Sleep apnoea can encourage cancer growth

A new study has shown how patients who suffer from sleep apnoea may leave themselves open to encouraging the growth of cancer tumours.  The hypoxia caused by the condition results in blood vessel growth in tumours.
Sleep apnoea is a disorder whereby the patient has shallow breaths and pauses in breathing during sleep, which can last from a few seconds to a few minutes and can happen up to 30 times in an hour. This can be due to the airway becoming blocked or collapsing during sleep.  Risk factors include a small upper airway, smoking, alcohol use, being overweight and having a large neck. Many patients who suffer respiratory disease also find that they suffer from sleep apnoea, especially COPD patients as a large proportion of COPD patients still continue to smoke.
Previous studies have linked sleep apnoea to an increase of death from cancer but this recent study has made the mechanisms a bit clearer. It seems that the intermittent hypoxia (reduction of oxygen in the blood available to the tissue cells) suffered by the patient during episodes of sleep apnoea encourages mechanisms that result in tumour growth.  Mice that had tumours and experienced intermittent hypoxia (like with sleep apnoea) showed an increase in vascular progenitor cells and endothelial cells. These cells than can mature to create blood vessels in tumours. This increase in blood vessels within the tumour will allow the tumours to receive more oxygen and nutrients from the blood to encourage growth and for them to metastasise and spread throughout the body.
Also these mice showed an increase in levels of VEGF (vascular endothelial growth factor) which is a protein known to boost blood vessel formation.  Overall the team behind the study believe that the findings indicate that sleep apnoea may worsen the outcome for cancer patients.
Dr. Vilaseca says “patients suffering from obstructive sleep apnoea usually suffer from intermittent hypoxia at night. This work shows that intermittent hypoxia has the potential to promote the formation of blood vessels within tumours, meaning that the tumours have access to more nutrients.”
Prof. Arnulf Stenzi comments that the findings are remarkable and shows how oxygen deficiency can really influence the body in many ways and especially in this case with tumours. “It may be postulated that increased oxygenation of the blood may be the underlying mechanism why not smoking or giving up smoking, regular sport activity, reducing the body mass index (BMI) and other lifestyle changes that increase tissue oxygenation have a supportive beneficial effect on better outcomes in….cell cancer.”
Further studies will be carried out as it opens up the question as to whether this only happens during sleep apnoea episodes or whether it could happen during the waking day with patients who suffer from shortness of breath with respiratory conditions such as asthma and COPD. It could make it even more vitally important that patients who suffer from conditions where blood oxygen levels drop ensure they are monitored and take their medication and supplemental oxygen regimentally both day and night to ensure that they are not risking an increase in tumour growth. Cancer can go undetected and you may not be aware that you have it but allowing your body to become hypoxic could be encouraging tumour growth; whether malignant or benign and worsening the condition and your outcome.

Oxygen could help in the battle against depression

depressionIn March this year researchers showed that rats exposed to high-altitude conditions exhibited increased depression-like behaviour. This study proved that hypoxia (low oxygen levels) is a distinct risk factor for depression in those that either live at high altitudes or suffer from COPD, asthma or who smoke.
The link between altitude and high depression rates and suicide is very obvious in the intermountain region of the United States where the rates are considerably higher than any other part of America. The region has earned itself the nick-name of the ‘suicide belt’.
Rats are not however subject to the same psychological and social pressures as people are and more research on humans would need to be undertaken in order to substantiate this link. Other risk factors are also important such as poverty, low population and psychiatric disorders. This study shows that this risk factor would be present with everybody who either live in high altitudes or suffer with a condition that results in a lowering of oxygen levels in your blood.
Hypoxia is thought to impair an enzyme involved in the synthesis of serotonin (a compound that contributes to happiness and feelings of well-being), resulting in lower Serotonin levels and leading to depression. Depression is normally treated with anti-depressants however ‘The Utah Paradox’ illustrates how drugs do not necessarily work in high-altitude regions, as Utah has the highest depression index and the highest use of antidepressants in the country.
The fact that both depression and suicide rates increase with altitude, where there are low oxygen levels, implies that antidepressant treatment is not adequate for those suffering from depression and as low oxygen is the main common factor in most cases, maybe this needs to be looked into as a possible new treatment for depression in those that experience low oxygen levels.
Significant improvements were demonstrated when schizophrenic patients underwent oxygen therapy and now they will try it out on sufferers of depression. Oxygen therapy is easy, non-invasive and safe so new research will trial it on sufferers of low and medium-level depression.
Researchers found that exposing psychiatric patients to 40% concentration of oxygen rather than 21% oxygen levels from the air, via a plastic tube is safe and effective and the patients functioned significantly better than those who inhaled normal air. Increasing the supply of oxygen to the brain will increase the function of mitochondria which produce energy in the cells. Poorly functioning mitochondria can disrupt the functioning of neurones and the electrical activity of the brain. Theoretically therefore raising oxygen levels inhaled by patients can improve psychiatric functioning, it now just needs to be proven. If it is proven to be the case then oxygen therapy could relieve depression symptoms in hours/days and weeks compared to antidepressants which can take months and years to take full effect. You wouldn’t be using medications but a natural substance, which is easy to use, cheaper and brings about results a lot quicker, reducing the likelihood of a potential attempt on life.

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Oxygen can aid in Wound Healing

Oxygen is fast being recognised as one of the most powerful agents available to medicine. The therapeutic use of oxygen under pressure has been used to assist wound healing for almost 40 years.

oxygen and healing

It was first used to re-compress divers in the 1930s, and was developed to complement the effects of radiation in cancer treatment in the 1950s. Within a few years it was being used to support patients undergoing cardiac surgery, and to treat gas gangrene and carbon monoxide poisoning. Pressurized oxygen was first used to assist wound healing when it was noted in 1965 that burns of the victims of a coal mine explosion, treated with it for their CO poisoning, healed faster. In spite of this long history of therapeutic use, the mechanisms of pressurized oxygen are still being discovered and the medical use of oxygen under pressure is still an evolving speciality.
In wound healing, hypoxia can be defined as an insufficient supply of oxygen to allow the healing process to proceed at a normal rate and it is possible to have hypoxia in one area of a wound and not in an adjacent area.
Not all effects of hypoxia are bad and in fact all wounds initially have areas of hypoxic tissue. It actually causes several wound healing processes to occur but when hypoxia is severe, prolonged or widespread it can cause tissue cells to die and the wound can worsen and have effects on other parts of the body.
The capillaries can become leaky and oedema accumulates and blood circulation can become compromised. Surgery or medicine can re-establish circulation which sends blood to the ischaemic area, providing new oxygen substrate for the formation of more free radicals, with the result that the injury temporarily worsens. In massive injury the release of inflammatory cytokines and free radicals are high enough that it  can lead to multiple organ failure. Therefore a catastrophic chain of events can be initiated by oxygen deprivation.
When used in wound healing pressurized oxygen is administered as a short pulse of oxygen – 90 minutes in a 24-hour day. Although the elevated amount of oxygen is only for a short time, the numerous other effects of pressurized oxygen carried on affecting and treating the wound after the treatment has stopped.
At elevated pressures the harmful effects of gas bubbles in the tissue are minimised.
The vasoconstrictive effects can be used to good effect and causes a significant reduction of oedema, which has been shown to be beneficial in re-perfusion injury, crush injury, compartment syndrome, burns and wound healing.
High levels of oxygen can diffuse into the wound which may otherwise be restricted if administered via the blood due to oedema or if blood vessels to the area have been damaged.
It is also capable of increasing the number of cytokines and many growth factors important to wound healing.
Pressurized oxygen also aids in the prevention of infection by not only the killing of bacteria, by aiding in providing an oxygenated environment which would kill of anaerobic organisms and increases the production of neutrophils which aid in also destroying bacteria but by also aiding and increasing the effectiveness of administered antibiotics.
Therefore pressurized oxygen has the potential to be used more widely in the future to aid in the healing of severe wounds and burns, as it has been proven to have reduced morbidity and infection, increases the healing process and reduces the extent of tissue necrosis and prevents further systemic problems in the body normally associated with severe wounds.