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Entries in Treatments (7)

Wednesday
Sep052012

Drinking Pig Worms to Fight Crohn's Disease

iStockphoto/Thinkstock(NEW YORK) -- Eight years ago, New Yorker Herbert Smith did the unthinkable -- he swallowed thousands of pig whipworm eggs in a desperate bid to quell his advancing Crohn's disease.

The microscopic eggs, invisible to the naked eye, were suspended in a liquid solution.

"There was nothing to it," said the 33-year-old financial analyst, who uses a pseudonym to talk about his worm-drinking ways. "It was drinking half a cup of salty water."

At that moment, he said, "I felt excitement and definitely hope."

For Smith, something incredible happened. After swallowing 2,500 worm eggs every two weeks for three months, most of his Crohn's symptoms vanished.

"I was definitely ecstatic," he said. "The symptom reduction was pretty drastic."

"I did have blood tests before and after," he said, and "the markers of inflammation went down significantly."

As for his physician's reaction, Smith said "he was cautiously optimistic."

Smith has been battling Crohn's disease since he was diagnosed as a teenager.

"The worst day of your life is to find out there's no known cure," he said. "It affects your quality of life in a significant way, and most treatments are subpar."

As many as 1.4 million Americans live with Crohn's disease or its cousin, ulcerative colitis, according to the U.S. Centers for Disease Control and Prevention. In Crohn's disease, the body's immune system mistakenly attacks the lining of the intestine, causing diarrhea, abdominal pain, fatigue, bleeding and infections. For Smith, the disease has been difficult to control.

Despite undergoing multiple operations to remove part of his gut, his symptoms always returned, he said. He calculated that at his current rate of required surgeries, he would eventually run out of small intestine. If this occurred, he would require liquid feedings through an intravenous line, with potentially fatal consequences.

"That realization was pretty hard to take in," said Smith. "I had to do my own research."

Smith started studying the medical literature on how parasites might be useful in the treatment of inflammatory bowel disorders such as Crohn's disease. He also learned that one could order a three-month supply of pig whipworm eggs from Europe for 3,500 euros.

But he was realistic about his treatment goals.

"I knew that the most I could hope for was a remission for Crohn's, not a cure," he said.

Despite his promising response to pig whipworms in 2004, Smith had to stop because "it was very expensive and hard to get," he said.

Today, researchers are eagerly studying the experimental therapy. After finding that pig whipworm treatment was effective and safe in a small number of Crohn's patients, scientists are now conducting multicenter studies across the United States and Europe. The goal is to determine if this treatment will relieve symptoms and be tolerated across a larger group of patients.

Dr. Joel V. Weinstock, a parasitologist and chief of the Division of Gastroenterology/Hepatology at Tufts Medical Center in Boston, said there was a scientific basis behind drinking pig whipworms to help reduce symptoms in autoimmune disorders, such as Crohn's.

"Parasites are known to dampen the immune systems of their hosts," Weinstock explained. More specifically, drawing from animal studies from his laboratory, pig whipworms appear to activate cells that regulate the immune system so that it doesn't overreact.

One advantage of pig whipworms is that they don't cause disease in humans. Weinstock emphasizes that this parasite doesn't migrate outside your gut, can't reproduce in humans and dies off after two months. People who have pig whipworms can't spread them to others, and there are several medications that can be used to rid the body of whipworms, Weinstock said.

According to Weinstock, there have been no major side effects or complications of pig whipworm treatment reported in studies on Crohn's patients. One study on whipworm treatment in those with hayfever documented mild side effects (gas, diarrhea and cramping) that were usually resolved after two weeks. According to Dr. P'ng Loke, an assistant professor in the department of microbiology at New York University, citing the studies available so far, "pig whipworms look to be extremely safe for the time being."

Stories of other patients with autoimmune diseases, like Smith, who are deliberately infecting themselves with worms have surfaced. Dr. Weinstock cautions that patients shouldn't treat themselves with worms. He encourages Crohn's patients to remain on standard, proven treatments and to talk to their physicians.

Smith noted that he kept his physician informed about his parasite experiments. One reason, he said, is that "I didn't want him to do a colonoscopy and be horrified."

For patients who want to explore whipworm therapy, Weinstock encourages patients to talk to their doctors about enrolling in clinical studies. Other pig whipworm clinical trials are planned or under way for more autoimmune diseases, including ulcerative colitis (an inflammatory bowel disease), multiple sclerosis (an autoimmune disorder that affects the brain and spinal cord), psoriasis (an autoimmune skin disorder) and type 1 diabetes.

Smith has declined to participate.

Heather Gelabert, a 32 year-old Florida homemaker, was forced to drop out of college because her Crohn's disease proved so difficult to treat. She was initially taken aback when her physician described pig whipworm treatment, but after a long discussion, she decided to enroll in a clinical trial.

For Gelabert, the promise of this upcoming clinical trial for Crohn's patients brings new optimism. "I am excited and very hopeful," she said with enthusiasm. "I'd like to start now!"

Copyright 2012 ABC News Radio

Tuesday
Jul102012

Top Seven Summer Health Risks

Stockbyte/Thinkstock(NEW YORK) -- The heat facilitates a great deal of summer fun, but it's also the culprit behind many threats to your health.

According to the National Oceanic and Atmospheric Administration (NOAA), heat is the number one weather-related killer in the United States, causing more deaths annually than floods, lightning, hurricanes and tornadoes combined.

In 1980, a U.S. heat wave claimed more than 1,200 lives, and about 50,000 Europeans died in a 2003 heat wave. North American tends to have at least one heat wave each summer, according to NOAA.

A number of other health issues come with the summer heat. While not all are necessarily fatal, in many cases they are serious enough to send you scrambling for a remedy.

Here's how to avoid and treat seven common summer heat ailments:

Swimmer's Ear
When you get out of the pool this summer, make sure not to let any water stay behind in your ears. Swimmer's ear -- an infection of the ear canal --  most often develops with the help of water, which facilitates the growth of bacteria. The infection can be extremely painful and disfiguring, but it is eminently avoidable, says Dr. Iyad Saidi, an otolaryngologist at Metropolitan ENT in Alexandria, Va. Use a towel, not a Q-tip, he says, and treat the infection with antibiotic drops and by cleaning the ear canal. "The most important thing is to make sure all the water comes out," Saidi says.

Sunburn
As many have learned the hard way in this scorching summer, sunburns do not only strike at the beach. In fact, many are vulnerable to sunburns even when the sun is hidden behind clouds, partly because of the common misconception that clouds provide enough protection from the sun's rays. "I see the worst burns on cloudy days," says Dr. Doris Day, a professor of dermatology at New York University Medical Center. Day advocates the daily use of sunscreen — lots of it. Cover every inch of skin that will be exposed to the sun, she says, and use enough to make the most of your lotion's SPF rating. If you do get sunburn, get to some shade as quickly as possible, she says. Take a lukewarm bath, with whole milk mixed in if desired, and cool off.

Heat Rashes
The people most at risk for sunburn are also most vulnerable to heat rashes, which emerge when heat irritates the skin, particularly around body folds. The result looks much like hives, but this is no allergic reaction. To treat heat rashes, Dr. Day recommends using powder to absorb extra moisture — though not corn starch — and staying in the air-conditioned indoors.

Tick and Mosquito Bites
Camping trips are not the only times to worry about bug bites. Lyme disease-carrying ticks exist in all 50 states, and not only in wooded areas, says Dr. Day. The most troubling part: only half of people who contract Lyme get the telltale rash associated with it. Others get symptoms like headaches, but the disease remains under-recognized and under-treated, according to Day. If untreated long enough, the disease can become debilitating. Mosquitoes also pose an increased threat as the amount of clothing covering people's skin decreases. Among the mosquito-borne dangers to watch out for is the West Nile virus, Day says. While insect repellant is a powerful tool to have in your arsenal, she says, beware that mosquitoes may develop resistance to them. And be sure to check your body for ticks after you come in from the outdoors.

Grill Burns
Most Americans dusting off their grills this summer do not suspect that they are inviting any dangers. But grill burns tend to happen suddenly — in a rush to save the burgers from burning, for instance. If you are burned, do not apply ice to the burn, says Dr. Day. Doing so might result in an "ice pack burn." Cortisone and aloe work to soothe the inflammation, with the latter also serving as an anesthetic to quell the pain. Honey may also help, Day says. If the burn is deep and painful, head to the emergency room for proper wound care. The key, Day says, is caution and preparedness. Even if you're in a hurry, take care to avoid touching the grill, and make sure you have a cooking glove nearby at all times.

Jellyfish Stings
If you are stung by a jellyfish at the beach this summer, vinegar or urine should do the trick, right? Wrong, according to a new study published in the Annals of Internal Medicine. Those two acidic liquids do not work nearly as effectively as hot water and painkillers, the study said. In particular, the study recommended painkillers containing lidocaine, which appears to inhibit the poison sacs left behind by jellyfish from spreading their venom. Hot water helps to denature the sacs. The trick, according to the study, is to avoid rupturing the sac, as may easily happen in an attempt to wipe the affected area off with a towel.

Food-Borne Illnesses
The heat is also a culprit in the rise of food-borne illnesses during the summer. Of course, industrial and agricultural mishaps account for outbreaks of food-borne illnesses throughout the year, but the hot temperatures allow bacteria to thrive, making food more vulnerable to contamination, says Dr. Jeff Bender, an epidemiologist at the University of Minnesota. There are three main steps consumers should take to avoid food-borne bacteria such as salmonella, E. coli, and campylobacter, Bender says: prevent cross-contamination (for example, allowing meat juice to come into contact with food that will not be cooked), refrigerate foods appropriately, and cook meats thoroughly. A meat thermometer is a great help for the last step, Bender says. The symptom common to infections by all three of the above bacteria is diarrhea. If diarrhea persists for three days or longer, or if you develop a fever, Bender recommends a hospital visit.

Copyright 2012 ABC News Radio

Wednesday
Feb222012

New Drug Promising Against Deadly Melanoma

iStockphoto/Thinkstock(NEW YORK) -- When Richard Kaminski had an unusual mole removed from his cheek in 1998, he thought it was the end of his experience with melanoma.

But more than 10 years later, Kaminski developed a cough that didn't go away. Medical tests confirmed the diagnosis: metastatic melanoma that had spread to his lungs.

Melanoma is a form of skin cancer that kills 85 percent of its victims within five years if it has spread. It is responsible for about 9,000 deaths in the United States a year, according to the American Cancer Society.

Kaminski was floored. "I had this awful thing working in my lungs," he said.

Doctors treated Kaminski with a drug typically used against this form of cancer, but without success. It was only when his oncologist put him in touch with Dr. Anna Pavlick at New York University, who enrolled him in a clinical trial of a medication called vemurafenib, that he began to turn the corner on the deadly illness.

Before treatment, Kaminski recalled, "I had great difficulty breathing. I couldn't put sentences together because I couldn't get a deep breath. I had pain in my chest." Three weeks after beginning the drug, "A lot of that was greatly diminished," he said.

Within three months, Kaminski's symptoms disappeared. Scans showed his tumors starting to regress. By the end of 2010, the tumors were gone.

Kaminski, now 65, is understandably thankful.

"In two weeks, I will be two years on this drug," he said. "It was a lifeline."

On Wednesday, the results of the clinical trial in which Kaminski was enrolled appeared in the New England Journal of Medicine. In the study conducted at 13 centers in the U.S. and Australia, researchers followed 132 patients with Kaminski's type of melanoma who had failed to respond to standard treatment. In about half of them, vemurafenib shrunk their tumors. For another third of the patients, the tumors showed no progression once the drug regimen had kicked in. Dr. Lynn Schuchter at the University of Pennsylvania, another of the study's authors, called these numbers "unprecedented."

"I've treated patients [with melanoma] for almost 25 years and never seen a drug with this kind of activity," Schuchter said. "It's so much better than the therapies that have been available to us before."

Also impressive was the improvement in survival; patients on the drug lived, on average, for an additional 15.9 months after treatment began, compared with the six to 10 months typically seen with the disease. A larger trial, also published this year in the New England Journal of Medicine, showed that the drug brought about improved survival at six months. But the authors of the new study were able to follow some of their patients much longer -- for more than a year after they'd started treatment.

For patients like Kaminski who fail standard treatment, the new drug offers hope. Unlike many other cancer drugs, vemurafenib was just as effective in patients who had failed a previous treatment as it was in patients who had received the drug right off the bat -- a rare finding when it comes to cancer treatments.

The drug is not without its limits. In targeted therapy, cancer cells can mutate slightly and stop being a target, a process called resistance. In this study, cancer tended to recur in patients after about seven months of treatment. Dr. Kelly McMasters, chairwoman of surgery at the University of Louisville who treats melanoma patients, points out, "It can cause the tumors to shrink, but they will recur on average in about six months."

That being said, McMasters said, "In some patients...vemurafenib offers the hope to shrink the tumors enough to allow [surgical removal]."

So far, resistance hasn't been an issue for Richard Kaminski. Two years into treatment, he continues to enjoy a relatively normal life. He loves to garden, although he does have to take precautions out in the sun since one of the side effects of the medication is sun sensitivity.

Copyright 2012 ABC News Radio

Monday
Feb132012

Most Women With Breast Cancer Want a Role in Medical Decisions

Comstock/Jupiterimages(NEW YORK) -- Breast cancer patients aren't getting the control over their own bodies they would like, new research finds.

Almost 227,000 women will get breast cancer this year in the United States, according to the National Cancer Institute. Now a study from Virginia Commonwealth University published in the Journal of Clinical Oncology online finds that two-thirds of early-stage breast cancer patients want to have a role in decisions about their medical treatment.
 
In a survey of 683 women with breast cancer in five countries, only 28 out of 100 said they wanted to leave treatment decisions to their doctors. But 46 out of 100 said their doctors ended up making the final decisions anyway.
 
On the other hand, women who had more involvement where their breast cancer treatment was concerned were less conflicted over the final decision and more satisfied with that decision. About a third of the women wanted to give doctors a final say over treatment decisions.
 
According to one expert, when there are multiple reasonable treatment options for early-stage breast cancer women will usually choose participatory decision making.

Copyright 2012 ABC News Radio

Tuesday
Sep062011

FDA Committee to Review Osteoporosis Drug Safety

File photo. D-BASE/Getty Images(WASHINGTON) -- A U.S. Food and Drug Administration advisory committee will meet Friday to review the safety of a popular class of osteoporosis drugs called bisphosphonates amid worry that their long-term use could cause rare fractures of the thighbones and death of the jawbone.

According to The Wall Street Journal, the committee plans to evaluate whether women should temporarily stop using the drugs or use them for only a few years. The FDA did not immediately respond to ABC News' requests for comment.

In September, a report by the American Society of Bone and Mineral Research linked bisphosphonates, which include the drugs Fosamax and its generic counterparts, Boniva and Actonel, to rare femur fractures among patients with osteoporosis. Of 310 cases, 94 percent of the patients were taking bisphosphonates.

While the report's authors did not say that the osteoporosis medications caused the fractures, they recommended that the FDA change the drugs' labeling to warn patients about the possible risks.

"Based on the report, we now feel that there is a definitive relationship between these class of drugs and these fractures, and it's even stronger in those taking those drugs for a long time," Dr. Elizabeth Shane, a co-author and professor of medicine at Columbia University College of Physicians and Surgeons, told ABC News.

But she also said bisphosphonates could help prevent other types of fractures, and patients should still take them. She continues to prescribe bisphosphonates and evaluates each patient individually. Patients who take them, however, should be aware of warning signs, such as a hip, thigh or groin pain.

Many doctors are changing the way they prescribe bisphosphonates, taking patients off the drugs after two or three years. Others recommend a five-year limit.

Fosamax, a blockbuster drug that has earned billions for Merck and Co., has also been linked to severe muscle pain and osteonecrosis of the jaw, also known as jawbone death

Merck responded to the initial reports of jawbone death by saying the clinical information was inconclusive.

"In worldwide post-marketing experience with Fosamax, Fosamax Plus D, rare reports consistent with osteonecrosis of the jaw have been received. Many of these reports lack sufficient clinical details to make definitive assessments or are confounded, particularly since a generally accepted definition of ONJ in the general population is unknown," Merck wrote in a statement.

Copyright 2011 ABC News Radio

Tuesday
Aug302011

New Lung Cancer Pill Highlights Improved Way of Treating Patients

Jupiterimages/Thinkstock(NEW YORK) -- A new drug to combat a certain type of lung cancer is being hailed Tuesday as an "amazing development" by medical experts.

The drug crizotinib (Xalkori), manufactured by Pfizer and approved last week by the Food and Drug Administration, is intended for a small number of patients.

The twice-daily capsules are meant for patients with non-small cell lung cancer who have a unique gene known as an abnormal anaplastic lymphoma kinase (ALK). An ALK gene causes cancer growth and development.

Pfizer held a panel Tuesday to discuss the implications of the new drug.

"What we've seen from studies to date is that this pill does have significant activity," said Dr. Alice Shaw, a thoracic oncologist at Massachusetts General Hospital Cancer Center, who took part in crizotinib studies. "For about 60 percent of patients, they will have a significant shrinkage in their tumors and what the preliminary studies have also shown is that the median or average duration of response is on the order of 10 months."

Crizotinib works by blocking the proteins produced by the ALK gene. The FDA also approved a diagnostic test by Abbott Laboratories that screens for the gene. Patients found to have the gene would be able to be prescribed the pill, although chemotherapy and radiation therapies would remain options.

The most common side effects, according to Medpage Today, reported in patients taking crizotinib were vision disorders, nausea and edema.

"For many patients, this drug has been a lifesaver," Massachusetts General's Shaw told ABC News. "For many patients, they experienced a very immediate and significant relief in their symptoms, sometimes within the first week."

Dr. Roy S. Herbst, chief of medical oncology at Yale Cancer Center, said that crizotinib's FDA approval was a "pivotal milestone" in lung cancer treatment.

"It's another example of how we are using molecular medicine to effectively treat a subset of cancer patients," Herbst told ABC News via email.

Copyright 2011 ABC News Radio

Monday
Mar142011

Clinical Trial Participation Dampened by Motives, Fears

Thomas Northcut/Thinkstock(DURHAM, N.C.) -- Across cancers and a range of other life-threatening diseases, researchers struggle to recruit enough patients for trials to generate meaningful results.

Clinical trials are a crucial step in the search for disease treatments, tests and causes.  But fears, misconceptions and a lack of awareness -- among patients and doctors -- are major barriers that researchers across all fields are working hard to overcome.

"In just about every major disease, less than 10 percent of patients are enrolling in trials," said Dr. Richard Bedlack, director of Duke University's Amyotrophic Lateral Sclerosis Clinic in Durham, North Carolina.

Bedlack said only five percent of people with ALS (or Lou Gehrig's disease) -- a fatal neurological disease with no cure and only one treatment that extends the average three-to-five-year survival only slightly -- enroll in clinical trials.

Bedlack has been studying what motivates people to participate in trials and what dissuades them from signing up. Patients worry that participating in trials will spur out-of-pocket expenses, impose heavy time burdens, and possibly expose them to dangerous or unethical procedures, according to a survey he presented in December at the 21st annual International Symposium on ALS-Motor Neuron Disease in Orlando.

Websites touting bogus treatments and trials abroad also hinder research efforts in the United States.

Lack of awareness and worries about time burdens and paperwork dissuade doctors from recommending trials, too, Bedlack said.  Many doctors go with the standard treatments, and don't even mention trials unless asked.

Copyright 2011 ABC News Radio







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