Meet our doctors: M. Houman Fekrazad on a potential chemotherapy patch
Chemotherapy is a major tool in the fight against cancer. This method of using drugs to destroy cancer cells has successfully treated many patients. Yet while chemotherapy has been proven to effectively attack cancer cells, it can cause serious side effects that can severely impact a patient’s quality of life.
Here M. Houman Fekrazad, M.D., an associate clinical professor of medical oncology at City of Hope | Antelope Valley, discusses ongoing research, including a new chemotherapy patch he is currently developing. Such research has considerable promise not only to increase chemotherapy’s efficacy, but to reduce the toxic side effects that often accompany this form of treatment.
How does chemotherapy work? Chemotherapy works by stopping or slowing the growth of cancer cells. At the same time, it can damage normal healthy cells of the human body, such as those in the bone marrow, liver, kidney, nerves, hair or the lining of your mouth and intestines. Damage to healthy cells may cause side effects. Most are temporary while the patient is on treatment. However, long-term side effects of chemotherapy need to be discussed with patients prior to initiating therapy.
You own a patent on a patch that can deliver chemotherapy through the skin. Can you tell us more? Sure. By today’s standards, there has only been two ways to administer anti-cancer drugs – intravenously (IV) and orally. In this project (which is still in the planning stages), we aim to put chemotherapy into nanoparticles and then pass it through the skin. The chemotherapy will then be released in the bloodstream to target the cancer cells. There are several issues that can potentially be eliminated when chemotherapy is administered through the skin. For example:
- We can control and hopefully eradicate cancer cells by providing lower doses of chemotherapy continuously, compared to the traditional IV and oral methods. Also, we expect patients will experience fewer side effects from the chemotherapy.
- Sometimes the active part of anti-cancer drugs is not bioavailable (i.e., active) when we administer it through an IV or orally. This means we have to give a pro-drug to the patient. Pro-drugs convert chemotherapy to the active drug by an enzymatic change in the human body. Through this process, sometimes we get an unwanted agent that can cause side effects. This can be eliminated by putting the active drugs into the nanoparticles and passing them through the skin. Nanoparticles dissolve in the body and chemotherapy will be delivered in the blood stream.
- We will decrease or avoid the first pass metabolism when transdermal delivery route is used.
We are in the beginning stages of this fascinating research project and expect to have a clinical trial underway in the coming months. This may change how we practice oncology and administer chemotherapy to cancer patients. It’s very exciting.
Can you describe what is meant by “chemo brain” and how can it be managed? Chemo brain is a common term used by cancer patients to describe thinking and memory problems that can occur after chemotherapy and sometimes following radiotherapy. Another term used by physicians is cognitive dysfunction or chemotherapy-related cognitive impairment. As far as management of the condition, research for chemo brain treatments is still in the very early stages. Patients may, however, feel some temporary relief by taking a stimulant, such as Adderall (dextroamphetamine and amphetamine), which can be prescribed by their physicians. However, before taking anything, patients should definitely discuss the benefit versus potential side effects of these agents with their physician.
Why did you choose this area of expertise? What inspires you to do the work you do? I have a passion to take care of cancer patients and individuals with blood disorders. The science behind this field is truly amazing. I learn something new every day. Also, my mother, who had Stage 4 metastatic colon cancer, is my other reason to practice in this field. She had colon surgery followed by chemotherapy prior to removing tumors from her liver. This was done in 2007 and today she is cancer-free. I do hope and pray that my mother continues to do well and my patients gain the same benefits she received from modern multidisciplinary cancer treatments.
What do you do outside of work? I have two young kids – one is almost 4 years old and the other less than 6 months. I am a heavily involved dad and enjoy my time with them while at home. I have various hobbies outside of work, too. I enjoy swimming, watching sports and listening to music, that is, if I have the time.
Do you have questions about this potential new patch as a form of administering chemotherapy? Let us know by posting your thoughts below.
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