The future holds good news for psoriasis patients

Psoriasis affects between 6 million and 7 million Americans, and while it is a condition of the skin, it leaves the patients with emotional issues due to the change in their appearance. The condition presents itself as raised, thickened patches of red skin covered in silvery-white scales. It can affect any part of the body including the nails and the scalp.

In addition to the creams that have long been available to treat the condition, the FDA has recently approved a foam called clobetasol propionate. In this form, it can penetrate the skin easily and is not as messy as many of the other medications. The medication has been found especially useful in treating the scalp, the upper torso and the extremities.

While most topical creams used to treat psoriasis have been corticosteroids, a new variety of non-steroidal creams are now available. These include Tazarotene, a cream made from vitamin A that has until recently only been available as a gel. Also, topical immunomodulators such as tacrolimus ointment are showing success in treating psoriasis on the face and other sensitive areas.

Finally, two drugs that have been used to treat Crohn’s disease, remicade and etanercept, are proving effective in treating psoriasis. These interfere with specific immune responses and have fewer side effects than other similar drugs.

The latest developments in psoriasis therapies are really a positive step forward in finding innovative ways to treat this chronic skin condition.

SOURCE: American Academy of Dermatology Summer Scientific Meeting in New York, July 31-Aug. 4, 2002

All Medicine is Not for Women

How much thought do you give the medication you’re taking? Even if it’s safe when used alone, it could suddenly become unsafe when used in combination with another drug. That can be especially true for women.

Men and women are, quite literally, different at heart. It’s the timing between heartbeats that separates the sexes — and it’s enough to cause a woman’s heart to overreact to some medications.

They notice there’s something funny about the heartbeat, or they’ll get dizzy or faint. Most women — and even some doctors — don’t know that certain drug combinations can trigger a problem. The four types of drugs that possibly could cause this problem, especially if taken in combination, are the non-sedating antihistamine category, some antifungals and antibiotics, some antipsychotic drugs, and, ironically, some drugs that are given to correct an abnormal heart rhythm.

Until drug labeling and awareness catch up with research, women need to be their own advocates. The best thing to do is simply talk to your doctor about it and ask whether these are drugs that can cause this problem, and, if so, should you be concerned.

Vitamins, herbal supplements, even certain foods like grapefruit juice can affect the way drugs work. So keep a list in your wallet of everything you take, and once a year. Take them to your doctor’s office, line them all up and say, ‘These are all the drugs I take. Are there any potential problems here? Is there anything here I could stop taking?

Careful drug management can help ensure the medications you’re taking are doing what they’re supposed to.

If you’re taking medications, don’t ignore any unusual symptoms. Tell your doctor how you’re feeling, so he or she can report the symptoms and drugs to the FDA. Responsible reporting will help you — and possibly millions of other women — take medication safely.

What are the downsides of using alternative medicine?

It is important to use the advice of a competent, licensed provider and be certain that all of your providers know everything you are doing

There are several important caveats for patients, First, not all cam providers are competent. A naturopathic physician licensed in a competent licensing jurisdiction is trained and regulated to physician standards.

Second, when using conventional and cam treatments together, it is important to be certain that there are no interactions. “Cam therapies can reduce side effects and even help some conventional treatments to work better but, when combined incorrectly with conventional treatments, they can interfere with the therapeutic effect, worsen side effects and reduce the chances of a positive outcome.”

As long as it is down responsively, and involves all of the practitioners, and everyone knows what everyone else is doing, then there are few downsides to using integrative medicine.

What treatments are being used outside the United States that are not used here?

Some therapies that are used worldwide are not approved for use in the United States, and may be difficult to find in this country. One is the anti-cancer drug Laetrile, a treatment first used in the 1920s, but not approved by the FDA as a cancer therapy. While a few doctors may offer it in this country, most patients desiring laetrile treatment go south of the border to Mexico, where it is an approved cancer treatment. Hydrazine sulfate, a treatment that has been investigated for the past 30 years, is commercially available in this country. But since it is not FDA approved as a cancer treatment, it must be offered as a food supplement.

Most treatments, though, are widely available here. There are new therapies coming out all the time, from Europe, Asia, South America and so on, but they’re small incremental things rather than a revolutionary advance.

Most of the cam treatments available in Europe are also available here. The FDA has rejected the importation of some treatments for safety, manufacturing and labeling reasons, but they are few compared to those that are available.

What do doctors not tell patients about using alternative therapies?

Until very recently, the majority of medical schools did not include any information about therapies beyond the Western model. As a result, many doctors were left unprepared to deal with the questions their patients were asking about alternative therapies. And because many therapies do not fit the model that doctors have been trained in, and cannot be “scientifically explained,” they often dismiss these treatments as snake oil.

Many conventional providers are wary of cam treatments because of a bad experience or their lack of knowledge about cam therapy effects on their treatments.

Doctors don’t acknowledge that there are a number of things that patients can do to build up their own systems and make themselves feel better. A lot of techniques have been ignored by doctors. It’s not enough just to hand someone statistics and say here are the chemo drugs I’m going to use — you have to look at a person as a whole, and look at how to treat every system in the person’s body and teach them, to some degree, to take charge of their own healing.

However, Dr. Labriola points out the experience at his practice, the Northwest Natural Health Specialty Care Clinic, provides some interesting insight into how conventional doctors view cam providers. “We receive many referrals from conventional medical specialists,” he says.” They tell us that they have confidence in us because they are familiar with our practice, our expertise with interactions and the fact that we are actually published in scientific journals on the subject of interactions and integrative care.”

“It has been our experience that conventional medical physicians are willing to say a whole lot more about cam therapies when they have the confidence that the patient can receive the benefits without being exposed to the risks of incorrect treatment,” he adds.

When are alternative treatments better than Western medicine?

A recent survey by the Fred Hutchinson Cancer Research Center in Seattle found more than 70 percent of adult cancer patients in Washington used alternative therapies and almost all report substantial improvements in well-being as a result of it. While some patients used alternative medicines to treat their cancer, most therapies were used to enhance overall health and well-being.

Many patients also turn to alternative modalities when they have exhausted options in conventional medicine, or if standard treatment is basically unavailable, such as an inoperable tumor, or if conventional options may only be minimally effective at best with a very high degree of adverse events.

“The best clinical outcomes occur when conventional western treatments and complementary and alternative medicine (cam) therapies are combined,” says Dan Labriola, ND, a Seattle based naturopath and nationally known cancer therapy expert. “Conventional interventions tend to be more effective in critical care situations whereas cam treatments can outperform Western medicine with some chronic disease and diagnoses, especially where it is important to utilize the least invasive treatment.”

Dr. Gaynor cautions about terming treatments as better or worse than one another. “I think it makes it makes a lot of sense to use them in conjunction with western medicine because every modality of treating a difficult disease like cancer is limited but can have an effect.”

As an example, he points to chemotherapy, which works predominantly by damaging cancer cells. “It’s not capable, for the most part, of killing every last cancer cell,” he says. “And we know that the immune system is very important in fighting cancer and we know that that it is better able to recognize a damaged cell than one that hasn’t been damaged by chemotherapy.”

Use of Alternative Medicine

Alternative or complementary medicine, often referred to as integrative medicine, includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments and alternative when it is used instead of them.

Use of alternative or complementary medicine has grown tremendously in the United States over the past decade. Some studies report that the percentage of Americans using alternative therapies rose from 34 percent in 1990 to 69 percent in 1998. Alternative therapies have become increasingly popular among patients with chronic illnesses, including cancer. Early pioneers, such as renowned oncologist O. Carl Simonton, introduced the idea that one’s state of mind could influence the ability to survive cancer.

In addition to the mind/body connection, alternative medicine encompasses a wide variety of modalities, including diet, vitamin supplements, herbs, Traditional Chinese Medicine, ayurveda, homeopathy, massage therapy, chiropractic, etc.

There have been a number of alternative therapies developed specifically for cancer treatment. One such treatment involves using antineoplastins, a naturally occurring group of amino acids, and is a relatively non-toxic therapy developed by Stanislaw R. Burzynski, MD, Ph.D. He administers this therapy at his Texas clinic.

According to Mitchell Gaynor, M.D., director of Integrative Medicine at the Strang-Cornell Cancer Prevention Center in New York City, the most common therapies used by cancer patients are usually a combination of both nutritional and mind/body treatments. “That can involve anything from vitamins and herbs to meditation, yoga, or body work such as acupuncture,” says Dr. Gaynor.

“In my experience,” he adds, “Which may be due to the nature of our center, most patients are doing both — conventional and complementary. We call it integrative therapy.”

Alternative Treatment for Cancer Patients

Dietary supplements continue to grow in popularity, especially among cancer patients. It is estimated each year consumers spend between $10 billion to $12 billion on pills. While many experts say supplements have their benefits, here is one doctor who tells her patients not to rush to the supplement aisle.

It’s shopping day for Bobbie Horne. As a breast cancer patient, her diet is important. “My goal right now is to keep it away and I guess that’s why I’m taking such an interest in everything that I’m putting in my body,” she tells Ivanhoe.

Horne says the diagnosis was no surprise. “In fact,” she says, “I told the doctor that I’ve been waiting 30 some odd years for this.”

Her mom died from breast cancer at 58. Now in remission, Horne is one of 80 percent of cancer patients who hopes supplements will keep her alive.

“Most of all it’s desperation and some sort of taking control of the situation,” clinical nutritionist Nagi Kumar, Ph.D., of Moffitt Cancer Center in Tampa, Fla., tells Ivanhoe.

Kumar is from India. As a scientist, she says patients should not take supplements. “The science isn’t there for any of them really,” she says.

For example, one popular alternative treatment for cancer patients is shark cartilage.

Horne says, “I started taking that because I was told and had read somewhere that sharks don’t get cancer.”

Kumar warns against it. she says, “This is not effective in preventing or curing cancer.”

Soy is recommended for women to prevent breast cancer, but Kumar says cancer patients like Horne should avoid soy.

Some stores have set up computers to provide more information about specific supplements. Still, d Kumar says your best bet is to stick to the produce aisle. She also says a big issue is taking mega doses of supplements. She says more isn’t always better. For example, too much garlic or vitamin E can cause bleeding problems.

Source: Ivanhoe News