European Stars and Stripes (Newspaper) - October 23, 1990, Darmstadt, Hesse                                Ups and Downs of disease As scientists explore the natural rhythms of the body they Are finding that timing can improve the results of certain treatments and explain previously mysterious disease patterns. Heart attacks in the morning a a heart attacks Peak just after waking. Levels of the hormone adrenaline which makes the heart pump faster Are highest then and other factors like the tendency of platelets to clump in the blood Are also at their extremes. Some doctors prescribe heart medication in forms that give extra Protection in the morning. Month of initial diagnosis 4 Hodgkin s disease in Spring certain Ceils of the immune system follow a yearly Cycle for example to Ceils fall to the lowest level in june. There Are some indications that people with Hodgkin a disease Are Tiore Likely to be diagnosed in the Spring and some scientists think the two cycles Are linked. Source journal of the National cancer institutes amps Sharon kit Day timing is everything. Even by Elisabeth Rosenthal new York times at 9 of clock every night a pump implanted under Harry Wynn s skin gears up for action. For precisely six hours it pours normally toxic doses of drug into Wynn s bloodstream to treat the kidney cancer the 74-year-old retired lawyer has battled intermittently for the past four years. By timing the drug infusion for the part of the Day when intestinal cells Divide slowly Wynn s doctors have avoided provoking the diarrhoea that usually limits the cancer drugs use. Since Wynn started on the program of synchronized chemotherapy four months ago the metastatic tumor in his lung has shrunk by almost half. A i m not As tired As i used to be and i no longer feel Short of breath Quot said Wynn a resident of Scarsdale n.y., who was looking trim and tanned after a tropical vacation. He had worried the faint outline on his Chest of the chemotherapy pump would be noticed when he swam. Quot when you look at me now you would t think that Harry Wynn is a seriously ill Man Quot he said. When it comes to health it is Only recently that some innovative doctors have Learned the age old lesson of comics and generals at War timing is everything. Research has revealed a number of cycles turning deep within the body that govern a patients susceptibility to disease and response to medical treatments. And a Small cadre of doctors Are now trying to synchronize the often haphazard timing of medical therapy to these newly defined biological rhythms. Quot doctors Are becoming increasingly sensitive to time effects in their evaluations and treatment a said or. Charles a. Czeisler director of the Laboratory for circadian rhythms at Harvard University a Brigham and women s Hospital and a Leader in the new Field of Chron biology. Quot the starting Point is that there a a Best time and a worst time to give every drug Quot said or. Robert Klevecz a senior scientist at the Beckman research Institute of the City of Hope medical Center in Duarte Calif. Quot the problem is getting doctors to pay attention to a simple thing like  the medical worlds interest in rhythms has been piqued in recent years by observations that some diseases occur More commonly at certain times of Day and during certain seasons. Heart attacks Are almost twice As Likely to occur in the hours after waking for example. Asthma frequently flares at night and the occurrence of Hodgkin s disease in Young men peaks in springtime. Researchers trying to explain these trends Are uncovering previously unappreciated internal rhythms As predictably As Day follows night the viscosity of the blood rises and Falls. As surely As the seasons turn the number of t cells to fight infections and tutors is at a High in the Winter and fails to a yearly Low in june. In a few instances insights about the rhythms of disease have already been incorporated into therapy. New once a Day timed release pills for asthma and ulcers Are taken at night and deliver a plateau of medication Between Midnight and 8 a.m., the period when these diseases commonly flare. In Many other Fields researchers looking into the advantage of the Well timed medical Dart have produced intriguing but preliminary results in one study premenopausal breast cancer patients survived far longer if mastectomies were performed in mid menstrual Cycle rather than near their menstrual periods. In another study jogging in the evening reduced the platelet clumping that contributes to heart attacks but jogging in the morning did not. The Small study could affect the exercise habits of thousands of cardiac patients if confirmed. The biology behind such findings is often poorly understood. Quot we re not smart enough yet to understand Many of the rhythms that exist Quot said or William Hrushesky senior oncologist at the Albany veterans affairs Hospital who is treating Wynn. Quot but As we do it will have enormous implications for the prevention diagnosis and treatment of  most doctors regard the sometimes startling results with caution. Quot in the cancer Field people Are sceptical that such a simple thing could have a significant Impact a said or. Mace Rothenberg of the division of cancer treatment at the National cancer Institute in Bethesda my. Quot but there s now too much suggestive evidence to discount it entirely it s very interesting and we re waiting for More  Rothenberg says it is too Early to change the treatment of cancer patients most diseases today Are diagnosed and treated without regard to biological rhythms. Doctors often gauge the severity of asthma by having patients breathe forcefully into a machine that measures the flow of exhaled air. But the air tubules in asthma amp tics that cause breathing difficulties when they go into spasm Are 25 percent More constricted in the Early morning than at noon. Quot so when you do the test really influences the perception of How serious the condition is a said or. Michael Smolensky a Chrono biologist at the University of Texas school of Public health in Houston. In hospitals the daily bags of chemotherapy Are Hung at haphazard times usually at some harried interns convenience. Quot most done to specify sequence much less time of Day Quot said Hrushesky. Quot none of this is taken into  part of the problem says Czeisler is Money. To determine the optimal timing to administer a medication drug companies would have to finance trials at different times of Day a costly Endeavor. For convenience most drug studies even those of sleeping pills Are generally performed by Day. A once you realize that things like asthma and rheumatoid arthritis Are mostly nighttime disorders Quot said Smolensky a you have to worry about daytime Only  Page 16 a a a the stars and stripes tuesday october 23,1990