July 26th, 2011
Perhaps one of the most alarming findings in the study of tamoxifen resistance is the evidence in humans and animals that after continued exposure to tamoxifen, tumors may actually become dependent on the drug for growth. The process is poorly understood and is being studied primarily in laboratory animals. Estrogen-receptor-positive tumors are grown in mice; when the animals are given tamoxifen, the tumors initially shrink. After about six months of continuous tamoxifen administration, however, the tumors begin to grow again. This time frame is approximately the same as is observed for the development of tamoxifen resistance in humans. Of further interest is the preliminary observation that if tamoxifen is given to mice for up to five years, then stopped, and estrogen is administered instead, the tamoxifen-resistant tumors disappear. It appears that the tumors not only avoid the inhibitory action of tamoxifen but somehow become dependent on it for continued growth.This evidence and other data on prolonged exposure of cells to tamoxifen suggest that breast cancer cells under conditions of long-term tamoxifen exposure can in fact learn to depend on the drug for growth and even be stimulated by it. Because these findings have been noted in laboratory studies on cultured cells and in animals, extrapolation to human patients is controversial. Nevertheless, several clinical studies have shown that in some women whose breast cancers began growing in the presence of tamoxifen, discontinuing the tamoxifen can itself produce a tumor stabilization or tumor regression.CAN TAMOXIFEN RESISTANCE BE PREVENTED?Although a number of advances have been made, little can yet be done to avoid tamoxifen resistance. On the assumption that tamoxifen resistance may be related to metabolism of the drug to estrogenic compounds, several laboratories are looking at experimental drugs that are similar to tamoxifen in chemical structure but cannot be metabolized into estrogenic metabolites. Some of these, as well as other new agents, are showing promise against tamoxifen-resistant tumors.*45\320\2*
Posted in Cancer | Comments Off
July 11th, 2011
The basic process paradigm is that signals and information from the client-therapist pair contain their own structure and implicit evolution, that is, the solutions to the problems at hand. The method was to wait to develop a strategy until the structure had become apparent.When working with people with whom I have trouble communicating, I always refer to my video tape recording. I often make decisions only after having studied the video in order to discover which information I have not allowed myself to pick up and why I did not pick it up. If the client becomes increasingly unhappy during the session or afterwards, or if my communication to the client does not receive a favorable response, I assume that I have to change. I usually find out that I have rigid conceptions of how people t should be or am unconscious of something I am projecting onto the client which makes it impossible for me either to pick up or to deal openly with what is happening. For example, in one sitting where a woman suffering from chronic alcoholism spoke about what seemed to me to be a harmful interaction with her little children, I entered a cyclical and antagonist process with her in which I was anything but helpful, either to her or those around her. She brought up problems in myself I first had to deal with before I was even able to understand the video tape.This particular woman helped me to be definitive about my own goals in working with her and others, and helped me to become aware of the occasional discrepancy between what the therapist’s and client’s goals may be. As far as I know, my goals seem to be (1) to achieve what I interpret to be unequivocal positive response from the client, (2) to get the same response from the environment, (3) to enjoy myself to the utmost, and (4) to appreciate the nature of difficult situations. Obviously I have to be wide awake about myself because not every client will automatically join me in these expectations!*30\227\8*
Posted in Anti-Psychotics | Comments Off
July 7th, 2011
Margaret, who was 70, had also struggled with BDD for many decades. Her concerns, too, had begun when she was a teenager and persisted ever since. She’d been treated in her teens for scoliosis (curvature of the spine), which was severe and required surgery and a brace. But after several surgeries, the scoliosis was much improved and hardly noticeable. Margaret, however, was still preoccupied with it. “It’s been a concern ever since then,” she said. “I think my back still looks very ugly. I think about it for hours a day. I can’t wear certain clothes because of how it looks. I wear clothes that hide it, and I change them a lot, trying to find an outfit that makes it look better.”Margaret spent approximately 8 hours a day doing BDD-related behaviors: selecting her clothes each morning and changing them during the day, scrutinizing how other people’s backs looked, checking mirrors, and asking her husband whether she looked okay. “I still think about how awful my back looks after all these years. I keep to myself because I don’t want to draw attention to it. It’s one of the things that’s made me depressed.”A woman in her sixties, who looked far younger than her age, was obsessed with getting eye surgery to eradicate facial “lines” that resembled those of a 35 year old. She’d seen most of the plastic surgeons in town, and she spent hours a day frantically examining the lines in mirrors and applying creams and makeup. Because of the lines, she restricted her activities and rarely left the house without wearing sunglasses.Given that untreated BDD may be a fairly chronic disorder, it isn’t surprising that it exists in the elderly. However, it isn’t known how common BDD is in this age group. The average age of the people I’ve seen is the thirties; I’ve seen far fewer elderly people with BDD. Does BDD “burn out” as people age, becoming less severe or remitting altogether? Conversely, can it become more severe over time, and can the elderly be particularly distressed and impaired because of the cumulative effect of suffering over so many years? Might they be particularly embarrassed about seeking help? Further research is needed to answer these important questions.*164\204\8*
Posted in Anti Depressants-Sleeping Aid | Comments Off