> >                                       leukemia was only three
> >                                       months; most secondary
> >                                       leukemias are resistant
> >                                       to therapy.
> >
> >                                       Based on these
> >                                       observations and the drug
> >                                       regimens used in their
> >                                       study, the authors
> >                                       estimated that out of
> >                                       10,000 ovarian cancer
> >                                       patients treated for six
> >                                       months with 500 mg to
> >                                       1,000 mg of cisplatin, an
> >                                       excess of 21 leukemias
> >                                       might be expected to
> >                                       occur in the following
> >                                       decade. At doses of 1,000
> >                                       mg and greater, an excess
> >                                       of 71 leukemias might be
> >                                       expected.
> >
> >                                       Typical therapy for
> >                                       advanced ovarian cancer
> >                                       during the time frame of
> >                                       the study included a
> >                                       combination of an
> >                                       alkylating agent, usually
> >                                       cyclophosphamide and a
> >                                       platinum complex, either
> >                                       cisplatin or carboplatin.
> >                                       Another alkylating agent,
> >                                       melphalan, was also used.
> >                                       Today, since the approval
> >                                       of Taxol (paclitaxel),
> >                                       therapy commonly includes
> >                                       paclitaxel and platinum.
> >
> >                                       Increased risks of
> >                                       secondary leukemia have
> >                                       been well-documented for
> >                                       several other
> >                                       chemotherapeutic drugs,
> >                                       especially the alkylating
> >                                       agents --
> >                                       mechlorethamine,
> >                                       chorambucil, melphalan
> >                                       and busulfan. Because the
> >                                       platinum drugs and
> >                                       alkylating agents have
> >                                       similar mechanisms of
> >                                       action in the cell --
> >                                       cross-linking strand(s)
> >                                       of DNA – the increased
> >                                       risks associated with
> >                                       platinum-based therapy
> >                                       regimens were not
> >                                       surprising.
> >
> >                                       The researchers in the
> >                                       current study also looked
> >                                       at the risks of leukemia
> >                                       associated with
> >                                       melphalan, an alkylating
> >                                       agent known to be linked
> >                                       to increased risks of
> >                                       leukemia and corroborated
> >                                       previous findings;
> >                                       intravenous melphalan was
> >                                       six times more
> >                                       leukemogenic than
> >                                       platinum. The authors
> >                                       pointed out that the
> >                                       lower risks of leukemia
> >                                       associated with platinum
> >                                       compared with melphalan
> >                                       should provide
> >                                       reassurance to ovarian
> >                                       cancer patients and
> >                                       clinicians because
> >                                       platinum-based
> >                                       chemotherapy is currently
> >                                       considered optimal
> >                                       therapy for most patients
> >                                       with advanced disease.
> >
> >                                       Another new finding in
> >                                       the current study was
> >                                       that radiation therapy
> >                                       may enhance the risk of
> >                                       leukemia associated with
> >                                       platinum drugs. The
> >                                       researchers recommended
> >                                       that additional studies
> >                                       be done to investigate
> >                                       the possibility that the
> >                                       risk of leukemia may be
> >                                       heightened when radiation
> >                                       is combined with platinum
> >                                       to treat patients with
> >                                       other cancers, especially
> >                                       cancers of the testis,
> >                                       bladder, or head and
> >                                       neck.
> >
> >                                       Related Links: New
> >                                       England Journal of
> >                                       Medicine
> >
> >              [Image]
> >
> >       [Image]                                       [Image]
> >
> >              [Image]
> >
> >                          ---------------------
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