Doctorweblog. About Health & Medicine

The active ingredient in evening primrose oil is gammalinolenic acid (GLA), and it is the GLA which gives the oil its cancer-controlling properties. It maybe working in three different ways:
1. Lipid peroxides. What the researchers have found is that when human cancer cells are exposed to polyunsaturated fatty acids in the laboratory, the cells generate large amounts of substances called lipid peroxides, and die.
Several different PUFAs have been tried to see which one is the most effective. GLA seems to be the best PUFA – it is highly toxic to malignant cells, but has no toxic effects whatsoever on normal cells.
It is now known that the majority of human and animal cancers contain low levels of lipid peroxides. There is evidence that lipid peroxides play a role in regulating cell division. In most cancers, the reason for the low levels of lipid peroxides seems to be a low concentration of PUFA substrate, which is needed for the formation of peroxide.
This may on the face of it seem paradoxical, because peroxides have a reputation for always being harmful. However, it now seems as though lipid peroxides, although indeed harmful in some situations, may be physiological regulators of cell division.
Some capsules of evening primrose oil contain Vitamin E as an anti-oxidant. However, studies have shown that Vitamin E in fact inhibits the toxic effects of GLA on malignant cells, so the best treatment for cancer would be large doses of evening primrose oil without the Vitamin E. Ideally, fish oils should also be taken. New clinical trials on cancer are using Efatnol Marine, instead of Efamol on its own.
2.  It by-passes the delta-6-desaturase enzyme block. Cancer is a known blocking agent of the metabolic pathway of linoleic acid. This block occurs at the first step, between linoleic acid and gammalinolenic acid, by inhibiting the delta-6-desaturase enzyme. The GLA in evening primrose oil by-passes this block by starting at the second stage in the metabolic pathway This means that GLA can convert to DGLA and then to prostaglandin El without hindrance.
3. Prostaglandins. Another way in which polyunsaturated fatty acids might be controlling cancer cells is by being converted into prostaglandins. Prostaglandins derived from PUFAs may inhibit the proliferation of human and animal tumour cells, and reverse transformed cells.
Originally it was thought that it was only PGE1 which had anti-cancer properties, but it now seems that other prostaglandins are important too.
It must be stressed that all the above studies are preliminary, and although major clinical trials are planned, there are no results to date.
However, evening primrose oil is already widely used by alternative health centers and practitioners, such as the Bristol Cancer Help Centre, for patients with cancer. In these cases it is used as part of a whole treatment programme, often involving several nutrients and a fundamental change of diet.
It must be emphasized that people with cancer should not treat themselves, but should always seek the advice of a qualified practitioner.
The studies with GLA are exciting, but the situation at the moment is that no double-blind trial has yet shown it to be effective. Until such trials are done, anyone with cancer taking evening primrose oil can only hope it will help them.

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Breathing extra oxygen will make you feel easier, whatever the reason for your breathlessness. Ask about this if the reason for your breathlessness cannot be corrected, or if you feel that the cost of trying to correct it is too great for the likely benefit, or while you are waiting for treatment of the cause to work. It is quite feasible to have an oxygen cylinder at home and it also comes in small cylinders which can be fixed to a wheelchair or carried around fairly easily.

Feeling very breathless can be extremely frightening and stressful. You may find it very hard to relax or to sleep, even with oxygen. Having somebody sit with you may help. Taking a sedative is another possibility. In considering whether to take sedatives you should understand that they could make your breathing and coughing less efficient. This is a cost that you may well be prepared to accept, especially if your cancer cannot be cured and the reason for your breathlessness cannot be relieved. Some doctors take this choice out of their patient’s hands, either by prescribing a sedative without telling them or by refusing to prescribe one even when the patient asks for it. The choice should be yours. Insist that your doctors prescribe nothing without your agreement. Tell them if you would prefer to be either more alert or more drowsy than you are. You have the right to choose, even if the choice to be more drowsy could mean that you don’t live quite as long.

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The anesthetist will then begin your anesthetic, and will remain with you throughout the whole operation to make sure you are asleep and that the function of your heart and lungs is satisfactory. Once the anesthetic has been injected into the tube in your hand or arm, you will fall asleep within seconds. The drug which makes you go to sleep may sting a little as it enters the vein from the cannula, but this feeling does not last long.

Several different types of drugs will be given to you during your operation:

1 induction agents to bring on sleep;

2 maintenance agents to keep you asleep;

3 analgesics to stop you feeling pain after the operation;

4 anti-emetics to help stop you feeling sick after the operation.

If local anesthetic is injected into the wound during surgery, you will have little or no pain for a few hours after you wake up.

After your operation

When your operation is over, the anesthetist will stop giving you the drugs that were keeping you asleep and you will probably be taken to a recovery room or step-down ward.

The recovery room

The nurses in the recovery room are specially trained to care for patients coming round from anesthetics after an operation. You will stay in this room, still watched over by monitoring equipment, until you are fully awake and ready to be returned to your own ward.

If you are in pain when you wake up, tell a nurse in the recovery room as you can be given an injection or tablets to relieve it.

The step-down ward

If you are going home on the same day as your operation, you may be taken to a step-down ward. The nurses on this ward will make sure that you are fit to go home and that your journey will be safe and pain free. They will also want to be sure that you have a responsible adult to care for you once you are at home, and should give you advice about how to manage your recovery over the next few days.

Back on the ward

If you are not going home the same day, you will be taken back to your own ward, where the anesthetist may visit you before you leave. This visit is to ensure that you are having adequate pain relief and have no ill-effects from your operation. Do tell the anesthetist if you have any concerns or questions.

Side-effects of the anesthetic

There are side-effects which can occur after anesthesia, but these do not normally last longer than a couple of days. A sore throat is quite common, and is caused by the dry gases breathed while you are asleep, or by the tube which may have been put down your throat to help you breathe during your operation.

If you feel unwell, or have pain anywhere other than at the site of your wound, do tell the anesthetist – or a nurse on your ward – so that the reasons for it can be discovered.

Pain relief

The house surgeon and nurses on your ward will be able to give you analgesics to control any pain. However, if these drugs are not enough, do tell the anesthetist or ward staff, which may be able to give you something more effective.

The amount of pain suffered after a breast operation varies from person to person. Some women have pain or slight discomfort for only 12 to 24 hours and will not need any pain-killing injections after this. Others may need injections for up to 3 days after their operation.

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