PSYCHOLOGICAL STRESS INDUCED CANCER AND ITS HOMOEOPATHIC

APPROACHDR. SINCHAN DAS

INTRODUCTION:

In this modern civilization, the society receives a good number of experiences along with many new diseases and defects which can harm the entire society. Among these, the most vulnerable is Cancer. But it should be clear in our mind that, it is not merely a pathological condition of the material body, rather it is the resultant of the extremely unscientific lifestyle of this time i.e. stress and mental anxiety, lack of physical exercise, irregular diet, extreme level of artificially harbored food products, irregular food habit, variety of addictions and lack of sound sleep. On the basis of our Homoeopathic concept of disease we know that, disease is not only a physical entity rather it is the dynamic deviation from the health, predisposed by “ the ascertainable physical constitution of the patient, his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual functions, and etc”(ORGANON OF MEDICINE, 6th edition by Dr.C.F.S.Hahnemann) even our mode of thinking also plays an important role in the formation of the disease.

Now let’s come to the matter of our discussion, “Psychological Stress induced Cancer and its Homoeopathic Approach." Stress or better to say Psychological stress is a serious threat to our society because it can lead to so many pathological conditions, among which cancer is the most dangerous. Before we go through the topic in detail we have to take a short view regarding the basic phenomenon of Psychological Stress and Cancer individually.

PSYCHOLOGICAL STRESS: Definition:

Psychological Stress is simply a reaction to a stimulus that disturbs our physical and or mental equilibrium. In other words, it is an omnipresent part of life.

Classification: It can be divided as: i) Acute Stress response and ii) Chronic Stress response.

PSYCHOLOGICAL STRESS

ACUTE STRESS RESPONSE CHRONIC STRESS RESPONSE

ACUTE STRESS RESPONSE/REACTION Acute stress reaction (also called acute stress disorder, psychological shock, mental shock, or simply shock) is a psychological condition arising in response to a terrifying or traumatic event, or witnessing a traumatic event. Acute stress disorder is the result of a traumatic event in which the person experiences or witnesses an event that causes the victim/witness to experience extreme, disturbing, or unexpected fear, stress, or pain, and that involves or threatens serious injury, perceives serious injury, or death to themselves or someone else. A study of rescue personnel after exposure to a traumatic event showed no gender difference in acute stress reaction. Acute stress reaction is a variation of post-traumatic stress disorder (PTSD).

Physiological Response to ASR The onset of a stress response is associated with specific physiological actions in the sympathetic nervous system, both directly and indirectly through the release of adrenaline and to a lesser extent noradrenaline from the medulla of the adrenal glands. These catecholamine hormones facilitate immediate physical reactions by---- i. Triggering increases in heart rate ii. Increases the breathing

iii. Constricting blood vesselsAn abundance of catecholamine at neuroreceptor sites facilitates reliance on spontaneous or intuitive behaviors often related to combat or escape. But long term or 'Chronic stress' can have detrimental effects on health.

Effects of Stressors on Nervous system The peripheral nervous system (PNS) consists of

two subsystems: (a) The somatic nervous system

and (b) The autonomic nervous system.

When a physical stressor acts upon the body the sensory-somatic

nervous system is triggered through stimulation of the body's sensory nerves. The signal acts as a nerve impulse and travels through the body in a process of electrical cell-to-cell communication until it reaches the autonomic nervous system. Activation of the autonomic nervous system immediately triggers a series of involuntary chemical responses throughout the body. Preganglionic neurons release the neurotransmitter acetylcholine (ACh). This stimulates postganglionic neurons which release noradrenaline. The noradrenaline flows directly into the bloodstream ensuring that all cells in the body's nervous and endocrine systems have been activated even in areas where the ganglionic neurons are unable to reach.

Body Body

Physical Stressor

Acts on the sensory nerves of the body

Stimulation of the Sensory Nerves of the body

Triggering of the Sensory- somatic nervous system

By the process of Cellto cell communication

Autonomic Nervous System

Activation of Preganglionic neuron

Release of Acetylcholine(Neurotransmitter)

Activates Postganglionic neuron

RESPONSE TO STRESSORS BY THE NERVOUS SYSTEM (Flow Chart)

Response of Endocrine system against the Stress: When a stressor acts upon the body, the endocrine system is triggered by the release of the neurotransmitter noradrenaline by the autonomic nervous system. Noradrenaline stimulates the hypothalamic-pituitary-adrenal axis (HPA) which processes the information about the stressor in the hypothalamus. This quickly signals the pituitary gland and finally triggers the adrenal cortex. The adrenal cortex responds by signaling the release of the corticosteroids cortisol directly into the bloodstream.

Stressors Body

Activation of the Autonomic Nervous System (ANS)

Release of Noradrenaline

Stimulates Hypothalamo-Pituitary-Adrenal axis

Processing of information in the Hypothalamus

Release of CRH

Quickly signals the Pituitary Gland

Release of ACTH

Triggering Adrenal Cortex

Cortisol

RELEASE INTO THE BLOOD STREAM

Diagrammatic view of Stress response system:

Processing of Stress The Central nervous system (CNS) is made up of the brain and the spinal cord. The brain is equipped to process stress in three main areas: the amygdala, the hippocampus, and the prefrontal cortex. Each of these areas is densely packed with stress corticosteroid receptors which process the intensity of physical and psychological stressors acting upon the body through a process of hormone reception. There are two types of corticosteroid receptors: i) Mineralocorticoid receptors and ii) Glucocorticoid receptors. The mineralocorticoid receptors (MR) have an extremely high affinity for cortisol. This means that they are at least partially stimulated at all times and therefore are entirely activated almost immediately when a true stressor is disrupting the homeostasis of the body. The second type of receptor, glucocorticoid receptors (GR), have a low affinity for cortisol and only begin to become activated as the sensation of stress reaches its peak intensity on the brain.

Stress dramatically reduces the ability of the blood brain barrier (BBB) to block the transfer of chemicals including hormones from entering the brain from the bloodstream. Therefore when corticosteroids are released into the bloodstream – they are immediately able to penetrate the brain and bind first the MR and then the GR. As the GR begin to become activated, neurons in the amygdala, hippocampus, and prefrontal cortex become over stimulated. This stimulation of the neurons triggers a fight-or-flight response which allows the brain to quickly process information and therefore deal with life-threatening situations. If the stress response continues and becomes chronic, the hyperactivity of the neurons begins to physically change the brain and have severe damaging effects on one's mental health. As the neurons begin to become stimulated, calcium is released through channels in their cell membranes. Although initially this allows the cells chemical signals to continue to fire, allowing nerve cells to remain stimulated, if this continues the cells will become overloaded with calcium leading to over-firing of neuron signals. The over-firing of the neurons is seen to the brain as a dangerous malfunction; therefore, triggering the cells to shut down to avoid death due to over stimulation.

Decline in both neuroplasticity and long-term potentiation (LTP) occurs in humans after experiencing levels of high continual stress.

Changes in the Brain In response to Stress To maintain homeostasis the brain continuously forms

new neural connections, reorganizing its neural pathways, and working to fix damages caused by injury and disease. This keeps the brain vital and able to perform cognitive complex thinking. When the brain receives a distress signal it immediately begins to go into overdrive. Neural pathways begin to fire and rewire at hyper-speed to help the brain understand how to handle the task at hand. Often, the brain becomes so intently focused on this one task that it is unable to comprehend, learn, or cognitively understand any other sensory information that is being thrown at it during this time. This over stimulation in specific areas and extreme lack of use in others causes several physiological changes in the brain to

take place which overall reduces or even destroys the neuroplasticity of the brain. Dendritic spines found in the dendrite of neurons begin to disappear and many dendrites become shorter and even less complex in structure. Glia cells begin to atrophy and neurogenesis often ceases completely. Without neuroplasticity, the brain loses the ability to form new connections and process new sensory information. Connections between neurons become so weak that it becomes nearly impossible for the brain to effectively encode long-term memories; therefore, the LTP of the hippocampus declines dramatically.

Stressors

Brain

Neural pathways begin to fire & rewire at hyper speed

Intently focused on one task

Unable to learn, comprehend or cognitively understand other sensory information

Reduces or Destroys Neuroplasticity of the brain

Dendritic cells on the neuron begins to disappearGlia cells begin To atrophy

Dendrites become shorter and less complex in size

Completely

Ceases neurogenesis

Loss of neuroplasticity + LTP of the hippocampus

declines dramatically

Response of the Immune system against stressors The most important aspect of the immune system are T-cells found in the form of T-helper and T-suppressor cells. Cortisol, once released into the bloodstream, immediately begins to cause division of T-Suppressor cells. This rapid cell division increases the number of T-Suppressor cells while at the same time suppressing T-helper cells. This reduces immune protection and leaves the body vulnerable to disease and infection.

Fight or Flight response

CANCER:

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. The hallmarks of cancer are:

Cell growth and division absent the proper signals. Continuous growth and division even in contrary

signals. Avoidance of programmed cell death. Limitless number of cell division. Angiogenesis Invasion of tissues and formation of metastasis.

Aetiology of Cancer

Chemicals- (a) Tobacco Smoke- Tobacco smoke contains over 50 known

carcinogens, including Nitrosamines and polycyclic

aromatic hydrocarbons. (b) Alcohol- Account for Hepatic and Gastro- Intestinal tract cancer (c) Inhalation of Asbestos dust, Silica etc- Lung cancer and

Mesothelioma (d) Benzene exposure- may leads to Leukaemia.

Diet and Exercise- Some risk factors associated with diet are- (a) High salt diet- Gastric cancer (b) Aflatoxin B1- Liver Cancer (c) Beetle nut chewing- Oral Cancer

Infections- Oncoviruses-

(a) Human Papilloma Virus (HPV) - Cervical Cancer of uterus (b) Epstein- Barr Virus (EPV) - B- cell lympho-proliferative

disease and Nasopharyngeal Carcinoma (c) Kaposi's sarcoma herpes virus (KSHV) - Kaposi's sarcoma

and Primary effusion

lymphomas. (d) Hepatitis B and C Viruses (HBV & HCV) - Hepatocellular

Carcinoma (e) Human T-cell Leukaemia Virus 1 (HTLV-1) - T-cell

leukaemia.

Bacteria- Helicobacter pylori- Gastric cancer

Parasites- a) Schistosoma haematobium- Squamous cell carcinoma

of bladder b) Liver flukes, Opistaorcis viverini and Clonorchis

sinensis-

CholangiocarcinomaRadiation-

(a) Ultra- Violet radiation from sun- Melanoma and other Skin malignancies

(b) Non- ionizing medium wave UVB- Non melanoma skin cancers

(c) Other radiations- Medical imaging, Radon gas exposure etc.

Heredity- Mutations in the genes BRCA1 and BRCA2- A BRCA mutation

is a mutation in either of the BRCA1 and BRCA2 genes, which are tumor suppressor genes. Hundreds of different types of mutations in these genes have been identified, some of which have been determined to be harmful, while others have no proven impact. Harmful mutations in these genes may produce a hereditary breast-ovarian cancer syndrome in affected persons. Only 5-10% of breast cancer cases in women are attributed to BRCA1 and BRCA2 mutations (with BRCA1 mutations being slightly more common than BRCA2 mutations), but the impact on women with the gene mutation is more profound. Women with harmful mutations in either BRCA1 or BRCA2 have a risk of breast cancer that is about five times the normal risk, and a risk of ovarian cancer that is about ten to thirty times normal. The risk of breast and ovarian cancer is higher for women with a high-risk BRCA1 mutation than with a BRCA2 mutation. Having a high-risk mutation does not guarantee that the woman will develop any type of cancer, or imply that any cancer that appears was actually caused by the mutation, rather than some other factor. High-risk mutations, which disable an important error-free DNA repair process (homology directed repair), significantly increase the person's risk of developing breast cancer, ovarian cancer and certain other cancers. Why BRCA1 and BRCA2 mutations lead preferentially to cancers of the breast and ovary is not known, but lack of BRCA1 function seems to lead to non-functional X-chromosome inactivation. Not all mutations are high-risk; some appear to be harmless variations. The cancer risk associated with any given mutation varies significantly and depends on the exact type and location of the mutation and possibly other individual factors. Mutations can be inherited from either parents or may pass to both sons and daughters. Each child of a genetic carrier, regardless of sex, has a 50% chance of inheriting the mutated gene from the parents who carry the mutation. As a result, half of the people with BRCA gene mutations are male, who would then pass the mutation on to 50% of their offspring, male or female. The risk of BRCA-related breast cancers for men with the mutation is higher than for other men, but still low. However, BRCA mutations can increase the risk of other cancers, such as colon cancer, pancreatic cancer, and prostate cancer.

Physical Agents- (a) Fibrous particulate- Asbestos, Wollastonite, Attapulgite, Glass

wool, Rock wool etc. (b) Non- Fibrous particulate- Powdered metallic cobalt, Nickel,

Crystalline- - Silica (c) Ingestion of Scalded Hot drinks (d) Chronic inflammation

Endocrinal factors- Chiefly the Stress hormones, e.g. Glucocorticoids,

Mineralocorticoids, Epinephrine, Nor- epinephrine etc and Growth hormones etc plays an important role in Carcinogenesis.

Cancer Triggers- Processed or Over cooked foods Raw sugars Trans fats HFCS (High Fructose Corn Syrup) Cow's milk Soda Deficiency of Vitamin-A Vitamin-C Vitamin-D Vitamin-E Vitamin-K2 Deficiency of Sulphur Excess of Sulphur Selenium Zinc Omega-3-EFA GLA (Gamma Linolenic Acid) Pancreatic enzymes Systemic enzymes Smoking Alcoholism Pharmaceutical drugs Environ Toxins Pesticides GMOs (Genetically Modified Foods) HFCS Artificial sweeteners Dyes Cosmetics Hair products Sedentary lifestyle No sunshine Stress Insomnia

Negative thinking Diabetes mellitus Obesity Cardio- Vascular Disturbances Hypertension Candiasis Autoimmune diseases etc.

OXIDATIVE STRESS: Oxidative stress reflects an imbalance between the systemic

manifestation of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage. Disturbances in the normal redox state of cells can cause toxic effects through the production of peroxides and free radicals that damage all components of the cell, including proteins, lipids, and DNA. Oxidative stress from oxidative metabolism causes base damage, as well as strand breaks in DNA. Base damage is mostly indirect and caused by reactive oxygen species (ROS) generated, e.g. O2− (superoxide radical), OH (hydroxyl radical) and H2O2 (hydrogen peroxide). Further, some reactive oxidative species act as cellular messengers in redox signaling. Thus, oxidative stress can cause disruptions in normal mechanisms of cellular signaling. This oxidative stress in responsible for development of Cancer mainly.

ANXIETY: Anxiety is an adverse emotional state, in which the feeling of fear is

disproportionate to the nature of the threat. Generally, anxiety is a normal or physiological emotional response to a threat. But if this response is inappropriate, extreme & persistent, it is classified as pathological. Anxiety is the result of stress or better to say section of stress (Ref: - STRESS; from Anxiety & Depression of America, www.healthline.com).

LINK BETWEEN OXIDATIVE STRESS METABOLIC PATHWAY & STRESS

Now, let us try to draw a link between Oxidative stress metabolic pathways and Anxiety (It is the commonest and a serious outcome of chronic psychological stress) related phenotypes. In 2005, Hovetta et al. identified a close relationship between anti-oxidative defense mechanisms and anxiety related phenotypes. They found that, in the brain, the expression of Glutathione reductase 1 and Glycoxalase 1, which are genes involved in anti-oxidative metabolism, is highly related with the anxiety related phenotypes.

In living organisms, an imbalance between oxidant production and antioxidant protection that favours oxidant causing a state termed as Oxidative stress. In this state, there can be differences in gene expression, protein conformation and cellular signaling. This state also alters neurotransmission, neuronal function and brain activity, as well as disrupting membrane integrity, even neuronal cell death may result. So, in the treatment our goal should be either activation of TSG to control cellular proliferation physiologically or facilitate DNA repair and prevention of mutation.

RELATION BETWEEN OXIDATIVE STRESS & CANCER: The term ‘‘oxidative stress” refers to a

cell’s state characterized by excessive production of reactive oxygen species (ROS) and oxidative stress is one of the most important regulatory mechanisms for stem, cancer, and cancer stem cells. The concept of cancer stem cells arose from observations of similarities between the self-renewal mechanism of stem cells and that of cancer stem cells, but compared to normal stem cells, they are believed to have no control over the cell number. ROS have been implicated in diverse processes in various cancers, and generally the increase of ROS in cancer cells is known to play an important role in the initiation and progression of cancer. Additionally, ROS have been considered as the most significant mutagens in stem cells; when elevated, blocking self-renewal and at the same time, serving as a signal stimulating stem cell differentiation. Several signaling pathways enhanced by oxidative stress are suggested to have important roles in tumorigenesis of cancer or cancer stem cells and the self-renewal ability of stem or cancer stem cells. It is now well established that mitochondria play a prominent role in apoptosis and increasing evidence supports that apoptosis and autophagy are physiological phenomena closely linked with oxidative stress. This review elucidates the effect and the mechanism of the oxidative stress on the regulation of stem, cancer, and cancer stem cells and focuses on the cell signaling cascades stimulated by oxidative stress and their mechanism in cancer stem cell formation, as very little is known about the redox status in cancer stem cells. Moreover, we explain the link between ROS and both of apoptosis and autophagy and the impact on cancer development and treatment.

HOMOEOPATHIC APPROACH IN THE TREATMENT OF CANCER: Although in Homoeopathic mode of treatment, there is no Medicine specified for a particular disease. Because, this mode of treatment does not categorize sufferings from their nosological name, rather it emphasized on the symptomatological totality of the suffering person. But, if we carefully go through the symptomatology of the patient & observe those chronologically, then we can easily construct the disease picture from those complains and simultaneously if we go through the medicinal symptoms from our ‘Materia Medica’, found during Drug proving and think about the pathogenesis of those symptoms, then we can easily find the similar disease symptoms and better to say the symptoms according to their cause, their different stages etc. Then by matching those, we can easily find our ‘Similimum’ suitable for a particular case.

For better understanding, we can discuss some cases treated as per Homoeopathic system of medicine. According to the ‘Clinical Repertory’ by Dr. Robbin Murphy, few 1st graded medicines suited for cancer are, Carcinocin, Arsenicum album, Sulphur, Coffea cruda etc, but these drugs are applicable as per the symptoms given by the patient. The symptoms varies according to the stage of the disease, responsible cause of the particular disease and above all the susceptibility of the particular patient.

CASES TREATED BY HOMOEOPATHIC MEDICINE: It is my observation that, physical general symptoms & mental general symptoms which are one of the chief guiding criteria of selection of the Similimum for a Homoeopathic physician is also changes with the advancement of the case.

Examples DATE

PERSONAL DETAILS

PRESENT COMPLAINS

HISTORY FAMILY HISTORY

GENERALITIES EXAMINATION

LABORATORY FINDINGS

SYMPTOMATOLOGICAL TOTALITY

PRESCRIPTION

RESULT

20.04.13

Name- xxAge- 74 ySex- MaleLocality- Howrah MaidanOccupation-Retired Police officer

1. Vertigo, with tendency to falling on the right side, dizziness, recurrent blackout.

2. Hemicrania, with cold feeling in head, relieved by cold application.

3. Recurrent respiratory infection.

4. Progressive weight loss

No serious ailments but leads a stressful life.

Father- Oral CA (Died)

Grandfather-Prostate CA (Died)

Mother- DM-2 (Alive)HTN

Maternal Grand Father- APL

Thermal Reaction- Chilly pt. (But previously he was Hot in nature)Appetite- Greatly decreased, even the smell of food also nauseates.Desire- Hot food, Meat, Pungent, Milk, Strong coffeeIntolerance- Sour, Ice cream, Cold drinks.Thirst- Great thirst, but very little at a time,

Anaemia- ++++HepatomegalySplenomegalyFacies- AnxiousTongue- Dirty coated.B.P.- 70/40 mm of HgPulse- TachycardiaWeight- 45 kg

Hb- 7.5gm/dLHaematocrit- 12%W.B.C.- 1,22000/cu.mmPlatelet 30,000/cu.mmBone marrow examination:

1.Anxiety about trifles2. Mentally restless, but physically weak.3. Can’t bother about other’s feelings.4. Chilly Patient5. General Burning Sensation6. easily exhausted7. Great thirst, but small quantities at a time.8. Desire for coffee.9. General amelioration Hot10, Headache relieved by cold application.

Arsenicum album 30/12 dosagesB.D. x 6 days

Stress releasing therapy through Indian Classical Music

28.04.131. Frequency of blackout improves2. Hemicrania is initially aggravate for few hours then disappears the entire complain. 3. Cough is still persisting but Intensity of suffering relieves.4. Absence of epistaxis.5. Sleep- Improves6. Stool- Clear than previous days7. Burning is relieved

19.05.131. Frequency of Blackout still improving2. Hemicrania is still absent3. Cough is absent, Chest

5. Delayed coagulation, Small wound bleeds excessively, Epistaxis with burning in nose, relieved by hot water.

excess quantity causing vomiting.Stool- Semi liquid muddy stool with Offensive odour, dark in colour, too much prostrating & burning at anus for long time..Urine- Clear with offensive smell & burning for long timeSweat- Very offensive, Profuse, prostratingSleep- Disturbed, Anxious Decubitus- in supine position with 3 pillow & place hand over the head.Dream- of fear.MENTAL- Too much anxious about trifles, Mentally too much restless but can’t express that restlessness physically because of weaknessCan’t bother feelings of anybody, Fear of everything

11. Great prostration even after small stool12. Offensive urine13. Sleep anxious14. Dream of fear15. Decubitus- Must lie with 3 pillows due to the fear of suffocation16. Lying with hand over the head.

28.04.13Arsenicum album200/2 dosages in liquidO.D. x 2 days

Nihilinum 200 /20 dosagesO.D.x 20 days

Stress releasing therapy through Indian Classical Music

19.05.13Ferrum Phos. 3x4 tabs X 4 times X 16 days

Nihilinum 200/ 30 dosages O.D. X 30 days.

Advice to manage the Stress.

is clear4. Epistaxis is still absent5. Stool- Clear6. No complain of burning7. Sleep- Sound8. No complain of dyspnea9. weight- 48 kg10. B.P. 100/60 mm of Hg11. Platelet- 1,20,000/cu. Mm12. Hb- 13.5 gm/dl13. W.B.C.- 14,600/cu mm

7.7.131. No Complain of the patient2. Weight- 54.5 kg3. Appetite- Good4. Thirst- for moderate amount of water5. W.B.C. 7,500/cu mm6. Platelet- 2,95,000/cu mm7. Hb- 14.5.gm/dl

16.o6.14

Name- YYYAge- 38 yearsSex-MaleLocality-

1. Stitching pain in Right side of the throat on deglutition, Mainly with solid foods,

1. Pain in throat from last 3 years but in varying intensity

Father- DM-II (Alive)

Mother- DM-II, OA

Thermal ReactionChilly patient

Appetite- Lost, due to pain in throat with

Anaemia++++-Mouth-Multiple, Irregular growths under the

Hb- 9gm/dL

W.B.C. - 72000/cumm.

1.Extreme level of fastidiousness2. Anxious about conscience.3. Anxious about health.4. Too much

16.06.14Arsenicum album 30/16 dosage

28.06.141. Surprisingly growths under the tongue absolutely disappeared.2. Pain in throat is reduced relatively.3. Burning pain

Mukundapur, KolkataOccupation- Care taker of a housing

temporarily relieved by Swallowing of Hot liquids.

2. Severe burning pain in the oral cavity with salivation & multiple small growths under the tongue, relieved by taking hot liquids.

3. Right sided hemicrania on noon very much sensitive to the open air relieved by pouring icy cold water on the head associated with restlessness.

4. Profound weakness with loss of energy & marked weight loss abruptly.

, It becomes worsen day by day.

2. Growth in the oral cavity gradually worsen day by day from last 2.5 years. (1st it was single small growth but at present it is multiple in no. & of varying size)

3. Rt.Sided hemicrania from last 6 months.

4. Profound weakness from last 2 months.

5. DM-II from last 3 months

(Alive)

Paternal Grandfather- Non Hodgkin’s Lymphoma (Died)

Paternal Grandmother- D.M.-II, T.B.(Alive)Maternal Grandfather- DCLAD(Died)

Maternal Grandmother- CA Uterus (Died)

continual nausea & vomiting of bitter fluid.

Thirst- Great thirst but small quantities at a time, can’t swallow too much because of nausea.

Desire- Warm food, Hot Drinks, Fried food, Sour, Sweet, Fish, Milk, Alcohol

Aversion- Fatty Farinaceous foods, Meat, Food, especially at night.

Intolerance- Cold foods & drinks,

Stool- Small, Hard, Dark in colour, Very much offensive, & prostrating; long after defecation persistent burning.

Urine- Yellowish, Offensive urine sedimentation if keep it for long time

Sweat- Offensive & exhausting.

Sleep—Disturbed

Dreams- of fire, of death, of fear.

Taste- Bitter or sometimes metallic taste in the mouth.

Tendency- to catches cold easily

tongue, Rt. Side of the uvula with irregular surface.

Throat-Rt. Sided enlargement of tonsil, cervical glands.

HepatomegalyTenderness at the rt. Hypochondriac region.

B.P.- 90/60mmof Hg

Pulse rate-112/minute

Alkaline phosphatase- 345IU/L

FBS- 267mg/dl

PPBS- 526 mg/dl

U.S.G. of neck- Right sided lymphadenopathy

Urine- Albuminuria

restless mentally, but physically too weak.5. Selfishness6. Sudden attack of fear causes drive to escape.7.Chilly patient8. Loss of appetite.9. Continual nausea.10. Great thirst but for small quantities at a time.11. Desire for Hot foods.12. Desire for hot liquids.13. Desire for alcohol.14. Desire for milk.15. Aversion to meat at night.16. Small, dark, offensive stool.17. Great exhaustion and prostration.18. All discharges are offensive.19. Burning is associated with everything.20. Dream of fear.21. Dream of fire.

sB.D. X 8 days

Echinesia Q for flushing & gurgle. Twice daily after lunch & dinner.

Adviced to quit al type of harmful addictions.

Stress relaxation in done

28.06.14Arsenic trioxide0/116 dosagesO.D. X 16 days

Carduus marianus Q5 drops in water for B.D. X 30 days

Advice are repeater as previous prescription.

18.07.14Brimestone

absolutely disappeared.4. Physical examination reveals reduced no. of swelled cervical gland.5. Appetite is still poor.6. Nausea is still persisting.7. Weakness is still persisting.8. Hb- 10.5 gm/dL9. W.B.C.- 31,500/cu.mm10. Alkaline phosphatase 243IU/L

18.07.141. No change in growths or in pain.2.Appetite is better than before.3. Bitter taste in mouth is now absent.4. Weakness is markedly reduced.5. Alkaline phosphatase- 128 IU/L6. FBS- 132mg/dl7. PPBS- 149 mg/dl8. Generalities are changed Hot pt.Desire for sweet.Desire for fried food.Averse to workAverse to waterTake large quantities of water at a time.Take water with food.Intolerance of milk.Burning in sole.

12.09.141. Growths are surprisingly totally disappeared.2.Appetite is good3. Now the patient have no other complains.4. Laboratory findings are also within normal limits.

Sensation- Burning along the vertebral column.

MENTAL- Irritable, Angered easily, Anxious about very small matters, Selfish, Anxious about conscience , Anxious about health, Desire for company, Fear of being alone, Fear of poisoning, Extreme level of fastidiousness, Sudden attack of fear results into jumps out from bed to escape from that place, mentally too much restless.

0/2 16 dosagesO.D. X 16 days

Carduus Marianus Q 3 drops X O.D. X 20days

Stress relaxation is done.

Advice to maintain a healthy life and avoid of unhygienic lifestyle.

EFFICACY OF ARSENICUM ALBUM IN THE TREATMENT OF CANCER: Now, let us come to the Arsenicum album and its role in the treatment of the cancer. Our Arsenicum album is chemically Arsenic trioxide. This arsenic trioxide chemically has the potential to kill the targeted pathological areas when it is prescribed homoeopathically in lower potency. The chimeric protein encoded by the PML-RAR alpha gene that is pathognomonic of acute promyelocytic leukemia (APL) causes the arrest of myeloid cell development at the promyelocyte stage, leading to an accumulation of abnormal promyelocytes in the bone marrow. Differentiation therapy with all-trans retinoic acid (ATRA) is used routinely in patients with APL, but ATRA is not the only agent in clinical use that promotes differentiation of the abnormal clone. Arsenic trioxide (ATO) has been shown to cause degradation of PML-RAR alpha, promoting differentiation. APL cells are extremely sensitive to ATO, which has shown good clinical activity at low doses in patients with relapsed APL. However, degradation of PML-RAR alpha may not be wholly responsible for the great sensitivity of APL cells to ATO that also acts through the intracellular environment to influence apoptosis, differentiation, growth arrest, and angiogenesis. ATO can act at several points in mitochondrially induced apoptosis, including degradation of peroxides and interaction with glutathione (GSH)-related enzymes. Subclones that are resistant to ATO have been used to demonstrate that sensitivity can be

restored by reducing the cellular GSH content. GSH can be reduced using agents such as buthionine sulfoximine (BSO) and ascorbic acid. The key factors that determine the ATO sensitivity of cells and control ATO-induced apoptosis have not yet been defined. It has been proposed that ATO acts through activation of Jun N-terminal kinase (JNK), activator protein-1, and inhibition of dual-specificity phosphatases, and evidence is accumulating that JNK activation is an important event in arsenic-induced apoptosis. Further research is required to determine the exact pathways through which the cytotoxic actions of ATO are mediated.

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