WHEN DRINKING WATER, REMEMBER THE SPRING

Siyuan pictures (Mar 2010)

2010-04-02T20:30:00.000-07:00

Siyuan's photoes (Oct & Nov 09)

2009-11-20T17:35:00.000-08:00

Ara-C

2009-10-15T07:51:00.001-07:00

Ara-C

Generic name: CytarabineTrade names: Cytosar-U®Other names: Ara-C, Arabinosylcytosine
This medication is classified as an "antimetabolite." (For more detail, see "How this drug works" section below).
What this drug is used for:
Cytarabine is used to treat different forms of leukemia, including acute and chronic myelogenous (AML and CML) and acute lymphocytic leukemia (ALL). It is also used to treat lymphoma, meningeal leukemia and lymphoma (cancers found in the lining of the brain and spinal cord)
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How this drug is given:
Cytarabine may be given as an infusion into the vein (intravenous or IV).
As an injection into the layer of tissue between the skin and the muscle (subcutaneous or SubQ).
As an injection into the muscle (intramuscular or IM).
Another method it is given is by intraventricular or intrathecal infusion. This method is used when drugs need to reach the cerebrospinal fluid (CSF) the fluid that is surrounding the brain and spinal cord, the drug is infused directly into the spinal fluid.
There is no pill form of cytarabine.
The amount of cytarabine that you receive and the way it is given depends on many factors, including the type of cancer you have, your height and weight, your general health, any other health problems you may have. Your doctor will determine your dose, how it should be given and the schedule.
Side effects:Important things to remember about the side effects of cytarabine:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
Side effects and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.
The following side effects are common (occurring in greater than 30%) for patients taking cytarabine:
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at risk for infection, anemia and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
Onset: 4-7 daysNadir: White blood cells: 7-10 days, platelets: 12-15 daysRecovery: 21-28 days
Nausea and vomiting.
Mouth sores (usually occur 7-10 days after therapy).
Blood test abnormalities: Increase in blood level of uric acid. A pill called allopurinol may be given to decrease these levels.
Increases in blood tests measuring liver function. These return to normal once treatment is discontinued. More often associated with high-dose regimens.
These side effects are less common side effects (occurring in about 10-29%) of patients receiving cytarabine:
Diarrhea
Loss of appetite
Skin rash, redness and itching
Flu-like symptoms (fever, chills, generalized aches and pains) within the first few days of treatment.
Pain redness and skin peeling of the palms of hands and soles of feet (hand-foot syndrome) may occur with high-dose therapy (rare). Use of steroid creams or moisturizers may be helpful.
Temporary hair loss (uncommon, but thinning may occur).
Eye pain, tearing, sensitivity to light and blurred vision may occur with high-dose therapy. Often steroid drops or ointment to the eyes are used to prevent or relieve this condition.
Dizziness, headache, excessive sleepiness, confusion, loss of balance may occur in up to 10% of patients receiving high dose therapy. Onset is usually 5 days after treatment and may last up to 1 week. More often these toxicities are mild and reversible. (see central neurotoxicity).
Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider: Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5ºF (38ºC) or higher or chills (possible signs of infection).
Chest pain or heart palpitations
Inability to pass urine
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
Diarrhea (4-6 episodes in a 24 hour period)
Nausea (unable to drink fluids and unrelieved with prescription medication).
Vomiting (more than 4-5 times in a 24 hour period)
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Extreme fatigue (unable to carry on self-care activities)
Mouth sores (painful redness, swelling or ulcers)
Cough and/or shortness of breath
Excessive sleepiness or confusion
Changes in balance and coordination.
Yellowing of the skin or eyes
Changes in vision or burning/or tearing of eyes
Swelling, redness and pain in one leg or arm and not the other
Stomach pains
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
Before starting cytarabine treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
Do not receive any kind of immunization or vaccination without your doctor's approval while taking cytarabine.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (cytarabine may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking cytarabine. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Self-care tips:
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
Wash your hands often.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Keep palms of hands and soles of feet moist using emollients such as Aveeno®, Udder Cream, Lubriderm® or Bag Balm®.
Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
Monitoring and testing:You will be checked regularly by your doctor while you are taking cytarabine, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC), the function of other organs (such as your kidneys and liver) and check your uric acid levels will also be ordered by your doctor.
How this drug works:
Chemotherapy (anti-neoplastic drugs)
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Cytarabine belongs to the category of chemotherapy called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.
Folic acid antagonist: Methotrexate.
Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine.
Purine antagonist: 6-Mercaptopurine and 6-Thioguanine.
Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin.

Cytarabine

2009-10-13T08:08:00.001-07:00

Cytarabine

Trade names: Cytosar-U®Other names: Ara-C, Arabinosylcytosine
Drug type: Cytarabine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite." (For more detail, see "How this drug works" section below).
What this drug is used for:
Cytarabine is used to treat different forms of leukemia, including acute and chronic myelogenous (AML and CML) and acute lymphocytic leukemia (ALL). It is also used to treat lymphoma, meningeal leukemia and lymphoma (cancers found in the lining of the brain and spinal cord)
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How this drug is given:
Cytarabine may be given as an infusion into the vein (intravenous or IV).
As an injection into the layer of tissue between the skin and the muscle (subcutaneous or SubQ).
As an injection into the muscle (intramuscular or IM).
Another method it is given is by intraventricular or intrathecal infusion. This method is used when drugs need to reach the cerebrospinal fluid (CSF) the fluid that is surrounding the brain and spinal cord, the drug is infused directly into the spinal fluid.
There is no pill form of cytarabine.
The amount of cytarabine that you receive and the way it is given depends on many factors, including the type of cancer you have, your height and weight, your general health, any other health problems you may have. Your doctor will determine your dose, how it should be given and the schedule.
Side effects:Important things to remember about the side effects of cytarabine:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
Side effects and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.
The following side effects are common (occurring in greater than 30%) for patients taking cytarabine:
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at risk for infection, anemia and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
Onset: 4-7 daysNadir: White blood cells: 7-10 days, platelets: 12-15 daysRecovery: 21-28 days
Nausea and vomiting.
Mouth sores (usually occur 7-10 days after therapy).
Blood test abnormalities: Increase in blood level of uric acid. A pill called allopurinol may be given to decrease these levels.
Increases in blood tests measuring liver function. These return to normal once treatment is discontinued. More often associated with high-dose regimens.
These side effects are less common side effects (occurring in about 10-29%) of patients receiving cytarabine:
Diarrhea
Loss of appetite
Skin rash, redness and itching
Flu-like symptoms (fever, chills, generalized aches and pains) within the first few days of treatment.
Pain redness and skin peeling of the palms of hands and soles of feet (hand-foot syndrome) may occur with high-dose therapy (rare). Use of steroid creams or moisturizers may be helpful.
Temporary hair loss (uncommon, but thinning may occur).
Eye pain, tearing, sensitivity to light and blurred vision may occur with high-dose therapy. Often steroid drops or ointment to the eyes are used to prevent or relieve this condition.
Dizziness, headache, excessive sleepiness, confusion, loss of balance may occur in up to 10% of patients receiving high dose therapy. Onset is usually 5 days after treatment and may last up to 1 week. More often these toxicities are mild and reversible. (see central neurotoxicity).
Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider: Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5ºF (38ºC) or higher or chills (possible signs of infection).
Chest pain or heart palpitations
Inability to pass urine
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
Diarrhea (4-6 episodes in a 24 hour period)
Nausea (unable to drink fluids and unrelieved with prescription medication).
Vomiting (more than 4-5 times in a 24 hour period)
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Extreme fatigue (unable to carry on self-care activities)
Mouth sores (painful redness, swelling or ulcers)
Cough and/or shortness of breath
Excessive sleepiness or confusion
Changes in balance and coordination.
Yellowing of the skin or eyes
Changes in vision or burning/or tearing of eyes
Swelling, redness and pain in one leg or arm and not the other
Stomach pains
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
Before starting cytarabine treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
Do not receive any kind of immunization or vaccination without your doctor's approval while taking cytarabine.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (cytarabine may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking cytarabine. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Self-care tips:
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
Wash your hands often.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Keep palms of hands and soles of feet moist using emollients such as Aveeno®, Udder Cream, Lubriderm® or Bag Balm®.
Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
Monitoring and testing:You will be checked regularly by your doctor while you are taking cytarabine, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC), the function of other organs (such as your kidneys and liver) and check your uric acid levels will also be ordered by your doctor.
How this drug works:
Chemotherapy (anti-neoplastic drugs)
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Cytarabine belongs to the category of chemotherapy called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.
Folic acid antagonist: Methotrexate.
Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine.
Purine antagonist: 6-Mercaptopurine and 6-Thioguanine.
Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin.

Asparaginase

2009-10-13T08:06:00.000-07:00

Asparaginase

Trade names: Elspar®, Kidrolase®Other names: L-asparaginase, Erwinia L-asparaginase
Drug type: Asparaginase is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "enzyme." (For more detail, see "How this drug works" section below).
What this drug is used for:
Acute lymphocytic leukemia (ALL)
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How this drug is given:
Aspariginase is given as an injection into a large muscle (intramuscular or IM). Depending on your dose, the medication may need to be divided into two injections.
Also may be given into the vein as an infusion (intravenous or IV). This method has higher risk of allergic reaction so often a test dose is given first.
There is no pill form of aspariginase.
The amount of aspariginase that you will receive, and how it is given, depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.
Side effects: Important things to remember about the side effects of asparaginase:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for patients taking asparaginase:
Fever, chills (see flu like symptoms)
Nausea and vomiting
Allergic reaction, (sudden onset of wheezing, itching, rash, face swelling, agitation, low blood pressure). You will be monitored closely for this reaction.
Poor appetite
Stomach cramping
Central neurotoxicity: excessive sleepiness, depression, hallucinations, agitation, disorientation or seizure. Less commonly seen stupor, confusion and/or coma.
These side effects are less common (occurring in about 10-29%) of patients receiving asparaginase:
Mouth sores
Pancreatitis (inflammation of the pancreas) in up to 10% of patients. Mainly noted in blood tests that return to normal after therapy is discontinued. Rarely may be severe causing symptoms. Symptoms of acute pancreatitis include: (pain in the upper abdomen that worsens with eating, swollen and tender abdomen, nausea, vomiting, fever, and rapid pulse).
Blood test abnormalities (Increased blood glucose level - some refer to this as "sugar").
Increases in blood tests measuring liver function. These return to normal once treatment is discontinued (see liver problems).
Blood clotting disorders, increases risk of both bleeding and clotting.
Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5º F (38º C) or higher, chills (possible signs of infection).
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
Nausea (interferes with ability to eat and unrelieved with prescribed medication)
Vomiting (vomiting more than 4-5 times in a 24 hour period)
Persistant upper abdominal pain or pain that worsens with eating
Abdominal swelling
Diarrhea (4-6 episodes in a 24-hour period)
Unusual bleeding or bruising
Swelling, redness and/or pain in one leg or arm and not the other
Extreme fatigue (unable to carry on self-care activities)
Yellowing of the skin or eyes
Unusual thirst, need to urinate frequently
Confusion, excessive sleepiness, hallucinations (seeing, hearing or feeling things that are not there), agitation, or disorientation (not able to recognize familiar surroundings)
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
Before starting asparaginase treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
Do not receive any kind of immunization or vaccination without your doctor's approval while taking asparaginase.
Asparaginase may be inadvisable if you have had a hypersensitivity (allergic) reaction to asparaginase. If you have had a reaction to Elspar®, Erwinia L-asparaginase may be used with caution.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking asparaginase. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Those who have a history of pancreatitis (inflammation of the pancreas) should not be treated with asparaginase.
Self-care tips:
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.
You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
Wash your hands often.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Avoid driving and tasks that require being alert until your response to this drug is well understood.
Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
Monitoring and testing:
You will be checked regularly by your doctor while you are taking asparaginase, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC), blood clotting factors, pancreatic enzymes, blood sugar as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How this drug works:
All cells need a chemical called asparagine to stay alive. Normal cells can make this chemical for themselves, while cancer cells cannot. Asparaginase breaks down asparagine in the body. Since the cancer cells cannot make more asparagine, they die.
When asparaginase breaks down asparagine it is broken down into 2 chemicals, aspartic acid and ammonia. The neurologic side effects seen with asparaginase (such as, confusion, excessive sleepiness, agitation, disorientation, or coma) are related to increased levels of these chemicals circulating in the body.

Doxorubicin

2009-10-13T08:01:00.000-07:00

Doxorubicin
Brand Names: Adriamycin ®, Rubex ®
Drug Type:
Doxorubicin is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug. Doxorubicin is classified as an “anthracycline antiobiotic.” (For more detail, see “How Doxorubicin Works” section below).
What Doxorubicin Is Used For:
Cancers treated with Doxorubicin include: bladder, breast, head and neck, leukemia (some types), liver, lung, lymphomas, mesothelioma, multiple myeloma, neuroblastoma, ovary, pancreas, prostate, sarcomas, stomach, testis (germ cell), thyroid, uterus.
Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.
How Doxorubicin Is Given:
Doxorubicin is given through a vein by intravenous injection (IV). The syringe needle is placed directly into the vein or central line and the drug is given over several minutes. Doxorubicin can also be given by continuous infusion. Rarely, Doxorubicin is given by injection into an artery. There is no pill form of Doxorubicin.
Doxorubicin is a vesicant. A vesicant is a chemical that causes extensive tissue damage and blistering if it escapes from the vein. The nurse or doctor who gives Doxorubicin must be carefully trained. If you notice redness or swelling at the IV site while you are receiving Doxorubicin, alert your health care professional immediately.
The amount of Doxorubicin you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your exact dosage and schedule.
Side Effects of Doxorubicin:
Important things to remember about the side effects of Doxorubicin:
You will not get all of the side effects mentioned below.
Side effects are often predictable in terms of their onset, duration, and severity.
Side effects are almost always reversible and will go away after therapy is complete.
Side effects are quite manageable. There are many options to minimize or prevent them.
The following side effects are common (occurring in greater than 30%) for patients taking Doxorubicin:Early Side Effects: (within one week after treatment begins)
Pain along the site where the medication was given
Nausea or vomiting
Later Side Effects: (within two weeks after treatment begins)
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
Onset: 7 daysNadir: 10-14 daysRecovery: 21-28 days
Mouth sores
Hair loss on the scalp or elsewhere on the body (called alopecia). Most patients do lose some or all of their hair during their treatment. But your hair will grow back after treatment is completed.
The following side effects are less common (occurring in 10-29%) for patients taking Doxorubicin:
Early: (within one week after treatment begins)
Eyes watering
Urine may appear red, red-brown, orange or pink from the color of the medication for one to two days after you receive a dose.
Later: (within two weeks after treatment begins)
Darkening of the nail beds.
Darkening of the skin where previous radiation treatment has been given.
Problems with fertility – ability to bear children. (occurs in about 10% of both men and women – this should be discussed with your doctor prior to therapy).
A serious but uncommon side effect of Doxorubicin can be interference with the pumping action of the heart. You can receive only up to a certain amount of Doxorubicin during your lifetime. This “lifetime maximum dose” may be lower if you have heart disease risk factors such as radiation to the chest, advancing age, and use of other heart-toxic drugs. Your doctor will check your heart function before you may take any Doxorubicin and will monitor your heart closely during your treatment. Dose-related heart problems can occur as late as 7 or 8 years after treatments have ended.
Delayed Effects of Doxorubicin:
There is a slight risk of developing a blood cancer such as leukemia years after taking Doxorubicin. Talk to your doctor about this risk.
This list includes common and less common and important side effects for those taking Doxorubicin. Side effects that are very rare – occurring in less than 10 percent of patients – are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.
When To Contact Your Doctor or Health Care Provider:Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5º F (38º C), chills (possible signs of infection)
Blistering at the IV site
Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling of facial features, hives (possible allergic reaction).
The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:
Mouth sores (painful redness, swelling or ulcers)
Nausea (interferes with ability to eat and unrelieved with prescribed medication)
Vomiting (vomiting more than 4-5 times in a 24 hour period)
Diarrhea (4-6 episodes in a 24-hour period)
Fast or irregular heart beats
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Extreme fatigue (unable to carry on self-care activities)
Swelling of the feet or ankles
Doxorubicin Precautions:
Before starting Doxorubicin treatment, make sure you tell your doctor about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). Do not take aspirin or products containing aspirin unless your doctor permits this.
Do not receive any kind of vaccination without your doctor’s approval while taking Doxorubicin.
For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking Doxorubicin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant after therapy.
Do not breast feed while taking Doxorubicin.
People with congestive heart failure, those who have already had high doses of Doxorubicin or a similar drug, and those with permanent problems with blood counts (bone marrow suppression) cannot receive Doxorubicin.
Doxorubicin Self Care Tips:
Apply ice if you have any pain, redness or swelling at the IV site, and notify your doctor.
You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
Wash your hands often.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
Drink two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
Get plenty of rest.
Maintain good nutrition.
In general, drinking alcoholic beverages should be minimized or avoided. You should discuss this with your doctor.
Monitoring and Testing While Taking Doxorubicin:A baseline heart evaluation is recommended before starting treatment. A full blood count will be done regularly, and a heart function test will be done as your doctor prescribes. Various tests to monitor the function of other organs (such as your kidneys and liver) will also be ordered by your physician.
How Doxorubicin Works: Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. “Normal” cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normalchecks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. Chemotherapy will kill all cells that are rapidly dividing. The “normal” cells will grow back and be healthy but in the meantime, side effects occur. The “normal” cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Doxorubicin is classified as an antitumor antibiotic. Antitumor antibiotics are made from natural products produced by species of the soil fungus Streptomyces. These drugs act during multiple phases of the cell cycle and are considered cell-cycle specific. There are several types of antitumor antibiotics:
Anthracyclines: Doxorubicin, Daunomycin, Mitoxantrone, and Idarubicin
Chromomycins: Dactinomycin and Plicamycin
Miscellaneous: Mitomycin and Bleomycin

Vincristine

2009-10-13T07:59:00.000-07:00

Vincristine
Trade Names: Oncovin ®, Vincasar Pfs ®Other Names: Vincristine Sulfate, LCR, VCR
Drug Type:
Vincristine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Vincristine is classified as a plant alkaloid. For more detail, see "How Vincristine Works" section below.
What Vincristine Is Used For:
Cancers treated with Vincristine include: acute leukemia, Hodgkin's and non- Hodgkin's lymphoma, neuroblastoma, rhabdomyosarcoma, Ewing's sarcoma, Wilms' tumor, multiple myeloma, chronic leukemias, thyroid cancer, brain tumors.
It is also used to treat some blood disorders.
Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.
How Vincristine Is Given:
Vincristine is given through a vein by intravenous injection (IV push) or infusion (IV). There is no pill form.
Vincristine is a vesicant. A vesicant is a chemical that causes extensive tissue damage and blistering if it escapes from the vein. The nurse or doctor who gives Vincristine must be carefully trained. If you notice pain, redness or swelling at the IV site while you are receiving Vincristine sulfate, alert your health care professional immediately.
The amount of Vincristine you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dose and schedule.
Vincristine Side Effects:
Important things to remember about the side effects of Vincristine:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of Vincristine.
The following side effects are common (occurring in greater than 30%) for patients taking Vincristine:
Hair loss (in 20-70% of patients) may be partial or complete hair loss
The following are less common side effects (occurring in 10-29%) for patients receiving Vincristine:
Constipation
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
Onset: 7 daysNadir: 7-10 daysRecovery: 21 days
Abdominal cramps
Weight loss
Nausea and vomiting
Mouth sores
Diarrhea
Loss of appetite
Taste changes
Peripheral neuropathy: Although uncommon, a serious side effect of decreased sensation and paresthesia (numbness and tingling of the hands and feet) may be noted. Sensory loss, numbness and tingling, and difficulty in walking may last for at least as long as therapy is continued. These side effects may become progressively more severe with continued treatment, and your doctor may decide to decrease your dose.
Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When To Contact Your Doctor or Health Care Provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5º F (38º C), chills (possible signs of infection)
Urinary retention (inability to urinate)
The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Constipation
Diarrhea (4-6 episodes in a 24-hour period)
Nausea (interferes with ability to eat and unrelieved with prescribed medications)
Vomiting (vomiting more than 4-5 times in a 24-hour period)
Severe abdominal pain
Lip or mouth sores
Painful urination
Bone pain
Always inform your health care provider if you experience any unusual symptoms.
Vincristine Precautions:
Before starting Vincristine treatment, make sure you tell your doctor about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). Do not take aspirin or products containing aspirin unless your doctor permits this.
Decreased sensation, numbness and tingling in fingers and toes may become progressively worse with repeated doses of Vincristine. It is important to report this to your doctor.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Vincristine may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking Vincristine. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking Vincristine.
Vincristine Self Care Tips:
Apply warm compress if you have any pain, redness or swelling at the IV site, and notify your doctor.
Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by Vincristine.
Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. This will decrease your chances of being constipated, and prevent dehydration.
You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your healthcare provider.
Wash your hands often.
Use an electric razor and soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Keep your mouth clean with baking soda and salt rinses. You can mix 1/2 to 1 tsp. of baking soda and/or 1/2 to 1 tsp. salt in 8 ounces of water, and use as a mouthwash, to avoid or decrease the severity of mouth sores.
In general, drinking alcoholic beverages should be minimized or avoided. You should discuss this with your doctor.
Monitoring and Testing While Taking Vincristine:
Because drug toxicity is seen as numbness and tingling of fingers and toes, a periodic physical examination, which includes a check of your reflexes, is necessary to detect the need for decreased dosages.
Periodic blood work will be obtained to monitor your complete blood count (CBC). Various blood tests to monitor the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How Vincristine Works: Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Vincristine belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May Apple plant. Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division.
Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine
Taxanes: Paclitaxel and Docetaxel
Podophyllotoxins: Etoposide and Tenisopide
Camptothecan analogs: Irinotecan and Topotecan
Antimicrotubule agents (such as Vincristine), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.

Methotrexate

2009-10-13T07:55:00.000-07:00

Methotrexate
Trade names: Rheumatrex®, TrexallTMOther names: Amethopterin, Methotrexate Sodium, MTX
Drug type: Methotrexate is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite." (For more detail, see "How this drug works" section below).
What Methotrexate is used for:
Used in the treatment of breast, head and neck, lung, stomach, and esophagus cancers. Acute lymphoblastic leukemia (ALL), sarcomas, non-Hodgkin's lymphoma (NHL), gestational trophoblastic cancer, and mycosis fungoides (cutaneous T-cell lymphoma).
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How Methotrexate is given:
As an infusion into the vein (intravenous, IV).
As an injection into the muscle (intramuscular, IM).
Another method it is given is by intraventricular or intrathecal infusion. This method is used when drugs need to reach the cerebrospinal fluid (CSF) the fluid that is surrounding the brain and spinal cord, the drug is infused directly into the spinal fluid.
There is also a pill form of methotrexate.
The amount of methotrexate and how it is given depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose, schedule and how it is given.
Side effects of Methotrexate: Important things to remember about the side effects of methotrexate:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
The side effects of methotrexate and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.
In some cases leucovorin infusion (see leucovorin) may be given 24 hours after methotrexate to lessen the side effects of methotrexate.
The following side effects are common (occurring in greater than 30%) for patients taking methotrexate:
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
Onset: 7 daysNadir: 10 daysRecovery: 21 days
Mouth sores. (usually occur 3-7 days after treatment)
Nausea and vomiting. (uncommon with low dose)
Poor appetite
These side effects are less common side effects (occurring in about 10-29%) of patients receiving methotrexate:
Kidney toxicity (see kidney problems) particularly with high-doses. In severe cases can lead to kidney failure. Care is taken to make sure patient is well hydrated with IV fluids before infusion of high-dose methotrexate.
Skin rash, reddening of the skin (with high doses).
Diarrhea
Hair loss
Eye irritation (conjunctivitis) (see eye problems).
Increases in blood tests measuring liver function, often seen with high dose treatment. These return to normal within about 10 days. (see liver problems).
Darkening of the skin where previous radiation treatment has been given. (radiation recall - see skin reactions).
Loss of fertility. Meaning, your ability to conceive or father a child may be affected by methotrexate. Discuss this issue with your health care provider.
Side effects specific to intrathecal administration of methotrexate (the drug is infused directly into the cerebrospinal fluid (CSF) the fluid that is surrounding the brain and spinal cord):
Acute chemical arachnoiditis: a syndrome that can be seen immediately after the infusion of methotrexate intrathecally. It is an inflammation of the membrane surrounding the brain and spinal column. Symptoms are: severe headache, stiff neck, seizures, vomiting, and fever.
Central neurotoxicity: Less-common, seen with intrathecal or very high IV dose methotrexate. Symptoms are; difficulty with speech, paralysis of the arms and legs, seizures, or coma. This may develop within 6 days of treatment and resolves within 48-72 hours.
Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5º F (38º C) or higher, chills (possible signs of infection).
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Extreme fatigue (unable to carry on self-care activities)
Mouth sores (painful redness, swelling or ulcers)
Nausea (interferes with ability to eat and unrelieved with prescribed medication)
Vomiting (vomiting more than 4-5 times in a 24 hour period)
Diarrhea (4-6 episodes in a 24-hour period)
No urine output in a 12 hour period
Yellowing of the skin or eyes
Swelling of the feet or ankles. Sudden weight gain.
Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
Before starting methotrexate treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
Do not take non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprophen or naproxen unless your doctor specifically permits this. Bone marrow suppression, intestinal irritation and severe anemia have occurred with combined usage of non-steroidal anti-inflammatory drugs (NSAIDS) and methotrexate.
Folic acid supplements should be avoided while on methotrexate. Folic acid may counteract the anti-cancer effects of methotrexate.
If you are on warfarin (Coumadin®) as a blood-thinner, adjustments may need to be made to your dose based on blood work.
Do not receive any kind of immunization or vaccination without your doctor's approval while taking methotrexate.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (methotrexate may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking methotrexate. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Self-care tips:
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
Wash your hands often.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
Monitoring and testing: You will be checked regularly by your health care professional while you are taking methotrexate, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor. Blood levels of this drug may be monitored in patients receiving high-dose methotrexate.
How Methotrexate works: Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Methotrexate belongs to the class of chemotherapy drugs called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.
Folic acid antagonist: Methotrexate.
Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine.
Purine antagonist: 6-Mercaptopurine and 6-Thioguanine.
Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin.
Methotrexate exerts its chemotherapeutic effect by being able to counteract and compete with folic acid in cancer cells resulting in folic acid deficiency in the cells and causing their death. This action also effects normal cells which can cause significant side effects in the body, such as: low white, red and platelet blood cell counts, hair loss, mouth sores, difficulty swallowing, diarrhea, liver, lung, nerve and kidney damage. These complications and side effects of high-dose methotrexate can be either prevented or decreased by using leucovorin, which provides a source of folic acid for the body's cells. Leucovorin is normally started 24 hours after high-dose methotrexate is given. This delay gives the methotrexate a chance to exert its anti cancer effects.

Dexamethasone

2009-10-13T07:54:00.001-07:00

Dexamethasone
Brand names: Decadron, Dexasone, Diodex, Hexadrol, MaxidexOther names: dexamethasone sodium phosphate, dexamethasone acetate
Drug type: Dexamethasone has many uses in the treatment of cancer. It is classified as a glucocorticosteroid. (For more detail, see "How this drug works" section below).
What this drug is used for:
As an anti-inflammatory medication. Dexamethasone relieves inflammation in various parts of the body. It is used specifically to decrease swelling (edema), associated with tumors of the spine and brain, and to treat eye inflammation.
To treat or prevent allergic reactions.
As treatment of certain kinds of autoimmune diseases, skin conditions, asthma and other lung conditions.
As treatment for a variety of cancers, such as leukemia, lymphoma, and multiple myeloma.
To treat nausea and vomiting associated with some chemotherapy drugs.
Used to stimulate appetite in cancer patients with severe appetite problems.
Also used to replace steroids in conditions of adrenal insufficiency (low production of needed steroids produced by the adrenal glands).
Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.
How this drug is given:
This medication may be given to you in many forms. In a pill form, it is available in a variety of tablet sizes. If you are on a daily dose of dexamethasone (usually less than 10 mg), and you miss a dose, take the dose as soon as you remember. If you are on high doses of dexamethasone (20 mg or 40 mg per day for 4 days out of the month), and you miss your dose, contact your healthcare provider. You may be instructed to repeat the missed dose, and continue the medication.
Take pills with food or after meals
This medication may also be given by infusion into a vein (intravenously or IV)
Dexamethasone eye drops are given to treat or prevent many eye conditions. The eye drops are most commonly given to patients with leukemia or lymphoma, to prevent inflammation of the eyes (conjunctivitis), if you are receiving high dose chemotherapy (usually Cytarabine [Ara-C]). The eye drops are given every six hours, in both eyes, and for at least 48 hours after the chemotherapy has completed. Do not stop taking these eye drops unless directed by your healthcare provider.
You may be given dexamethasone as a lotion (topical) to treat skin disorders.
The amount of dexamethasone you will receive depends on many factors, including your general health or other health problems, and the reason you are receiving this drug. Your doctor will determine your dosage and schedule.
Side effects: Important things to remember about the side effects of dexamethasone:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
The following side effects are common (occurring in greater than 30%) for patients taking dexamethasone:
Increased appetite
Irritability
Difficulty sleeping (insomnia)
Swelling in your ankles and feet (fluid retention)
Heartburn
Muscle weakness
Impaired wound healing
Increased blood sugar levels. (Persons with Diabetes may need to have blood sugar levels monitored more closely and possible adjustments to diabetes medications).
The following are less common side effects (occurring in >10%) for patients receiving dexamethasone:
Headaches
Dizziness
Mood swings
Cataracts and bone thinning (with long-term use)
This list includes common and less common side effects for individuals taking dexamethasone. Side effects that are very rare, occurring in less than 10% of patients, are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5º F (38º C), chills (possible signs of infection)
If you feel an irregular or fast heart beat, shortness of breath, or chest or jaw pain, seek emergency help and notify your healthcare provider
If you become suddenly confused
The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:
Extreme fatigue (unable to carry on self-care activities)
Any unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Nausea (interferes with ability to eat and unrelieved with prescribed medications)
Vomiting (vomiting more than 4-5 times in a 24-hour period)
Dizziness or lightheadedness, feeling faint.
Persistent headache
Severe hot flashes or mood swings
Inability to sleep (insomnia)
Severe skeletal (bone) pain
Difficult or painful urination; increased urination, or severe thirst
Changes in vision, blurred vision, eye pain, enlarged pupils, discharge
Any new rashes or changes in your skin
Swelling of the feet or ankles. Sudden weight gain (greater than 3 pounds a week)
Swelling, redness and/or pain in one leg or arm and not the other
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
Before starting dexamethasone treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
Do not receive any kind of immunization or vaccination without your doctor's approval while taking dexamethasone.
If you have been on dexamethasone pills daily, for a long period of time, serious side effects may occur if you discontinue the medication abruptly. Do not stop taking this medication unless directed by your healthcare provider. Do not change the dose of dexamethasone on your own.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking dexamethasone. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Self Care Tips:
If you are on this medication for a long period of time, you may be more susceptible to infection. Wash your hands well, and report any symptoms of infection to your healthcare provider if noted.
If you are given eye drops or eye ointment: You may be more sensitive to the light. Wearing sunglasses may help. It is normal to notice a little blurriness for a short time after the drops or ointment are placed in your eyes. Notify your healthcare provider with any changes in vision, blurriness, or eye pain.
If you are given eye drops or eye ointment: Ask your healthcare provider if you may wear contact lenses. Contact lenses may absorb the medication for at least 15 minutes. Wash your hands well before putting eye drops, to decrease the chance of a bacterial infection in your eyes.
If you are dexamethasone as a lotion (topical) to treat skin disorders: Do not apply to open areas of skin, or if you have open or weeping sores. Topical dexamethasone should not be used for a long time. Discuss this with your healthcare provider.
Take this medication with food to lessen an upset stomach. Also take this medication early on in the day (before 12:00 noon, if possible), so you will be able to sleep better at night.
If you have diabetes, this medication may increase your blood sugar levels. You may need more frequent monitoring.
Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition.
Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
In general, drinking alcoholic beverages should be avoided. You should also limit caffeine intake (colas, tea, coffee and chocolate, especially). These beverages may irritate your stomach.
Monitoring and testing: You will be checked regularly by your health care professional while you are taking dexamethasone, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How this drug works:Corticosteroids are naturally produced by the adrenal gland in the body. Corticosteroids influence the functioning of most of the body's systems (heart, immune, muscles and bones, endocrine and nervous system). They exert a wide array of effects including effects on the metabolism of carbohydrates, protein and fats. They help to maintain balance of fluids and electrolytes.
Dexamethasone is classified as a corticosteroid (more precisely a glucocorticosteroid), and has many uses in the treatment of cancer.
One way that it works is to decrease inflammation (swelling). It does this by preventing infection- fighting white blood cells (polymorphonuclear leukocytes) from traveling to the area of swelling in your body. (This is why you are more prone to infection while taking steroids). Taking advantage of the anti-inflammatory properties of the medication, corticosteroids are used to decrease the swelling around tumors. For example, by decreasing swelling around tumors in the spine, brain, or bone, it can decrease the pressure of the tumor on nerve endings and relieve pain or other symptoms caused by the pressing tumor.
Another way this drug works is by altering the body's normal immune system responses. Corticosteroids are used to treat certain conditions that effect the immune system such as aplastic anemia (AA), Immune Thrombocytopenia Purpura (ITP), Thrombotic Thrombocytopenia Purpura (TTP), or hemolytic anemia.
In addition, it is thought that corticosteroids may help in the treatment of patients with blood disorders, such as multiple myeloma. Corticosteroids may work by causing programmed cell death (apoptosis) of certain cells, which may help to fight your disease.
Dexamethasone is also used in the short-term treatment of nausea caused by chemotherapy. How it does this is not fully understood. It also has been used to stimulate appetite for patients with severe appetite problems.
Corticosteroids are used to replace steroids in conditions of adrenal insufficiency (low production of needed steroids produced by the adrenal glands).

6-MP

2009-10-13T07:48:00.001-07:00

6-MP
Mercaptopurine
Trade names: Purinethol®Other names: 6-Mercaptopurine, 6-MP
Drug type: Mercaptopurine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite." (For more detail, see "How this drug works" section below).
What this drug is used for:
Acute lymphoblastic leukemia (ALL)
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How this drug is given:
As a tablet by mouth. Comes in one tablet size (50mg).
Take as a daily dose at the same time each day. Preferable to take on an empty stomach (1 hour before or 2 hours after meals).
The amount of mercaptopurine that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.
Side effects: Important things to remember about the side effects of mercaptopurine:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for patients taking mercaptopurine:
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
Onset: 7-10 daysNadir: 14 daysRecovery: 21-28 days
Liver toxicity. (see liver problems) Increased bilirubin, increased liver enzymes, jaundice, abdominal swelling (ascites). Increased with higher doses of drug. Usually occurs within 2 months of treatment.
These side effects are less common side effects (occurring in about 10-29%) of patients receiving mercaptopurine:
Nausea and vomiting
Poor appetite
Diarrhea. (rare - usually seen with higher dose)
Mouth sores (rare - usually seen with higher dose)
Loss of fertility. Meaning, your ability to conceive or father a child may be affected by mercaptopurine. Discuss this issue with your health care provider.
Skin rash, dry skin, itching, discoloration of the skin (hyperpigmentation) (uncommon) (see skin reactions).
Darkening of the skin where previous radiation treatment has been given. (radiation recall - see skin reactions) (rare).
Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5º F (38º C) or higher, chills (possible signs of infection)
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
Yellowing of the skin or eyes
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Extreme fatigue (unable to carry on self-care activities)
Nausea (interferes with ability to eat and unrelieved with prescribed medication)
Vomiting (vomiting more than 4-5 times in a 24 hour period)
Diarrhea (4-6 episodes in a 24-hour period)
Mouth sores (painful redness, swelling or ulcers)
Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
Before starting mercaptopurine treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
Do not receive any kind of immunization or vaccination without your doctor's approval while taking mercaptopurine.
Certain medications are contraindicated when taking mercaptopurine. Medications used to treat ulcerative colitis (olsalazine, mesalamine, sulfasalazine) interfere with how mercaptopurine works and may increase the toxicities experienced. If you are being treated for ulcerative colitis discuss this risk with your doctor.
If you are on warfarin (Coumadin®) as a blood-thinner, adjustments may need to be made to your dose based on blood work.
Allopurinol (Zyloprim®) a medication used to treat gout (high uric acid levels) may increase the toxicity seen with mercaptopurine. Adjustments in the medication dosage may need to be made. If you are taking this medication discuss this with your doctor.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (mercaptopurine may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking mercaptopurine. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Self-care tips:
Take as a daily dose at the same time each day. Preferable to take on an empty stomach (1 hour before or 2 hours after meals).
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
Wash your hands often.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
This medication causes little nausea. But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
Monitoring and testing: You will be checked regularly by your health care professional while you are taking mercaptopurine, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How this drug works: Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Mercaptopurine belongs to the class of chemotherapy drugs called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.
Folic acid antagonist: Methotrexate.
Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine.
Purine antagonist: 6-Mercaptopurine and 6-Thioguanine.
Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin.

Thioguanine

2009-10-13T07:45:00.000-07:00

Thioguanine
Trade Name: Thioguanine Tabloid ®Other Names: 6-TG, 6-Thioguanine, 2-Amino-6-Mercaptopurine
Drug Type:
Thioguanine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Thioguanine is classified as an "antimetabolite." (For more detail, see "How Thioguanine Works" section below).
What Thioguanine Is Used For:
Acute myelogenous leukemia (induction, consolidation and maintenance).
Thioguanine may be used in chronic myelogenous leukemia but may not be the preferred drug.
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How Thioguanine Is Given:
Thioguanine is a pill, taken by mouth.
The amount of Thioguanine that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.
Thioguanine Side Effects:
Important things to remember about the side effects of Thioguanine:
Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for patients taking Thioguanine:
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
Onset: 7-10 daysNadir: 14 daysRecovery: 21 days
These side effects are less common side effects (occurring in about 10-29%) of patients receiving Thioguanine:
Nausea (usually mild)
Poor appetite
Increases in blood tests measuring liver function. These return to normal once treatment is discontinued. (see liver problems)
Tumor lysis syndrome may occur as a result of leukemia treatment. Tumor lysis syndrome occurs when large amounts of cancerous cells are rapidly killed by the therapy. These cells release uric acid, potassium and phosphorus into the blood stream. Tumor lysis syndrome can lead to kidney failure. Tumor lysis syndrome usually occurs within 24 - 48 hours of therapy. Care must be taken to prevent the development of tumor lysis syndrome. Your health care provider will prescribe plenty of fluids to keep you hydrated. You may be given a drug called allopurinol that blocks uric acid production. In some cases, your health care provider may prescribe other measures to lower your white blood count before therapy. Let your health care provider know immediately if you are unable to urinate. Your health care provider will monitor your progress carefully during therapy.
A serious, but uncommon side effect of Thioguanine is veno-occlusive liver disease (VOD). VOD is most common in patients who have been treated with high dose chemotherapy followed by bone marrow or stem cell transplant.VOD is characterized by painful enlarged liver, rapid weight gain from fluid retention, and rising bilirubin levels. Two of the three in a post-treatment setting must be present to establish the diagnosis. Additional testing will reveal elevated liver enzymes (Alkaline phosphatase and GGT); as well as a reversal of blood flow in the veins of the liver on ultrasound. Once VOD occurs, the chances for other organs to fail increases dramatically and potentially fatal multi-organ failure may occur.
Your fertility, meaning your ability to conceive or father a child, may be affected by Thioguanine. Please discuss this issue with your health care provider.
Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.
When To Contact Your Doctor or Health Care Provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
Fever of 100.5º F (38º C) or higher, chills (possible signs of infection)
Painful upper abdomen along with rapid weight gain and/or swelling
Yellowing of the skin or eyes
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
Nausea (interferes with ability to eat and unrelieved with prescribed medication)
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools
Blood in the urine
Swelling of the feet or ankles. Sudden weight gain.
Always inform your health care provider if you experience any unusual symptoms.
Thioguanine Precautions:
Before starting Thioguanine treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
Do not receive any kind of immunization or vaccination without your doctor's approval while taking Thioguanine.
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Thioguanine may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking Thioguanine. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking Thioguanine.
Thioguanine Self Care Tips:
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
Wash your hands often.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
Thioguanine causes little nausea. But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
Monitoring and Testing While Taking Thioguanine:
You will be checked regularly by your health care professional while you are taking Thioguanine, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How Thioguanine Works:
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Thioguanine is an antimetabolite. Antimetabolites are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.
Folic acid antagonist: Methotrexate
Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine
Purine antagonist: 6-Mercaptopurine and Thioguanine
Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin
Ribonucleotide reductase inhibitor: Hydroxyurea

薏米

2009-09-17T08:10:00.000-07:00

薏米知识介绍：
薏米为禾本科植物薏苡的成熟种仁，为一年或多年生草本。秋季果实成熟时采割植株，晒干，打下果实，再晒干，除去外壳、黄褐色种皮及杂质，收集种仁。薏米具有容易消化吸收的特点，不论用于滋补还是用于医疗，作用都很缓和。
薏米在我国栽培历史悠久，是我国古老的药食皆佳的粮种之一。全国大部分地区均产，以福建、河北等省为主，由于薏米的营养价值很高，被誉为“世界禾本科植物之王”和“生命健康之禾”，在日本最近又被列为防癌食品，因此身价倍增。

薏米营养分析：
1. 薏米因含有多种维生素和矿物质，有促进新陈代谢和减少胃肠负担的作用，可作为病中或病后体弱患者的补益食品；
2. 经常食用薏米食品对慢性肠炎、消化不良等症也有效果。薏米能增强肾功能，并有清热利尿作用，因此对浮肿病人也有疗效；
3. 经现代药理研究证明，薏米有防癌的作用，其抗癌的有效成分中包括硒元素，能有效抑制癌细胞的增殖，可用于胃癌、子宫颈癌的辅助治疗；
4. 健康人常吃薏米，能使身体轻捷，减少肿瘤发病几率；
5. 薏米中含有一定的维生素E，是一种美容食品，常食可以保持人体皮肤光泽细腻，消除粉刺、色斑，改善肤色，并且它对于由病毒感染引起的赘疣等有一定的治疗作用；
6. 薏米中含有丰富的维生素B，对防治脚气病十分有益。
薏米适合人群：
一般人群均可食用
1. 适宜各种癌症患者、关节炎、急慢性肾炎水肿、癌性腹水、面浮肢肿、脚气病浮肿者、疣赘、美容者、青年性扁平疣、寻常性赘疣、传染性软疣、青年粉刺疙瘩以及其他皮肤营养不良粗糙者、适宜肺痿、肺痈者食用；
2. 据前人经验，妇女怀孕早期忌食；另外汗少、便秘者不宜食用。
薏米食疗作用：
薏米味甘、淡、性微寒、归脾、胃、肺经；
有健脾利水、利湿除痹、清热排脓、清利湿热之功效；
可用于治疗泄泻、筋脉拘挛、屈伸不利、水肿、脚气、肠痈、淋浊、白带等症。

薏米做法指导：
1. 生薏米煮汤服食，利于去湿除风；用于健脾益胃、治脾虚泄泻则须炒熟食用。
2. 薏米用作粮食吃，煮粥、做汤均可。夏秋季和冬瓜煮汤，既可佐餐食用，又能清暑利湿。
3. 将鲜奶煮沸，加入薏仁粉适量，搅拌均匀后食用。常食可保持皮肤光泽细腻，消除粉刺、雀斑、老年斑、妊娠斑、蝴蝶斑。
4. 薏仁较难煮熟，在煮之前需以温水浸泡2-3小时，让它充分吸收水分，在吸收了水分后再与其他米类一起煮就很容易熟了。

Siyuan Pictures (Aug 09)

2009-08-16T22:57:00.000-07:00

Siyuan picture (end of Jul 09)

2009-08-02T23:01:00.000-07:00

Recent Pictures (Jun 09)

2009-07-21T20:29:00.000-07:00

Dick & Rick Hoyt - a touching, loving and caring story

2009-03-05T07:56:00.000-08:00

http://www.youtube.com/watch?v=dDnrLv6z-mM

rick在出生时因脐带绕颈导致脑部缺氧受损，医生告诉dick，孩子是植物人，没有任何希望了因此他只能在轮椅上渡过他的一生。dick引述在rick九个月大时，医生对他和他妻祖迪（judy）说︰「他从此会像植物人一样，还是把他送到疗养院吧。」
　　然而，他们两夫妇对此并不认同。他们发觉当他们在屋内活动时，rick的眼睛会紧盯着他们。当rick十一岁时，他们把他送到特夫斯大学（tufts university）的工程系，询问是否有令孩子与人沟通的办法，可惜dick得到的回复是︰「不可能，他根本没有任何脑部活动。」
　　dick反驳说︰「跟他说个笑话吧。」他们便说了个笑话，rick果然笑了，证明了他的脑内确有不少活动。结果，他们为rick加装了一部能用头的侧面控制鼠标标的计算机， rick终于能和外界沟通了！
　　在rick十五岁时，rick的一位中学的同学因意外而瘫痪了，学校为那位学生举行跑步筹款，rick便透过计算机打出︰「爸，我也想参加。」dick之前并非跑步运动员，也没有跑过马拉松赛，但因为儿子的要求就参加了，于是他就推着rick跑完了5mile的全程。
　　在结束之后rick对父亲说:”我今生第一次不觉得残障了!”这句话深深地震撼了爸爸dick！他决心要把那种感觉尽可能带给儿子，预备好参加1979年的波士顿马拉松。「不接受报名。」便是比赛当局给dick的话，原因是hoyt父子既不是单独跑手，又不是轮椅参赛者。结果几年来，hoyt父子只在赛事中跟着大队一起跑，但他们终于找到正式参加比赛的方法︰
　　1983年，他们参加了另一个马拉松，他们速度之快，令他们能入围参加之后一年的波士顿马拉松。
　　不久后便有人对dick说︰「何不参加三项铁人赛？」一个从来未曾学过游泳的人，一个自六岁起便从未踏过单车的人，如何能拖着110磅（50公斤）的儿子完成三项全能赛？
　　但dick还是勇于一试。屈指一算，他现在已完成了212次三项全能赛，当中包括了四次在夏威夷举行，极费体力的15小时铁人赛！
　　因着父爱，父亲去学习游泳，学习踏自行车…
　　他愿意为rick做出许多的牺牲和付出，他又曾拖着他的儿子越野滑雪，又曾背着他爬山，其中一次更用单车拉着他横越美国。
　　于是从那时候开始他们父子就常以”team hoyt”报名参加马拉松和三项铁人赛:跑步时dick就推着rick跑游泳时dick就拖着rick躺着的橡皮艇游。骑自行车时dick就骑着特制的自行车将rick放在自行车前骑乘……
　　那么dick为何不试试自己一个人参加比赛，看看表现如何？「我不会独个儿参赛。」dick说。他参加比赛纯粹是为了当他们一起跑步、游泳和踏单车，看到rick面上露出甜美笑容时的「奇妙感觉」。
　　今年，dick与rick分别65和43岁，已完成了他们第24次波士顿马拉松，在20,000名参赛者中排名第5,083。他们的最佳时间？是在1992年的两小时40分——只落后世界纪录35分钟；当然，或许你还未留意到，这纪录是由一个没有推着轮椅的人所创的。
　　两年前，在一次比赛中，dick轻微心脏病发。其后医生发现他的一条大动脉有95%栓塞了。其中一名医生对他说︰「若非你一直保持着这样好的状态，你大可能15年前已不久于人世。」现在，尽管rick有自己的住宅单位（他享有居家照料服务）并在波士顿工作，而dick从军队退役后已在麻萨诸塞州的荷兰市居住，但他们总有团聚的方法。他们经常在全国各地发表演说，而每周末也会参加极耗体力的比赛，当中包括今年的父亲节。
　　当晚，dick会请父亲吃晚饭，但他最想送给父亲的礼物，是他永远买不到的。rick打道︰「我最想送给爸爸的，是爸爸坐在椅上，由我推他一次！」

国大医院设立的Viva国大儿童癌症中心

2009-03-04T06:40:00.000-08:00

http://www.xin.sg/article.php?article=29280&st=dtl

picture on 16th Feb 09

2009-02-15T08:16:00.000-08:00

Almost back to normal, if no Chemotherapy.

一位白血病人的感人故事

2009-02-14T11:01:00.000-08:00

我是吉林省辽源市西宁街人，1983年高中毕业后，我进入了辽源市金属材料加工厂，做一名供销员。1985年我同本厂工友李红相恋并结了婚，次年又添了女儿。妻贤贤惠惠，女儿活泼可爱，虽然只是一个普通工人，我觉得幸福而踏实。没有想到，1988年秋天我们夫妻俩同时下了岗。看着愁眉苦脸、唉声叹气的妻子，我的胸脯不由得挺了起来，我说：咱们不怕，我有的是力气，不论做什么，咱都能过上好日子。第三天，我就租了一个卖水果的摊位，我们起早摸黑地干，这样过了几年，小家庭有了两三万元的积蓄。然而命运再次开起了天大的玩笑。1996年9月初，我的头突然晕起来，到市医院一查：白血病！妻子知道这个结果，整个人都傻了。 10月5日我和妻子来到北京人民医院，医生说，我只有一条出路——骨髓移植，否则我的时间最多只有三年了，倒霉的话，也许一年都撑不到。但是骨髓移植意味着至少20万人民币的费用，我知道，想筹集到这么多的钱简直就是天方夜谭，我们默默无语回到了租住的小房子。几天后我的大姐来京，妻子说，她想让大姐暂且陪我一段时间，她自己要返回老家看看孩子。大姐同意了。一连一周没有了妻子的音讯，我忍不住打了一个电话过去，我责问：“我不明白，你在干着什么呢？” 妻痛哭失声：“大伟，我真的是没有地方借了！” 我这才知道，她这次只身回去竟是为了给我筹集手术费。我的眼泪涌出来，我声嘶力竭地说：“李红，你明天就到北京来，否则，我就立即买车票回辽源，从此彻底放弃治疗的念头！” 那是一个晴朗的天，我去车站接她。当我走过一个煎饼摊，我一下子热泪盈眶：摊主在忙忙活活地叫卖着，煎饼正冒着白白的热气，四溢的麦香扑面而来，进入我的鼻孔。那是什么味道？我真真切切地感觉到：那是一股强烈的生命的味道啊。我恍然明白，生命是如此的珍贵，我没有理由不去珍惜。为了自己，为了亲爱的妻子、女儿，我想活下去！妻子出站，看到我一脸的笑意，她吃惊地问：“有什么高兴的事情吗？”我说：“很高兴的事，我决定活下去！”我们拥在一起，拥了大约一分钟。在这短短的一分钟之后，一个决心形成并坚定了下来：我有双手，我有头脑，我要自己救自己！我和妻子在北京的各个角落里寻找机会，没过几天，妻终于发现在东四隆福寺有一个市场，全是摆地摊的，摊位租金等各方面的费用都很少，我们就在那里定了一个摊位，打算卖一些钥匙链之类的小商品。交完了摊位租金，妻手里只剩下1000多元钱了。没有足够的流动资金，我们就只好早上去进货，下午再拿卖得的货款进新货。到了晚上，我算算帐，居然赚了200元，我和妻子高兴极了。一个月过去，小生意净赚了6000元！按这个速度，凑到那个朝思暮想的数目也许用不了三年呢，夜里，我和妻子瞪着眼睛睡不着觉，生的诱惑太大了，我们渴望着，算计着。为了更快一些地挣钱，我让妻子又租了一个摊点，我与她各守一个。艰难是可想而知的。夏天，烈日暴晒，炎热逼人，我多次出现中暑症状，而妻子总是抢着选择最热的那个摊位守着。冬天的时候北京的风沙大极了，天气格外的冷，我们却不能戴手套，因为要卖货，戴上手套不方便。一个冬天过去，两个人的手和脚都要裂开许多血红血红的大口子。可是在艰难中我们的生意却做的越来越红火。我想更上一层楼，于是把电话打到老家，让哥哥姐姐都到北京来，再租下两个摊点大家一起做。从1998年下半年，两个摊点的收入变成了四个摊点的收入。尽管每个月的收入已经相当可观，我们却始终不敢乱花一分钱。全家9口人同住在一间10平方米的破房子里，拥挤的程度让别人无法想象，到了睡觉的时候，甚至连腿都伸不直。我们躺在大通铺上，每餐吃着最简单的饭菜，尽管如此，谁也没有怨言。 1999年，北京开始流行美甲，这是一个难得的商机。我买了许多有关美甲的书细细研读，一有空就在自己或家人的手指上试画一些图案，慢慢地，手艺成熟了，我就打出牌子给人做美甲。当时美甲艺术刚刚兴起，在正规的美甲店里做一副手指要三、四百元，来我这里呢，只收十元。没多少日子我的美甲生意便火爆了，许多爱美的女孩子远道而来，指名要我亲自做。 2001年的金秋时节，20万凑齐了！看着银行存折上的那一串数字，我和妻子喜极而泣。2001年10月，我们再次来到北京人民医院，妻子掏出笔，填写了骨髓移植申请单。医生隐约还记得我们，他算了算时间，从发病开始，我已经活了四年多。知道这期间我没有住院化疗，只是依靠药物维持，他惊叹起来：“这真是个奇迹呀！”我说：“没有挣够做手术的钱，我是不会死的。”我第一次看到了医生抹泪，他说：“我见到过许许多多的病人，有钱的，没有钱的，但能够凭自己的劳动在几年内为自己挣足手术费的，真的只有你一个。” 随后我同我的哥哥、姐姐做了骨髓配型。老天再次给了我笑脸，我的二姐与我骨髓相合！至此，我具备了进行骨髓移植的全部条件。我和妻子一起到银行取出了20万，我把钱放在包里，又把包背在肩上。从来没有感觉过钱的重量，它好重啊，直压得我肩膀生疼。医生特地把手术日期定在了11月6日，他说：“我不是个迷信的人，可我希望这一天六六大顺，不辜负几年间你那些惊人的拼搏。” 11月6日上午10时刚过，第一袋骨髓来了。鲜红的液体顺着静脉流进我的身体，也许还是温热的，它来自我姐姐的身体，它载着我对新生命的希望——我的全部寄托。在第一袋马上就要结束护士已经多少有些着急的时候，第二袋到了。不到一个小时，架子上就排了整整齐齐的五大袋。看着它们，我的眼泪忍不住象断线的珠子一般流下来。移植后的第十天，出现了非常严重的药物反应，我吃什么吐什么，甚至一闻到饭菜的味道，我的胃肠就痉挛不止。一般情况下为了保证体质，病人需要静脉输注营养液，但这种营养液贵得惊人。医生为了给我节省费用已经做了最低的预算，能用国产药的就不用进口药，能用口服药的就尽量不注射。护士为我挂营养液时体贴地告诉我：“这药1000多块钱一瓶呢，你想想，1000块钱要是拿来买东西吃的话，得吃下多少东西！” 我决定停下营养液，自己进食。每次护士把饭菜送进来的时候，我赶紧做一个深呼吸，强忍着不让自己吐出来；等护士离开了，我就象面对一个仇人一样，憋住气，一口连一口地扒下去。有时侯，刚一吃完，甚至还没有来得及喘一口气，人就忍不住了，所有吃进去的东西都原封不动地吐了出来。我只得再屏呼吸，再吃……听说我吞咽时那种惨不忍睹的表情经常使通过电视监看我的护士们落下泪来，好几次，妻哭泣着央求我：“咱还是输一些营养液吧！” 我摇头拒绝了：“等等再说吧。”至少眼下的困难，我相信自己可以克服。妻子和女儿在窗外的玻璃上贴了许多幸运星，挂了许多纸鹤，希望我早日康复。每天醒来，一看到这些花花绿绿的东西，一看到妻子和女儿美丽的脸，我就觉得，爱真是太使人幸福了。对比起爱，那痛苦又算得了什么呢？我在日记上写下歪歪扭扭的一排字：“这世上只要存在情和爱，就值得我们为了生命而受苦。” 按常规，骨髓移植后的病人应至少再在无菌病房里住上40天，但那里的费用每天都高得惊人，所以第19天我便向医生要求转移。考虑到我的实际情况，医生同意了，我改住普通病房。为了早一天离开医院，我开始注意锻炼身体。尽管体力还虚弱不堪，但只要一睁开眼睛，我就想办法坐起来，再想办法站起来，再想办法下床活动。眼看着妻子和兄弟姐妹们的付出，我知道一分一秒我都没有理由浪费，我必须珍惜所有的时间。 2002年2月，经染色体检查和基因检查，白血病细胞已经不复存在，医生说，你彻底与白血病告别了。与此同时，我的体力也恢复了正常。简直不敢想象，真的会有这一天。走过了那段路，我想对所有面临厄运的人们说：这世间，只有绝望的人，没有绝望的处境。一个身处绝境的人一定要冷静机智，只有冷静机智才能在最大的限度上拯救自己！

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猪脚炖黄豆

2009-01-20T04:52:00.001-08:00

取黄豆250克（最好为当春产的新鲜小种黄豆），猪脚两只，重约1000克。
　　具体做法如下：将猪脚洗净，一定要洗得特别干净，如表皮有毛请用男士们常用的刮胡刀将猪毛刨刮干净，斩成三厘米宽的块状，备用。用清水搓洗黄豆，然后换干净的清水浸泡黄豆约30分钟，以水能没过黄豆为宜。将铁锅烧热，注入约一小汤匙花生油，开始冒烟时倒入斩成件的猪脚略为翻炒一分钟。然后转入事先准备好的砂锅内，加清水1500毫升，同时，放入已经泡好的黄豆，另加三块切薄的姜片和约20粒拍碎的胡椒，旺火烧开后改文火连续炖上150分钟。需要注意的细节：火候以汤水不外溢为佳，中途不掀开盖子查看，炖好准备享用时才下盐调味，如不是特别追求很鲜的口味，最好不要下味精或鸡精，这锅汤本身已经够鲜，是黄豆和猪脚合炖产生的很独特的鲜，此汤允许稍微偏咸一点。
　　特别强调：此汤最适合30至50岁有妻室男子，能坚持每周喝上一次，倍感精力充沛，提高工作效率。而女士常喝亦有助于美容和面色红润，皮肤光滑。功效和作用源于其高蛋白和丰富胶质物。

白血病病人的常用食疗方

2009-01-17T20:17:00.000-08:00

（一）调养原则
１．白血病是一种恶性程度高的血液系统肿瘤，对人体消耗极大，多属脏腑内虚，所以上要加强，增强机体抵抗能力，以减缓病情，保证治疗。素的供应：精选高热量（每天至少６３００～７５６０千焦耳）的高蛋白，瘦肉、禽蛋、鱼类、动物内脏和豆类及其制品；糖，每天至少３００克；高维生物，新鲜蔬菜、、果汁等。要充分补充水分和维持其电解质的平衡。如钠、钾、氯、钙的无机盐供应；含水多津，清淡甘凉的汁、乳、粥、羹、汤类，如西瓜汤、秋梨汁、番茄汁、甘蔗汁、牛奶、等。
２．化疗时的以高蛋白、多为主，如牛奶、鸡蛋、鹅血、蘑菇、猴头、大枣、莲藕、菠菜、苹果、柑橘、饴糖等。因化疗而致恶心呕吐、、食少的患者，可用竹笋、芦笋、甘蔗汁、秋梨、苡米、山药等，其具有和胃止呕，健脾止泻的作用。
３．放疗时的以滋润适口，丰富为好，如山药粉、杏仁霜、鲫鱼、鳝鱼、莲藕、黑芝麻、桑椹、香蕉、白梨等。
４．晚期患者多为气血大伤，阴阳俱虚，脏腑失和，胃气衰败，以补为主，但不宜大补，而宜于开胃进食，益气健运为主。如肉汤、羹粥、牛奶、参汤等流质易消化，尚可加用香菇、甲鱼、海参、胎盘、穿山甲、蛤士蟆油、桂圆、大枣、石榴等。制作烹调又应当考究，有益增进食欲。
５．发热、出血、贫血是白血病的常见重要症状之一，需多吃些补血、生血、活血的，如龟胶、阿胶、乌龟汤、骨头汤、鱼鳞胶、山药粥；虚证出血贫血者宜用西洋参、龙眼肉、大红枣、连皮花生、鲜猪殃、鹅血等具有益气滋阴养血作用的。对于血热妄行当选凉血止血的中药，鲜藕、白茅根、大小蓟、荠菜、马兰菊、茄子、木耳等取汁饮用。
６．治疗和药物治疗要贯通一致，因此要选些中草药与抗白血病的一起食用。
（二）常用方简介
[用料]荸荠、雪梨、鲜麦冬、鲜莲藕、鲜芦根、甘蔗各２００克。
[制作]将６种原料分别洗净，切碎榨汁。各汁液混合，放入锅内，加清水适量，用小火煮２０分钟即成，代茶饮。
[功效]清热解毒，生津止渴。
[适应范围]白血病有发热、口干、、有出血倾向、皮下出血点。或食管癌、肺癌、胃癌、鼻咽癌放疗后症见口干口苦，大结不通，舌红、苔黄、脉数或有咳血、鼻衄、尿血者兼见上述症状者皆可用之。
[注意事项]使用时以热毒内阻或温毒邪入营血分为主，以发热、口干口苦、、舌红、苔黄、脉数为要点。本方偏于清凉滑利，若症属虚寒，大便溏泄者忌用。
[用料]生石膏４０克，知母、玄参、麦冬、生地各１５克、粳米１００克，冰糖适量。
[制作]
（１）将生石膏捣成细粉，加清水２００毫升，中火煮２０分钟，去渣留汁。
（２）余中药装入纱布袋加水３００毫升煮３０分钟，去渣留汁。
（３）粳米洗净入锅，加入石膏汁和药片，加清水适量，熬煮至米烂成粥，即可。
[功效]清热凉血，滋阴生津。
[适应范围]用于急性白血病高热不退，汗出不解，口渴思饮，鼻衄不止或其他肿瘤症见高热不退，证属实火者，见有、尿黄、舌红，苔黄，脉数者皆可用之。
[注意事项]使用时注意以实证为主，见高热不退，舌红，苔黄，脉数为要点。性偏寒凉，如属终末期病人证见虚寒者慎用。
[原料]南杏仁、北杏仁各１５克，桑白皮１５克，沙参１５克，猪肺１５０克。
[制作]
（１）将猪肺洗净，切块。
（２）把南、北杏仁、桑白皮洗净，装入纱布袋中。
（３）将全部用料放入锅内，加水１０００毫升，武火煮沸，文火煮1小时，去药渣，调味即可，饮汤食猪肺。
[功效]滋阴润肺，化痰止咳。
[适应范围]用于白血病、肺癌、食管癌、鼻咽癌、乳腺癌或其他肿瘤属于阴虚内热者，或放疗后出现口干咽燥，干咳痰少难咯，，低热盗汗，失眠多梦，舌淡，苔少，脉细数者。
[用料]天门冬３０克，猪瘦肉１００克，粳米１００克。
[制作]将天门冬切斜条，煎取浓汁，去渣，猪瘦肉切件，加入粳米煮成粥，加入食盐少许，即可饮用。
[功效]滋阴润肺，生津止渴。
[适应范围]用于白血病阴虚有热者，证见干咳痰少，或其他肿瘤病证属阴虚内热者均可使用。
[注意事项]使用时以阴虚内热为主，性偏滋阴，如外感实证者慎用。
５．红萝卜荸荠脊骨汤
[用料]红萝卜２５０克，荸荠１５０克，猪脊骨２５０克。
[制作]
（１）将红萝卜、荸荠去皮洗净，红萝卜切段。
（２）猪脊骨洗净，斩件。
（３）把全部用料放入瓦煲内加入清水适量，先用武火煮沸，继用中火煲２小时左右，加入适量食盐调味即可饮用。
[功效]滋阴润燥。
[适应范围]用于白血病及其他肿瘤证属阴津不足，口干咽燥，低热，心烦失眠者。
[用料]西洋参１５克，淮山３０克，红枣２０克，乌鸡２５０克，生姜三片。
[制作]
（１）将西洋参洗净切薄片，淮山、红枣洗净。
（２）乌鸡洗净，斩件，放入沸水中煮３分钟，捞起，备用。
（3）把全部用料放入瓦煲内，加入清水适量，先用武火煮沸，继用文火煮１小时左右，调味即可饮汤食肉。
[功效]健脾益气。
[适应范围]用于白血病化疗后出现体质虚弱，不思，体倦乏力，头晕短气，面色泛白无华，舌淡，苔薄白，脉沉细。或其他肿瘤病人有上述症状者。
[注意事项]本方偏于滋补，多适于肿瘤病人体质差或放、化疗后正气亏虚者。如外感未清或湿热明显者慎用。

猪肝汤的做法

2009-01-17T20:09:00.000-08:00

番茄猪肝汤做法

　　原料：蕃茄，猪肝，姜，香菜
　　腌料：姜汁半匙、酒半匙、油半匙、太白粉半匙、酱油一匙
　　做法如下：
　　1、蕃茄洗净切片。
　　2、猪肝洗净切薄片，加入腌料腌十分钟。
　　3、将锅烧热后，下油半匙爆香蕃茄及姜片，加适量水滚十五分钟，放入猪肝煲煮，下调味料拌匀，放上香菜。

菠菜豆腐猪肝汤做法

　　特点：猪肝与菠菜都是补血的食物，常吃可起到补血的作用。
　　做法：
　　1.将猪肝洗净滤去血水再切片。
　　2.水烧开后放入猪肝、豆腐、生姜及少许猪油。
　　3.待水开后再煮二分钟，放入菠菜后，立即放适量盐和味精调味。
　　4.慢慢搅动一次，放入香葱便可起锅食用。

银耳猪肝汤做法

　　配方：银耳10克、猪肝50克、小白菜50克、姜3克、葱3克、盐3克、酱油5克、生粉15克、鸡蛋1只、素油20克
　　制作：
　　1．把银耳放入温水中泡发，去蒂根，撕成瓣状，猪肝洗净、切片；小白菜洗净，切5厘米长的段，姜切片、葱切段。
　　2．把猪肝放在碗内，加入生粉、盐、酱油；打入鸡蛋拌匀挂浆，待用。
　　3．把炒锅置武火上烧热，加入素油，六成熟时，下入姜、葱爆香，注入清水300毫升，烧沸，下入银耳、猪肝，煮10分钟即成。
　　功效：补肝明目，润肺养阴。

胡萝卜猪肝汤做法

　　配方：胡萝卜200－250克，猪肝100－200克，生姜、精盐适量。
　　制作：将胡萝卜、猪肝各洗净，切片备用，锅内加适量水，再放入生姜、精盐同煮，武火烧沸后，先放胡萝卜，后放猪肝，煮至熟后，即可食用。
　　用法：喝汤，吃猪肝和胡萝卜。
　　功效：补血，明目，养肝。
　　应用：适用于维生素A缺乏所致的夜盲症。

婴儿食谱猪肝泥做法

2009-01-17T20:06:00.000-08:00

此肝泥软烂，鲜香，含有丰富的铁和维生素A、B1、B2、B12等多种营养素。其中维生素A含量极为丰富，对防治婴儿维生素A缺乏所致的夜盲症，具有良好的作用。还含有大量的铁，能预防缺铁性贫血的发生。制作中，要去掉肝上的筋膜和脂肪。
　　主料猪肝50克。
　　辅料香油1克，酱油、精盐各少许。

　　制法：
　　① 将猪肝洗净，横剖开，去掉筋膜和脂肪，放在菜板上，用刀轻轻剁成泥状。
　　②将肝泥放入碗内，加入香油、酱油及精盐调匀，上笼蒸20-30分钟即成。

猪肝

2009-01-17T20:02:00.000-08:00

原料介绍
肝脏是动物体内储存养料和解毒的重要器官，含有丰富的营养物质，具有营养保健功能，是最理想的补血佳品之一。

营养分析
1、猪肝中铁质丰富，是补血食品中最常用的食物，食用猪肝可调节和改善贫血病人造血系统的生理功能；
2、猪肝中含有丰富的维生素A，具有维持正常生长和生殖机能的作用；能保护眼睛，维持正常视力，防止眼睛干涩、疲劳，维持健康的肤色，对皮肤的健美具有重要意义；
3、经常食用动物肝还能补充维生素B2，这对补充机体重要的辅酶，完成机体对一些有毒成分的去毒有重要作用；
4、猪肝中还具有一般肉类食品不含的维生素Ｃ和微量元素硒，能增强人体的免疫反应，抗氧化，防衰老，并能抑制肿瘤细胞的产生，也可治急性传染性肝炎。

相关人群
一般人群均可食用
1. 适宜气血虚弱，面色萎黄，缺铁性贫血者食用；适宜肝血不足所致的视物模糊不清，夜盲．眼干燥症，小儿麻疹病后角膜软化症，内外翳障等眼病者食用；适宜癌症患者及放疗、化疗后食用；适合贫血的人、常在电脑前工作、爱喝酒的人食用；
2. 患有高血压、冠心病、肥胖症及血脂高的人忌食猪肝，因为肝中胆固醇含量较高。有病而变色或有结节的猪肝忌食。
食物相克
猪肝忌与鱼肉、雀肉、荞麦、菜花、黄豆、豆腐、鹌鹑肉、野鸡同食；不宜与豆芽、辣椒、毛豆、山楂等富含维生素C的食物同食；动物肝不宜与维生素C、抗凝血药物、左旋多巴、优降灵和苯乙肼等药物同食。

制作指导
1. 肝是体内最大的毒物中转站和解毒器官，所以买回的鲜肝不要急于烹调，应把肝放在自来水龙头下冲洗10分钟，然后放在水中浸泡30分钟；
2. 烹调时间不能太短，至少应该在急火中炒5分钟以上，使肝完全变成灰褐色，看不到血丝才好；
3. 治疗贫血配菠菜最好；
4. 猪肝常有一种特殊的异味，烹制前，首先要用水将肝血洗净，然后剥去薄皮，放入盘中，加放适量牛乳浸泡，几分钟后，猪肝异味即可清除；
5. 猪肝要现切现做,新鲜的猪肝切后放置时间一长胆汁会流出,不仅损失养分,而且炒熟后有许多颗粒凝结在猪肝上,影响外观和质量，所以猪肝切片后应迅速使用调料和湿淀粉拌匀,并尽早下锅。

食疗作用
猪肝味甘、苦，性温，归肝经；
有补肝、明目、养血的功效；
用于血虚萎黄、夜盲、目赤、浮肿、脚气等症。

骨头汤的做法

2009-01-17T19:15:00.000-08:00

骨头汤的做法
材料: 扇子骨500克，直通骨1000克，尾脊骨500克，碎骨500克，葱结1小扎，生姜1小块，酒50克，清水5公斤。

做法：

第一步:将骨头放入温热水中，用抹布将骨头逐根洗清爽，尤其是骨头缝里的血沫、杂质，都要抹掉清洗.
第二步:将直通骨劈断，劈开两片，放入锅中(我这里用的是沙锅),加入葱、姜,然后放入冷水，冷水最好一次性加足.
第三步:用大火烧开，撇去浮沫(根据肉质,可能要撇1-2次)，转小火慢慢加温炖。
第三步:撇去浮沫(根据肉质,可能要撇1-2次)后，转小火炖,然后倒入酒适量(根据酒量..嘿嘿开玩笑)50K左右。
第四步:从营养获取角度考良,在水烧开后可适量加醋，因为醋能使骨头里的磷、钙溶解到汤内；同时，不要过早放盐，因为盐能使肉里含的水分很快跑出来，会加快蛋白质的凝固，影响汤的鲜美。
第五步:炖至2- 3小时后出汤，即完成出汤! 怎么样不错吧.一般猪肉骨头汤能连续用，家庭中可煮1-3小时左右，可取用2次，至扇子骨已酥化，骨头颜色呈灰暗色，汤质鲜味、脂肪营养已用尽为止。颜色：汤清而漂油。

如果骨油大的话，就改加萝卜炖。萝卜可以吸油，而且萝卜也很好吃。如果感觉油还是大的话，就用几片馒头片把上面的那层油吸走再喝汤。

作用:
　　骨头汤能起到抗衰老的作用。这是由于人体骨胳中最重要的是骨髓，血液中的红、白细胞等就是在骨髓中形成的，随着年龄的增大和机体的老化，骨髓制造红、白细胞的功能逐渐衰退，骨髓功能降低，直接影响到人体新陈代谢的能力。而骨头汤中含有的胶原蛋白正好能增强人体制造血细胞的能力。所以对于中老年人来说，喝些骨头汤加以调理，可以减缓骨骼老化；同样，骨头汤也能有利于青少年的骨骼生长。

Much better now

2008-12-25T06:02:00.000-08:00

Siyuan started to eat from yesterday and is feeling much better now. He is searching for food almost every hour, always trying different food.

Siyuan recent picture in NUH

2008-12-19T05:58:00.000-08:00

What happened when Siyuan was in Shanghai

2008-12-07T06:32:00.002-08:00

9月20日左右额头部红斑，肿块，怀疑天气热（蚊虫叮咬）或水土不服，去上海交通大学附属儿童医院配药；

10月4日左右发现孩子眼睛哭笑时有大小，嘴巴有点歪，去上海交通大学附属儿童医院后转市9医院就诊配药1天；隔天去奉贤区中医院检查，经专家诊断后打吊水8天，用药青霉素，地塞拉蒙等；

10月15日上海天山医院就诊1天；

10月18日上海南京西路1213弄私人诊所就诊（4天1次，共4次）；

10月15日左右又打了4次吊水，并做了B超检查，肝，脾，胰，胆均无异常；

11月3日上海儿童医院就诊，发烧，咳嗽，配消炎药等；

11月4日区中医院专家会诊；

11月12日由于呕吐等去儿童医院，诊断脱水，配药（吗丁林等），吊水1次，停止吃奶粉，改喝粥，后好转至回新加坡。

Siyuan hospitalised in NUH

2008-12-06T05:43:00.000-08:00

Pictures in Jul & Aug 08

2008-08-20T18:24:00.000-07:00

Siyuan had loose bowels at his 8 months plus 24 days (27 jul 08)

2008-07-27T20:14:00.000-07:00

Symptom:
1. baby do like to eat; vomitted if you forced him to eat;
2. less smiling even you teased him, or hold him over your head;
3. sad face most of time, always tried to raised his buttock when you carry him in your arm;
we brought him to see doctor in early morning, got some medicine from him, a little fever and maybe his stomach was affected by some knids virus by eaten or contecting some dirty things. But not a serious case according to what doctor said.
In the afternoon, he became activie again, started to smile , and looked a bit recovery.

This is his 1st time to get illness since his birthday, I should learn something from this time, at least ensure the hygiene condition in his surrounding area.

3 more pictures to share

2008-06-30T04:29:00.000-07:00

pictures of June 08

2008-06-22T07:08:00.000-07:00

Swimming at Jurong West Stadium

2008-06-19T07:02:00.000-07:00

Same product, but different maker and much more different price

2008-06-04T01:54:00.000-07:00

Siyuan's first haircut (just after Chinese new year)

2008-05-16T02:54:00.000-07:00

photos taken during Chinese New Year 08

2008-05-16T02:42:00.000-07:00

Visiting his girl friend for celebration of his 1st Christmas

2008-05-15T23:42:00.000-07:00

100 days after Siyuan's birth

2008-05-15T23:37:00.000-07:00

20 days later after birth

2008-05-15T23:29:00.000-07:00

Born in MAH (Singapore Mount Alvernia Hospital)

2008-05-15T22:10:00.000-07:00

Kindergartens in Singapore

2008-05-14T01:40:00.000-07:00

Kindergartens in Singapore provide up to three years of pre-school for children ages three to six. The three years are commonly called Nursery, Kindergarten 1 (K1) and Kindergarten 2 (K2), respectively.
Kindergartens provide an environment for children to learn how to communicate, play, and interact with others, and to prepare them for the start of formal education in primary schools. Activities include learning of language and numbers, development of personal and social skills, games, music, outdoor play. Children learn two languages, English and their official mother tongue (Chinese, Malay, or Tamil). Many private or church-based kindergartens might not offer Malay or Tamil, so non-Chinese pupils might also learn Chinese in these kindergartens.
The kindergartens are run by the private sector, including community foundations, religious bodies, and civic or business groups. There are more than 200 kindergartens registered with the Ministry of Education. Kindergartens are also run by child care centres as well as international schools.

思远 – 思源致远

2008-05-04T18:49:00.001-07:00

New baby born on 03 nov 07, named siyuan (思远 – 思源致远)，hope he won’t forget where he came from and step further forward when he grow up. This name is truly from my university in china – shanghai jiaotong university’s motto “饮水思源, 爱国荣校”. To me, this name is quite meaningful. What is more, I don’t want to give his English name now, leave it to himself when he grow up. He discharged from MAH (Mount Alvernia Hospital) after 3-day staying, 3.11 kg weight at the time of born and 3.04kg when he left for home. I was quite busy recently, also managed to get the baby birth certificate from ICA - Immigration and Checkpoints Authority (you can get S$3000 allowance if your child is or become citizen under 6 for 1st child, S$6000 for 2nd child), and applied china passport from embassy, but it need to wait for another 10 working day (as they said, all passport need to send to HK to process, I am just wondering why).

To record growth of Dai Siyuan

2008-04-03T05:28:00.000-07:00

Birthday: 03rd Nov 2007.