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:THE MOSS REPORTS Newsletter (12/25/02)

 

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Ralph W. Moss, Ph.D. Weekly CancerDecisions.com

Newsletter #66 12/25/02

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PDT for Liver Metastases?

 

 

 

A small study from Germany suggests the potential

efficacy of photodynamic therapy (PDT) in the treatment

of liver metastases. Results of this study were

presented at the annual meeting of the Radiological

Society of North America in December 2002. A research

team led by Kerstin Engelmann, MD, of Johann Wolfgang

Goethe University in Frankfurt-am-Main, treated five

patients using a photosensitizing drug called SQN 400.

This agent, manufactured by Scotia QuantaNova (SQN), is

activated by infrared light at a wavelength of 740

nanometers. SQN 400 is the trade name of a chemical

called meta-tetra(hydroxyphenyl) bacteriochlorin

(mTHPBC), which is a chemically modified form of

chlorophyll, or chlorin.

 

 

All patients in the study had colorectal cancers that

had spread to the liver, and all had been treated

previously with chemotherapy. One had also received

radiation therapy, and another had undergone the

surgical removal of half his liver.

 

 

Laser light was delivered through a catheter five days

after the injection of the photosensitizer. Dr.

Engelmann reported complete destruction of the cancer

in three of five patients at follow-up examination

three months after treatment.

 

 

There were some serious side effects with SQN 400.

Patients had to avoid bright electrical light for

several days and direct sunlight for four weeks

following treatment, due to the drug's photosensitizing

effect and its slow elimination from the body. Three of

the five patients reported local pain during injection.

One reported that pain then spread to the shoulder.

Several patients experienced minor burns.

 

 

There are some significant differences between PDT

using SQN 400 and Cytoluminescent Therapy (CLT) using

PhotoFlora. PhotoFlora is absorbed and eliminated more

quickly, and therefore has fewer side effects and less

discomfort. Also, the source of light in CLT is

whole-body red and infrared light that is administered

externally, not through fiber optic catheters, making

for a noninvasive procedure.

 

 

Despite the differences, this study does show that the

combination of light at high wavelengths and green

chlorin-based photosensitizers is a promising cancer

treatment. In the authors' words, " This pilot study

establishes that the procedure…can eliminate metastatic

liver tumors in some patients. " But as they properly

point out, more study is needed to see how useful the

treatment is when compared with other ways of

eliminating liver tumors.

 

 

==========

 

 

Life Lessons from Long Ago

 

 

 

Many years ago, I lived in an apartment house in

Sheepshead Bay, Brooklyn. It was exceptionally well

run. The superintendent was a modest, soft-spoken man,

self-confident in his abilities. Unlike other supers I

had known, he replied courteously to one request after

another. I didn't have to bribe him to do his job.

 

 

**Please view picture of Sheepshead Bay at:

http://www.cancerdecisions.com/images/sheepsh.gif

 

 

One day, just after New Year's, I identified nine

things around the house that needed fixing. I

prioritized my list on the back of an envelope and took

it down to his first-floor apartment. I was happy at

the prospect that all these little tasks, which I had

neglected for months, would now be fixed. The super

greeted me courteously at the door of his apartment,

and I handed him my " shopping list. " He glanced from

item to item, considering each one in turn. Then he

handed the envelope back to me, said, " I'm not going to

do all this, " and closed the door in my face!

 

 

I returned to my apartment, list in hand, angry and

ashamed. Some time later, I took the first item on the

list and, bracing myself for a fight, knocked on his

door. He answered it courteously, as always, as if

nothing had happened between us. I then presented him

with my single request. That afternoon he promptly

repaired the living room radiator. Some time later, I

presented the second request, and so forth. Eventually

everything got done.

 

 

This occurred 25 years ago, and I can no longer recall

the name of this superintendent. Too bad. I'd like to

send him a holiday greeting because he taught me an

important life lesson. No matter how urgent your own

needs, other people also have their own needs and

limitations. If you overwhelm someone with your own

needs, no matter how justified, you can strain or

short-circuit the entire relationship.

 

 

Since that time, I have tried to present a person with

one problem at a time. When that is finished, we can go

on to the next problem. I admit, in the onrush of

events, I do not always remain conscious of this rule.

But when I forget, failure usually catches me up short.

 

 

Recently, I watched a budding relationship between two

intelligent people break up disastrously when one party

presented the other with a huge list of questions, each

of which implied or required remedial action. Each

question in and of itself was perfectly reasonable. But

the cumulative load blew the circuits and angry words

were spoken, leading to hard feelings that may last a

lifetime. If you want to avoid such disasters, remember

that people cannot do more than one thing at a time.

 

 

 

To Catch a Rat

 

 

 

I learned another important life lesson at this

apartment house. Although our super and his staff kept

the building spic-and-span, it was situated across the

street from Sheepshead Bay, the source of a number of

problems. Sometimes, for instance, a family of

waterfront rats would take it into their collective

head to invade the building's warm and inviting

basement. Who could blame them?

 

 

The super put out traps, but also instructed the staff

to be vigilant. One day, looking up from my IBM

Selectric, I saw one of our handymen chasing a big gray

rat out of the basement. The man brandished a stick at

the fleeing rodent. The rat was determined to save its

skin, and so it zigzagged its way between the cars and

across Emmons Avenue onto Plum Beach. This was not

unexpected behavior from a rat. But what amazed me was

how the handyman executed a perfect imitation of the

zigs and zags of the rat, until, following in his

tracks, he felled him with a thundering blow.

 

 

I had a kind of epiphany and quickly wrote this

short poem:

 

 

To catch a rat

A man must run like a rat.

 

 

This turned into one of my hard life lessons. You see, I

had had a wonderful academic education, but it had left

me unprepared for the problems of the real world. In

particular, years in academia had left me thinking that

life was logical, and that one should proceed straight

towards any goal. I was finding out, painfully, that

the world didn't work that way. It wasn't filled with

straight shooters and rats didn't play " according to

Hoyle. " I knew this handyman well. He didn't have much

formal education, but he was involved in the daily

struggle to keep the rodents at bay. His eloquent body

language taught me the fundamental need to zig and to

zag when confronting life's difficulties. Especially

those involving rats.

 

 

 

---Ralph W. Moss, Ph.D.

 

 

======================

 

 

References

 

 

Thomasson WA. Pilot study suggests photodynamic therapy

effective for liver metastases. Doctor's Guide News,

December 5, 2002.

 

http://www.docguide.com/news/content.nsf/news/8525697700573E1885256C86004EE65C?O\

penDocument & id=48DDE4A73E09A969852568880078C249 & c=Radiology & cont=10

 

 

Rovers JP et al. In vivo photodynamic characteristics

of meta-tetrahydroxyphenyl bacteriochlorin. Paper 171.

Presented at the American Society for Photobiology 28th

Annual Meeting, San Francisco, CA, July 2, 2000.

 

http://www.pol-us.net/ASP_Home/Meetings/Annual2000/Sunday/view_abstract171.html

 

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

 

IMPORTANT DISCLAIMER

 

 

The news and other items in this newsletter are

intended for informational purposes only. Nothing in

this newsletter is intended to be a substitute for

professional medical advice.

 

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