Monday, January 12, 2009

Cancer becomes major cause of mortality and morbidity

Cancer is one of the major causes of mortality and morbidity in this world.

The annual incidence of cancer in India is about 7.0 lacs with atleast 2 milion people suffering with it at any given time. About 4 lacs die every year in India due to cancer. About 30% of cancers are diet related.

The components of the food we eat on one side cause cancer but on the other also protect us from this dreaded disease. The dietary factors which may promote cancer are the fatty acids, i.e. saturated and to some extent n-6 PUFA, while n-3 has a distinct preventive role.

Diets low in micronutrients increase the risk of cancers in a milieu of pro-carcinogens. Se, Zn, ascorbic acid etc. act as antioxidants have anticancer properties. Fruits and vegetables are the most beneficial in cancer prevention.

Isothiocyanates in cruciferous vegetable, phenolic compounds in garlic, green tea, soya, cereals, etc. flavonoids in fruits, vegetables, green tea, soya bean, mono-terpenes in garlic, citrus fruits, mint, , organo sulfides, isoflavones, indole contribute to the anti-cancer properties.

Food analysis would provide the basis for choice of food, which may benefit significantly by reducing cancer risk.

Targeted therapies target aggressive breast cancer

1 out of 5 women in advanced stage of breast cancer is HER2 positive

Hyderabad: For a woman Breast Cancer is the greatest fears of all. It is the leading cause of death in women aged 35-55 and the second leading cause of death in
women of all ages. As many as eight to nine percent of women will develop
breast cancer during their lifetime, making it the second most common cancer
in the world.

In India, breast cancer accounts for 20 per cent of the total cancer-related
diseases and is largely prevalent among urban women.

According to The International Agency for Research on Cancer, which is part
of the World Health Organisation, there were approximately 79,000 women
per year affected by breast cancer in India in 2001 and over 80,000 women in
2002. Breast cancer has certain patterns in its incidence.

The incidence of breast cancer is higher in the urban areas (metropolitan
cities) than in rural areas, with Delhi having the highest incidence, followed
by Mumbai, Chennai, Bangalore and Kolkata. Breast cancer occurs at a
younger age in India as compared to developed countries. Breast cancer is
not just one single disease - there are several types of breast cancer (such as
‘HER2-positive’), which grow at different rates, and respond differently to
treatments.

HER2 positive breast cancer is an aggressive form of breast cancer. About
one out of every five women with advanced breast cancers is HER2 positive.

HER2 stands for human epidermal growth factor receptor 2. HER2 is a
protein produced by a specific gene with cancer-causing potential. It is a gene
that helps control how cells grow, divide, and repair themselves. It directs the
production of special proteins, called HER2 receptors. In this condition,
excessive quantities of a special growth promoting gene called HER2 is
present in the cells of the breast.

Research has shown that in case of women with HER2 positive breast cancer:

The tumors grow faster
There is an increased risk of spread
There are greater chances of the tumor coming back

Compared to women with normal breast cancer (HER2 negative) HER2
positive condition reduces the life expectancy of the woman by
approximately half.

Treatment options

The search for a cure for this deadly disease has led to the development of a
breakthrough line of therapy called targeted therapy, which helps combat
complicated forms of the disease effectively. Targeted therapies have
emerged as the latest treatment option for people suffering from cancers. The
therapy terminates the cancerous cells without affecting the quality of life of
the patient.

Herceptin is a unique biologic targeted therapy for women with HER2-
positive breast cancer. It differs from traditional treatments. Cancer cells are
cells that grow in an uncontrolled fashion. Herceptin stops or slows the
growth of certain breast cancer cells by blocking the chemical signals they
need to grow. It specifically targets the cancerous cells that overexpress the
HER2 protein and blocks the tumour cell growth. It signals the body’s
immune system to kill the tumor cell and works with chemotherapy to slow
the growth of the tumor.

Since Herceptin targets mostly tumor cells that overexpress the HER2
protein, it does not affect normal healthy cells. Patients on this therapy alone
may be less likely to experience the side effects typical of other types of
treatments, such as hair loss, fatigue, or a decline in certain blood counts.

Benefits of target therapies over existing therapies.

Target therapies act only on the cancerous cells, thus the following side
affects are normally not experienced by patients who are administered this
therapy:

Hair loss (alopecia)
Nausea, vomiting, and loss of appetite (anorexia)
Low white blood cell count (neutropenia)
Low red blood cell count (Anemia)
Fatigue
Diarrhea or constipation
Mouth sores (stomatitis or mucositis)
Inflammation of the esophagus (esophagitis)
Fever, body aches and pains
In men, lowering the number of sperm cells and reduce their ability to move
causing infertility
In women, it affects the ovaries reducing the amount of hormones they
produce.
Menstrual periods become irregular or stop completely
Targeted therapy is helping patients minimize side affects and greatly
enhance their quality of life.

The best protection against the diseases is awareness. Timely detection of
such a life threatening condition helps towards early treatment.
Early treatment of the condition not only prevents further disease progression
and complications but also gives better response rates.

Concern over increase in childhood cancers

By Syed Akbar
Hyderabad: Researchers and doctors throughout the world have now focused their attention on childhood cancer which is rapidly expanding in both developed and developing nations.
In India alone as many as 1.60 lakh new cancer child-patients are added to the existing list every year and of them nearly a lakh succumb to the dangerous disease. While Western nations maintain statistics on cancer with a particular emphasis on cancer in children, unfortunately in India neither the Indian Council of Medical Research nor the Indian Medical Association have ever bothered to conduct a full-fledged survey of the problem.
Oncologists and doctors have selected the theme, "My Child Matters", giving emphasis on childhood cancers this World Cancer Day being observed on February 4. Cancer specialists in Hyderabad and elsewhere in Andhra Pradesh have decided to take up awareness campaign among parents and in schoolchildren telling them about the steps to be taken to prevent cancers, and in case cancer strikes the steps to be followed to escape death.
"Childhood cancer refers to all cancers in children aged 14 and under. Unfortunately, information on the occurrence of childhood cancer in developing countries like India is largely inadequate. More population-based cancer registries are needed to measure the real number of children with cancer," argues Dr Vijay Anand P Reddy, director of Apollo Cancer Hospital.
The common childhood cancers include leukaemia, lymphomas, central nervous system tumours, neuroblastoma, retinoblastoma, renal cancer, bone tumours and soft tissue sarcomas. Although there are different types of cancer, at least 85 per cent of all childhood cancers have similar signs and symptoms.
Explaining the symptoms of cancer, Dr Vijay Anand says, the main warning signs include continued, unexplained weight loss and fever, pallor, headaches with early morning vomiting, unusual swelling and abdominal mass, swollen head, development of excessive bruising or bleeding, white glow in the eye, and sudden changes in balance or behaviour. "Since most of the symptoms of cancer can be interpreted as common child ailments, parents should insist, where possible, that physicians carry out tests to rule out cancer," he suggests.
Childhood cancer is more than twice as curable as all adult cancers and it is vitally important that childhood cancer is detected early and that access to treatment is improved. Although childhood cancers represent a small percentage of all cancers, most of them can be cured if prompt and essential treatment is accessible. About 80 per cent of children with cancer live in developing countries with a survival rate below 50 per cent. However, the survival rate in developed nations is more than 80 per cent.
Dr Mukesh Batra, chairman-cum managing director of Dr Batras’ Positive Health Clinic, says globally more than 10 million people are diagnosed with cancer every year and it is estimated that there will be 15 million new cases every year by 2020.
"Cancer causes six million deaths every year, 12% of deaths world-wide. In the developed countries cancer is the second leading cause of death accounting for 21 per cent (2.5 million) of all mortality. In the developing countries cancer ranks third as a cause of death and accounts for 9.5 per cent (3.8 million) of all deaths. Tobacco alcohol, infections and hormones contribute towards occurrence of common cancers all over the world," Dr Batra observes.
In India cancer has become one of the 10 leading causes of death. It is estimated that there are nearly 15 lakhs to 20 lakhs cancer cases at any given point of time. Over seven lakh new cases of cancer and three lakh deaths occur annually due to cancer.
"In reality, cancer cure exists and many cases of cancer have been successfully reversed. The answers might not be only found in drugs, surgery, radiation and chemotherapy, although, in certain cases they are useful. Statistics show that the most successful recipe to cancer cure is the synergistic approach, combining a holistic lifestyle with different natural treatments," says Dr Batra.
An arsenal consisting of a diet rich in raw organic foods and juices, regular exercise, therapeutic doses of antioxidants and other natural supplements, regular detoxification, a healthy emotional state through counselling and meditation can dramatically increase the chances of combating and reversing cancer.

Tuesday, December 23, 2008

South Indians have their paternal lineage in Europe, maternal genes in East Asia

December 24, 2008
By Syed Akbar
Hyderabad, Dec 23: The paternal lineage of South Indians is traceable to Europe while their maternal genes point to East Asia.
A joint study by a group of international research organisations on the caste populations in Tamil Nadu and Andhra Pradesh has revealed that South Indian paternal lineages have been more substantially influenced by western or central Eurasians compared to South Indian maternal lineages.
The study was conducted by the Department of Human Genetics, University of Utah, USA, Schizophrenia Research Foundation, India, Queensland Centre for Mental Health Research, Australia, and University of Washington School of Medicine, USA. The researchers suggested an affinity between Dravidian populations from South India
and populations in the north and west.
The research team led by senior scientist Dr LB Jorde studied Y-chromosomes (for paternal lineage) and found that Tamil castes showed higher affinity to Europeans than to eastern Asians, and that genetic distance estimates to the Europeans are ordered by caste rank.
And when the team studied the mitochondrial DNA (maternal lineage), it found that Tamil castes have higher affinity to eastern Asians than to Europeans. Same was the case with caste populations in Andhra Pradesh.
Certain South Asian lineages are common in Tamil and Andhra castes. One of the South Asian lineages, U7, is the most prevalent "U" lineage in both the groups. Interestingly, U7 is also common in Iran, Pakistan, and northern India. "This suggests an affinity between Dravidian populations from South India and populations to the north and west," Dr Jorde said.
Although other interpretations may be possible, Dr Jorde said their data from the research study is "consistent with a model in which nomadic populations from northwest and central Eurasia intercalated over millennia into an already complex, genetically diverse set of subcontinental populations."
As these populations grew, mixed, and expanded, a system of social stratification likely developed in situ, spreading to the Indo-Gangetic plain, and then southward over the Deccan plateau. The predominantly south and east Asian mtDNA (maternal) haplogroup M is found in more than half of individuals from a wide sampling of castes and is nearly fixed in some AustroAsiatic tribal populations. This maternal
haplogroup is uncommon in western European populations.
In contrast, some paternally-inherited Y-chromosome lineages are more closely related to lineages originating in central Asians and Europeans.Genetic distances estimated from autosomal polymorphisms have typically demonstrated that caste populations tend to occupy a position intermediate between European and East Asian populations.
"The genetic affinities among the more than 2000 extant caste populations of India, however, are complex. Genetic distances between caste populations from Andhra Pradesh are correlated with differences in caste rank, suggesting that endogamy and differential inter-caste gene flow influences genetic structure," the study noted.
The study reveals that in Tamil Nadu, genetic distances between castes are positively correlated with caste rank. A similar pattern was detected in upper, middle, and lower rank castes of Andhra Pradesh.

Monday, December 22, 2008

Musi pollution: Hookworm threat due to use of sewage in agriculture


December 22, 2008
By Syed Akbar
Hyderabad, Dec 21: Hyderabadis, who consume fruits and vegetables grown over 3,600 hectares under Musi ayacut, run the risk of severe worm infection that may cause appetite loss, abdominal pain, shortness of breath and a variety of skin diseases.
According to a joint study by the London School of Hygiene and Tropical Medicine and the International Water Management Institute, Hyderabad, farmers as well as consumers are hit by use of sewage or wastewater in agriculture in and around Hyderabad. As unpolluted water is not available in sufficient quantities in the State capital region for agriculture, scores of farmers in the downstream of Musi are increasingly going in for untreated water for their crops and orchards,
exposing their health as well as of consumers.
If the WHO standards are to be followed, wastewater used in Hyderabad to irrigate is unfit for crop production.
"Intestinal nematode infections have been identified as the main health risk associated with this practice. To protect consumer and farmer health, the World Health Organisation has established an intestinal nematode water quality standard... The use of wastewater poses a number of health risks. Predominant among these is the risk of intestinal helminth infection," Jeroen H J Ensink of London School of
Hygiene and Tropical Medicine, told this correspondent.
The study found that in Hyderabad around 250 households use wastewater from the Musi river to irrigate 500 hectares of land. Downstream of Hyderabad, farmers, with the help of weirs, irrigate 3,100 hectares of agricultural land.
For the purpose of the study, the research team divided the city and its suburbs into three zones, centre of Hyderabad (high concentration of hookworm eggs), peri-urban zone of Hyderabad (medium concentration of hookworm infection) and villages downstream of the river Musi.
The team found prevalence of hookworm and heavy hookworm infection and other intestinal parasites like Ascaris (giant round worms) and Trichuris (whip worms). Overall, 31.2 per cent of persons, who formed part of the study, were infected by at least one intestinal nematode infection. Of these, hookworm is the most prevalent (29.8 per cent), followed by Ascaris lumbricoides and Trichuris trichiura.
The mean intensity of infection ranged from 35 eggs per gram of faeces (epg) for hookworm to 1.7 epg for T. trichiura. The highest intensity of infection in a person was found for hookworm (1,789 epg), followed by A. lumbricoides (1,333 epg) and T. trichiura (336 epg).He said a significant difference in the prevalence of hookworm, Ascaris and Trichuris was found among the three city zones. Farming families
in centre of Hyderabad had a significantly higher prevalence of hookworm, Ascaris and Trichuris infection. In addition, they also exhibited a significantly higher intensity of infection for all three infections relative to farming families in other two zones.
"Among all persons, use of untreated wastewater, when controlled for confounding variables, was associated with an almost four-fold increased risk of hookworm and heavy hookworm infection. This result was in contrast to the use of partially treated wastewater, which showed no significant association with hookworm infection when controlled for confounding variables. Use of untreated wastewater further showed a greater than five-fold increased risk of Ascaris and Trichuris infection.
Use of partially treated wastewater was associated with a greater than three-fold increased risk of Ascaris infection," Jeroen Ensink said.
The highest risks were associated with use of untreated wastewater, and use of partially treated wastewater was associated only with an increased risk of Ascaris. Use of untreated wastewater was also associated with a higher intensity of infection, especially for hookworm infection.

Thursday, December 11, 2008

Metals in Ayurveda: Scientific evaluation and standardisation of herbal drugs


November 23, 2008
By Syed Akbar
Hyderabad, Nov 22: With the USA and European nations rejecting Ayurvedic drugs containing metals, the Central government has now embarked on a mega scientific mission to prove that metallic compounds in traditional Indian system of medicine are indeed helpful in fighting diseases.
Only Ayurveda system of medicine extensively utilises a variety of metals to treat certain health problems and boost immunity to fight diseases. But since there's no scientific evaluation of these drugs, developed nations have put a ban on them.
The Department of Science and Technology has entrusted the research, evaluation and standardisation work of Ayurvedic drugs containing metallic compounds to a number of scientific, research and pharma bodies across the country, including the city-based Indian Institute of Chemical Technology.
Ayurvedic medicines consist of ingredients of herbal, mineral, metallic and animal origin. While scientists in many countries are working on herbal products, no country is working on metallic products, which is an important strength area of Ayurveda. This is because, barring India, this knowledge does not exist anywhere else.
"Arsenic and mercury may be harmful. But when taken in minute quantities they have several health benefits. Ayurvedic drugs have been using these and other metals for centuries. What we need to prove is that these metallic compounds are beneficial to health in small quantities. We have taken up the evaluation and standardisation work.
Once our task is complete Ayurvedic drugs will get scientific backing," Dr J Madhusudhan Rao, director-grade scientist, IICT, told this correspondent. The DST believes that it is one area where India can make original contribution to the world and thus there's need for validation of claim of metallic products. "It is our heritage and needs to be subjected through well planned research in order to bring it to international fora as India’s unique contribution," he added.
The task before the scientific team is to identify different types of bhasmas and formulations for carrying out scientific studies with regard to the standardisation of raw materials, processes and finished products. It also involves chemical transformation, safety, efficacy evaluation, and validation through networking of the various institutions and industries having expertise in this area.
Ayurvedic drugs containing metals will be subjected to pre-clinical studies in animal models for pharmacological evaluation and toxicity,pharmacodynamic and tissue distribution studies. Later, the drugs will be used on human beings for clinical studies, though thousands of Indians have already been using them for centuries.
"It is essential to understand the chemical nature of the complexation taking place with metallic ions and organic phyto-constituents present in medicinal plants with which the metals are treated. Unless we understand the nature of the complex compounds formed during the processing of metals/minerals and medicinal plant material, it is not possible to evolve the quality parameters and understand the
mechanism of action of such important, potent and unique drugs of Ayurveda and Siddha," DST guidelines on Ayurveda research point out.