Personalities of Research 2006 - By Taijoo Benedict Ha - Miscellaneous

In accordance to the request of exploring outside my "comfort zone" for this particular project, instead of Space Elevators or Nintendo, I will be exploring psychology. For my final project, I have studied and researched various personality types according to the Jung - Myers-Briggs Typology.

Hormonal therapy is the best treatment available for certain malignancies. Some cancers can be inhibited or stimulated by appropriately changing the hormone balance. Steroids can inhibit tumor growth or the associated edema, and may cause weakening of lymph node malignancies. Prostate cancer responds well to finasteride, which prevents testosterone from converting to dihydrotestosterone, causing the abnormality. Breast cancer cells usually have a lot of estrogen or progesterone receptor or both. Inhibiting the production or action of these hormones can often be used as an adjunct to therapy. Dosage of chemotherapy can be difficult: if the dose is too low, it will be ineffective against the tumor, while at excessive doses the toxicity (side-effects, neutropenia) will be intolerable to the patient. This has led to the formation of detailed "dosing schemes" in most hospitals, which give guidance on the correct dose and adjustment in case of toxicity. In most cases, the dose is adjusted for the patient's body surface area, calculated by a combined measure of the patient’s weight and height that mathematically approximates the body volume. The body surface area is usually calculated with a mathematical formula, rather than by direct measurement. Now the most interesting and pressing question that prompted this research topic is: how is chemotherapy administered? Most chemotherapy is delivered intravenously, although there are a number of agents that can be administered orally. Depending on the patient, the cancer, the stage of cancer, the type of chemotherapy, and the dosage, IV chemotherapy may be given on either an inpatient (patients that stay overnight at a hospital) or outpatient (patients who visits a hospital but then leaves) basis. For continuous, frequent or prolonged IV chemotherapy administration, various systems may be surgically inserted into the vasculature (an arrangement of blood vessels) to maintain access. Commonly used systems are the Hickman line, the Port-a-Cath or the PICC line. Though this method may be less comfortable in that it is a continuous treatment, these systems are less prone to infection and are more convenient in that they remove the need for repeated insertion of other forms of administration. There are a number of strategies in the administration of chemotherapeutic drugs used today. Chemotherapy may be given with a curative intent or it may aim to prolong life or to palliate symptoms. Combined modality chemotherapy is the use of drugs with other cancer treatments, such as radiation therapy or surgery. Most cancers are now treated in this way. Combination chemotherapy is a similar practice which involves treating a patient with a number of different drugs simultaneously. The drugs differ in their mechanism and side effects. The biggest advantage is minimizing the chances of resistance developing to any one agent. In neo-adjuvant chemotherapy (preoperative treatment), initial chemotherapy is aimed for shrinking the primary tumor, thereby rendering local therapy (surgery or radiotherapy) less destructive or more effective. Adjuvant chemotherapy (postoperative treatment) can be used when there is little evidence of cancer present, but there is risk of recurrence. This can help reduce chances of resistance developing if the tumor does develop. It is also useful in killing any cancerous cells which have spread to other parts of the body. This is often effective as the newly growing tumors are fast-dividing, and therefore very susceptible. Palliative chemotherapy is given without curative intent, but simply to decrease tumor load and increase life expectancy. Basically this method of chemotherapy should only expect to alleviate a tumor condition, not eliminate it. For these regimens, a better toxicity profile is generally expected. Most chemotherapy treatments require that the patient is capable to undergo the treatment. Performance status is often used as a measure to determine whether a patient can receive chemotherapy, or whether dose reduction is required. Any treatment can be physically exhausting for the patient. Current chemotherapeutic techniques have a range of side effects mainly affecting the fast-dividing cells of the body. Important common side-effects include (dependent on the agent): Hair loss, Nausea and vomiting, Diarrhea or constipation, Anemia, Depression of the immune system hence (potentially lethal) infections and sepsis, Hemorrhage, Secondary neoplasms (abnormal tissue growth), Cardiotoxicity (heart muscle damage), Hepatotoxicity (liver damage), Nephrotoxicity (kidney damage), Ototoxicity (hearing and balance impairment). Virtually all chemotherapeutic regimens can cause depression of the immune system, often by paralyzing the bone marrow and leading to a decrease of white blood cells, red blood cells and platelets. The latter two, when they occur, are improved with blood transfusion. Sometimes, in a very severe case scenario, all the bone marrow stem cells (cells which produce white and red blood cells) are destroyed, meaning bone marrow cell transplants are necessary. There are two methods to increasing the bone marrow count. One method involves cells being removed from the patient before the treatment, multiplied and then re-injected afterwards. The other method simply involves a bone marrow donor. Some patients still develop diseases because of this interference with bone marrow. The chemotherapy may upset the patient’s stomach, triggering a strong urge to vomit, or forcefully eliminate what is in the stomach. Stimulation of the want to vomit results from the coordination of responses from the diaphragm, salivary glands, cranial nerves, and gastrointestinal muscles to produce the interruption of cellular respiration (metabolism) and forced expulsion of stomach contents known as retching and vomiting. The 5-HT3 inhibitors are the most effective antiemetics (vomit prevention drugs) and constitute the single greatest advancement in the management of nausea and vomiting in patients with cancer. These drugs are designed to block one or more of the signals that cause nausea and vomiting. The most sensitive signal during the first 24 hours after chemotherapy appears to be 5-HT3. Blocking the 5-HT3 signal is one approach to preventing acute emesis (vomiting), or emesis that is severe, but relatively short-lived. The newest 5-HT3 inhibitor, palonosetron, has a distinct advantage over the other 5-HT3 inhibitors because, in addition to preventing acute nausea and vomiting, palonosetron also prevents delayed nausea and vomiting, which occurs during the 2-5 days after treatment. This is the only drug in its class that is approved by the FDA for the treatment of delayed nausea and vomiting. Some studies and patient groups claim that the use of cannabinoids derived from marijuana during chemotherapy greatly reduces the associated nausea and vomiting, and enables the patient to eat. Some synthetic derivatives of the active substance in marijuana (tetrahydrocannabinol or THC) such as Marinol may be practical for this application. This is why some cancer patients will opt to take medical marijuana. However, some skeptics speculate the cancer patients are just being given more liberties for being terminally ill. In particularly large tumors, such as large lymphomas, some patients develop tumor lysis syndrome from the rapid breakdown of malignant cells. Although treatment to prevent disease is available and is often initiated in patients with large tumors, this is a dangerous side-effect which can lead to death if left untreated. Chemotherapy may increase the risk of cardiovascular disease and occasionally leads to secondary cancer. Some patients report fatigue or general headache problems, such as the inability to concentrate. Such symptoms are colloquially referred to as "chemo brain" by patient support groups (by the patients themselves, or else it might have been a bit insensitive).

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