Pediatric+Oncology

=Pediatric oncology= Leukemia Lymphomas Neuroblastoma Brain Cancers Surgery prep Wilms' Tumor Bone Cancers Osteosarcoma Retinoblastoma Rhabdomyosarcoma Germ Cell Tumors
 * Most common pediatric cancers:**

Underlying Causes:

Leukemia
(http://www.acor.org/ped-onc/diseases/germcell.htm)/ The Leukemia & Lymphoma Society • 1311 Mamaroneck Avenue • White Plains, NY 10605 Information Resource Center (IRC) 800.955.4572

Leukemia is a cancer of the bone marrow, the spongy center of the bones that makes blood cells. In leukemia, abnormal white blood cells divide out of control and crowd out the normal cells in the bloodstream. The abnormal white blood cells are not mature, and therefore cannot carry out their infection-fighting function in the blood. These cells crowd out healthy white blood cells, as well as the red blood cells which carry oxygen to the body and the platelets which cause the blood to clot.

The most common type of leukemia in children is acute lymphocytic (or lymphoblastic) leukemia or ALL, which is further characterized as pre-B, B, or T-cell ALL. Childhood acute myeloid leukemia or AML is less common. "Acute" means that the diseases progress rapidly. The chronic forms of these leukemias, CLL and CML respectively, are seen almost solely in adults. In general, acute leukemias are most prevalent in children and are therefore often referred to as "childhood leukemias". ALL: acute lymphocytic leukemia (pre-B, B, or T-cell). AML: acute myeloid leukemia Types of white blood cells
 * What are the different types of childhood leukemia?**

In acute lymphocytic leukemias, the B- or T-lymphocytes are growing out of control. In acute myelogenous leukemias, the granulocytes are growing out of control. lymphocytic (ALL): uncontrolled growth of B- or T-lymphocytes myelogenous (AML) (granulocytic): uncontrolled growth of granulocytes In all of the leukemias, immature white cells (undifferentiated stem cells) crowd out the good cells. Since they crowd out the red blood cells, a person with leukemia is anemic, without enough red blood cells to carry the necessary oxygen or energy to the body. That's why fatigue is a sign of leukemia. The leukemia cells also crowd out the platelets, so if a person with leukemia is cut, the bleeding does not stop as readily. They also bruise easier. Since the blasts are immature, non-functioning infection fighting cells, a person with leukemia is easily susceptible to infection

Symptoms of leukemia include:
Fatigue Malaise (vague feeling of bodily discomfort) Abnormal bleeding Excessive bruising Weakness Reduced exercise tolerance Weight loss Bone or joint pain Infection and fever Abdominal pain or "fullness" Enlarged spleen, lymph nodes, and liver

Treatment for childhood leukemias
-ALL. The primary treatment for newly diagnosed ALL is combination chemotherapy. Radiation and bone marrow transplantation may be used in some cases. -Treatment begins with an intense treatment called "induction" with a combination of several chemotherapy drugs, usually cytosine arabinoside, vincristine, prednisone, L-asparaginase, and daunorubicin. -The goal of induction is to kill most of the leukemia cells; most patients do not have any leukemic cells in the bone marrow at the end of induction. (At least, not detectable in a light-microscopic examination of stained bone marrow smear.) -The next phase is called "consolidation" in which a different combination of drugs is administered, usually methotrexate, cyclophosphamide, cytosine arabinoside, mercaptopurine, and prednisone.

--"Maintenance" follows, in which the chemotherapy is lessened to a few of the drugs administered less frequently. --Maintenance is generally well tolerated by the patient. Often a period of maintenance is followed by another cycle of induction-consolidation, called "re-intensification". --Total therapy lasts from two to three years. --**AML** -In general, newly diagnosed AML is initially treated more aggressively than is ALL. --Intensive chemotherapy followed by bone marrow transplantation is becoming the first treatment chosen, especially when a suitable donor is available. --After the intensive chemotherapy and/or bone marrow transplant, children with AML do not go on maintenance; studies have shown that AML children in remission have had as much chemotherapy as their bodies can tolerate, and additional maintenance chemotherapy does not benefit them.

Cytarabine or cytosine arabinoside:
//More Common Side Effects:// Decreased white blood cell count with increased risk of infection - can be treated w/ maitake mushroom (1drop/kg.) Decreased platelet count with increased risk of bleeding - can be treat w/ black sesame seed Nausea - can treat w/ ginger, ST-36, PC-6 Vomiting Tiredness (fatigue) - carmatine treatment [in red meat] Sores in mouth or on lips - treat w/ honey or popsicles

//Less Common Side Effects:// Mild diarrhea - seacure works well, heals gut lining Decreased appetite Rash Hair loss - cold caps can help Fever Muscle and bone aches - Tx with ST-36, SP-6 & regular points Liver toxicity Can use all vitamins plus quercitin Vincristine: SE: numbness and tingling – plus above SE - for peripheral neuropathy: preventatively Tx w/ glutamine (30gm.) Use with Ginseng, Vitamin C and fish oil, maitake mushroom (1 drop/kg.)

CoQ10 & carnanine can help prevent Heart damage from Perceptin or anything else that causes cardiac damage

Use with Astragalus, PSK 1000-3000mg, and Ashwaganda 300mg bid–for cell blood counts; melatonin to increase anti cancer actions and reduce SE. Avoid using with Curcumin (reduces antitumor effects) and Quercitin Relapsed leukemia. Relapse, or recurrence of leukemia, can occur anytime during therapy or after completion of treatment. Generally, it is more difficult to cure a child after relapse of the leukemia; relapse during or soon after the completion of treatment is considered less favorable than relapse a year or several years after treatment. Treatment depends on the site of relapse, whether it is in the bone marrow, central nervous system, testes, or other locations. Aggressive chemotherapy and radiation treatment, often followed bone marrow transplantation, are used to treat relapse of childhood leukemia.
 * Cyclophosphamide:** SE: same sxs, plus bladder problems

Statistics
Leukemia accounts for approximately 35% of all childhood cancers Approximately 1 in 1000 children will be diagnosed with leukemia by the age of 19 It is more common in children under the age of 10 The five year survival rate for children diagnosed with leukemia and subsequently treated is approximately 70% 2500 cases of leukemia are diagnosed per year in the US

Kristopher Schmidt, 6, of Lake Villa with his mother, LeAnn Schmidt. Kristopher is battling acute myeloid leukemia and will undergo cord blood treatment Dec. 10. (Marina Samovsky/News-Sun)

Diet
-It is important to eat foods that provide optimal nutritional benefit. A person trained in effective nutrition therapy should work with the patient and family to develop an individualized meal plan. -Selections include fish, poultry, legumes, low-fat yogurt, fruits and vegetables, whole grains and cereals, and other healthy food choices. -Eat organically-raised foods and foods that support detoxification, immunity, and are high in antioxidants: beets, carrots, artichokes, yams, onions, garlic, yellow and orange vegetables, shiitake mushrooms, sea vegetables, green tea, filtered water, dark leafy greens, and whole grains. -Avoid refined foods, sugar, alcohol, caffeine, and saturated fats (animal products). -Eliminate organ meats and processed meats. No sugar or bad fats

Children eating 12 hotdogs/month have 10 times the risk of Leukemia Kids eating hamburgers, bacon and cured meats – sausage have 3x risk of lymphoma Ground meat 1x/week has 2 times the risk of ALL.

Books: Preventing & Tx Cancer by Murray I use Patrick Quillon’s book : Beating Cancer With Nutrition The CD is great too.

Shake recipe: liquid, -4-8 oz, Protein 4T, vegetables (carrots, beets, broc, caul, cabbage, tomatoes, onions, asparagus, spinach, kale, …, Thicken – 2T frozen bananas, applesauce, agar, guar, gelatin, ice cubes, and can add: MCT (weight gain), lecithin, greens powder, aloe, perfect7, Vit/min powder, immune pwr, cod liver oil

Supplementation
Vitamin and mineral supplements help provide nutrients that diet may not, and offer a boost where illness may have depleted the body. A supplementation plan includes nutrients that may support the immune system and may reduce toxic side effects. At CTCA practitioner will recommend daily dosages of various nutrients, including: Beta carotene – not with Cis-platinum Selenium 100-200mcg Vitamin C 1000-2000 tid Eicosapentaenoic acid (EPA) 1gm/d Vitamin E 400iu mixed tocopherols Multivitamin with no iron

Nutritional Support
-Patients unable to eat or digest food, may be provided parenterally (through a vein) or enterally (through a feeding tube). Ideally nutrition/metabolic support team  comprised of their physicians – MD and ND, nurse, counselor if needed and pharmacist  works closely with the patient. -I have sometimes worked with kids that could not eat. We accessed their G (gastric) tube to put in herbs. Essiac is the one I’ve used most, but often I will use other supplements as well, especially in young ones and failure to thrive. Body Cleansing for kids Parasites cleanse Dental cleanup .. Kids older then 8 may need dental cleanup (amalgam) and liver cleanse Liver support – be careful, this can interfere with chemo

Aplidin (Marine substance) Effect of Aplidin in acute lymphoblastic leukemia cells The cytotoxic effect of Aplidin was investigated on fresh leukemia cells derived from children with B-cell-precursor (BCP) acute lymphoblastic leukemia (ALL). In ALL cell lines Aplidin was cytotoxic at nanomolar concentrations. In the ALL cell lines the drug-induced cell death was clearly related to the induction of apoptosis and appeared to be p53-independent.

Aplidin treatment caused a block of vascular endothelial growth factor (VEGF) secretion and down regulation of VEGF-mRNA,

Bovine lactoferricin selectively induces apoptosis in human leukemia and carcinoma cell lines and kills them in vitro The mechanism by which LfcinB causes the death of cancer cells is not well understood. Increases Interferon, binds iron delivers to tissues in need. VitE/A/C may interfere –Herbs?

Boswellic acid acetate induces apoptosis through caspase-mediated pathways in myeloid leukemia cells Morphologic and DNA fragmentation assays indicated that the cytotoxic effect of boswellic acid acetate was mediated by induction of apoptosis. More than 50% of the cells underwent apoptosis after treatment with 20 µg/mL boswellic acid for 24 hours. This apoptotic process was p53 independent. Mol Cancer Ther. 2005;4:381-388

Piplartine induces inhibition of leukemia cell proliferation triggering both apoptosis and necrosis pathways. The plant grows all over India, in evergreen forests and is cultivated in Assam, Tamil Nadu and Andhra Pradesh.

The botanical name of pippali is piper longum and it belongs to family piperaceae. “Bi Ba” The research findings suggest that piplartine can suppress leukemia growth and reduce cell survival, triggering both apoptosis and/or necrosis, depending on the concentration used. Toxicology in Vitro Volume 21, Issue 1, February 2007, Pages 1-8 doi:10.1016/j.tiv.2006.07.007

Nakaya and his colleagues observed in laboratory experiments that an extract from the roots of the Sophora subprostrata Chun et T. Chen plant caused apoptosis in human leukemia cells. Other flavonoids: Grapes/ Polygonum cuspidatum June 20th issue of the International Journal of Cancer.

Donny Yance and his company Natura takes a very scientific approach to address cancer cell pathways

GreenTea & VEGF Receptor : CLL Oridonin Inhibits Lymphoid Ca Cells (Rabdosia Rubescens) ~Oridonin, a diterpenoid purified from Rabdosia rubescens, (Dong Ling Cao) inhibits the proliferation of cells from lymphoid malignancies in association with blockade of the NF-B signal pathways.

Cannabidiol-induced apoptosis in human leukemia cells In this study, the effect examined of the non-psychoactive cannabinoid, on the induction of apoptosis in leukemia cells.

Essiac: It is thought that essiac was used by Native Americans for the purpose of treating various maladies. Rene Caisse, a nurse, was given this formula by one of her patients who were using it to treat her own cancer. Although her cancer was cured, this version of the formula did not help a good many others who tried it. The eight herb formula Rene Caisse revealed to Dr. Charles Brusch contained: Burdock Root, Blessed Thistle, Kelp, Red Clover, Sheep Sorrel, Slippery Elm Bark, Turkish Rhubarb Root, and Watercress. Brusch performed eight years of clinical research on this oral form of essiac.

SUMMARY:
Selenium 100-200mcg Vitamin C 1000-3000mg/day Eicosapentaenoic acid (EPA) 1-2gm/d Vitamin E 200-400iu mixed tocopherals Multivit Parasites cleanse GI health panel to check for parasites -also consider Lyme’s disease Dental cleanup .. Kids older then 8 may need dental cleanup (amalgam) and liver cleanse: Detox - mediclear Boswellia -Dosages depend on the strength of the herb or supplement used Aplidin Bovine lactoferricin

Coriolus versicolor (Yunzhi) – with caution? (stim immune system) -3000mg - adult Piplartine [Black Pepper] Flavonoid - Sophora [Ku Shen] Resveratrol, as well as the hydroxylated analog piceatannol Epigallocatechin-3-gallate (EGCG) –green tea Oridonin - Rhabdosia long dan cao] Cannabidiol Carnitine Melatonin Curcumin and quercitin Case: Luke

Find the drivers and treat them BCL2 inhibits Apoptosis. Quercitin, ellagic A. And Resveratrol Counter this.

Viruses, chemicals Bad foods… induce BCL2 GENES & inflammatory markers

Cytochrome p450 Breast and P ca: assoc w/ Cytp1A1, 1B1 (Berries), COMT, NAT2, GSTM, SOD (track Cyp3A4 for chemo functionality, Cyp2D6 – (Tamoxifen), CYP2C19 (concomitant meds) Current research w/: CYP3A5, CYP17, CYP19, UGTA1, SULT1A1, 17hydroxysteroid-dehydrogenase, COMT, GST, ESR1, ESR2 1A1 – estrogens, Prozac -had 2-4x increases B Ca (increases estrogen breakdown) (broccoli family) 1A2 – reduced by I-3C 3A4 – Grapefruit increases detoxification activity, metabolizes A,C, &T, Femara  slower metabolism (more side effects and more problems with grapefruit, milk thistle 2D6 – Parkinson’s, tamoxifen, ` codeine - morphine 2C8 &2C19 pathways are involved with Doxorubicin metabolism: Eleuthero inhibits metabolism possibly by inhibition of cyt p450 2C19

NHL (Non-Hodgkin's Lymphoma)
The three types of NHL that occur most often in children are: lymphoblastic: Predominantly T-cell origin, sometimes hard to distinguish from leukemia; 30% of childhood NHLs. small noncleaved cell lymphoma (Burkitt's and non-Burkitt's): B-cell origin, cALLa; 40-50% of childhood NHLs. large cell lymphoma A heterogeneous group B lineage and T lineage, some are like both T and B; 20-25% of childhood NHLs.

Treatment for Lymphomas
The treatment for all types of lymphoma depends on type, stage, and grade of disease. The types are listed in the descriptions and the embedded links. The stages and grades are outlined below. Stages: I cancer site, no bone marrow involvement II two sites, both either above or below the diaphragm; no bone marrow involvement III sites above and below the diaphragm; no bone marrow involvement IV bone marrow is effected or the cancer cells have spread outside the lymphatic system B fever, weight loss or night sweats A absence of fever, weight loss or night sweats E disease has spread to organs outside the lymph system Grades: high: usually found in B-cell and T-cell types intermediate: usually found in B-cell and T-cell types low: predominantly found in B-cell types

Lymphomas are usually treated by a combination of chemotherapy, radiation, surgery, and/or bone marrow transplants [ Satya always uses glutamine 30gm. with bone marrow transplant patients and they bounce back much faster]. The cure rate varies greatly depending on the type of lymphoma and the progression of the disease. Hodgkin’s Lymphoma (EBV induction is seen) is treated often with methotrexate. Pediatric ports Methotrexate: SE: Decreased blood counts, N&V, mouth ulcers, skin rashes and photosensitivities, dizziness, HA, drowsiness, Kidney damage, liver damage, hair loss, seizures. Use: Soy – helps gut, fish oil, VitE – Increases anticancer effects, Dietary folate. No Kava – (Liver), and ASA – increased toxicity.

When someone is very bone marrow suppressed Satya give maitake mushrooms at high dose of 1 drop/kg. [60lbs =~28kg.]

Non-Hodgkins Lymphoma: Rituximab (Rituxan®), which recognizes the antigen CD20, has been approved by the Food and Drug Administration (FDA) for the treatment of some types of non-Hodgkin's lymphoma (e.g., relapsed or refractory low-grade lymphoma, follicular lymphoma, CD20 positive lymphoma, B-cell non-Hodgkin's lymphoma). In most cases, patients receive once weekly intravenous (IV) antibody treatments over a 4 - 8 week period. Side effects associated with the use of antibodies may occur rapidly after the first dose and often involve fever, nausea, headache, and chills/rigidity. Severe infusion reactions and hypersensitivity reactions, which are fatal in some cases, also may occur.

Seems to reduces Rituxin's side effects Surgery Genistein Green tea Carnitine Melatonin [questions about this now, unlikely to use] Flavonoids compounds: grape, curcumin, quercitin, pomegranite

-Vitamin C (250 to 500 mg twice per day), vitamin E (400 IU twice per day), beta carotene (50,000 IU one to two times per day), coenzyme Q10 (100 mg three times per day), and zinc (30 mg per day) -Coenzyme Q10 and L-carnitine (600 mg three times per day) may reduce toxicity from chemotherapy -Selenium (200 mcg twice per day) and glutathione (500 mg twice per day) may reduce toxicity from chemotherapy -B-complex (50 to 100 mg) for stress -Juicing: In a juicer, combine equal parts romaine lettuce, green pepper, celery, parsley, cucumber, and apple or pear (for flavor). Use organic fruits and vegetables. Drink one glass per day. -Herbs: - Can use the same as leukemia

Neuroblastoma
Neuroblastoma is a cancer of the sympathetic nervous system, a nerve network throughout the body that carries messages from the brain. Neuroblastoma is a solid, malignant tumor that manifests as a lump or mass in the abdomen or around the spinal cord in the chest, neck, or pelvis. Neuroblastoma is often present at birth, but is most often diagnosed much later when the child begins to show symptoms of the disease. A condition known as "opsoclonus-myoclonus syndrome" can sometimes be a symptom of neuroblastoma. [bilateral amblyopia] It is bursts of rapid and involuntary, chaotic eye movement in all directions. It's important to note that not all children with this syndrome have neuroblastoma. In the majority of cases (73%), neuroblastoma has already spread to areas outside of the original site at the time of diagnosis.

Diagnosis of neuroblastoma can be complicated. It has been called the "great masquerader" because its symptoms mimic so many other diseases. Even a pathological study (biopsy) might reveal cells that can resemble other small round blue tumor cells, like lymphomas and rhabdomyosarcomas. Only a pathologist familiar with neuroblastoma can distinguish the difference (and neuroblastoma is rare). Other characteristics of the suspected neuroblastoma cells can be studied by immunohistochemistry and electron microscopy. In about 90% of cases of neuroblastoma, elevated levels of catecholamines or its metabolites are found in the urine or blood. Catecholamines and its metabolites include dopamine, homovanillic acid (HVA), and/or vanillylmandelic acid (VMA).
 * Diagnosis**

Chemotherapy, surgery, radiation, and autologous bone marrow transplantation has been the mainstay of treatment for neuroblastoma. “Promising new approaches used in various clinical trials across the continent include”: Immunotherapy using monoclonal antibodies. Therapeutic dosing of I-131 mIBG, sometimes in combination with chemotherapy. Vaccines that attempt to initiate the immune system against the disease, including IL-2. New combinations of anti-cancer drugs, such as BSO/melphalan. A derivative of vitamin A, called fenretinide. Tandem (or "back-to-back") transplantation.

5%-7% of all childhood malignancies about 1 in 6000 children will be diagnosed with neuroblastoma by the age of five 1 in 100,000 per year in US The average age at diagnosis is two About 25% of newly diagnosed neuroblastomas are found in children under the age of one Children under the age of one have a cure rate as high as 90%.
 * Statistics**

Surgery preparation and support are essential and would be: Good rest, and good nutrition Avoid toxics that could deter healing Two weeks prior no: VitE, fish oil One week prior: garlic, ginkgo, Panax ginseng Three days prior no: valerian, silymarin, St John’s, echinacea, kava, garlic With biopsies and surgeries for solid tumors modified citrus pectin – reduces metastasis from surgical procedures Probiotic Arnica for bruising – homeopathic or cream VitC, zinc, copper, selenium, bromelain, flavonoids Colostrum for kids.

Radiation therapy. Both high dose X-rays (external beam) and radioisotopes through thin plastic tubes, (internal radiation) therapies may be used. Radiation support: Multimin 2 green drinks/day VitC 500-1000mg tid –adults VitE 400-800 iu adults Continue for 1mo after radiation, then take a flavonoids – quercitin or curcumin, Echinacea Maitake D fraction 1mg/2.2lb or PSK? PSK 300mg continue until remission then reduce in half Melatonin 20 mg bedtime 1 week prior to radiation and then 1 week after and continue until remission Alkylglycerols - Ecomer 1200 mg/day –adults during radiation and then 600mg until normal WBCs Ginkgo Consider : Cat’s Claw specifically for neuroblastoma

Chemotherapy. Common chemotherapy agents are: daunorubicin, cyclophosphamide, carboplatin, and epotoside. Use: Daunorubicin : L-carnitine and CoQ10 for heart protection, green tea, melatonin and VitD No NAC (chemo resistance) or herbs (conversion interfence) SE: hair loss, mouth ulcers, dec blood cells, N/V, Heart damage and facial flushing

Cyclophosphamide: astragalus: ashwaganda, and PSK (WBC), avoid curcumin and quercitin Carboplatin – Vit C, E, D Milk thistle Agaricus Blazeii/ PSK Alpha lipoic acid - nerves and hearing Ginger VitK Avoid NAC, L-Glutathione, and milk thistle

Nausea and vomiting are less severe and more easily controlled, compared to the incessant vomiting and antiperistalsis that some patients using CISplatin may experience. (Feverfew improves effects) CARBOplatin has also proven effective in some strains of cancer that may not be susceptible to CISplatin, including germ-line cell, small and non-small cell lung, ovary, and bladder cancers, as well as acute leukemia.

The main drawback of CARBOplatin is its myelosuppressive effects. This causes the blood cell and platelet output of bone marrow in the body to decrease quite dramatically, sometimes as low as 10% of its usual production levels. The nadir of this myelosuppression usually occurs 21-28 days after the first treatment, after which the blood cell and platelet levels in the blood begin to stabilize, often coming close to its pre-CARBOplatin levels. This decrease in white blood cells (neutropenia) can cause complications, and is sometimes treated with drugs like filgrastim. The most notable complication of neutropenia is increased probability of infection by opportunistic organisms, which necessitates readmission to hospital and treatment with antibiotics.

Etoposide. Use Vit E, C, D Avoid herbs and Vit K Bone marrow transplantation. Autologous BMT may be used following aggressive chemotherapy. – Treat with glutamine

Brain tumor is a leading cause of tumor death, which has poorer survival rates than other cancers, benign or malignant alike. A traditional Chinese drink has been proved to be an effective treatment in inhibiting brain tumor growth. For thousands of years, two plant fruits, lycium barbarum and ligustrum lucidum, have been taken as drinks in many Chinese' daily lives. Chinese clinical studies have proved the ingredients in these two plant fruits are effective in inhibiting brain tumor growth.

lycium

These two plant fruits contain lycium barbarum polysaccharides (LBP) and ligustrum lucidum polysaccharides (including ursolic acid and oleanolic acid). Numerous clinical studies have proved LBP is effective treatment in inhibiting brain tumor growth, enhancing sensitivity to radiotherapy and increasing effect of chemotherapy etc. In recent studies, ursolic acid is proved to be an active component to inhibit tumor growth and induce necroses of HL-60 cell. Researchers find oleanolic acid plays a role in protecting liver, inhibiting enzyme and enhancing immunity. ligustrum

900mg each tablet, 90tablets each bottle,3 bottles each period of treatment $298--For each period of treatment (one month). For children, dosage reduced proportionally(two to three months) Austin can dance - Neuroblastoma

Bone Cancers
Recommended: Bone cancers on the cancer.gov sitEOn this site: Warning Signs of Childhood Cancer: Bone Cancers Osteosarcoma and Ewing's sarcoma are the most common malignancies of bone tissues in children. Osteosarcoma, the more common of the two types, usually presents in bones around the knee; Ewing's sarcoma may affect bones of the pelvis, thigh, upper arm, or ribs.

Osteosarcoma -Etiology be may linked to fluoride in water Recommended cancer.gov link: NCI PDQ

A recent national case control study conducted by scientists at Harvard University found a significant relationship between fluoride exposure and osteosarcoma among boys, particularly if exposed to fluoridated water between the ages of 6 and 8 (the mid-childhood growth spurt).

The Harvard study's findings are consistent with the U.S. National Toxicology Program's congressionally-mandated fluoride/cancer study in rats; the National Cancer Institute's 1990 analysis of osteosarcoma rates among young males in fluoridated versus unfluoridated areas in the U.S., and the New Jersey Department of Health's 1992 analysis of osteosarcoma rates among young males in fluoridated versus unfluoridated areas of Central New Jersey.

In addition, two later independent analyses of NCI's national cancer data also found a relationship between fluoridation and osteosarcoma among young males (Yiamouyiannis 1993; Takahashi 2001).

There are several types of cells in our bones. Osteoblasts are the cells that form the matrix of the bone. Osteoclasts prevent too much bone matrix from accumulating, help bones maintain their proper shape, and control the amount of minerals in the blood. Some bones also contain bone marrow, which consists of fat cells and hematopoietic cells (cells which produce blood). Recommended cancer.gov link: NCI PDQ

Treatment
Treatment and prognosis depends on the subtype and grade of the tumor. Low grade tumors are surgically removed and usually not treated with chemotherapy; 85% of the patients should expect a five year event free survival. Intermediate grade tumors are treated with both surgery and chemotherapy. High grade tumors consist of immature cells which require aggressive chemotherapy; 75% of these patients expect a five year survival. Osteosarcomas do not respond to radiation therapy.

When possible, the limb is spared by removing the tumor and replacing the bone with a bone graft or metal rod. If chemotherapy is used, the drugs are usually ifosfamide, cisplatin, methotrexate, and doxorubicin. ( see pg 31)

Methotrexate: SE: Decreased blood counts [can be treated with maitake mushroom], N&V [sheng jiang], mouth ulcers [tx: popscicles, honey], skin rashes and photosensitivities, dizziness, HA, drowsiness, Kidney damage, liver damage, hair loss, seizures. Use: Soy, fish oil, VitE – Increases anticancer effects, Dietary folate. No Kava – (Liver), and ASA – increased toxicity.

Cisplatin: SE: The same plus confusion, numbness and tingling [tx w/ glutamine], muscle cramps and taste changes, kidney toxicity, loss of hearing and visual changes, allergic reaction Use VitE, VitA, Melatonin, Magnesium, L- Carnitine, Ginkgo, Astragalus, PSK, Silymarin, ginger

Statistics
900 new cases in US each year usually occurs in teenagers accounts for about 5% of all childhood cancers twice as common in males 20% have metastasized at diagnosis

Potentially beneficial nutrient supplements include the following: Vitamin C (250 to 500 mg two times per day), vitamin E (400 IU two times per day), beta carotene (50,000 IU once or twice a day), coenzyme Q10 (100 mg three times per day), and zinc (30 mg per day). Coenzyme Q10 and L-carnitine (600 mg three times per day) may protect the heart from the effects of chemotherapy. Selenium (200 mcg twice per day) and glutathione (500 mg twice per day) may minimize the side effects of chemotherapy. Magnesium (200 mg two to three times per day), vitamin D (400 IU per day), vitamin K (5 mg per day), and boron (3 to 5 mg per day) can help normal bone growth. Bromelain (250 to 500 mg between meals) may enhance chemotherapy. Glutamine (3 to 10 g per day) can be helpful after a bone marrow transplant. N-acetylcysteine (200 mg three times a day) may minimize the side effects of chemotherapy. Vitamin K: 60mg for Bone pain and induces differentiation in undifferentiated stem cells

Combine equal parts of coneflower (Echinacea angustifolia), poke root (Phytolacca americana), red clover (Trifolium pratense), plantain (Plantago lanceolata), gotu kola (Centella asiatica), and yellowdock (Rumex crispus). Take 30 to 60 drops tincture three times per day, or drink three to four cups tea daily for up to six weeks at a time Combine equal parts of astragalus (Astragalus membranaceus), schizandra berry (Schizandra chinensis), licorice root (Glycyrrhiza glabra), lomatium root (Lomatium dissectum), barberry (Berberis vulgaris), and queen's delight (Stillingia sylvatica). Take 30 drops tincture twice a day for four to six months

Herbs: Herbal remedies may offer relief from symptoms. Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp. per cup of water steeped for 10 minutes (roots need 20 minutes). Include one or more of the following formulas to support your immune system.
 * Turmeric ( //Curcuma longa// ): 500 mg four times a day may enhance certain chemotherapies.
 * Ginkgo ( //Ginkgo biloba// ): 120 mg standardized extract twice a day may reduce toxic effects of certain chemotherapies.
 * Scudder's Alterative Compound: Combine equal parts of corydalis tubers ( //Corydalis yanhusuo// ), black tag alder ( //Alnus serrulata// ), mayapple root ( //Podophyllum peltatum// ), figwort ( <span style="font-family: Times New Roman,serif;">//Scrophularia nodosa// <span style="font-family: Times New Roman,serif;">), and yellowdock ( <span style="font-family: Times New Roman,serif;">//Rumex crispus// <span style="font-family: Times New Roman,serif;">). Take 30 to 40 drops tincture three to four times per day for six months
 * <span style="font-family: Times New Roman,serif;">Herbal mixes containing burdock root ( <span style="font-family: Times New Roman,serif;">//Arctium lappa),// <span style="font-family: Times New Roman,serif;">sheep sorrel ( <span style="font-family: Times New Roman,serif;">//Rumex acetosella),// <span style="font-family: Times New Roman,serif;">slippery elm ( <span style="font-family: Times New Roman,serif;">//Ulmus// <span style="font-family: Times New Roman,serif;">fulva), turkey rhubarb ( <span style="font-family: Times New Roman,serif;">//Rheum palmatum)// <span style="font-family: Times New Roman,serif;">, and other herbs: <span style="font-family: Times New Roman,serif;"> <span style="font-family: Times New Roman,serif;">for brand name products, follow dosing instructions on the product labeling
 * <span style="font-family: Times New Roman,serif;">Combine equal parts of coneflower ( <span style="font-family: Times New Roman,serif;">//Echinacea angustifolia// <span style="font-family: Times New Roman,serif;">), poke root ( <span style="font-family: Times New Roman,serif;">//Phytolacca americana// <span style="font-family: Times New Roman,serif;">), red clover ( <span style="font-family: Times New Roman,serif;">//Trifolium pratense// <span style="font-family: Times New Roman,serif;">), plantain ( <span style="font-family: Times New Roman,serif;">//Plantago lanceolata// <span style="font-family: Times New Roman,serif;">), gotu kola ( <span style="font-family: Times New Roman,serif;">//Centella asiatica// <span style="font-family: Times New Roman,serif;">), and yellowdock ( <span style="font-family: Times New Roman,serif;">//Rumex crispus// <span style="font-family: Times New Roman,serif;">). Take 30 to 60 drops tincture three times per day, or drink three to four cups tea daily for up to six weeks at a time
 * <span style="font-family: Times New Roman,serif;">Combine equal parts of astragalus ( <span style="font-family: Times New Roman,serif;">//Astragalus membranaceus// <span style="font-family: Times New Roman,serif;">), schizandra berry ( <span style="font-family: Times New Roman,serif;">//Schizandra chinensis// <span style="font-family: Times New Roman,serif;">), licorice root ( <span style="font-family: Times New Roman,serif;">//Glycyrrhiza glabra// <span style="font-family: Times New Roman,serif;">), lomatium root ( <span style="font-family: Times New Roman,serif;">//Lomatium dissectum// <span style="font-family: Times New Roman,serif;">), barberry ( <span style="font-family: Times New Roman,serif;">//Berberis vulgaris// <span style="font-family: Times New Roman,serif;">), and queen's delight ( <span style="font-family: Times New Roman,serif;">//Stillingia sylvatica// <span style="font-family: Times New Roman,serif;">). Take 30 drops tincture twice a day for four to six months

Rhabdomyosarcoma:
Recommended: www.rhabdomyosarcomabooklet.org.uk/ On this site: Warning Signs of Childhood Cancer: Rhabdomyosarcoma Rhabdomyosarcoma is a fast-growing, highly malignant tumor which accounts for over half of the soft tissue sarcomas in children.

Less frequently, other soft tissue sarcomas are found in children: fibrosarcoma, mesenchymoma, synovial sarcoma, and liposarcoma. Rhabdomyosarcoma often causes a noticeable lump on a child's body. If the tumor is located internally, the symptoms depend on its location. For example, tumors in the nasal passage may put pressure on the eustachian tubes; a bladder tumor can cause trouble urinating; an orbital tumor may cause the eye to protrude.

Rhabdomyosarcoma tumors arise from a cell called a "rhabdomyoblast", which is a primitive muscle cell. Instead of differentiating into striated muscle cells, the rhabdomyoblasts grow out of control. Since this type of muscle is located throughout the body, the tumors can appear at numerous locations. The four major sites in which rhabdomyosarcoma is found are: head and neck; around the eyes -- 35-40% genitourinary tract -- 20% extremities -- 15-20% trunk (chest and lungs) -- 10-15%

Treatment:
Rhabdomyosarcoma is treated by a combination of surgery, chemotherapy, and radiation. Surgery. Resection (removal) of the primary tumor. If necessary after chemotherapy or radiation has shrunk the tumor. Chemotherapy. The following chemotherapy agents are commonly used: vincristine, cyclophosphamide, dactinomycin, adriamycin, ifosfamide, VP-16.

Decreased white blood cell count with increased risk of infection Decreased platelet count with increased risk of bleeding Nausea / Vomiting Tiredness (fatigue) Sores in mouth or on lips
 * More Common Primary Side Effects:**

Mild diarrhea Decreased appetite Rash Hair loss Fever Muscle and bone aches Liver toxicity Vincristine: SE: numbness and tingling – plus above SE Use with Ginseng, Vitamin C and fish oil Dactinomycin and Cyclophosphamide: SE: same symptoms, plus bladder problems Use with Astragalus, PSK, and Ashwaganda –for cell blood counts; melatonin to increase anti cancer actions and reduce SE Avoid Curcumin (reduces antitumor effects)
 * Less Common Side Effects:**

Adriamycin (Doxorubicin) –primary SE plus heart damage Use L-carnitine, VitE and CoQ10 for the heart, Green tea (theanine) extract to increase antitumor & reduce SE, melatonin - antitumor & reduce SE, Vit D – anti cancer, Avoid herbs (may stop liver conversion to active form) and NAC VP-16 – Etoposide –SE: Same plus allergic reaction, bronchospasm, low BP, Fluish sxs Ifosfamid: same plus bladder irritation and kidney damage, confusion and hallucinations Use ginger, fiber- water soluble, L-carnitine for fatigue, and numbness and tingling. Avoid NAC and glutathione.

Radiation. External beam radiation is used in some cases of rhabdomyosarcoma. Statistics Accounts for 5-8% of childhood cancers. 70% of all rhabdomyosarcoma cases diagnosed in the first ten years of life. Usually affects children the ages of 2 to 6 and 15 to 19. The peak incidence in 1-5 age group. Overall, 50% of the children diagnosed with rhabdomyosarcoma survive 5 years. Shark Liver oil or squalene for radiation

HopeKids provides ongoing events & activities and a powerful, unique support community for children with cancer and other life-threatening medical conditions. This groups surrounds these remarkable children and their families with the message that hope can be a powerful medicine. "There is no medicine like hope, no incentive so great, and no tonic so powerful as the expectation of something tomorrow." - Orison Swett Marden

Heal Our Planet Earth/ HOPE

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