Rawat
Kanser Guna Imun Sistem
In the last 25 years, immunology has answered one of
the central questions about cancer – why cancer cells are not destroyed by the
patient’s immune system. Based on the research of Dr. Lentz and others, we now
know that cancer cells create inhibitors to shield themselves from attack, much
the way military aircraft produce “chaff” to fend off defensive fire.
Using a technology akin to dialysis, Immunepheresis removes these inhibitors
from the patient's bloodstream, eliciting a natural immune system response
that in most cases leads to rapid tumor shrinkage. The method has
been used in human clinical trials for over 15 years, and in several hundred
patients, with consistent, encouraging data on efficacy and safety.
Immunepheresis appears to be effective in a wide range
of solid tumor cancers, though not in all patients: the key prognostic
variables are (a) cancer stage and (b) strength of the patient's immune system
before treatment begins.
Importantly, Immunepheresis has usually shown results
that are better than chemotherapy or radiation in terms of killing most
malignant tumors. Even in patients with Stage IV disease; multiple metastases
and major tumor burden; extensive prior chemotherapy; and exhaustion of
conventional therapeutic options, Immunepheresis has shown significant clinical
responses (i.e. >50% reduction in measurable tumor volume).
There are a number of reasons this therapy especially
interests immunologists:
1. The apparent universality of its
efficacy in cancers of varied types; this implies a common immunologic
mechanism;
2. The high rate of tumor necrosis
(cancer cell death) that can be achieved without collateral harm to the
patient;
3. No ‘dose limiting’ toxicity, or
long-term damage to the patient’s immune system, as experienced with
chemotherapy.
4. The relatively mild, short-term side
effects, in dramatic contrast to what the patient endures with chemotherapy or
radiation.
5. The short initial term of therapy
needed to confirm positive response;
6. The response rate even in patients
who have exhausted all other therapeutic options; and
7. The expected lack of long-term
complications such as the secondary cancers that are known to follow
chemotherapy and radiation.
In theory, Immunepheresis in particular and immune
therapies in general hold the potential to eliminate virtually every cancer
cell in the body over time. Given the newness of the therapy, we can only
measure initial, not long term response. In many but not all new cancer
therapies, such favorable initial response has proven to be predictive of
improved intervals before disease progression and ultimately of improved rates
of survival.
Basics of Immunepheresis
A standard dialysis central venous catheter is
surgically implanted. Blood is withdrawn from the catheter through specialised
tubing to a machine that filters TNF inhibitors out of the blood and returns
the blood to the patient through the same catheter. Removal of the inhibitors
frees the immune system to attack the cancer. The lower the inhibitor
level, and the longer it is maintained, the more effective is the resulting
tumor inflammation in effecting tumor necrosis.
Typical sessions last 4 - 6 hours a day. Skilled
nurses and doctors are continually present.
Side effects are typically mild and short-lived.
Patients often experience a mild flu-like feeling, low-grade fever and fatigue
due to the immune unblocking. A patient during treatment can either doze, eat
and drink, talk, read, listen to music, watch a movie or sleep. If
tumor-specific inflammation is created, the patient can experience a dull ache
or pain in the tumor site. Cutaneous tumors can become red, hot, tender and
swollen. This tumor tenderness usually resolves within hours of treatment.
Early Stage Cancer Patients
Early stage (Stage I-III, pre-metastatic) patients may
be the best candidates for Immunepheresis. Since most patients have been
Stage IV, we have relatively few cases of early stage disease. However,
among those few, improvement has been consistent and significant, including
apparent remission in several cases. Among the reasons that make such
results plausible in early-stage patients: their cancers tend to be less extensive,
their health more robust, and they sometimes have not received extensive prior
chemotherapy. Any co-morbid condition, especially those that compromise the
immune system, might lessen the efficacy of the therapy.
Late Stage Cancer Patients
Stage IV patients generally show a better response to
Immunepheresis than would generally be expected from chemotherapy and/or
radiation. Despite suppression of their immune systems through prior
chemotherapy and radiation, about two-thirds of Stage IV patients show a
positive response to Immunepheresis in terms of tumor inflammation and necrosis
– the key signs of cancer cell death. This suggests that while
Immunepheresis does not help every Stage IV patient, it is a better option than
any other systemic therapy, including chemotherapy.
The key variables for Stage IV patients are high tumor
burden, weaker general health, an immune system compromised by extensive
cytotherapy and/or radiation, or cachexia.
Stage IV patients can also receive a three-week trial
of Immunepheresis, after which their response is evaluated. If their response
has been positive, further treatment can be considered. Some patients require
many weeks, even months, of treatment to obtain maximal response. The good news
is that such patients are showing continued improvement.
Referring physicians and their patients are welcome to
contact the Foundation to inquire about treatment.
You may contact us by phone or complete the on-line patient information form.
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