Sunday, October 12, 2008

What is chronotherapy?

Chronotherapy takes into account how our body's natural rhythms' impact our ability to process medications. Patterns like sleeping, menstrual cycles, even our physical response to the changing seasons, are different for everyone. In the old days we called these biorhythms. Today, doctors are finding that understanding a patient's biorhythms, and coordinating the timing of their medical treatments to these biorhythms, can profoundly affect the outcome of their treatments. This is called chronotherapy.

Every drug has an optimal time when it is least toxic and most effective. says Keith Block, MD, editor-in-chief of the peer-reviewed journal Integrative Cancer Therapies, and Clinical Professor, Department of Medical Education, at the University of Illinois College of Medicine at Chicago (UIC), and at the Department of Pharmacology. For cancer treatment, this is determined by several factors, including the biological uniqueness of the particular drug being given, the time when the specific type of cancer cells divide the most, when the normal healthy cells of the patient generally divide the least, the patient's circadian clock and individual rest-activity cycles, and even the time zone the person resides in.According to Dr. Michael Smolensky, co-author of the book The Body Clock Guide to Better Health, when cancer medications are given in a chronobiological manner, patients may be able to tolerate higher, more potent doses than would be possible otherwise.

This method of administering chemotherapy is revolutionary and has demonstrated in large randomized trials its potential to improve survival, states Dr. Block. We have found that often patients receiving chronotherapy reduce what would have been recurring side effects of nausea, vomiting, diarrhea, and fatigue. This is important because the debilitation caused by chemo can cause patients to reduce or even stop treatments that could otherwise help them win their battle with cancer.

Chronotherapy is being widely researched around the world: there are over 62,000 references in the National Institute of Health's archive of biomedical and life sciences journal articles about chronobiology and how biology is affected by timing and over 500 scientific articles specifically about chronotherapy.

The National Cancer Institute's Office of Cancer Complementary and Alternative Medicine (OCCAM) devoted an entire web cast for doctors on chronotherapy.So why isn't chronotherapy used more widely?One of the main problems has been logistic, figuring out how to deliver chemotherapy in exactly timed doses. Portable infusion pumps may hold the answer, explains Gerald Sokol, MD, an oncologist with the division of oncology in FDA's Center for Drug Evaluation and Research.

Dr. Block has brought technology to the U.S. that administers chemotherapy via a pump designed to precisely time up to four channels of infusion simultaneously to the individual needs of a patient. Highly portable and small enough to fit in a fanny pack, patients are able to maintain full mobility, play sports, and enjoy a full night's sleep while receiving their specifically timed cancer therapy.


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