Friday, January 9, 2015

Banking Your Baby's Cord Blood

The pros and cons, costs, and reasons behind saving your newborn's umbilical cord blood.

If you're expecting a baby, you might have thought about umbilical cord blood - along with the many other ways you can hope to make life safe for your child.

Expectant parents do all kinds of things for safety's sake. They plug up empty electrical sockets, childproof their cabinets, pore over car seat research, and measure the space between the bars of hand-me-down cribs -- all months before their son or daughter is born.

And some are now choosing a procedure that, they feel, could further protect their children from harm: umbilical cord blood banking.

The procedure takes blood from the umbilical cord at birth and stores it for a fee in a private blood bank. (Public banks are another option - see below.) Because this blood is rich in stem cells -- cells that have the ability to transform into just about any human cell -- it could someday be used as treatment if your child ever became ill with certain diseases. It might also be useful for a sick sibling or relative. Banking cord blood is a way of preserving potentially life-saving cells that usually get thrown away after birth.

What is Cord Blood?

After a baby is born and the umbilical cord is cut, some blood remains in the blood vessels of the placenta and the portion of the umbilical cord that remains attached to it. After birth, the baby no longer needs this extra blood. This blood is called placental blood or umbilical cord blood: "cord blood" for short.

Cord blood contains all the normal elements of blood - red blood cells, white blood cells, platelets and plasma. But it is also rich in hematopoietic (blood-forming) stem cells, similar to those found in bone marrow. This is why cord blood can be used for transplantation as an alternative to bone marrow.

Cord blood is being used increasingly on an experimental basis as a source of stem cells, as an alternative to bone marrow. Most cord blood transplants have been performed in patients with blood and immune system diseases. Cord Blood transplants have also been performed for patients with genetic or metabolic diseases.  More than 80 different diseases have been treated to date with unrelated cord blood transplants.

What is the umbilical cord?

The umbilical cord connects a baby in the womb to its mother. It runs from an opening in your baby’s stomach to the placenta in the womb. The average cord is about 50cm (20 inches) long.

What does the umbilical cord do?

In the placenta, oxygen and nutrients from your bloodstream pass into your baby's bloodstream and are carried to your baby along the umbilical cord.
Blood circulates through vessels in the cord, which consists of:
  • one vein that carries blood rich in oxygen and nutrients from you to your baby
  • two arteries that return deoxygenated blood and waste products, such as carbon dioxide, from your baby back to the placenta
These blood vessels are enclosed and protected by a sticky substance called Wharton’s jelly, which itself is covered by a layer of membrane called the amnion.
Towards the end of your pregnancy, the placenta passes antibodies through the umbilical cord from you to your baby, giving it immunity from infections for about three months after birth. However, it only passes on antibodies that you already have.

Monday, December 22, 2014

Chemotherapy for malignant mesothelioma

Chemotherapy (chemo) is treatment with anti-cancer drugs. There are 2 main ways that chemotherapy can be given to treat mesothelioma. 

In systemic therapy, chemotherapy is injected into a vein. The drug enters the bloodstream and travels throughout the body to reach and destroy the cancer cells wherever they may be.

Chemo drugs can also be placed directly into the body cavity where the cancer is – either intrapleurally (directly into the chest) or intraperitoneally (into the abdomen) – with a small catheter (tube) placed through a small cut in the chest or abdominal wall. Chemo drugs given this way are still absorbed into the bloodstream, but the highest concentration of the drug goes directly to where the cancer cells are. 

Chemo drugs are sometimes heated before they are placed directly into a body cavity (called hyperthermic chemotherapy), which may help them work better. Sometimes this treatment is given as a single dose in the operating room, right after surgery to remove the cancer. This approach is called heated intraoperative chemotherapy or HIPEC. It is more often used to treat peritoneal cancers, in which case it may be called heated intraperitoneal chemotherapy.

Radiation therapy for malignant mesothelioma

Radiation therapy uses high-energy x-rays or particles to kill cancer cells. Mesotheliomas are often hard to treat with radiation therapy. They are not usually contained as single, discrete tumors, so aiming radiation at them while avoiding nearby normal tissues is difficult. But new radiation therapy techniques may make this form of treatment more useful.

Uses of radiation therapy

Radiation therapy may be used in different ways to treat mesothelioma:
  • It can be used after surgery to try to kill any small areas of cancer that could not be seen and removed during surgery. This is called adjuvant radiation therapy.
  • It can be used as a palliative procedure to ease symptoms of mesothelioma such as shortness of breath, pain, bleeding, and trouble swallowing.

Types of radiation therapy

Two main types of radiation therapy can be used to treat mesothelioma:

External beam radiation therapy (EBRT): This type of radiation therapy uses x-rays from a machine outside the patient’s body to kill cancer cells. It is the most common form of radiation therapy for mesothelioma.