I spoke with her this afternoon and she said she'd been much better and was able to do more than she'd been able to do for the previous few days. Hopefully she'll progress in a positive way now..fingers crossed.

When I last posted she was going to take her DCA in the evening, which she did. She said she had a terrible night and her pulse rate rose to between 92 and 102. She was very concerned and said she felt the need to prop herself up through the night. She has not continued with the DCA at this stage.

I am going to suggest she take a half dose of the DCA (5mg per kg) in the beginning to see how she tolerates it for five days. She actually took two days of half dose when she first started earlier in the week because of a misread of her scales, and had no side-effects at this dose. I'm thinking some DCA is better than no DCA....any comments?

Thanks again for any input.

Best wishes
Kylie

>I spoke with Mum this afternoon and she said she didn't take
>her juice today as she felt it was making her insides "work
>too hard" and exhausting her.....she actually felt better
>today and tells me she has nice pink nail beds etc.
>(indicating iron levels are probably OK!).

(A.K.) Pale nail beds can be one indicator of aenemia, but it's not always a reliable measure .

-- Excerpt --

On examination, the signs exhibited may include pallor (pale skin, mucosal linings and nail beds) but this is not a reliable sign.

Source: http://en.wikipedia.org/wiki/Anemia#Diagnosis

-- End Excerpt --

>Perhaps her lethargy is post surgical tiredness or the cancer is
>becoming active or it is a post radiotherapy symptom.

(A.K.) This is very likely to be radiotherapy related. Please read this excerpt about common radiotherapy side effects:

-- Excerpt --

Common side effects of radiotherapy

Common side effects of radiotherapy include:

* tiredness,
* nausea,
* diarrhoea,
* stiff joints and muscles,
* dry mouth,
* loss of appetite,
* hair loss,
* sore skin, and
* a lack of interest in sex.

Tiredness

You will probably feel tired both during and after your radiotherapy treatment. Tiredness is particularly common towards the end of a course of treatment and can last for some time.

Tiredness usually occurs as a result of the body repairing the damage to healthy cells. It can also be caused by anaemia (a shortage of red blood cells).

Anaemia can develop if too many healthy red blood cells are destroyed during treatment, meaning less oxygen is carried around your body. During your treatment, you will have regular blood tests. If you have anaemia, you may need a blood transfusion.

Doing some gentle exercise may help relieve the symptoms of tiredness. Your doctor or treatment team can advise you about suitable exercise.

Source: http://www.nhs.uk/Conditions/Radiotherapy/Pages/Side-effects.aspx

-- End Excerpt --

>I'm still keen to receive advice from anyone who may have
>experienced similar symptoms or any advice at all! She was
>considering not taking the DCA today but decided to take the
>dose in the late affternoon today. Does anyone take their
>dose at this time? I can't imagine this being a problem
>but please advise if it is!
>
>Mum is scheduled to meet with her oncoclogist on the 11th, I
>assume to disccuss further treatment with chemotherapy.
>This will be the first appt post surgery and since finishing
>radiotherapy...Chemo wasn't being started until she was
>fully recovered from her surgery. She does not plan to
>inform him that she is taking DCA at this stage.

{A.K.}Some general advice:

My research so far indicates that the existence of tumor hypoxia (areas of the tumor with poor oxygen supply) tends to be associated with poorer outcomes and higher radiotherapy and chemotherapy resistance (source: http://theoncologist.alphamedpress.org/cgi/content/full/9/suppl_5/4).

Because treatment related anemia is one possible cause for tumor hypoxia, if they do end up finding out that this is indeed it, I would look into the possibility of having her treated with recombinant erythropoietin or epoetin alfa which stimulates the maturation of red blood cells. A blood transfusion is also a possible way to combat anemia; however, I would personally still favor the drugs.

As far as her DCA treatment goes, the only thing I can really comment on is that I would speculate that hypoxia might also affect how well DCA works, being as DCA modulates cellular energy production from the anaerobic kind (does not require oxygen to generate energy) to the aerobic kind (which requires oxygen). It would be interesting to see what happens to hypoxic tumor cells when they are forced to use oxygen to generate energy in an environment where oxygen is lacking.

All the best to you and your mom Kylie!

Allan.

>
>
>Thanks again!
>
>Kylie

-- Disclaimer --

Please note, I'm not a trained physician or a doctor of any sort. While I hope that the above information is accurate and helpful I cannot guarantee it is the right advice for you. Please seek to confirm everything I have pointed out with your oncologist or other expert in the field - particularly so in regards to my comments about DCA.

"In a revised Black Box Warning FDA notes significant risks associated with use. ESAs should only be used in patients with cancer when treating anemia specifically caused by chemotherapy and not for other causes of anemia. Further, it states that ESAs should be discontinued once the patient's chemotherapy course has been completed."

http://en.wikipedia.org/wiki/Erythropoietin

-----------------------------------

Oxygen breathing may be a cheaper and safer alternative to exogenous erythropoietin (EPO).

Burk R.
Burk Labs, 9414 168th Place NE, Redmond, WA 98052, USA. ronburk@gmail.com

Erythropoietin (EPO) is a glycoprotein hormone produced by renal tissue in response to hypoxia; EPO functions as a cytokine to precursor cells produced by the bone marrow, stimulating red blood cell production. Erythropoiesis stimulating agents (ESAs) are manufactured molecules designed to mimic the ability of endogenous EPO to bind to EPO receptors and increase red blood cell production. To achieve desired dosing schedules and avoid the need for blood transfusions, oncologists have become increasingly reliant on ESAs to counter the anemia often experienced during chemotherapy. In recent years, significant concerns have been raised about the safety of ESAs, including the possibility of increased cardiovascular events and even increased tumor growth and accelerated mortality in cancer patients. ESAs also contribute significantly to the expense of chemotherapy, rendering them unavailable to some patients and available to others only upon achieving insurance-mandated levels of anemia. A recently discovered "normobaric oxygen paradox" demonstrates that renal tissue can be stimulated to increase EPO production via a simple pattern of oxygen breathing at normal atmospheric pressures. This leads directly to the hypothesis that oxygen breathing may provide chemotherapy patients with a convenient and inexpensive alternative to ESAs. Stimulating endogenous EPO production eliminates the small risk of immune system reaction associated with ESAs. Further, the endogenous physiological EPO doses provided by this method may be safer, in terms of cancer mortality, than the exogenous pharmacological doses inherent in ESA administration. A single patient test case is presented to support the hypothesis that normobaric oxygen breathing can be an effective replacement for ESAs in treating chemotherapy-induced anemia. In this case, a stage III breast cancer patient undergoing dose-dense AC+T chemotherapy obtained a clear response equivalent to ESA treatment by using a pattern of simple oxygen breathing.

http://www.ncbi.nlm.nih.gov/pubmed/17493766?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed