prader will hoitoKeuhkokuume voi olla tappava newborn. HIV on virus, joka aiheuttaa aidsia. Tietynlainen bakteerit aiheuttaa klamydia. Ne voivat olla mieelialaan kokoisia ja muotoisia. Useimmat ihmiset tartunnan HPV ei ole oireita. Infektio steroidien vaikutus mielialaan olla kiusallinen. Mutta jotkut ihmiset, infektio aiheuttaa satunnaista puhkeamista kutiava ja kivulias haavaumia sukuelinten alueella.
Keuhkokuume voi olla tappava newborn. HIV on virus, joka aiheuttaa aidsia. Tietynlainen bakteerit aiheuttaa klamydia. Ne voivat olla eri kokoisia ja muotoisia.
Useimmat ihmiset tartunnan HPV ei ole oireita. Infektio voi olla kiusallinen. Mutta jotkut ihmiset, infektio aiheuttaa satunnaista puhkeamista kutiava ja kivulias haavaumia sukuelinten alueella. Asiat kuten stressi, sairaus, uusi sukupuolta olevan kumppanin, tai kuukautiset voivat laukaista uuden puhkeaminen. Sukupuolielinten herpes on aiheuttanut virus-joko herpes simplex virus tyyppi 1 tai herpes simplex -viruksen tyypin 2.
Ennen kuin aloitat seksuaalinen suhde, keskustele parisi sukupuolitaudeilta. Testosteroni korvaushoito on saatavilla useissa eri muodoissa, tohtori Farooq sanoo. Yleisin on ajankohtainen geeli. Iho imee testosteroni, joka on hitaasti vapautuu verenkiertoon.
Kuten monet muut krooniset sairaudet, jos lopetat hoidon, ongelma palaa - testosteronitaso laskee takaisin alas alla normaalia tasoa. Mutta valtion lakeja vaihtelevat niiden vaatimukset. Sinun ei tarvitse asianajaja suorittaa hoitotahto.
Voit muuttaa tai perua hoitotahto milloin tahansa. Voit muuttaa lomakkeiden puuttua sinun toiveiden. Muista puhua agentti noin uskomuksia ja toiveita. Elintarvikkeiden pakkoa vaatii jatkuvaa valvontaa. Vaikka he tuntevat paremmin, on vaikea korjata joitakin vahinkoja aiemmin. Liittyminen meille puhelimessa on tohtori Philip M. Ja Aloitetaan ensin terapeuttista. Joten ne ovat terapeuttisia rokotteita.
Olen ilmeisesti kuullut jotain. Pahoinvointia tai oksentelua ei esiinny. Joten on olemassa pari muuttujia. Joten keskustelu on hieman kaksijakoinen. Joten miten se vertautuu peptidityyppisen rokotteet, ei-koko-solu kasvain? Joten yhteenvetona, kumpi olisi parempi - koko tuumorisolun tai peptidi? On Web-sivuston hoitaa liittohallitus.
Onko rokote auttaa minua, ja miten? Joten on olemassa useita rokotteita, joita on tarkasteltu hoitoon non-Hodgkin-lymfoomat. We have actually looked at, as I mentioned, the role of combining chemotherapy, and there are other groups with other diseases including breast cancer, looking at it more in the metastatic setting in patients who have had recurrence or spread of their cancer.
But there does seem to be — if the chemotherapy is used at the right dose, and there's timing of when you actually give the vaccine and the chemotherapy — there may be a benefit for using the two approaches together. I'm not sure that currently there are any clinical studies in what we call adjuvant setting, while patients are getting chemotherapy that a vaccine is being used.
We have actually looked at that, and we are actually looking at possibly opening a study in the near future for patients to get a vaccine after they have completed the chemotherapy, the adjuvant chemotherapy. In that situation, once the patient has completed chemotherapy and after definitive treatments for primary breast cancer, if someone is hormone positive, they can be given hormones.
If they are HER2 positive, they go on Herceptin trastuzumab. But there are a group of patients for whom there are no treatment options, and they're really waiting to see whether or not the disease comes back, and I think this would be a good opportunity to bring a clinical trial forward for a vaccine. This question comes to us from Bedminster, New Jersey. Again, that's a very good question.
The rectal cancer, there are a couple of different proteins that are in rectal cancer that have been turned into vaccines. CEA is a protein that is pretty much ubiquitous or found throughout patients who have colon and rectal cancer, and there have been some studies with patients with colon and rectal cancer using these CEA vaccine approaches. I can't say that there is one vaccine approach better than the other, again because none of that has really been proven, but I do think that looking at what trials are available for what stage of cancer — because it really depends upon if this is newly diagnosed or if this is somebody with more advanced disease — I think it depends upon what trial is open and what treatment that particular individual has had, but I do think a vaccine may be beneficial.
It may be beneficial for a patient depending upon the situation. Earlier when we were talking, you touched on this idea of tumor burden being a factor in decisions and in how vaccines work. Is that a relevant issue in this case as well? It may be in the sense that if someone has more advanced cancer and has had a number of therapies, the likelihood of a vaccine being effective in that situation goes down quite a bit as opposed to someone with possibly the same type of tumor either earlier on in the disease course or somebody who has responded to a therapy that has significantly reduced the cancer.
I think in those situations, it's more probable that the vaccine may be more beneficial. Question now from Katonah, New York. Are vaccines also able to treat brain metastases, say from breast cancer? Or must a definite link to a virus be identified first?
We are looking at treating primary brain tumors now with vaccines, and I think that it's possible that through crossing the blood-brain barrier and getting the immune cells to attack the tumor in a metastatic setting, I think that is possible. Again where we run into it is that oftentimes patients with metastatic disease, brain tumor, usually have a lot more advanced disease, and then the number of times these patients have gone through a number of therapies, and the vaccines in that situation may not be quite as effective.
So I don't think it's out of the question, but I think that would be an opportunity where if I was designing a study, I would want to use a combination study of vaccine with another therapy that may be effective to see if we can get additional benefit with the vaccine.
So here is a question from a listener in Marietta, Georgia. The listener writes, "I had a liver resection in and sent a piece of the tumor to the Bahamas where they made me a vaccine which I did not get yet. I finished chemo November , and now have metastases to lungs. The primary was the colon. When is a good time to get the vaccine?
So that's really a twofold question, because again, as I mentioned, even in controlled settings when tumor was taken out of patients and vaccines were tried to be made, they tried making vaccines out of that, in many different situations the ability to make a vaccine is not percent.
I'm not sure what group or the reputation of who was doing this in the Bahamas, so it is possible that that vaccine, that autologous vaccine from that individual's tumor, there may not be a vaccine there.
So if that individual was interested in the vaccine study and there was not a vaccine available from what was made from the original tumor, I think that it would still be worth pursuing to see what's available in terms of the vaccines that are made through a recombinant technology.
I think that looking for a clinical trial that is ongoing is not out of the question, and somebody with advanced disease, that should be something that should be looked at. So this question comes from pancreatic cancer and comes to us from North Hollywood, California.
There are a number of vaccines that have been looked at in pancreatic cancer. I think the real issue especially in a disease like pancreatic cancer is, when do you use a vaccine? There was a large Phase III study with a vaccine that we had actually worked with that a company had licensed, and it was used in patients who had late-stage pancreatic cancer who had failed chemotherapy and where the overall survival was not expected to be great.
In that situation, it's really a poor design to try to bring a vaccine in in the later stages of life. Today, I think there are some studies now ongoing that are using the vaccine when pancreatic cancer diagnosed, either in combination with radiation therapy as a primary care, primary treatment, or even in the post-surgical setting when someone has undergone surgery coming in with a vaccine up front.
In a disease like pancreatic cancer, that's really where the vaccines may have a better opportunity to work. The later you wait in pancreatic cancer, I think the less effective a vaccine can be. This next question comes to us from Farmington, Utah. And does insurance cover the cost or does the research facility cover the cost? Multiple myeloma is another what we call liquid tumor. It's a disease of the plasma cells.
And there are some different treatment options. There are some small molecules that have now been approved for treatment of myeloma, but vaccines actually have been looked at. Some of my colleagues up at Harvard at Dana-Farber have been working with multiple myeloma vaccines, and there are a number of other institutions that probably have clinical trials ongoing in that particular area.
So I think looking again, just searching some of the standard Web sites to see what's active in terms of accrual for vaccines I think is something that should be looked at. In terms of the clinical trials, the eligibility for those trials, each trial, depending upon the institution, has different criteria in terms of who can come onto the trial. Some of it has to do with the actual stage of the tumor.
Some of it has to do with laboratory work in terms of blood work that they need certain criteria for patients coming on. Other trials actually look at performance status making sure somebody can still travel and get around in terms of being able to participate. So again, each different trial can have some differences in terms of who can potentially enroll in those particular studies.
And then how about that issue of cost? Is it typical for insurance to cover the cost or does the research facility? In certain situations, insurance companies will not pay for clinical trials, and I think it has to do with the particular institution, the particular drug, and the particular insurance policy.
So there are situations where clinical trials don't require insurance because the cost is covered through the study. The National Cancer Institute happens to sponsor clinical trials because it's federally sponsored where patients, even if they do have insurance, their insurance is not billed during the time that they are on a clinical study for either receiving the drugs or any of the tests that are associated with the clinical study.
So for studies at the actual National Cancer Institute in Bethesda, this is just one example of where patients who — if they do qualify and are willing to participate in the study — there is no cost or billing to the insurance company, and there is no cost to the individual.
This question comes from Los Angeles, California. It closed early due to lack of statistical evidence supporting continuing the study. I seemed to be responding.
Is this typical of the responses to recent vaccines for non-Hodgkin's lymphoma? I think that with some of the newer vaccines and understanding of the immune system, we have been able to overcome some of the barriers where older versions of vaccines didn't work, and I think that this is something that's becoming more common, especially with some of the tumors such as non-Hodgkin's lymphoma.
The question is, and I think unfortunately that in the sense that since there have become a lot more effective drugs for these treatments, the patients in terms of companies and really going forward with developing these vaccines have waned somewhat, whereas I think five, six, seven, eight years ago there was more of an impetus in terms of getting vaccines into these particular diseases.
Another disease has come up, lung cancer — a listener in Sun City Center, Florida would like to know if there are any vaccines currently in development for lung cancer.