Cancer Treatment San Francisco Bay Area

Cancer Treatment San Francisco Bay Area

Cancer Treatment San Francisco Bay Area is about finding real solutions for cancer.  Clinical case histories are further validating the strong theoretical  foundation that elevated substance p secondary to jaw misalignment are a major contributory factor to  the development of multiple types of cancer. See prior blog.

Today I saw two cases that I have been treating with dental orthopedics for 6months and fifteen months respectively.  Both have had major improvement in their cancer markers.  The first case with leukemia has dramatically improved his blood cell types.  In this case, his substance P levels have dropped from over 300 to 39 (less than 60 is normal). It is suspected that the elevated substance P was impacting stem cell differentiation (based on research).

The other with breast cancer has documented many months of continued improvement in CA125.

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TMJ, Substance P, and Cancer

TMJ, Substance P, and Cancer:

substance P

Substance P molecule

Case histories suggest daily, ever stronger, that bite dysfunction with its sub-sequential elevated substance P through trigeminal nerve stimulation, is likely a major contributor to the development of many types of cancer.  This belief is based on a multitude of clinical observations and very strong medical literature.

Medical Literature:Substance P is known to be a major regulator of tumor cell proliferation (favoring tumor growth), angiogenesis, and migration of the tumor cells for invasion and metastasis (see article-particularly look at extensive references in article or abstract below).  The role of substance P in stem cell differentiation strongly suggests that bite dysfunction is likely cause of a large percentage of leukemias and lymphomas (see article or abstract below).

Case histories:

The incidence of breast cancer amongst my TMJ patients is very high.  Currently, I am providing optimal dental orthopedic therapy in conjunction with physician managed treatment for a number of other cancers with good early response.

 

 

Neurokinin-1 Receptor: A New Promising Target in the Treatment of Cancer

Published on October 8, 2010
Author: Miguel Muñoz
Specialty: Pediatrics
Institution: Research Laboratory on Neuropeptides, Hospital Infantil Universitario Virgen del Rocío
Address: Sevilla, 41013, Spain

Author: Rafael CoveñasSpecialty: Neuroscience
Institution: Laboratory of Neuroanatomy of the Peptidergic Systems, Institute of Neuroscience of Castilla y León (INCYL), University of Salamanca
Address: Salamanca, 37007, Spain

Abstract: Substance P (SP) has a widespread distribution in the whole body. After binding to the neurokinin-1 (NK-1) receptor, SP regulates biological functions related to cancer: tumor cell proliferation (favoring tumor growth), angiogenesis, and migration of the tumor cells for invasion and metastasis. SP also exerts an antiapoptotic effect. The peptide is secreted from primary tumors and from peripheral nerves, and reaches the whole body through the blood stream. NK-1 receptors are overexpressed in tumors (cancer cells express more NK-1 receptors than normal cells). By contrast, after binding to NK-1 receptors, the NK-1 receptor antagonists specifically inhibit tumor cell proliferation (tumor cells die by apoptosis), angiogenesis and the migration of the tumor cells. Thus, 1) the SP/NK-1 receptor system plays an important role in the development of cancer, angiogenesis, and metastasis; 2) a common mechanism for cancer cell proliferation mediated by the SP/NK-1 receptor system occurs; 3) NK-1 receptor antagonists act as a broad-spectrum antitumoral agent; 4) the NK-1 receptor could be a new promising target in the treatment of cancer; 5) NK-1 receptor antagonists could improve cancer treatment — the development of antagonist molecules of the NK-1 receptor represents an important opportunity for exploiting these molecules as novel therapeutic agents.

 

Postepy Hig Med Dosw (Online). 2009 Mar 2;63:106-13.

[Substance P as a regulatory peptide of hematopoiesis and blood cell functions].

[Article in Polish]

Source

Zakład Hematologii Eksperymentalnej, Instytut Zoologii Uniwersytetu Jagiellońskiego, Poland.

Abstract

SP is an undecapeptide that belongs to the family of related neurokinins termed tachykinins. SP is one of the mediators responsible for the neural-immune/hematopoietic cross-talk. It is released from the nerve fibers of the autonomic and enteric nervous systems in lymphoid organs and is also produced by the resident, stromal or hematopoietic cells. SP stimulates the production of hematopoietic cytokines (e.g. IL-1, IL-3, IL-6, SCF, GM-CSF) by bone marrow stromal cells. It enhances the proliferation of bone marrow progenitors, both directly by binding to progenitor’s receptors and indirectly by interacting with marrow stromal cells. SP can also modulate immune and hematopoietic functions like phagocytosis, immunoglobulin production, lymphocyte proliferation and platelet aggregation. SP fragments derived from endopeptidase activity could also exert immune and hematopoietic regulation. The biological effects of SP are mediated through interactions with certain G protein-coupled receptors: the neurokinin (NK) receptors. Different studies have shown that NK receptors are localized on immuno-competent cells, including monocytes/macrophages, neutrophils, mast cells, dendritic cells and T or B lymphocytes, bone marrow stromal cells and hematopoietic progenitors. The disturbance of the neural-hematopoietic-immune axis may be implicated in hematological malignancies. SP seems to be important in the neoplastic transformation of bone marrow, leading to the development of acute leukaemia in children; myelofibrosis and also metastases to bone marrow of solid tumors in early stages of these diseases.

PMID:19252469  Free full text

 

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Dental Orthopedics

Dental orthopedics is the area of dentistry concerned with the structure, function, and alignment of the upper and lower jaw bones.  It is some times referred to as dentofacial orthopedics, craniomandibular orthopedics, or jaw orthopedics.  The term is applied to efforts to expand the size of jaw bones (vertical and horizontal), lengthen the upper or lower jaws, or reposition either the upper or lower jaw.

There are many appliances that are designated as dental orthopedic appliances like Crozats, Bimler, Schwartz, Bionator, Sagittal, etc.  Splint therapy, occlusal guards, and sleep apnea appliances  are also a form of dental orthopedics as they reposition the lower jaw.

The American Dental Association some years ago changed the official title of orthodontists from “orthodontic specialist” to “orthodontic and dentofacial orthopedic specialist” without substantially changing their educational requirements.  Hence, many orthodontists know very little about dental orthopedics and concentrate on aligning teeth with braces.  This treatment often falls short of the most ideal treatment.  Giving someone a pretty smile does not assure that their jaw is appropriately developed laterally, vertically, or positioned properly in space.  This has to be done with proper assessment (medical history and functional tests), and often appliances other than braces.

Before the proper orthopedic treatment can be rendered to a patient, it is necessary to have a good understanding of ideal structure and function.  This is missing in orthodontic training.  Research shows that modern man has devolved with substantial retrusion of both the middle and lower face.  Too many orthodontists are too willing to work with the structure that their patients present with since most orthodontic training programs impart a poor understanding of ideal structure and how to achieve it.

In addition, in order to provide proper orthopedic treatment, it is critical that the correct diagnostics are perfomed before treatment begins.  Before orthodontic treatment is initiated there are certain dental records that are required legally to satisfy the standard of care.  They include study models, photographic pictures, and dental x-rays and cephalometric x-ray (side view of head).  These are only structural tests.  This list does not include the critical functional assessment of where the muscles want the jaw to be, nor how much tension is in the muscles when the teeth are brought together, etc.

It is not surprising under such circumstances, why many patients end up after orthodontic treatment with significant dysfunction and TMJ pain.  Corrective treatment then is to do the dental orthopedic diagnostics that were never done.

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Another reason why TMJ treatment fails

There is something to be said for years of experience.  One of the things that I have observed from treating thousands of TMJ cases is that compressed jaw joints continue to decompress for months, if not years.  This is demonstrated by the fact that over time many cases develop excess anterior contact or the lower jaw functionally wants to be more forward.  This is such a consistent phenomenon that my treatment is designed to allow for this movement.  In less experienced professional treatment plans I suspect that it leads to many cases of recurrent pain and joint dysfunction.  It is but another reason why TMJ treatment fails.

The best way that I have found to remedy this moving structure is over treat TMJ cases such that I leave them with an anterior open bite for approximately three to 6 months (function brings them back together).  I find that if the anterior teeth contact sooner than that, that the likelihood of eventual failure is high.

Other aspects of why TMJ treatment fails can be found at my Youtube video.

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TMJ, Dental Orthopedics, and Movement Disorders

The connection between TMJ, dental orthopedics, and movement disorders and jaw misalignment is rapidly being uncovered.  (Note: Definition of dental orthopedics: the assessment and treatment of jaw alignment)  The information is quickly being spread to TMJ treatment dentists (see article on movement disorders and TMJ). Regretfully, I am not aware of any academic institutions that have taken an interest in this discovery.  The American Academy of Craniofacial Pain has taken the lead in presenting the clinical research on movement disorders.

TMJ twin block appliances

dental orthopedic appliances

My own personal investigation into TMJ, dental orthopedics, and movement disorders has led me to a view somewhat different than a number of the articles published on movement disorders. I believe the primary pathology is caused by trigeminal proprioception impact on reticular formation sensory integration, rather than by direct trigeminal sensory input. A more thorough analysis of TMJ, dental orthopedics and movement disorders is covered on my supported website of parkinsonstmj.com.

What seems to be often missing with dentists performing this treatment and the numerous articles is a thorough understanding of Biomechanical Principles of Occlusion and the jaw orthopedic splinting process. It is my expectation that jaw orthopedics as a specialty of dentistry will be elevated as the triad of TMJ, dental orthopedics, and movement disorders evolves. It is regretful that the orthodontic community has not pursued a more rigorous investigation of TMJ, dental orthopedics, dental medicine, and the application to movement disorders.

It must be recognized that TMJ dysfunction and movement disorders are both symptoms of an abnormal dental orthopedic relationship.  Clinical experience has shown that neuromuscular dental diagnostics are often not accurate on patients with long term accommodation (possibly termed contracture).  I am a strong advocate of the application of neuromuscular diagnostics, but I am always suspicious of the results and cross check them with other functional tests.

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Brain blood flow is affected by bite

Brain blood flow is affected by bite for sure (see http:tmjcalifornia/elder-care-initiative).  And brain blood flow can impact brain function in a wide range of ways.  When a patient has a  known condition associated with altered brain blood blow, the doctors never  consider the bite as a possible cause.  They should.

I came across an interesting example of how the bite impacts brain blood flow this week.  When one eats something too cold- like ice cream, it causes a severe headache in the frontal area of the head (sometimes called a brain freeze).  This pain is known to be preceded by a dramatic increase in blood flow to the pre-frontal cortex area of the brain (NPR story this week).  What that means is that trigeminal nerve sensory is modulating pre-frontal  blood flow.  But the medical community does not know that bite misalignments can alter trigeminal sensory input, hence possibly causing dysfunction of the prefrontal cortex.

Many disorders, such as schizophrenia, bipolar disorder, and ADHD, have been related to dysfunction of the prefrontal cortex. Several studies have indicated that reduced volume and interconnections of the frontal lobes with other brain regions is observed in those with Attention Deficit Hyperactivity Disorder, schizophrenia, depression, and bipolar disorder; those subjected to repeated stressors; suicide victims;those incarcerated; criminals; sociopaths; those affected by lead poisoning;and drug addicts. It is believed that at least some of the human abilities to feel guilt or remorse, and to interpret reality, lie in the prefrontal cortex. The prefrontal cortex is presumed to act as a high-level gating or filtering mechanism that enhances goal-directed activations and inhibits irrelevant activations. This filtering mechanism enables executive control at various levels of processing, including selecting, maintaining, updating, and rerouting activations. It has also been used to explain emotional regulation.( http://en.wikipedia.org/wiki/Prefrontal_cortex).

Dr. J

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TMJ and Brain Blood Flow

A new case that presented about two months ago illustrates the profound impact that the bite can have on brain blood flow.  This relationship is often referred to as the trigeminal vascular system.

Case history:  male in his mid sixties with history of fainting when he walked up hill.  He had been examined by mulitple physicians and undergone xrays, MRI, and EKG with no abnormal findings.  In a phone interview he mentioned that before the passed out he would develop pain in his ankles, knees, and hips- a sign that there was possible a trigeminal nerve component to his fainting (trigeminal nerve modulates pain perception in the brain).  An examination was recommended.  When he presented to the office, observation showed a very large jaw malalignment caused by orthodontic extraction therapy when he was a teenager.  A 4 mm tall mouthpiece was made for him which gave him immediate relief.  He reported a significant improvement in memory within about 1 week.

This has major implication to many types of disorders that have impaired brain blood flow (mood disorders, cerebral palsy, Parkinson’s, Alzheimer’s, dementia, ADD, autism, etc.).  But few are aware of this relationship.

 

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Treatment requirements for pain resolution

The treatment for  a malaligned jaw is both simplistic and often difficult.  The proper treatment is nearly always anterior repositioning of the lower jaw through the use of one or more diagnostic orthosis (what many call a splint).  The difficulty arises in achieving the precision necessary to create a stable and effective therapeutic repositioning.  In many cases, long term jaw malalignment has caused the person to become systemically hypersensitive, hence they get worse with an orthosis unless it is done very precisely.  The degree of precision required in many cases is much more than most dentists have been trained to provide.  I have developed a number of techniques that allow for more precise jaw stabilization.

Further failures in splint therapy often come because dentistry has not yet agreed on what should be the treatment goals.  That is, there is no agreement on what is the best treatment for cranio-mandibular dysfunction (see ICCMO position paper).  My 30 years of experience has led me to believe that the ideal treatment is not based on occlusion (which most dentist strive to achieve), but is based on ideal jaw function (see article on Bio-mechanical Principles of Occlusion ).

Treatment begins with a thorough medical history.  Often the patient has experienced multiple symptoms in their past that are likely due to the life long neurological disturbance induced by the jaw malalignment.  Knowledge of the patient’s past is very helpful on planning the appropriate appliances and supportive therapies. Sleep habits, medications, airway adequacy, dietary limitations, psychosocial stress level, allergies, and behavioral considerations are but a few of the concerns when taking a medical history.

Diagnostics performed before treatment typically include jaw motion analysis, study models, postural evaluation, photographic pictures, and TMJ x-rays.  Occasionally other records are required.

Treatment is typically divided into three phases: Phase I- to find the therapeutic position of the lower jaw; Phase II- stabilize the jaw in the therapeutic position; and Phase III-long term maintenance.

In Phase I (diagnostic repositioning of lower jaw) typically takes 3 to 6 months  The types of appliances that I use to reposition the jaw are less bulky than those used by most dentists.  The appliance I use most often is a “twin block crozat”.  This is a hybrid appliance that combines the smallness of a crozat framework with the effective repositioning mechanics of twin block pads.  This appliance I have been using for over 20 years with a tremendous degree of success.  It provides a wide

advantage over other types of orthosis in that it can be used for both pain resolution and orthodontic/orthopedic resolution. It can correct asymmetrical dental malalignments; it doesn’t interfere with cranial motion; it doesn’t interfere with speech, its hygienic, it can be modified (i.e. versatile), and it can be used in conjunction with other appliances as needed.

Phase II in initiated when it becomes evident that there is a therapeutic position that needs to be maintained for the long term.  This is done in one of three ways or a combination of two or more.  Most cases are finished orthodontically- the primary tooth movement being the passive eruption of posterior molars to support the lower jaw in a more forward and downward position.  In some cases the teeth do not erupt fast enough so crowns are cemented over the top of existing molars.  In some instances a permanent partial is fabricated out of durable materials that the patient wears over their existing teeth to maintain the proper jaw position.

Phase III is the retention phase.  Most patients wear an appliance

at night for the rest of their life.  This is necessary because the jaw displaces when they are unconscious, causing the jaws joints and muscles to get traumatized.  The appliance is like a security blanket, and most patients become highly attached to their night appliance because they sleep better and awake more rested and relaxed.

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Elder Care Initiative

Please see our newest article posted under Elder Care Initiative in the  menu selection.  I am excited about the possibilities and application for seniors with diminishing abilities.  All seniors with diminishing cognitive and physical abilities should be examined by a qualified orthopedic dentist as most would find ideal jaw positioning of significant benefit.  Dr. Jennings

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Use of Jaw orthopedics in an anti-aging regimen

TMJ manifests as a lot of different conditions, from mild to life threatening.  One area that is often overlooked is the effect of a poor aligned jaw on elder persons.  This can be critical to quality of life.  In some instances where the TMJ condition is affecting blood flow to the brain, it can be life threatening.  The following article discusses many of the ways jaw malalgnment affects the elderly (Use_of_Jaw_Orthopedic_Therapy_in_an_Anti-aging Regemin).

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