Cytotoxic means destructive to living cells. Cytotoxic drugs possess anti-cancer properties but also have the potential to damage normal tissue. Their use is twofold: to eliminate a cancer and so prolong life; or to alleviate distressing symptoms, especially in patients whose prospects of a cure are poor. In many cases CHEMOTHERAPY with cytotoxic drugs is combined with surgery, RADIOTHERAPY or both. Chemotherapy may be used initially to reduce the size of the primary TUMOUR (a process called neoadjuvant therapy) before using radiotherapy or surgery to eliminate it. Cytotoxic drugs may also be used as adjuvant treatment to prevent or destroy secondary spread of the primary tumour that has either been removed by surgery or treated with radiotherapy. All chemotherapy causes side-effects: the ONCOLOGIST – a specialist in cancer treatment – has to strike a balance between hoped-for bene?ts and acceptable (for the patient) toxic effects, which include nausea and vomiting, BONE MARROW suppression, ALOPECIA (hair loss) and teratogenic effects (see TERATOGENESIS).
Cytotoxic drugs are used either singly or in combination, when an enhanced response is the aim. Chemotherapy of cancer is a complex process and should be supervised by an oncologist in co-operation with physicians, surgeons, radiotherapists and radiologists as appropriate.
The cytotoxic drugs include:
(1) The alkylating agents which act by damaging DNA, thus interfering with cell reproduction. Cyclophosphamide, ifosfamide, chlorambucil, kelphalan, busulphan, thiotepa and mustine are examples of alkylating agents.
(2) There are a number of cytotoxic antibiotics used in the treatment of cancer – doxorubicin, bleomycin, dactinomycin, mithramycin and amsacrine are examples. They are used primarily in the treatment of acute leukaemia and lymphomas.
(3) Antimetabolites – these drugs combine irreversibly with vital enzyme systems of the cell and hence prevent normal cell division. Methotrexate, cytarabine, ?uorouracil, mercaptopurine and azathioprine are examples.
(4) Another group of cytotoxic drugs are the vinca alkaloids such as vincristine, vinblastine and vindesima.
(5) Platinum compounds such as carboplatin, cisplatin and oxaliplatin are e?ective. All of them are given intravenously, but the latter two tend to have more unpleasant side-effects. Carboplatin and cisplatin are useful in the treatment of solid tumours. Carboplatin, a derivative of cisplatin, is given intravenously in ovarian cancer and in small-cell lung cancer. Better tolerated than cisplatin, the drug causes less nausea and vomiting, nephrotoxicity, neurotoxicity and ototoxicity. Where platinum-containing therapy has failed, intravenous treatment with paclitaxel may be tried. With only a limited success rate, it is relatively toxic and should be carefully supervised; responses, however, are sometimes prolonged.
Also of increasing importance in treating cancer are interferons. These are naturally occurring proteins with complex effects on immunity and cell function. Although toxic, with numerous adverse effects, they have shown some anti-tumour e?ect against certain lymphomas and solid tumours.... cytotoxic
a malignant disease of lymphatic tissue – a form of *lymphoma – usually characterized by painless enlargement of one or more groups of lymph nodes in the neck, axillae (armpits), groin, chest, or abdomen; the spleen, liver, bone marrow, and bones may also be involved. Apart from the enlarging nodes, there may also be weight loss, fever, profuse sweating at night, and itching (known as B symptoms). Hodgkin’s disease is distinguished from other forms of lymphoma by the presence of large binucleate cells (Reed–Sternberg cells) in the affected lymph nodes. Treatment depends on the extent of disease and may include surgery, radiotherapy, drug therapy, or a combination of these. Drugs used in the treatment of the disease include vincristine, procarbazine, prednisolone, chlorambucil, and vinblastine. Many patients can be cured; in the early stages of the disease this may be in the order of 90% or more. [T. Hodgkin (1798–1866), British physician]... hodgkin’s disease
If you like herbal teas, there are lots of types you can try - one of them is periwinkle tea. Like most herbal teas, it has a slightly bitter taste, but it also has important health benefits. Read to find out more about periwinkle tea!
About Periwinkle Tea
Periwinkle tea is made from the vinca plant, an herbaceous plant which can be found in Europe, northwest Africa and southwest Asia.
Vinca plant has long, trailing stems that grow near the ground, touching it. The branches can reach about half a meter in height. The leaves are evergreen and, opposite, the flowers are salverform, with 5 vilet (and sometimes white) petals connected together at the base.
Two species of the plant are often cultivated as ornamental plants. However, in some parts of Australia, New Zealand, and the United States, it has spread too much, becoming an invasive plant.
Interestingly, it is said that the plant protects you from voodoo magic.
Periwinkle Tea constituents
Vinca plants have lots of constituents which are transferred to periwinkle tea, as well.
Periwinkle tea is rich in alkaloids that come from the vinca plant. It has at least 86 different alkaloids. Some of them are: vincamine, vinpocetine, vinblastine, vincristine, alstonine, ajmalicine, leurocristine, and reserpine.
How to prepare Periwinkle Tea
For a cup of periwinkle tea, you need a teaspoon of dried herbs. Pour boiling water into the cup and let it steep for 10-15 minutes. Once the steeping time is done, strain to remove the herbs and your cup of periwinkle tea is done.
If the taste is too bitter for you, you can sweeten the tea by adding honey or fruit juice to your cup.
Periwinkle Tea Benefits
Thanks to the many constituents derived from the vinca plant, periwinkle tea has lots of important health benefits.
Periwinkle tea plays an important role in the fight against cancer. It is often recommended in the treatment for leukemia, Hodgkin’s disease, malignant lymphomas, neuroblastoma, Wilm’s tumor and Kaposi’s sarcoma.
Drinking periwinkle tea will help lower blood sugar levels and blood pressure, as well as improve blood circulation. You can drink periwinkle tea during menstruation if you’ve got an excessive blood flow. It should help in such situations. This tea is also useful in treating diarrhea, colitis and diabetes.
You can use periwinkle tea to treat mouth sores and bleeding gums; it acts as a good mouth rinse. It can help you with headaches and memory loss problems and it enhances your memory. It also has calming effects, helping you with anxiety and nervousness.
Periwinkle tea can be used topically, as well. You can wet a cloth with tea and use it to stop wounds from bleeding. You can also put it on the skin to treat wasp stings or on the eye if you’ve got an eye infection.
Periwinkle Tea Side Effects
With so many health benefits, periwinkle tea has to have a few side effects too. Here are some which you have to be careful with.
If you’ve got kidney, liver or lung diseases, you should avoid drinking periwinkle tea. Also you should not drink it if you’ve got low blood pressure, or if you’re constipated.
Pregnant women shouldn’t drinkperiwinkle tea, as it may lead to birth defects or even miscarriages. Also, it is best to stay away from this tea if you’re breast feeding; even in this case, it might affect the baby.
It is best to stop drinking periwinkle tea before a surgery. It can lower blood pressure and it might lead to problems during and after the surgery. Check with your doctor and make sure you’re safe to drink periwinkle tea after a surgery.
It is also recommended that you not drink more than 4 cups of periwinkle tea. Besides the usual symptoms (low blood pressure and constipation) you might also get other symptoms: headaches, loss of appetite, insomnia, dizziness, and irregular heartbeats.
Drinking periwinkle tea can help you a lot, with its many health benefits. Don’t forget about the side effects, though. As long as you make sure it’s safe to drink periwinkle tea, you can happily drink it!... enjoy periwinkle tea
The management of MALIGNANT disease – a major health problem since successful management requires close liaison between the patient, surgeons, physicians, oncologists, haematologists, paediatricians and other specialists. Diagnosis may involve various investigations and often requires a BIOPSY. Once a diagnosis has been established, treatment may involve surgery, radiotherapy or chemotherapy (or various combinations as required) – see below, and main dictionary entries.
Surgery may be most common, and is often the only treatment, for some gastrointestinal tumours, soft-tissue tumours, gynaecological tumours and advanced cancers of the head and neck.
Radiotherapy uses ionising radiation to kill tumour cells. Radiation is by naturally occurring isotopes (see ISOTOPE) or arti?cially produced X-RAYS. Germ-cell tumours (see SEMINOMA; TERATOMA) and malignant lymphomas (see LYMPHOMA) appear to be particularly sensitive to irradiation, and many head and neck tumours, gynaecological cancers, and localised cancers of the PROSTATE GLAND and URINARY BLADDER are curable with radiotherapy. It is also a valuable means of reducing pain from bone metastases (see METASTASIS). Unpleasant side-effects are common: chie?y lethargy, loss of appetite and dry, itchy skin symptoms.
Chemotherapy is also an important treatment in germ-cell tumours (see above); in some forms of LEUKAEMIA and lymphoma; in ovarian cancer (following surgery – see OVARIES, DISEASES OF); and in small-cell lung cancer (although most patients die within 18 months – see LUNGS, DISEASES OF). It is also used in some breast cancers (see BREASTS, DISEASES OF); advanced myeloma (see MYELOMATOSIS); sarcomas (see under CANCER); and some childhood cancers (such as WILMS’ TUMOUR).
More than 20 substances are in common use, the major classes being ALKYLATING AGENTS (e.g. cyclophosphamide, chlorambucil, busul fan); ANTIMETABOLITES (e.g. methotrexate); VINCA ALKALOIDS (e.g. vincristine, vinblastine); and antitumour ANTIBIOTICS (e.g. actinomycin D). Choice of agent and the appropriate regimen requires expert guidance. Common side-effects include nausea and vomiting, bone-marrow suppression and ALOPECIA, with each substance having its own spectrum of unwanted effects.
Good doctor-patient communication, with the sharing of information and bringing the patient into the decision-making process, is vital even if time-consuming and exhausting.
Equally imortant treatment is PALLIATIVE, for example to ensure e?ective pain or nausea control. Common sources of pain in cancer may involve bone, nerve compression, soft tissue, visceral, myofascial, constipation, muscle spasm, low-back pain, joint pain (e.g. capsulitis) and chronic post-operative pain. Patients may be suffering from more than one pain, all of which should be identi?ed. The aim should be to eliminate pain.
There are three rungs of the analgesic ladder; if one rung fails, the next one should be tried:
(1) non-opioid drugs – for example, aspirin, PARACETAMOL, NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS); (2) weak opioids – for example, CODEINE, DIHYDROCODEINE, dextropropoxyphene; (3) strong opioids
– for example, MORPHINE, DIAMORPHINE, buprenorphine. Oral treatment is always preferable, unless prevented by severe vomiting. (See also CANCER; ONCOLOGIST; PAIN; PALLIATIVE CARE.)... oncology
Catharanthus roseusApocynaceaeSan: Nityakalyani;Hin: Sadabahar, Baramassi;Mal: Ushamalari, NityakalyaniTel: Billaganeru;Tam: Sudukattu mallikai; Pun: Rattanjot;Kan: Kasikanigale, Nitya MalligeImportance: Periwinkle or Vinca is an erect handsome herbaceous perennial plant which is a chief source of patented cancer and hypotensive drugs. It is one of the very few medicinal plants which has a long history of uses as diuretic, antidysenteric, haemorrhagic and antiseptic. It is known for use in the treatment of diabetes in Jamaica and India. The alkaloids vinblastine and vincristine present in the leaves are recognized as anticancerous drugs. Vinblastine in the form of vinblastin sulphate is available in market under the trade name “VELBE” and Vincristine sulphate as “ONCOVIN” (Eli Lilly). Vinblastine is used in combination with other anticancer agents for the treatment of lymphocytic lymphoma, Hodgkin’s disease, testicular carcinoma and choriocarcinoma. Vincristine is used in acute leukemia, lymphosarcoma and Wilm’s tumour. Its roots are a major source of the alkaloids, raubasine (ajmalicine), reserpine and serpentine used in the preparation of antifibrillic and hypertension-relieving drugs. It is useful in the treatment of choriocarcinoma and Hodgkin’s disease-a cancer affecting lymph glands, spleen and liver. Its leaves are used for curing diabetes, menorrhagia and wasp stings. Root is tonic, stomachic, hypotensive, sedative and tranquilliser (Narayana and Dimri,1990).Distribution: The plant is a native of Madagascar and hence the name Madagascar Periwinkle. It is distributed in West Indies, Mozambique, South Vi etnam, Sri Lanka , Philippines and Australia. It is well adapted to diverse agroclimatic situations prevalent in India and is commercially cultivated in the states of Tamil Nadu, Karnataka, Gujarat, Madhya Pradesh and Assam. USA, Hungary, West Germany, Italy, Netherlands and UK are the major consumers.Botany: Catharanthus roseus (Linn.) G.Don.syn. Vinca rosea Linn. belongs to the family Apocynaceae. It is an erect highly branched lactiferous perennial herb growing up to a height of one metre. Leaves are oblong or ovate, opposite, short-petioled, smooth with entire margin. Flowers are borne on axils in pairs. There are three flower colour types , pink, pink-eyed and white. Calyx with 5 sepal, green, linear, subulate. Corolla tube is cylindrical with 5 petals, rose-purple or white with rose-purple spot in the centre; throat of corolla tube hairy, forming a corona-like structure. The anthers are epipetalous borne on short filaments inside the bulging distal end of corolla tube converging conically above the stigma. Two characteristic secretary systems, namely a column like nectarium on both sides of pistil and a secretory cringulam circling the papillate stigma with a presumed role in pollination - fecundation process are present. Ovary bicarpellary, basally distinct with fused common style and stigma. The dehiscent fruit consists of a pair of follicles each measuring about 25 mm in length and 2.3 mm in diameter, containing up to thirty linearly arranged seeds with a thin black tegumen. On maturity, the follicles split along the length dehiscing the seeds.Agrotechnology: Periwinkle grows well under tropical and subtropical climate. A well distributed rainfall of 1000 mm or more is ideal. In north India the low winter temperatures adversely affect the crop growth. It can grow on any type of soil ,except those which are highly saline, alkaline or waterlogged. Light soils, rich in humus are preferable for large scale cultivation since harvesting of the roots become easy.Catharanthus is propagated by seeds. Fresh seeds should be used since they are short-viable. Seeds can be either sown directly in the field or in a nursery and then transplanted. Seed rate is 2.5 kg/ha for direct sowing and the seeds are drilled in rows 45 cm apart or broadcasted. For transplanted crop the seed rate is 500gm/ha. Seeds are sown in nursery and transplanted at 45x 30cm spacing after 60 days when the seedlings attain a height of 15-20cm Nursery is prepared two months in advance so that transplanting coincides with the on set of monsoons. Application of FYM at the rate of 15 t/ha is recommended. An alternate approach is to grow leguminous green manure crops and incorporate the same into the soil at flowering stage. Fertilisers are recommended at 80:40:40 kg N:P2O5:K2O/ha for irrigated crop and 60:30:30 kg/ha for rainfed crop. N is applied in three equal splits at planting and at 45 and 90 days after planting. 4 or 5 irrigations will be needed to optimise yield when rainfall is restricted. Fortnightly irrigations support good crop growth when the crop is grown exclusively as an irrigated crop. Weeding is carried out before each topdressing. Alternatively, use of fluchloraline at 0.75 kg a.i. /ha pre-plant or alachlor at 1.0 kg a.i. per ha as pre-emergence to weeds provides effective control of a wide range of weeds in periwinkle crop. Detopping of plants by 2cm at 50% flowering stage improves root yield and alkaloid contents. No major pests, other than Oleander hawk moth, have been reported in this crop. Fungal diseases like twig blight (top rot or dieback) caused by Phytophthora nicotianae., Pythium debaryanum, P. butleri and P. aphanidermatum; leaf spot due to Alternaria tenuissima, A. alternata, Rhizoctonia solani and Ophiobolus catharanthicola and foot-rot and wilt by Sclerotium rolfsii and Fusarium solani have been reported. However, the damage to the crop is not very serious. Three virus diseases causing different types of mosaic symptoms and a phyllody or little leaf disease due to mycoplasma -like organisms have also been reported; the spread of which could be checked by uprooting and destroying the affected plants.The crop allows 3-4 clippings of foliage beginning from 6 months. The flowering stage is ideal for collection of roots with high alkaloid content. The crop is cut about 7 cm above the ground and dried for stem, leaf and seed. The field is irrigated, ploughed and roots are collected. The average yields of leaf, stem and root are 3.6, 1.5and 1.5 t/ha, respectively under irrigated conditions and 2.0, 1.0 and 0.75t/ha, respectively under rainfed conditions on air dry basis. The harvested stem and roots loose 80% and 70% of their weight, respectively. The crop comes up well as an undercrop in eucalyptus plantation in north India. In north western India a two year crop sequence of periwinkle-senna-mustard or periwinkle-senna- coriander are recommended for higher net returns and productivity (Krishnan,1995).Properties and activity: More than 100 alkaloids and related compounds have so far been isolated and characterised from the plant. The alkaloid contents in different parts show large variations as roots 0.14-1.34%, stem 0.074-0.48%, leaves 0.32-1.16%, flowers 0.005-0.84%, fruits 0.40%, seeds 0.18% and pericarp 1.14% (Krishnan et al, 1983). These alkaloids includes monomeric indole alkaloids, 2-acyl indoles, oxindole, -methylene indolines, dihydroindoles, bisindole and others. Dry leaves contain vinblastine (vincaleucoblastine or VLB) 0.00013-0.00063%, and vincristine (leurocristine or LC) 0.0000003-0.0000153% which have anticancerous activity (Virmani et al, 1978). Other alkaloids reported are vincoside, isovincoside (strictosidine), catharanthine, vindolinine, lochrovicine, vincolidine, ajmalicine (raubasine), reserpine, serpentine, leurosine, lochnerine, tetrahydroalstonine, vindoline, pericalline, perivine, periformyline, perividine, carosine, leurosivine, leurosidine and rovidine. The different alkaloids possessed anticancerous, antidiabetic, diuretic, antihypertensive, antimicrobial, antidysenteric, haemorrhagic, antifibrillic, tonic, stomachic, sedative and tranquillising activities.... periwinkle
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