Tips to help manage diarrhea and fatigue during advanced Renal Cell Cancer treatment

-----------------------------------------------------(From Medlinx) -----------------

Diarrhea

Diarrhea is an abnormal increase in stool liquidity and frequency (4 to 6 stools or more per day over baseline) with or without nocturnal bowel movements and/or moderate abdominal cramping. Diarrhea, a common side effect of many cancer regimens, can cause depletion of fluids and electrolytes, malnutrition, dehydration, and hospitalization, and therefore can interfere with cancer treatment, causing dosing delays or reductions.1

Patient education strategies

• Emphasize the importance of maximizing oral hydration strategies to avoid dehydration and electrolyte imbalances2
• Educate patients about the likelihood that diarrhea will develop3-5

Management tips for patients

• Diarrhea may be managed through diet as well as pharmacologic treatment when necessary, based on the clinical judgment of the treating healthcare provider (HCP).1,3,4 The first step in treatment is dietary management3,5,6:
  • Yogurt containing probiotics
  • Soluble fiber
  • Small but frequent meals
  • Fluids, such as water, diluted cranberry juice, broth, decaffeinated tea or coffee
• Over-the-counter and Rx agents may also be used, according to labeling1,3,4

 

Fatigue/asthenia

Fatigue/asthenia is a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion, related to cancer or cancer treatment, that is not proportional to recent activity and interferes with usual functioning.7

Patient education strategies7,8

• Encourage patients to:
  • Take short naps and breaks instead of long ones
  • Eat well and drink plenty of fluids
  • Take short walks and/or do light exercise
  • Do relaxing activities as a distraction (eg, listening to music or reading)

Management tips for patients

• Stay as active as possible9
• Maintain normal work and social schedules9
• Take breaks as needed9
• Report all medications to your HCP, including over-the-counter, herbal, and vitamin supplements7,10

RENAL CANCER PREVENTION (CHRONIC USE OF DECONGESTANT -AFRIN- COULD DECREASE RENAL CANCER.) and so does a CPAP mask for patients with Sleep Apnea

Renal cell cancer risk is associated to smoking and Obesity (hypertension is a corollary risk we claim).   These 2 conditions lead to Hypoxia generally through sleep Apnea  which in turn leads to a relative increase of Hemoglobin. The rise of Hemoglobin increases the portion of Desaturated hemoglobin. After many years of such exposure desaturated Heme enhances Phosphorylation at Tyr-530 of the SRC leading to its deactivation. In some individuals with the right MEK, suppression pf the SRC could lead to persistent amplification at the MEK which is a versatile activator of almost all signals, but particularly VEGF receptor.  This in turn usually lead to papillary cancers. Amplification of signal transduction started at the MEK (which amplifies almost all major known pathways) will lead to increased ubiquitination and proteasome destruction of the HYPOXIA-inducible factor  (following the Von Hippel-Lindau model.  This will lead to clear cell cancer. Associated desaturated Heme and hypoxia at the mitochondria will participate in the transformation (and possibly the Atypia/clear cell transformation).  The preponderance and center piece role of MEK amplification and subsequent VGEF/PDGF will justify the "bloody" nature of kidney cancers, and vessel involvement in these diseases  (MEK is the driver Mutation in papillary cancers).  IT ALSO EXPLAINS WHY SUTENT, NEXAVAR WORKS.  AND MITOCHONDRIAL DISTURBANCES AND SECONDARY AMPLIFICATION OF AKT, THE MTOR INHIBITORS WORK IN RENAL CANCERS  (MTOR participates more in clear cells)  (proof of concept pending)

In Western society, obesity is increasing, and so is Sleep Apnea.  Also, we live in closed homes (in some regions such as Texas and Louisiana, Mosquitoes are not helping) the level of dust participates in the increased level of allergic Rhinitis/ upper respiratory ailments.  It is not unusual to sleep and wake with closed Nostrils.  In obese individuals, this compounds the hypoxic episodes and worsened and prolonged hypoxia.  And we are back to depression of SRC, activation of MEK---akt, MAPK and so forth.
Keeping your nostrils open at night appears to be a critical strategy in preventing renal cancer, particularly in patients with breathing issues.   Lung cancer may be reduced for non smokers, but I wont touch that speculation, but do remember the role of VEGF in non-smoker lung cancers!

The involvement of PDGF which is by the way affected by Sutent seems to open a window in the frequency of strokes and heart attacks at night!  That's another debate to have...!

MTOR inhibitor in combination with Anti-VGEF/ MEK could have a significant role in non smoker lung cancer.?
Velcade could have a role in VHL prevention ? and in Pheochromocytoma?

Avastin and Mtor inhibitor could treat Leiomysarcoma of the Uterus if you follow this logic!

A FREED CPRIT AND THE NIH COULD HELP!