radiation therapy Archives - Amazing Health Advances

The Cognitive Side Effects of Radiation Treatment

AHA Publisher — Fri, 01 Jul 2022 07:00:52 +0000

Benedette Cuffari, M.Sc. via News-Medical – Although radiation treatment is one of the primary methods to treat both brain tumors and brain metastases, it can be associated with several adverse effects that can be difficult to diagnose and manage. Introduction Many different types of cancer will often be treated with therapeutic ionizing irradiation. When used to treat benign and malignant conditions in the brain, cranial radiation therapy (CRT) is often used for both curative and palliative purposes. Regardless of where the radiation treatment is localized, nervous system injury can occur through several mechanisms. For example, irradiation treatment that damages blood vessels that supply the brain or endocrine organs with oxygen can cause secondary neurological effects. Similarly, CRT can directly damage normal neurological structures adjacent to the benign or malignant tissue of interest. Several factors can determine the damage caused by radiation treatment to the nervous system. These include the total radiation dose and dose per fraction delivered to the nervous system, the total volume of the nervous system that was irradiated, if any, the amount of time that has passed since the radiation was completed, and whether the patient has any comorbidities that might increase the intensity of radiation side effects, such as diabetes or hypertension. Acute and Early Delayed Damage Several different types of radiation can be used in the clinical setting, including photons, electrons, protons, and other particle-based radiation. Typically, CRT will be delivered in either X-rays or gamma rays, both photons, through external sources like teletherapy or directly into the tissue of interest through implanted or injectable radioisotopes. Primary neurologic damage that is caused by radiation can be classified according to the time between after the radiation treatment was administered and when the patient began to experience symptoms related to this damage. Acute neurologic damage after radiation, which typically arises within minutes to days after the radiation treatment, is often associated with a rise in intracranial pressure, likely due to acute vasogenic edema. These patients can experience a wide range of symptoms, including nausea, headache, vomiting, somnolence, fever, and worsening neurologic symptoms. However, acute encephalopathy due to radiation treatment will rarely cause cerebral herniation or death. Comparatively, early delayed neurologic damage after CRT, which typically takes several weeks to months for symptoms to develop, is often due to demyelination of surrounding structures. Some possible symptoms of this type of neurologic damage can include headache, lethargy, and worsening of lateralizing signs. Late Delayed Damage The third type of neurologic damage that can occur following CRT is referred to as late delayed damage, which may not cause symptoms to appear for several months or even years after the radiation treatment. Late delayed neurologic damage to the brain can include radiation necrosis (RN), stroke-like migraine attacks after radiation therapy (SMART syndrome), and cerebral atrophy. RN is estimated to occur between 5% and 25% of CRT patients; however, the true incidence of this condition has not been fully established. Several possible mechanisms have been proposed to be responsible for RN. These include disruption to the blood-brain barrier that increases brain permeability, or the CRT directly damages glial cells. Some common symptoms that patients with RN may experience include headaches, nausea, cognitive impairment, seizures, or focal deficits related to the location of their irradiated tumor. SMART syndrome is considered a rare complication of CRT that can occur between one and ten years after treatment. Some characteristic symptoms of SMART syndrome include migraine-like headaches associated with transient neurologic signs that may or may not be accompanied by seizures. Cerebral atrophy typically only arises after whole-brain irradiation, rather than more localized CRT treatments like gamma-knife. Although patients with cerebral atrophy may not report any symptoms at all, others may experience memory loss that can be severe in some cases. References Kaley, T. J., & Deangelis, L. M. (2021). Chapter 28 – Neurologic Complications of Chemotherapy and Radiation Therapy. In: Aminoff’s Neurology and General Medicine; 521-537. https://www.clinicalkey.com/#!/content/book/3-s2.0-B9780128193068000289. Tanguturi, S. K., & Alexander, B. M. (2018). Neurologic Complications of Radiation Therapy. Neurologic Clinics 36(3); 599-625. doi:10.1016/j.ncl.2018.04.012. Vellayappan, B., Tan, C. L., Yong, C., et al. (2018). Diagnosis and Management of Radiation Necrosis in Patients With Brain Metastases. Frontiers in Oncology 8(395). doi:10.3389/fonc.2018.00395. To read the original article click here.

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Futuristic Tech Brings Healing Relaxation to Radiotherapy

AHA Publisher — Fri, 18 Feb 2022 08:00:58 +0000

Abigail Klein Leichman via Israel21c – The first day of cancer radiation therapy begins inside a simulator machine. The patient lies immobilized for up to 45 minutes while lasers and imaging scans pinpoint areas for treatment. From his office next to the simulator, Israeli radiation oncologist Dr. Ben Corn senses the anxiety attacks brewing in the waiting area. And he understands. He understands that patients are fearful of entering the simulator. He understands that people associate radiation with causing cancer (think Hiroshima and Chernobyl) rather than treating it. Corn knows the radiation oncology unit can cause stress and anxiety for patients, their families and even the medical workers. And he’s determined to tackle this problem. “I’m extremely interested in the emotional and psychological dimensions of cancer, both in terms of the consequences for patients and their caregivers and in terms of enhancing the potential of therapies I have available as an oncologist,” he tells ISRAEL21c. That’s why Corn is partnering with trailblazing neuroscientist Amir Amedi, head of the Baruch Ivcher Institute for Brain, Cognition & Technology at Reichman University. (Read about our recent visit to the lab here. ) The place nobody wants to be Amedi and his lab are inventing multisensory devices to infuse a feeling of emotional wellbeing into the waiting, treatment and staff areas of the Radiotherapy Center that Corn will head at Jerusalem’s Shaare Zedek Medical Center. The lab’s new discoveries on the link between body and mind, and how that’s mapped in the brain, form the scientific basis for relaxation-inducing inventions such as: MRI-safe, whimsical-looking 3D glasses that immerse the patient in an entertaining movie or relaxing virtual environment. Chair and treatment tables embedded with tactile and auditory sensations that may relieve pain and focus attention away from the stressful environment. Breathing sensors with relaxing and soothing visual, sound and tactile feedback elements to encourage deeper, slower breaths that foster feelings of control and calm — and even enhance the clinical efficacy of imaging and radiotherapy. Relaxing auditory experiences created through in-ear recordings that aggregate how different people hear the same sounds coming from different parts of the room. “There are patients who cannot go through the simulation because they are so afraid, and I think this is a way to take the edge off that,” says Corn, noting that the procedure may never be pleasant but at least could be tolerable. Although music or videos inside the simulator can lower stress and anxiety, especially for children, Corn was seeking much more than that. When he read an article about Amedi’s groundbreaking multisensory technologies, he knew he’d found it. “I loved the disregard for boundaries that I saw in his work,” says Corn. “Imagine instead of just relying on sight alone or music alone – or tactile sensations, which nobody was even considering — we can begin to combine the three,” says Corn. “I contacted Amir and said, ‘This has to be imported into the place nobody wants to be, which is cancer medicine.’ And that appealed to him. So we’ve been designing all sorts of cool ways to do that.” The Shaare Zedek Cancer Center, set to open in the summer, will be the testing ground. “Medicine without data is voodoo,” says Corn. “I want to do things that not only sound nice but are proven, and part of the fun is the journey of proving these things in the context of clinical trials.” Training wheels “I feel everything we’ve done is preparing us for this project,” Amedi tells ISRAEL21c. “During the pandemic we started to work on reprogramming senses and combining them with sensory signals from the body to reduce stress and anxiety. I built a sophisticated multisensory room for this.” His lab created technologically upgraded versions of mindfulness meditation, body scan meditation and attention training technique (ATT). “If you do one of these techniques for a few minutes every day it works well, but if people are already highly stressed it just makes their symptoms worse,” Amedi explains. “They need ‘training wheels’ and that is what we try to provide.” Amber Maimon, Amedi’s academic lab manager, has been working on these technologies for her postdoc studies on the bidirectional link between mental and physical health. “We want to create a multisensory environment where the minute you walk in you are encompassed in relaxation,” Maimon tells ISRAEL21c. Pediatric patients are the primary focus of the project. “These technologies can capture their attention and take them out of the ‘dark bubble’ of treatment,” she says. “Everything we are doing has definitely never been done before. Some of the experiences, like body scan meditation and ATT, have been tested and validated but our implementation and technology are totally novel. Prof. Amedi’s neuroscience research itself is novel.” Hope heals Amedi, in turn, was intrigued by Corn’s research into “hope theory” — developed by University of Kansas Prof. Rick Snyder in 1989 – as a way to improve cancer patients’ recovery rates and longevity. Hope is not the same as optimism or wishful thinking, Corn explains. Rather, it’s a perception of what is possible. “Hope is a very active concept, and nobody needs it more than the cancer patient and the people surrounding that patient,” says Corn. “We have systematically pushed the concept of hopefulness into the clinical arena,” he says. Life’s Door, an Israeli organization he founded with his wife, family therapist Dvora Corn, teaches health professionals and patients strategies for finding hope, meaning and wellbeing throughout illness. “Three conditions allow hope to thrive: selecting a goal that is both meaningful and plausible; a pathway to get to that goal, recognizing there will be obstacles to circumnavigate on the way; and the agency – motivation — to set out on that pathway,” Corn explains. “In the world of cancer medicine, somebody might have a goal of curing their cancer. The pathway might be radiation treatment. But the obstacle is the anxiety of being exposed to radiation. We might find a workaround through Amir’s technology, and if we can temper the anxiety that will, in turn, unleash the third component, agency,” he says. Amedi saw the potential for promoting hope by stimulating the senses, especially from the perspective of kids facing that scary simulator. “We are doing imaging studies to understand why the body is so susceptible to feeling anxiety,” says Amedi. “My philosophy is to look at brain organization and plasticity to inspire new technologies, but it goes in the other direction as well.” He and Corn got a research grant from Israeli VC firm Joy Ventures, as well as support from Siemens, one of the manufacturers of radiotherapy simulators. The Helmsley Foundation is funding the purchase of the latest simulator model for the Radiotherapy Cancer Center. While older models used CT technology, the next-gen model uses MRI technology. “You can do all sorts of clever things with it, but you have the problem of MR-related claustrophobia,” says Corn. “When you add the issue of claustrophobia to the stigma of radiation, that’s quite a challenge. I think with Amir we can lick both problems.” Environment of hope The multisensory technologies would be used not only in the simulator, “which is the most stressful place for the cancer patient,” but also in treatment rooms. “Somebody who is very nervous about getting radiotherapy may get jittery. We have immobilization devices to make sure you don’t move but even small movements can be a problem because we always want to target the tumor and not the surrounding tissue. If you move even a few millimeters that can throw it off,” says Corn. “By finding out who you are and having you tell me what makes you feel good — like walking on a beach, or smelling the forest after it rains, or baking bread — we can virtually create that desired environment for you as part of your prescription,” he explains. “I hypothesize that it will make patients feel less stressed, less jittery and more cooperative. They will feel empowered because they are helping us help them and they will reclaim a sense of control.” Corn and Amedi want this “environment of hope” to extend to staff members. “There is a lot of burnout and even suicidal ideation for oncology healthcare professionals. Amir’s idea is to help them to contend with the stresses and actively reflect on hope and how to get there with the help of these technologies,” says Corn. “No one is doing that, not even close. We want to document our results in the medical literature for the critique of colleagues because we think it can be such a gamechanger.” Two research centers in the United Arab Emirates have expressed interest in developing a similar project, and Corn and Amedi have applied for a US government grant to facilitate that. “If we can use Amir’s technology to optimize cancer medicine,” Corn says, “it will expand our toolbox with things they don’t teach you in medical school.” To read the original article click here.

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Study: Light Therapy Fast-Tracks Healing of Skin Damage from Cancer Radiation Therapy

AHA Publisher — Mon, 31 Jan 2022 08:00:46 +0000

University at Buffalo via Newswise – BUFFALO, N.Y. – Light therapy may accelerate the healing of skin damage from radiation therapy by up to 50%, according to a recent University at Buffalo-led study. The research found that photobiomodulation – a form of low-dose light therapy –lowered the severity of skin damage from radionecrosis (the breakdown of body tissue after radiation therapy), reduced inflammation, improved blood flow and helped wounds heal up to 19 days faster. The findings, published on Dec. 28 in Photonics, follow prior reports on the effectiveness of light therapy in improving the healing of burn wounds and in relieving pain from oral mucositis caused by radiation and chemotherapy. The research was led by Rodrigo Mosca, PhD, visiting fellow from the Nuclear and Energy Research Institute (IPEN) and the Federal University of Rio de Janeiro, both in Brazil. Carlos Zeituni, PhD, professor at IPEN and the Federal University of Rio de Janeiro, is a senior author. “To our knowledge, this is the first report on the successful use of photobiomodulation therapy for brachytherapy,” said senior author Praveen Arany, DDS, PhD, assistant professor of oral biology in the UB School of Dental Medicine. “The results from this study support the progression to controlled human clinical studies to utilize this innovative therapy in managing the side effects from radiation cancer treatments.” Brachytherapy is a form of radiation therapy where a radiation source is implanted within the cancer tissue, exposing surrounding healthy tissue to lower doses of radiation than through teletherapy, a form which fires a beam of radiation through the skin to reach the tumor. Although brachytherapy has improved the precision and safety of cancer care, skin damage is still an unfortunate side effect. Similar to burn wounds, radionecrosis may cause inflammation and scarring and hinder blood flow. Current treatments to manage radionecrosis include routine wound care, pain medication and, in some cases, surgery. Previous research conducted by Arany’s lab found that photobiomodulation promotes healing by activating TGF‐beta 1, a protein that controls cell growth and division by stimulating various cells involved in healing, including fibroblasts (the main connective tissue cells of the body that play an important role in tissue repair) and macrophages (immune cells that lower inflammation, clean cell debris and fight infection). The new study, completed in an animal model, examined the effectiveness of both near-infrared and red LED light at improving the healing of skin damage during radiation therapy. Without photobiomodulation, wounds took an average of 61 days to heal. Using near-infrared light therapy, healing occurred within an average of 49 days. Healing occurred the fastest when using red light therapy, at an average of 42 days. “For over 40 years, photobiomodulation has been known to accelerate the healing of acute and chronic wounds, triggering cellular processes that control inflammation, pain signaling, and tissue regeneration and repair,” said Mosca. Research suggests that the effects of photobiomodulation does not extend to tumor cells, likely due to their perturbed metabolic and regulatory signaling, adds Arany. To read the original article click here.

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New Drug Candidate Could Boost Potential of Immunotherapy

AHA Publisher — Tue, 31 Aug 2021 07:00:24 +0000

Abigail Klein Leichman via Israel21c – One of the biggest breakthroughs in cancer treatment today is immunotherapy. Rather than flooding the body with toxic chemicals and radiation, this method recruits the patient’s own system to fight the cancer. While the immune system’s job is to detect and destroy intruders, cancer cells have various ways to disable it. Immunotherapy, therefore, aims to help immune cells recover their natural function. Although a powerful class of immunotherapy drugs, PD-1 inhibitors, was approved by the FDA in 2014, only 20-30 percent of cancer patients respond well to them. Even among those who initially respond, often the therapy stops working once cancer cells learn how to evade PD-1 inhibitors. “The reason seems to be that like cars in a traffic jam, the cancer cells find an alternative route to bypass the treatment, engage the immune cell [and shut it down],” explains Dr. Gavin Samuels, executive director of Jerusalem-based Nectin Therapeutics. The company is named after the nectin family of proteins, whose pathways are a common alternate route for cancer cells to evade immunotherapy. Established in 2017 based on a collaboration between scientists at the Hebrew University of Jerusalem and the University of Rijeka, Croatia, Nectin Therapeutics’ drugs set up a roadblock in the nectin pathways. Used alone or in conjunction with PD-1 inhibitors, this treatment could be a strong contender in the quest to boost the success of immunotherapy for cancer patients. Like a Key in a Lock “There are probably many cells in our bodies that are constantly moving on a spectrum from normal cells to cancer cells, and an active immune system constantly surveys the situation,” explains Samuels, a physician. “As soon as the immune system detects these abnormal cells, it attacks them.” To protect themselves and take root as tumors, cancer cells develop anchors to reach specific receptors on the immune cell, fit into it like a key in a lock, switch it off and inactivate it. By breaking that locking mechanism, immuno-oncology drugs reactivate the immune response and provide a safer treatment with fewer side effects than traditional chemo or radiation therapy. “You have horrific side effects with chemotherapy because it’s essentially a poison that is more toxic to cancer cells — because they are rapidly dividing — than to normal cells,” Samuels explains. “We’ve developed a series of monoclonal antibodies and antibody-drug conjugates – an antibody with a toxin attached, sent directly to the cancer cell.” Nectin Therapeutics’ drugs have been shown in preclinical studies to effectively restore the function of immune cells when used alone, and even more when combined with a PD-1 drug, he says. The company’s lead candidate is expected to go into human clinical trials early next year. Other Nectin Therapeutics drugs could get to clinical trials about a year later, depending on FDA consideration, based on preclinical studies taking place in the US, Israel and Europe. Unique to Nectin Therapeutics Keren Paz, Nectin’s chief development officer, based in New York, explains that many research groups have sought alternative pathways to PD-1. Most have been unsuccessful. “We’re trying to find a common denominator among a lot of patients who did not respond well enough or long enough to that first family of immunotherapy drugs,” she says. “We see tumors that express the nectin proteins from the beginning and others that become dependent on these proteins only when the patient’s immune cells are already exhausted following treatment.” Nectin’s drugs use several different mechanisms of action to help restore the power of the immune system and shrink existing tumors. Immunology researcher Pini Tsukerman, Nectin Therapeutics’ cofounder and chief scientific officer, says the company has gained an in-depth understanding of the evasion mechanisms of cancerous cells from the immune system. “This comprehensive understanding, together with our track record in drug discovery and development, allowed us to select unique molecules as a target for the antibodies we develop,” says Tsukerman. Paz emphasizes that the antibodies demonstrated a favorable safety profile in preclinical studies and are expected to be effective in patients with many different types of cancer and at different stages of the disease. “Even targeted therapy has some side effects, but we’re not expecting any. We’re simply turning on an existing mechanism of the human body that was turned off,” Paz tells ISRAEL21c. Raising Funds Nectin Therapeutics’ investors include Integra Holdings, an investment company focused on life-science innovations emerging from the Hebrew University; aMoon Velocity, the early-stage fund of Israel’s largest health-tech and life-sciences venture fund aMoon; and Peregrine Ventures. The company closed a Series B round that raised about $15 million in May. “We believe that new immune checkpoint inhibitors will significantly enrich the toolbox of immunotherapy treatments and enable a more effective fight against cancer, whether as an independent treatment or in combination with existing approved drugs,” said Yaron Daniely, partner and head of aMoon Alpha. For more information, click here To read the original article click here.

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Researchers Developing New Cancer Treatments With High-Intensity Focused Ultrasound

AHA Publisher — Fri, 27 Aug 2021 07:00:27 +0000

University of Waterloo via Newswise – Researchers are bringing the use of acoustic waves to target and destroy cancerous tumours closer to reality. While doctors have used low-intensity ultrasound as a medical imaging tool since the 1950s, experts at the University of Waterloo are using and extending models that help capture how high-intensity focused ultrasound (HIFU) can work on a cellular level. Led by Siv Sivaloganathan, an applied mathematician and researcher with the Centre for Math Medicine at the Fields Institute, the study found by running mathematical models in computer simulations that fundamental problems in the technology can be solved without any risk to actual patients. Sivaloganathan, together with his graduate students June Murley, Kevin Jiang and postdoctoral fellow Maryam Ghasemi, creates the mathematical models used by engineers and doctors to put HIFU into practice. He said his colleagues in other fields are interested in the same problems, “but we’re coming at this from different directions”. “My side of it is to use mathematics and computer simulations to develop a solid model that others can take and use in labs or clinical settings. And although the models are not nearly as complex as human organs and tissue, the simulations give a huge head start for clinical trials.” One of the obstacles that Sivaloganathan is currently working to overcome is that in targeting cancers, HIFU also poses risks to healthy tissue. When HIFU is being used to destroy tumours or cancerous lesions, the hope is that good tissue won’t be destroyed. The same applies when focusing the intense acoustic waves on a tumour on the bone where lots of heat energy gets released. Sivaloganathan and his colleagues are working to understand how the heat dissipates and if it damages the bone marrow. Other researchers working with Sivaloganathan include engineers, who are building the physical technology, and medical doctors, in particular, James Drake, chief surgeon at Hospital for Sick Children, looking at the practical application of HIFU in clinical settings. Sivaloganathan believes HIFU will make significant changes in cancer treatments and other medical procedures and treatments. HIFU is already finding practical application in the treatment of some prostate cancers. “It’s an area that I think is going to take center stage in clinical medicine,” he said. “It doesn’t have the negative side effects of radiation therapy or chemotherapy. There are no side effects other than the effect of heat, which we are working on right now. It also has applications as a new way to break up blood clots and even to administer drugs.” To read the original article click here.

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