Tuesday, September 4, 2012

Preventing and Treating Desmoid Tumors


Extensive infiltrative mesenteric Desmoid tumor in 46-year-old man. Coronal true fast imaging with steady-state free precession MR image shows Desmoid tumor (arrows) infiltrating mesenteric fat.


What are Desmoid Tumors?
Desmoid tumors arise from cells called fibroblasts. Fibroblasts
are found throughout our body and their main function is to
provide structural support and protection to the vital organs such
as lung, liver, blood vessels, heart, kidneys, skin, intestines etc.
and they also play a critical role in wound healing. When
fibroblast cells undergo biological transformation from dietary
and/or metabolic acids they can become cancerous and become
encapsulated by the cross-linking of fibrin monomers forming
what is called a desmoid tumor (also known as "aggressive
fibromatosis"). Desmoid tumors can arise in virtually any part of
the body. These tumor formations often occur in women in their
30's, but can occur in anyone at any age. Desmoid tumors can be
slow or extremely aggressive depending on how acidic the
individual lifestyle and diet.

They do not metastasize (move from one body part to another), and if the fibroblasts develop slowly in any given area of the body they can be carefully watched by your Physician using non-radioactive Ultra-sound. However, when fibroblasts are accumulating aggressively they can cause life threatening problems or even death when they compress or block the flow of blood to vital organs such as the small or large intestines, kidney, lungs, brain, etc.

Desmoid Tumors are rare!
In the United States, approximately 900 people are diagnosed with desmoid tumors every year. This means that out of a million people approximately 2-4 people have desmoid tumors. Experts believe that the numbers are likely to be far greater because of the difficulty in correctly diagnosing this acidic disease.

Because of inconsistent and inaccurate reporting procedures, accurate statistics about the number of desmoid tumor cases have not been kept. Individuals between the ages of 15 and 60 are most often affected, but this disease can occur in anyone. The average age is 30's to 40's. They are slightly more common in women than in men (2:1), and there is no significant racial or ethnic distribution.

Causes of Desmoid Tumors
The cause of most desmoid tumors is the increase of fibroblasts in the repair of damaged tissues from dietary and/or metabolic acid being pushed out from the alkaline blood into the connective tissues. Most fibroblast cell aggregations have an acid damaged or mutated gene called beta catenin.

A minority of fibroblast cells are encapsulated or cross-linked by fibrin monomers forming a desmoid tumor are caused by acid damage or mutations in a gene called Familial Adenomatous Polyposis or FAP.  Patients with acid mutations in the FAP gene are predisposed to forming hundreds of polyps in the intestines and go on to develop a cancerous condition of the colon. Unfortunately, patients with FAP are often recommended to undergo surgical removal of their intestines when a change of lifestyle and diet can help in preventing the formation of desmoid tumors.  Medical savants consider that patients with FAP are at a very high risk of developing desmoid tumors, which can arise deep in the abdomen or in the abdominal wall. In older scientific literature, the combination of FAP and desmoid tumors is termed Gardner's Syndrome.

In some rare cases, desmoid tumors can occur in women who are pregnant. This happens during pregnancy or after a surgical delivery. Many researchers believe that this is caused by a combination of elevated hormones and surgery, both of which are disturbing to the alkaline design of the body fluids and tissues, however, these is no strong scientific evidence to support this claim. The relationship between pregnancy and desmoid tumors is very rare and consists of mostly anecdotes in the scientific literature.

Clinical Presentation
Metabolic and/or dietary acids when not properly eliminated through the four channels of elimination (respiration, defecation, perspiration, or urination) are deposited into the connective and fatty tissues.  This may cause cellular damage and a rise in fibroblast cells to repair damaged tissue increasing the risk for the formation of Desmoid tumors leading to the development at virtually any site in the body.  Superficial desmoids tend to be less aggressive than desmoids found deep inside the body (i.e., abdominal, extra-abdominal, mesenteric). Superficial desmoid tumors usually manifest themselves as a painless or slightly painful lump depending on location.  Desmoids inside the abdomen can cause severe pain, rupture of intestines, compression of the kidneys or ureters or rectal bleeding. They can compress critical blood vessels such as the mesenteric vessels and the vena cava. Desmoid tumors may have multiple sites of origin on chest, arms or legs.
Diagnosis
Ultrasound is often the first method of examination of a soft tissue tumor to determine the size and to safely monitor its changes without harmful radiation. If the mass is solid, a CT and/or MRI scan may be used to determine whether it adheres to nearby structures and whether it can be safely removed. A variety of options are available for biopsying a suspected desmoid: a core needle biopsy takes a small piece, usually 1 mm wide by 10 mm long; surgical biopsies may take a portion of the tumor ("incisional biopsy") or may remove all the visible tumor ("excisional biopsy"). While an excisional biopsy may remove all visible tumor, it rarely completely removes all microscopic traces of the tumor – usually leaving a positive margin, that is, tumor at the edge of the biopsy site.  There is always a risk for an increase in the size of the tumor when biopsying.   It is recommended to use Ultrasound as a safe non-radioactive way of monitoring the efficacy of non-invasive treatments.

Behavior of Desmoid Tumors
Although desmoid tumors generally do not metastasize, the formation of Desmoind tumors may be devastating and occasionally fatal when causing congestion or blockages of blood flow or fecal matter in the intestines.  Desmoid tumors may cause major health challenges when a group of tissues and Fibroblasts become locally acidic, infiltrating and sometimes causing acidic damaged to adjacent organs (intestines, lungs, blood vessels etc).  Some Desmoids tumors are well-contained and can be indolent and have periods of stability and temporary regression has encapsulated cells harden and breakdown. These need to be watched closely by physicians using weekly Ultrasound imaging.

Treatment?
Traditionally when one is diagnosed with a Desmoid tumor the recommendation is to be evaluated in a major, academic hospital with experts in sarcoma.  These hospitals are usually designated as NCCN (National Comprehensive Cancer Network) centers which is a recognition bestowed by the National Cancer Institute.  It is suggested when a patient is diagnosed with desmoid tumor he/she should be evaluated by a multi-disciplinary team of surgeons, medical oncologists, radiation oncologists, geneticists, and nurses.  There is currently no cure for desmoid tumors using traditional medical procedures.  When possible patients are encouraged to enlist in clinical trials by the National Cancer Institute (NCCN guidelines).  The prevention of Desmoid tumors may be achieved with an alkaline lifestyle and diet.  In the treatment of Desmoid tumors I have suggested hyper-perfusing the tissues with alkalinity using sodium bicarbonate IV’s to define borders, prevent healthy tissue from being affected, and to reduce Desmoid tumor size.  This reduction in the size of a Desmoid tumor can be followed by using non-radioactive Ultra-sound.

Traditional Medical Treatment
There is no single accepted medical treatment for Desmoid tumors. Numerous reports of individual cases show shrinkage or stabilization of tumor size or at least improvement in symptoms after a very wide variety of treatments.  Chemotherapy is a chemical drug that is usually injected in the veins.  A few chemotherapies that are commonly used include: doxorubicin, Doxil, dacarbazine, methotrexate, vinorelbine and vinblastine.  These are toxic chemotherapies that can have a wide range of short and long term tissue and/or organ degenerative effects.  There have also been anecdotal reports of using sulindac (non-steroidal anti-inflammatory) or anti-hormonal agents such as tamoxifen, however the true efficacy of these drugs have not been investigated in clinical trials.  To reduce the negative toxic effects of full dose chemotherapy one may consider low-dose (less than 10 percent of the normal dose) chemotherapy which is better tolerated and with generally lower toxic degenerative effects.

Alternative Medical Treatment
The pH Miracle “Life” style and diet is a natural way to protect healthy tissues from dietary and/or metabolic acids and prevent and/or treat tissue acidosis from and increase of Fibroblast cells and the formation of Desmoid tumors.  The key to preventing and/or reversing the increase of Fibroblast cells and the formation of Desmoid tumors is to decrease tissue acidosis caused by an acidic lifestyle and diet with an alkaline lifestyle and diet as outlined in The pH Miracle revised and updated book by Dr. Robert O. Young and Shelley Redford Young.  The five basic tenants of the pH Miracle “LIFE” style is as follows:

     1)   Open up the four channels of elimination including the bowels, urinary tract system, respiratory system and the pores of the skin for the removal of dietary and metabolic acids.
     2)   Heal the damage to the intestinal villi due to an acidic diet.
     3)   Build and restore health to the red blood cells.
     4)   Hyper-perfuse the blood and tissues with alkaline mineral salts including sodium bicarbonate.
     5)   Increase the pH of the saliva and the urine in excess of 7.2 with an alkaline diet, lifestyle and alkalizing minerals.

For more information read The pH Miracle revised and updated book published by Hachett Publishing, 2010. 




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