Algemeen: PDT - Photodynamische Therapie (laser- of lichttherapie) in Duitsland met enkele vragen en antwoorden over wat PDT precies inhoudt

29 november 2011: ik ben kanker-actueel aan het herzien en kwam onderstaand artikel tegen. De Duitse kliniek bestaat nog steeds maar zover ik kan zien op hun website wordt er niet meer gewerkt met PDT - Foto Dynamische therapie. U zou natuurljik zelf informatie in kunnen winnen of ze dit nog uitvoeren want ze doen wel RFA - Radio Frequency Ablation en ook hyperthermie maar wellicht hebben zij eerder aan een studie meegewerkt en is deze gestopt. Wel laat ik de beschrijving van wat PDT inhoudt nog maar even staan:

Mei 2003:

In deze Duitse kliniek hebben ze veel ervaring met PDT oftewel laser- of lichttherapie volg3ens enkele patienten die inforamtie bij hun inwonnen en worden tumoren tot 4,5 cm. doorsnee behandeld. In die zin interessant vooral bv. voor mond- en keelkanker, borstkanker, longkanker enz.

Radiologische Praxisklinik und Gemeinschaftspraxis

Dr. K. Korten und Partner Ringstrasse 44
Ringstrasse 44
32427 Minden
Tel 0049 571 88 - 95 - 110
afd. Lasertherapie: 0049 571 8895-116
Fax 0049 571 88 - 95 - 199
Website: http://www.rp-minden.de/praxis/standorte/minden/?L=0
E-mail: mail@rp-minden.de

Via hun kregen we via deelnemers van onze mailgroep deze vragen en antwoorden toegestuurd over PDT, ook wel laser - of lichttherapie genoemd, maar niet te verwarren met de RFA - laserbehandelingen bij levertumoren:

Patient Information on Photodynamic Therapy
Some Frequently Asked Questions
WHAT IS PHOTODYNAMIC THERAPY?
Photodynamic Therapy, abbreviated PDT, is a new treatment for some forms of cancer.
The treatment consists of two steps:
STEP 1 IS THE INTRAVENOUS INJECTION OF A PHOTOSENSITIVE SUBSTANCE, dihematoporphyrin ether (DHE), usually called by its trade name PHOTOFRIN®. Sometimes this is referred to as a "dye," although it cannot be seen after it is injected into a vein.
Two properties make DHE useful in cancer treatment - one is that cancer cells hold onto this material longer than normal cells do; the other is that light can activate the DHE inside the cells.
STEP 2 IS THE APPLICATION OF LASER LIGHT, approximately two days later, to the cancerous tissue which contains high concentrations of the dye. When the dye is exposed to the laser light, a series of chemical reactions occur, resulting in destruction of the cancerous cells. Since the normal tissue retains little or none of the dye, it is not usually affected.
IS PHOTODYNAMIC THERAPY DONE IN THE HOSPITAL?
The laser light application is always done in an operating room of the surgery department at the hospital. The injection of the dye is sometimes done just hours prior to the laser light application in a designated area near the main surgery department, and sometimes the PHOTOFRIN® is injected one or two days before treatment on an outpatient basis in the Laser Center. The doctor will determine when the PHOTOFRIN® is to be given in relation to the laser light treatment. Occasionally small cancers can be treated as out patients.
HOW DOES THE LASER LIGHT REACH THE CANCER?
Laser light can be directed very precisely to the diseased tissue through a fiber-optic (a very thin glass strand) attached to the laser at the point where the beam of light comes out. The fiber is then placed close to, or into the tumor to deliver the proper amount of light. These fiber-optic can be used free-hand for treatment of skin and subcutaneous cancers, or directed through a bronchoscope into the lungs, or through an endoscope into the esophagus, GI tract, or through a cystoscope into the bladder.
HOW IS LASER LIGHT DIFFERENT FROM ORDINARY LIGHT?
Ordinary light, such as that from light bulbs is diffuse, meaning the light rays are scattered rather than focused. Laser light is of a single wavelength - all the energy works together and in one direction. Because laser light can be focused to a fine point and can be controlled so precisely, it is a very useful tool for surgery.
There are many different types of lasers. The one we use in Photodynamic Therapy is the argon dye laser. In this case, the argon dye laser is used to produce red light.
IS LASER LIGHT A TYPE OF RADIATION?
NO. Some people confuse laser light with radiation, but these are not the same. Although radiation rays and laser light are both part of the electromagnetic spectrum, laser light lies within the visible or near visible light range, and is completely different from ionizing radiation treatment.
WILL PHOTODYNAMIC THERAPY MAKE ME "SICK" LIKE CHEMOTHERAPY AND X-RAY THERAPY SOMETIMES CAN?
Although skin photosensitivity is a temporary side effect of the PHOTOFRIN®, no one has ever gotten "sick" from the injection of the dye. The laser light destroys only those cells where it has been focused, meaning it is a localized treatment. It affects only the area tested rather than the whole body, whereas chemotherapy and ionizing radiation therapy can affect the entire body.
CAN PHOTODYNAMIC THERAPY BE DONE AT THE SAME TIME I AM RECEIVING CHEMOTHERAPY AND/OR X-RAY THERAPY?
Usually photodynamic therapy is done prior to or after chemotherapy or radiation therapy. However, it sometimes can be done concurrently with chemotherapy and radiation therapy. This issue must be decided by your physicians.
CAN THIS PROCEDURE BE DONE MORE THAN ONCE? IS THERE A LIMIT TO THE NUMBER OF TIMES I CAN RECEIVE PHOTODYNAMIC THERAPY?
To achieve the desired result, photodynamic therapy is often done more than once. There is no limit to the number of injections that may be given, nor is there a limit to the number of laser light applications possible. However, some clinical protocols limit the number of both injections and laser light applications for research purposes. One of our patients was injected 10 times over several years.
WHAT SIDE EFFECTS SHOULD I EXPECT?
The major side effect of PHOTOFRIN® is skin photosensitivity lasting usually four to six weeks from the time of injection. In rare cases, skin photosensitivity has persisted for several months. During this time, exposure to sunlight or very intense light (such as that from sun lamps, dentist's lamps, etc.) can result in redness and swelling of the skin of exposed areas, much like that of a sunburn. This skin reaction can happen after only a few minutes exposure to the sunlight an can be severe.
Depending upon the treatment site, there may also be other temporary side effects. The nurse and doctor will explain these side effects and the potential risks prior to treatment. These will also be outlined in the Informed Consent document that must be signed by you before treatment can be started.
HOW CAN I AVOID SUNBURN?
For the four to six weeks after injection of PHOTOFRIN® that your skin will be sensitive to sunlight, exposure must be controlled. During the first two weeks after injection, exposure to direct sunlight should be avoided completely, and when exposure to direct sunlight is unavoidable, protective clothing must be worn. While in the hospital, sunlight-blocking shades are drawn across the window of the room during the daytime. The return to normal sunlight exposure habits should take place very gradually and cautiously. More specific and detailed instructions will be given on how to protect against skin reaction and the time frame for following these precautions.
WHY ARE SOME OF THESE TREATMENTS CONSIDERED INVESTIGATIONAL?
The search for good cancer treatments begins with basic research in laboratory and animal studies. The best results of that research are tried in patient studies, known as clinical trials. Clinical trials help us find out if a promising new treatment is safe and effective. If the treatment under investigation, through clinical trials, is found effective, it may then be used together with other effective drugs, or with surgery, and/or radiation therapy. A number of standard treatments were first shown to be effective in clinical trials.
WHO CAN BE TREATED WITH PDT?
People with cancer should always have the best treatment available. Therefore, if there are other proven, effective forms of treatment for a particular type of cancer, those should be tried first. If the patient has failed, refused, or is found ineligible for the conventional treatment, he may then be considered for Photodynamic Therapy. Unfortunately PDT will not help patients with liver or bone metastases. Unless they are symptomatic from endobronchial or intestinal tumors.
WILL PHOTODYNAMIC THERAPY CURE MY DISEASE?
Whether cancer is curable with any type of treatment depends upon the type and location of the cancer and the extent of the disease. Often it is not possible to completely cure someone, but some of the cancer may be destroyed and it's progression checked. Life-threatening or painful conditions associated with the cancer may be relieved and additional time made more pleasant and comfortable.
1997 - Approved by France and The Netherlands for treatment of advanced lung and esophageal tumors; by Germany for treatment of early lung cancer.