2010/11/29

The advantages of minimally invasive treatment of cancer and current situation

1987, Lyon, France, Philipe Mouret with laparoscopic cholecystectomy in the first successful, minimally invasive surgery came into being. Past two decades, minimally invasive surgery means not only getting an unexpected rich and full, the breadth of its scope but also people anticipated. In tumor treatment, minimally invasive surgery is not only used for each stage of cancer treatment, and can complete most of the traditional surgery can accomplish. Although today's minimally invasive surgery can not completely replace traditional surgery, but has in many ways demonstrated its superiority and irreplaceable.

In the process of long-term development of modern surgery, the surgical sector has been the pursuit of a goal is how to treat the disease, based on the procedure itself to minimize harm to patients. To achieve this goal, requires the minimally invasive treatment of tumors in the following two aspects should be as follows: (1) as for therapeutic purposes (radical or palliative), (2) to minimize patient pain (including iatrogenic and disease are the cause of the pain), to maximize the protection of peritumoral normal tissues and organs of the functional integrity and quality of life.

Modern minimally invasive treatment of cancer is broadly divided into the following three areas:

(1) Laparoscopic Surgery

Removal of the tumor using endoscopic techniques have not news, application laparoscopic colon resection, rectal cancer resection, gastric resection, ovarian and uterine tumor resection, and even hepatectomy, pancreaticoduodenectomy, etc. have been There are many reports. Surgical trauma is indeed significantly reduced compared with traditional methods. However, its limitations can not be ignored: the lymph node dissection, tumor-free technology, the integrity of such specimens, have varying degrees of defects. Meanwhile, carbon dioxide laparoscopic surgery pneumoperitoneum and hypercapnia, the pressure of artificial pneumoperitoneum in the respiratory and circulatory effects of pneumoperitoneum on renal hemodynamics, abdominal compartment syndrome and other hazards on the body to be further clarified.

(2) the reform of traditional minimally invasive surgery

In the past to reduce the cancer recurrence rate, expanding the scope of surgical resection, but the last 20 years, people have to expand the trauma of surgery and effect into question. Line of early breast cancer breast-conserving surgery, the treatment effect can be comparable with radical surgery, this has been recognized, its cosmetic effect is radical surgery can not match. Renowned expert Professor Tang Zhaoyou hepatobiliary surgery also suggested the efficacy of local resection liver hepatectomy is effective than 5-year survival rate of up to 64.4%. Liver cirrhosis patients with hepatectomy, some patients died during surgery after the success of liver failure, and the partial removal of the operative mortality rate was significantly lower than the survival time is prolonged. With the longevity of the crowd, accompanied by senior cancer and cardiovascular diseases and other important organs gradually increasing the proportion of patients, many patients can not tolerate traditional surgery, we also need to reform the traditional minimally invasive surgery.

(3) Other:

Interventional therapy, radiofrequency ablation, microwave therapy, focused ultrasound therapy, photodynamic therapy, argon-helium cryoablation, radiation seed implantation and so on. Unlike the former two by the surgeon to implement the method of direct excision of the tumor, a wide variety of such methods, principles, different, but the results are in situ inactivation of the tumor, and by the internal medicine, radiology, ultrasound and other medical departments to implement.

In general, minimally invasive treatment of cancer has the following advantages: (1) trauma, only a small incision in the body surface or no open incision, rapid recovery. (2) partial curative effect. (3) can play a radical role in early cancer, advanced tumors can be achieved by palliative care and other purposes. (4) positioning accuracy, selectivity, to maximize protection of normal tissues and organs function. Because of these many advantages, minimally invasive treatment has become indispensable in comprehensive cancer treatment an important part.

Minimally invasive therapy is a local treatment, in the control and elimination of local lesion, the treatment with chemotherapy and biological means have an absolute advantage in comparison, but it is not a panacea. In practice we can not one-sided pursuit of minimally invasive. Only a matter of fact should be strictly controlled disease, a reasonable selection of appropriate means, and in combination with other effective way to fully reflect the advantages of minimally invasive treatment to improve the therapeutic effect.

Another bone cancer treatment drugs effect

Zoledronic acid is a class of drugs called bisphosphonates a member of the family, these drugs can prevent cancer patients with bone metastases (ie, other parts of the body of tumor metastasis to the bone on) the occurrence of fractures, but these drugs are also used for treatment of osteoporosis.

Previous laboratory studies and animal experiments strongly suggest that zoledronic acid may have anti-tumor effect, these studies suggest that zoledronic acid can inhibit cell proliferation and division, reduce the adhesion between cells have ability to inhibit growth of blood vessels supply the tumor nutrition, also promote tumor growth in immune cells. According to these results, the Austrian Breast and Colorectal Cancer Institute organized the clinical trials, a total of 1801 with early breast cancer in premenopausal women to participate.

All the participants will carry out a breast tumor resection, and taking a drug inhibiting estrogen production in order to induce menopause.

Participants were randomly divided into two groups, one group was injected with zoledronic acid, the other group received hormone therapy (tamoxifen or Arimidex). Tamoxifen inhibition of tumor cells through estrogen receptors, and Arimidex is synthetic estrogen by inhibiting the body's role in clinical trials showed that both drugs can prevent tumor recurrence in early breast cancer.

Each group has a half a placebo for comparison. The study carried out for three years.

Edge breast cancer chemotherapy can be on holiday

In the rare holidays, many people have the right to select their own holiday. But you know, metastatic breast cancer patients nowadays do not need to look "fake" sigh, holiday eating degrees into a lot of pills patients relax, a new method to improve the quality of life.

≠ intravenous chemotherapy, oral chemotherapy for breast cancer patients with a relaxing break

For metastatic breast cancer patients, should adhere to the full course of chemotherapy in order to "eliminate" all of the cancer cells, however, traditional chemotherapy need to travel back and forth the hospital, so do not expect patients to celebrate the National Day.

In fact, intravenous chemotherapy is not the same, with the technology, the advent of new oral chemotherapy so that patients can take pills to go on holiday. But the choice of drugs also has its limitations, we must first good effect, to control the disease, followed by ease of use, travel and will not break, finally, is to give patients the pain at least, only in the road as far as possible adverse drug reactions light, patients can enjoy a vacation like a normal person.

To sum up, the patient can choose to oral chemotherapy capecitabine, which is an efficient, safe, convenient advantage. Play because of its killing effect against tumor cells, less damage to normal cells, so patients in the resort to facilitate the process of taking medications, and does not produce strong side effects. Also, capecitabine is given orally in patients with self-medication at home, on the one hand and effective treatment of disease, on the one hand and improving the quality of life, do both.

Breast cancer patients should pay attention to what holiday?

Breast cancer patients should first consult a doctor, then doctor's advice and select the appropriate physical condition of their own vacation, in the physical conditions permit, a short-distance travel is a good way. But for low body immunity, patients with weak constitution, you can choose to visit family or to entertain their children at home.

Rehabilitation treatment of breast cancer patients

Breast cancer patients usually underwent surgery after which they will be subject to certain physical and psychological effects, but by the rehabilitation team is the early intervention and treatment can make the cancer itself caused by the phenomenon of disability, reduce to a minimum level, effectively improving the living quality.

Surgery is the most commonly used treatment for breast cancer, now more common surgical method adopted is to keep the chest muscles, and axillary lymph nodes were selectively removed, together with postoperative chemotherapy and radiotherapy, these treatments are even with physiological changes caused by psychological trauma. And patients for different treatment in various stages of recovery the focus of rehabilitation and his role, are described as follows:

After the completion of surgery for breast cancer patients should maintain the upper limbs in the direction of outreach, you can arm Xiadian pillow, and daily grooming, eating and other activities are also encouraged to use the affected hand. The second to third day after surgery to guide the patient in the exercise. Including hand pump movement, through the turn of the extension, flexion in order to avoid local edema. Elbow and wrist on both sides to conduct active and passive exercises to prevent atrophy and stiff joints. Another deep breath and sputum should guide the patient skills to avoid because of the pain caused by lung atelectasis or concurrent infection. And control with the drug after surgery to guide the patient to relax some of the essentials in order to reduce the patient's pain.

In patients with drainage tube removed, you can start to do the shoulder joint activities, and gradually increase the number of joint movement, to your fingers, and treatment with other assistive devices to assist the affected side of the good side of the joint activities.

Once the wound stitches, you can be a positive increase in joint activities, and allows for the patient's actual situation, select the appropriate rehabilitation equipment, such as the various thermotherapy, electrotherapy, so as to swelling, pain and prevention of atrophy.

Month after the surgery, you can start to do scar massage to soften and reduce connective tissue Zensheng. And some home exercise guide the patient, namely the use of some of the home facilities to cope with movement, such as using make-up units to support the affected arm, and gradually raise the arm to comb her hair. Front or side of the wall or do your fingers, so you can gradually increase the level of activity between the bladder.

Another way through some games, such as the use of small ball to hand grip and drop the training and exercises with skipping rope swing to do, and gradually try to rotate to the greatest extent, while smooth, counterclockwise should return to do so. Can also use the palm of your hand crumpled old newspapers, membership in order to strengthen the muscles of the forearm and hand strength. Usually you can observe both sides of the shoulder facing the mirror is balanced, if a high degree of symmetry, you can always remind patients adjust their attitude.

Basically, when the patients after four weeks, if the arm shoulder activity remains restricted, unable to return to normal, you should seek treatment as soon as possible to the rehabilitation for early active intervention to prevent joint atrophy. If the patient received local radiation therapy should be started from the continuation of joint activities during treatment with at least two years in order to avoid sequelae.

Some common complications after surgery for breast cancer are:

Ankylosis

Often because of reduced activity after surgery, along with pain caused by not caused by movement. Through placement of technology and range of motion exercise to maintain the activity level. When the joint stiffness atrophy has been generated, they can membership by hyperthermia from shallow to deep, and through the way of deep friction massage and some traction in the campaign to soften the fibers have been rigid and connective tissue.

Lymphedema

Because the affected area affected lymph nodes, resulting in blocked lymphatic flow, thereby causing ipsilateral upper extremity pain, swelling, and even affect the joint activities. Clinically simple way of measuring the amount of arm circumference, if the increase of up to two centimeters, said in meaningful ways need to be actively involved in rehabilitation therapy.

The early onset of symptoms can be affected limb elevation, or the patients themselves as to guide the direction of the massage and with the heart muscle pump activity. When the swelling when you can use elastic bandage or a pressurized air pump means to promote lymph return. However, when the affected area with secondary infection or spread of tumor cells when such treatment is absolutely contraindicated, so the root cause should be, after detailed assessment by a physician to be able to adopt such a treatment.

Pain

After the breast surgery, often caused by the phenomenon of ipsilateral sensory abnormalities, and some pain and discomfort, and even phantom limb pain after surgery, if symptoms persist, you can use a massage or go to the sensitivity of local law and transcutaneous electrical nerve stimulation method solution. Also note whether there is local soft tissue lesions, such as supraspinatus muscle two tendinitis, frozen shoulder affected side are common problems. In addition, as some superficial vein thrombosis bolt race and go far, and the resulting radiation neuropathy after treatment, all lead to pain. So for prolonged unhealed pain patients will need treatment by the physician to determine the cause.

Muscle weakness and poor posture

As part of the tissue resection and less active, often cause a decline in muscle strength, you can meet some of the activities, training of muscle strength gradually. When the patient was unable to continue the phenomenon, they will be excluded if the case of nerve injury industry, so as not to cause delays in patient treatment or even adding insult to injury.

In short, the patients after the surgery, you should begin to maintain the muscle strength, joint range of motion. If the affected area has the feeling of pulling or pain when you should relax and then continue movement, from simple to complex and progressive action. Generally speaking, prior to discharge to the activities of the main light. Discharged from the first month of the activity to moderate the main, take heavy weights no more than three to five pounds, a month after the can engage in heavy activities. If there is doubt produce sequelae are necessary to the doctor for treatment, to avoid delay in treatment.

Drug treatment

1, Chinese medicine: Cidan capsule, 10 boxes, 5 tablets, 4 times daily, after meals orally. Righting capsule, 5 capsules, 4 times daily, after meals orally.

2. Herbs: Bupleurum 35 grams, 35 grams of white peony root, Citrus aurantium 35 grams, 35 grams Chuanxiong, Cyperus rotundus 35 grams, 25 grams of peel, angelica 25 grams, heterophylla 25 grams, 25 grams Atractylodes, Poria 25 grams, 25 grams of licorice, white beans 10 grams, 10 grams of yam, Suanzaoren 10 grams, 10 grams of Polygala, Campanulaceae 10 grams, 10 grams of Coltsfoot Flower and so on. 30, Shuijianbi, morning and evening hours service.

Psychotherapy

People's mood disorder is caused by people's irrational beliefs, so briefly, this therapy is the treatment of non-rational to rational to help Qiu Zhizhe a reasonable way of thinking on behalf of the unreasonable way of thinking, on behalf of a reasonable belief irrational beliefs, thereby minimizing the irrational belief that the adverse effects to the mood, mainly through changes in cognitive therapy to help Qiu Zhizhe reduce or eliminate their existing emotional disorder, usually after a about group therapy on cancer patients with psychological response state and there will be significant changes in cognition, negative emotions have been alleviated, can improve their helplessness, despair, anxiety and depression, showed the spirit to fight the disease enhanced treatment of patients with a variety of easy to accept.

So maintain a healthy state of mind and optimism, is conducive to the normal regulation of endocrine activity, the prevention of breast cancer and breast cancer, an important aspect of the development. Practice has proved that, where the spirit of optimism, confidence in treatment than enough, patients and doctors with better efficacy better; the contrary, the poor. Correct despair, negative, and other psychological state. The establishment of good doctor-patient relationship, and enhance the confidence of the patient overcome the disease, is conducive to rehabilitation of the disease.

Diet therapy

Performance according to the tumor disease and the patient's own yin and yang, cold and heat rise and fall of Dialectic meal, from the set of square, screen side to the experiment, to develop a variety of anti-cancer diets, such as liver blood deficiency diets, herbs and other lung qi deficiency, and its main advantage :: ① also eat also governance; ② is effective; ③ no side effects; ④ wide range of applications; ⑤ plenty of raw materials; ⑥ made easy; ⑦ easy Jiufu.

1, time, and quantity consumed, not overeating, the partial eclipse, a planned intake of nutrients and calories.

2, eat foods rich in vitamin A, C vegetables and fruits. Eat foods with inhibition of cancer cell, such as cabbage, shepherd's purse, mushrooms and so on.

3, eat white rice, refined face, eat more whole grains, corn, beans and other grains.

4, low-fat diet. Eat lean meat, eggs, yogurt. Eat less salted, smoked, roasted, burned the coke, bad food.

5, eat dried foods, such as sesame, pumpkin seeds, watermelon seeds, peanuts, raisins and so on. They are rich in vitamins and trace elements, fiber, protein and unsaturated fatty acids, high nutritional value.

Exercise therapy

Physical therapy with physical exercise, encouraging the body upright, resist cancer Evils for the purpose of aerobic exercise based, designed to improve immune function; anti radiotherapy and chemotherapy toxicity; improve the environment for the body inhibit the growth of cancer cells; adjustment disorder of the nervous system; direct killing effect on cancer cells. To physical therapy under the guidance of teachers, and Hill & Knowlton presented a CD-ROM aerobic exercise cancer, ask the patient in the physical conditions permit, as far as perseverance.

Follow-up treatment: Cidan capsule, 10 boxes, 5 tablets, 4 times daily, after meals orally. Participation Capsules: 4 capsules, 3 times daily, after meals orally. Herbs: Bupleurum 30 grams, 30 grams of white peony root, Citrus aurantium 30 grams, 30 grams Chuanxiong, Cyperus rotundus 30 grams, 30 grams of peel, angelica 30 grams, heterophylla 20 grams, 20 grams Atractylodes, Poria 20 grams, licorice 20 grams, 20 grams of white beans, yam 20 grams, 20 grams of astragalus, angelica 20 grams. 10, Shuijianbi, day one.