Hi Everyone
Given that my daughters normal blood pressure has always been on the lower end of the scale, i have been giving her some OTC salt tablets (600mg Sodium Chloride) 4-5 times a day to counteract the Trandolapril and the higher dose of Verapamil over the week surrounding chemo treatments.
In reading an article from the library (Thank you Stephen for giving me access to the library) titled;
Losartan versus Enalapril on celebral edema, it states that lab rats were given a high salt intake to accelerate the appearance of celebral edema.
It concludes that chronic treatment with the AT receptor blocker Losartan prevents the development of celebral edema, and causes manifest cerebral edema to disappear in salt loaded rats?
I am totally new to all of this, and i struggle to understand the medical and scientific interpretations, so i guess my question is;
By giving my daughter a salt supplement to counteract her angiotensin medications, could i in fact be escalating the risk of additional edema.
Any feedback greatly appreciated.
Regards
Martin
Overconsumption of sodium could lead to water retention, but I've not seen any studies on this contributing to edema in brain tumor cases. In brain tumors, the edema is vasogenic in nature, meaning it is caused by leaky junctions in the blood vessels (because of too rapid angiogenesis), or disruption of the blood vessels by therapies such as radiation.
ReplyDeleteA doctor might be better able to answer this question though, or someone more knowledgeable than me on how the body maintains sodium equilibrium.
Thanks Stephen
DeleteI did speak with my doctor and he believes that the amount she is taking should not have any major effect, but appreciate the response.
Stephen, does this mean that the cerebral edema does not depend on the amount of liquid (water, tea) being drunk?
DeleteOur oncologist is very confident that the cerebral edema affects the fluid intake and categorically forbids drinking a lot of fluids. However, in other sources, on the contrary, it is written that for the withdrawal of toxins it is necessary to drink at least 2-3 liters of water per day.
I'm really unqualified to answer this question. On the one hand I would guess (and this is just a guess, not based on anything I've read) that the rate of leakage of fluid causing edema would be influenced by blood pressure (higher blood pressure causing an increased rate of leakage).
DeleteOn the other hand: "When cerebral edema causes raised ICP [intracranial pressure], systemic blood pressure rises as a compensatory phenomenon to ensure adequate cerebral perfusion. Hence, under these circumstances bringing down the raised blood pressure will increase the extent of cerebral ischaemic damage and will be counter productive."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923559/
I'm not sure how else liquid intake would effect edema, beyond its influence on blood volume and blood pressure.
Steven, thanks very much for your answers!
ReplyDeleteHave you heard of the recommendations to drink more water with chemotherapy to remove toxins from the decay of the tumor from the body?
Mom sometimes has vomiting and nausea, especially when taking DCA + caffeine. Unfortunately, no one will be able to say exactly what is happening. In the Russian-speaking forum about DCA there is an opinion that this is due to the toxins of the tumor disintegration.
I hadn't heard of this particular recommendation, again this isn't my area of expertise. I do know that both lomustine and temozolomide are eliminated primarily in the urine, so drinking enough water to maintain adequate kidney function makes intuitive sense.
DeleteMedicor Cancer Centre in Toronto Canada has treated hundreds of cancer patients with DCA. See their FAQ here:
http://medicorcancer.com/wp-content/uploads/DCA-FAQs_form-Medicor.pdf
"DCA and Caffeine
We have received a large number of inquiries about caffeine following some anecdotal reports of enhanced DCA effect with excessive tea/caffeine intake. After conducting a limited review of our DCA patients, we have noted that a few patients with high tea/caffeine consumption (> 10 cups per day) have shown no response to DCA. Also many patients who have shown an excellent response to DCA do not take tea/coffee or caffeine or take it in
minimal amounts." "We are presently recommending against the use of high dose caffeine, unless it is done with medical supervision."
I think the phenomenon you're asking about is called "tumor lysis syndrome".
Also from the Medicor FAQ: "TLS (Tumour Lysis Syndrome)
This is a condition in which a large number of tumour cells are rapidly killed, causing a sudden release of the contents of the dead cells into the bloodstream. It can result in abnormal heart rhythms, salt imbalance in the
blood and kidney failure. A detailed reference article can be found here:
http://www.emedicine.com/MED/topic2327.htm
TLS occurs most commonly in patients with a large mass of
tumour cells in the body who receive chemotherapy, especially with lymphomas or acute leukemia. We have not had a single case of TLS in our patients treated with DCA alone. Since DCA can enhance the effect of
chemotherapy in certain cases, it may be more likely to occur if DCA is combined with chemotherapy (especially without medical supervision). We have noticed that intravenous DCA can work more quickly than oral DCA in
some cases, so there is theoretically more risk of TLS. Still, we have not observed any cases of TLS with iv DCA so far after 1 year of use."
I personally doubt her nausea and vomiting is caused by tumor lysis syndrome. Many drugs can cause nausea including DCA.
DeleteFrom Medicor: "We have observed that DCA can have 2 main categories of side effects. Neurological... Gastrointestinal: Heartburn, nausea, vomiting, indigestion. These side effects may occur with DCA, and we prescribe a “proton pump inhibitor” antacid medication (e.g. pantoprazole) as needed to treat them."
Caffeine overdose can also cause nausea and vomiting.
Thanks for the very detailed answer!
DeleteWe tried to take omeprazole before breakfast and at the same time DCA (as in tests on mice), but immediately there was vomiting ((
Now we will try to take omeprazole before breakfast, and DCA - after breakfast ...
P.S. By the way, in one of the studies comparing omeprazole and pantoprazole, the following conclusion is made:
Omeprazole is an effective and relatively safe preparation for the treatment of diseases associated with high intensity of gastric acid production.
Pantoprazole is a proton pump inhibitor that, in comparison with omeprazole, has greater bioavailability, but less antisecretory activity and clinical efficacy in the treatment of peptic ulcer, reflux esophagitis of the 1st degree and 8 weeks of reflux esophagitis II and III degree according to Savary-Miller (equivalent to a daily dose of 20 mg of omeprazole and 40 mg of pantoprazole).
Of the two inhibitors of the proton pump, pantoprazole can definitely be recommended only when it is necessary to use together with clopidogrel or citalopram.