Diagnostic Evaluation of Prostate Cancer with 3D Ultrasound

The prostate, a motionless and small organ is ideal for 3D ultrasound as this organ can bee covered in a single acoustic area. It helps to acquire volume data more accurately and more rapidly.
Transrectal ultrasound is used for accurate volume measurements of whole prostate in transitional zone. Approximately 20% error has been measured in 2D transrectal ultrasound.3D ultrasound gives the volume in accuracy even in irregularly shaped structures.
Gray-scale 3D transrectal ultrasound increases both sensitivity and specificity of prostate cancer evaluation, due to better visualization of gland and focal lesions.
Color Doppler and power Doppler can aid the detection. 3D Doppler ultrasound increases the likelihood of positive Biopsy.
Signs of extracapsular extension can be seen more clearly on3D Doppler Ultrasound.
Contrast enhancement is used for diagnostic accuracy of 2D ultrasound.
Unlike the 2D approach, evaluation is not restricted to the axial plane.
Contrast-enhance power Doppler 3D ultrasound can increase the diagnostic accuracy of prostate cancer imaging from 61% to 86%.

Fixed High dose Melphalan in treatment of Multiple Myeloma

Multiple Myeloma is a chemotherapy -responsive, but an incurable disease. Standard chemotherapy gives response rate of 50-70% with survival upto 30-40 months.
Studies showed that dose intensification of Melphalan resulted in higher response rates even in patients refractory to standard dose. High dose Melphalan with stem cell transplantation shows higher response rates and longer survival time. Slight non –hematopoetic toxicity is observed.
At a higher dose levels, there are trends towards earlier and deeper mylosuppression.
Despite the slightly prolonged neutropenia, there is not a higher then expected incidence of infections, anorexia, diarrhea, headache or fatigue. No patient required intubations and there is no death reported.
No dose limiting toxicities are observed during treatment.
So the test regimen supplements total body irradiation and allows for administration of approximately 40% higher dose of Melphalan then standard.
The use of bone-seeking radiolabelled isotopes offers several advantages over that of a radiolabelled antibody. It offers a faster clearance from the blood and other organs, less non hematopoetic tissue toxicity. substantially greater doses of radiation can be delivered to hematopoetic tissues as compared to other organs. The toxicity of this supplemental radiation has not been appreciably greater than standard dose.
This approach offers possibility of augmenting antimyeloma therapy without increasing toxicity and improving the response rate and progression free survival. The results of this trial are encouraging.

Decrease in physical fitness in the survivors of childhood Leukemia

The best indicator of aerobics physical fitness, as recommended by WHO , is the peak oxygen update attained during a graded maximum exercise to volitional exhaustion.
Peak oxygen uptake is, Volume of Oxygen consumed per unit of time relative to body mass. This is a good indicator of health status and predicts mortality rate in both healthy and diseased persons. Improve quality of life reflects exercise capacity and VO2 peaks. That is normal activities can be carried out with no fatigue.
VO2 levels lowers in adult cancer patients, due to poor physical conditions. Studies shows there is decrease in VO2 peak in the survivors of acute lymphoblastic leukemia. So exercise training prescription is necessary to improve their work capacity.
Decrease in VO2 peak are largely attributable to impaired cardiac function as it mainly reflects maximal O2 supply to muscles rather than maximal rate of O2 utilization by muscles mitochondria.
Anticancer therapy and sedentary habits decrease cardiac output which can be improved by exercised based therapy. Different lung infections can also reduce lung capacity.
So impaired physical fitness leads to early fatigue during physical activities and can severely deteriorate the quality of life.
Studies shows these children should be engage in regular physical exercise. Also there are scientific indications that exercise training improves the function of several ant cancer immune system components.