Imrt In Breast Cancer

Worldwide breast cancer is the most common malignancy in women. In the developed world, it is responsible for 18 percent of all cases of cancers seen in women. One million new cases of breast cancer are registered worldwide every year and it is the single commonest cause of death among women in the 40- 50 years age group. In India breast cancer is the second commonest cancer seen in the women after carcinoma cervix. Its prevalence is higher in urban women and it accounts for 20% of all cancer related diseases. In Mumbai and Delhi, it is the commonest malignancy seen in women. In India it has an incidence of 17-40 cases per 1, 00,000 population and the 5 years survival is 42.3 percent to 46.8 percent.

Conventionally radiotherapy in early breast cancers is done by the whole breast technique which utilizes two tangential ports. Upper margin of the radiotherapy field lies at the first intercostals space, and the lower margin lies 2 cm below the inferior mammary line. Medial margin is in the midsternal line and the lateral margin is at the mid axillary line. A total dose of 50 Gy in 25 fractions is given over 5 weeks by conventional fractionation followed by boost of 10-20 Gy. This technique is easy to setup, and avoids the junction dose. Computerizes planning is done for dose optimization. Standard 2d treatment (conventional radiotherapy) techniques utilizes a simplistic view of patient anatomy and it creates hot spot because lung transmission is not accurately included and thinner regions of breast (superior and inferior) are modeled like the thickest slice of the breast. Thus conventional radiotherapy has limitations in the treatment of breast cancer and these include.

Dose inhomogeniety due to change in the contours of the breast 1520 percent of dose inhomogenicity in the superior and the inferior planes of the breast occurs. The medial and lateral aspects of the breast get higher doses of radiation.

Radiation accompaniments i. e. radiation effects on normal tissues in the field are seen uncommonly but they do occur in the lungs and the heart. Newer techniques are able to minimize them.

The newer techniques are used to

Improve dose homogeneity within the tumor volume.
Avoid radiation to normal tissues in the area.
Reduce side effects related to the radiation treatment.
Improve local tumor control and overall survival of the patient.
In an attempt to address the above mentioned parameters a number of newer radiotherapy techniques have been introduced for the treatment of early breast cancer. These include IMRT, external beam RT using 3D conformal RT, Intraoperative Electron Beam RT, Mammosite Ballon Branchytherapy and interstitial branchytherapy. Gated radiotherapy is also available.

All these techniques need a CT scan based treatment planning system and require the use of tissue compensators.

IMRT

IMRT is an approach to conformal therapy that not only delivers high dose to the tumor tissue but also ensures low dose to the surrounding normal tissue. The dose is varied depending on the tumor volume. A higher dose of radiation can be delivered to the areas with high tumor volume, a small dose where tumor volume is not so high and a minimal dose is delivered to surrounding normal tissue. By these means a higher tumor control probability and minimal or no side effects of radiotherapy are achieved, resulting in improved therapeutic ratio and better patient care.

Important normal structures that need to be examined and protected while IMRT for breast cancer is being planned include

Heart
Ipsilateral lung
Contralateral lung
Contralateral breast
Tissues outside the breast planned tumor volume (PTV)
Dose specifications in IMRT are as follows:

Breast volume receiving 105% of prescribed dose should be
Breast volume receiving 110% of prescribed dose should be 55
Breast receiving 115% of prescribed dose should be

How Did Chuck Kinsey Cure His Grade 3 Prostate Cancer

Last summer Chuck first discovered that he might have a problem when he got turned down for life insurance. Sure enough, a biopsy confirmed that he had cancer. His prostate had swelled up bigger than a baseball.

Chuck decided not to have surgery at least until January when his insurance would change. In November, he started following a recipe I came up with to cure my own stage 4 cancer 10 years ago.

When January arrived, his urologist examined him again and found that his prostate had shrunk quite a bit – down to the size of a small plum, according to his doctor.

His PSA score improved to 3.1 from a high of 5.8. His free PSA improved some as well, climbing from a paltry 12% to 21%…27% to 100% is considered normal.

His doctor was intrigued, telling Chuck he would be following his case closely, and took Chuck into his office to look up the hubpage where Chuck saw the recipe.

The recipe was simple. A habaneros pepper and two cloves of garlic plus an oil. In Chuck’s case, he used emulsified cod liver oil. Others might need evening primrose oil instead.

Chuck ate the recipe twice a day. I ate it once a day.

Chuck had another biopsy last Monday (March 2), on Thursday his report said he had no malignant tissue….he was cancer free. While there have been some tremendous improvements in other people with cancer who are eating the recipe…some more dramatic than Chuck’s…Chuck is the first who has a “before” and “after” biopsy confirming a cure.

When Chuck received the biopsy report, the doctor included an unusual note above his name, “Wow. I’m going to go get some more hot sauce.”

That’s probably the first time a note of that nature has ever appeared on a biospy report. But it might not be the last.

Right Heartworm Medicine for Dogs

Heartworm medicine for dogs is easy to find especially if you know where the resources are and who the proper person to seek advice for this kind of situation. Heartworm is a parasite that is lurking around your pets blood stream; this worm can be passed by a single bite of infected mosquito. Dogs are more prone to get this parasite however even cats, foxes and wolves can get this. It is called heartworm since it lives and reproduces in the pulmonary artery of the heart. This can be dangerous and can cause death especially if its taken for granted, but with the right heartworm medicine you can get rid of the risk for your pets health.

As most of the veterinarians agreed that the best protection against heartworm disease is the monthly application of a preventive heartworm medicine. These drugs like Heartgard, Interceptor and Sentinel are some of the brands that you can buy in order to protect your pets from heartworm disease. The good thing is that most of these treatments are available in pill or flavored chewable tablet form every month during mosquito season. Since it has flavored it is easier for pet owners to give and feed it to their pet. Nevertheless an assistance and guidance from a veterinarian is advisable especially if this is your first time to have a pet infected with heartworm disease. Another popular medicine is the Moxidectin, also known as ProHeart, can be administered in six or twelve month time release injections; however this is not available in the U.S. due to safety concerns. Advantage Multi Topical Solution is drugs which consist of both imidacloprid and moxidectin; it is advisable also if your pet have fleas and ticks. The moxidectin stops roundworms, hookworms, heartworms, whipworms, and the imidocloprid kills adult fleas. Nevertheless you need to read carefully the warnings and guidelines written on the leaflets of this drug; to prevent any accident that might cause danger to your pet. Ask your trusted veterinarian if you are new to this.

Heartworm medicine for dogs is a must in your First aid kit, it is important to have this preventive drug since having this disease is very serious that can lead death to your beloved pet. Make sure that you will take care of your pet as if it is part of your family and you dont want to get them sick. Indeed pet owners can have mistake sometimes, they might forget to give their pet the medicine it needs maybe because of busy schedule. However it doesnt mean that it will be the reason of the pets death since most monthly preventives are formulated so that if a single month’s dose is missed, your pet will be protected as long as the next months’ doses are not missed. But if this is not the case, make sure to give enough attention to your pets health and safety.