Friday, December 9, 2011

HIV and Burkitt's Lymphoma in the Brain

Chemotherapy typically follows after radiosurgery to treat small cancerous tumors in the human brain. However, when the tumors are the result of Burkitt's Lymphoma, the disease is exponentially more serious and requires many more treatments. Burkitt's Lymphoma is a fast-growing cancer of the lymphatic system, specifically B-Cells (classifying it as a type of leukemia). All types of Burkitt's are associated with HIV and immunodeficiency. In fact, 90% of AIDS cases are complicated by an onset of Burkitt's.


In the types of Burkitt's encountered in North America, the cancer usually starts in the belly area (abdomen). The disease can also start in the ovaries, testes, brain, and spinal fluid. Swelling of the lymph nodes is the primary symptom of the condition.

http://lymphoma.about.com/od/nonhodgkinlymphoma/p/burkitts.htm

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When diagnosed early, chemo can be extremely effective as a solution for Burkitt's ironically because of its naturally fast progression (the chemo progresses quickly when the cancer grows quickly). Patients treated with HAART (Highly Active Antiretroviral Therapy) for HIV, have a typically better chance for survival with Burkitt's lymphoma as well. These patients are basically being treated with a drug cocktail of sorts since HAART is defined as treatment with at least three active anti-retroviral medications (ARV’s).


The chemotherapy treatments are administered through a ventricular cathoder that is surgically inserted. It is a short surgery and an easy insertion into the third ventricle of the brain once the tumor is located via MRI scan. Surgeons implant what is called an Ommaya Resevoir for easy drug administration:


http://www.cw.bc.ca/library/pamphlets/search_view.asp?keyword=373


If the patient, however, has already developed carcinomatosis and has widespread cancerous lesions throughout the body (as is often the result of lymphoma), the treatments are unfortunately less effective.

Thursday, December 8, 2011

Clinical Applications of Hallucinogens

“Turn on, tune in, drop out.” Those are the famous words of the late psychologist Timothy Leary, a figurehead of the sixties famous for his experiments surrounding the psychological implications of hallucinogen, specifically LSD, use. Scientific interest in hallucinogen research more or less died with Leary’s dismissal from Harvard University in 1963, but, according to an article in Bloomberg Businessweek, it’s making a comeback.

This time, “magic mushrooms” are the focus of attention. Specifically, researchers are interested in psilocybin, the active compound responsible for the hallucinations mushroom users experience. Psilocybin accomplishes this, according to a very recent study, by acting as a “super agonist” to serotonin, a neurotransmitter associated with everything from depression to learning to hallucination. By binding to serotonin receptors, psilocybin both increases serotonin uptake and inhibits glutamate uptake. The resulting g-protein signal cascade is thought to trigger hallucinations, although the exact mechanisms are unknown.

Claimed clinical applications of the psychedelic compound range from anti-smoking therapy to chronic “suicide headache” relief. The most promising area of research surrounds the effect of psilocybin on the psyche of patients diagnosed with terminal illness. In a recent study, Roland Griffiths, a neuroscientist at Johns Hopkins University, administered psilocybin to 36 subjects, none of whom had taken the substance before. After taking the substance, the subjects were observed during their “trip,” an experience some described as “one of the five most meaningful experiences of their lives.”

But that was expected. Psilocybin is known to produce mystical, sometimes even spiritual short-term experiences. What is remarkable is that, 14 months later, almost all of the volunteers reported viewing life through a better, more positive lens. According to a Wired.com article on the study, “over half [of the volunteers] reported substantial increases in life satisfaction and positive behavior, while no long-term negative effects were reported.”

Although the implications are immense for increasing the quality of life for patients with depression or patients diagnosed with terminal illnesses suffering severe anxiety, I still do not know how I feel about the production of a drug derived from psilocybin. There certainly are cases were neurological intervention is necessary to improve the quality of life, but a pill so closely related to a well known hallucinogenic drug scares me. Is happiness, caused by the neurological tweakings of a drug, actually happiness?