Cancer Treatment Center

Non-Hodgkin lymphoma

2012-12-07T00:38:00.002-08:00

Since the late 1960s, treatment outcomes for pediatric patients with non-Hodgkin lymphoma have steadily improved. Even for patients with advanced disease, event-free survival rates are now 65-90%. (See Prognosis, Treatment, and Medication.) The mainstay of conventional therapy is multiagent chemotherapy tailored to the histologic subtype and the clinical stage of disease. In certain individuals with non-Hodgkin lymphoma, surgical resection and radiation therapy are also key components of definitive treatment. Newer therapies that target immunologic and biologic aspects of the lymphoma are still under development but beginning to appear in the clinical arena. (See Treatment and Medication.) Lymphomas are malignant neoplasms of lymphoid lineage. Broadly classified as either Hodgkin disease (Hodgkin's disease) or as non-Hodgkin lymphoma, lymphomas are clinically, pathologically, and biologically distinct (see the image below). (See Prognosis and Workup.)[1, 2] Massive mediastinal T-lymphoblastic lymphoma. NoteMassive mediastinal T-lymphoblastic lymphoma. Note compression of the left mainstem bronchus and the pulmonary atelectasis. According to the National Cancer Institute (NCI) formulation, most childhood non-Hodgkin lymphomas can be classified as one of the following types: Lymphoblastic lymphomas Small noncleaved cell lymphomas (SNCCLs) - Burkitt lymphomas and non-Burkitt lymphomas (Burkittlike lymphomas) Large cell lymphomas (LCLs) B-cell LCLs and anaplastic (usually T-cell) LCLs (ie, Ki-1+ lymphomas) have come to be viewed as distinct entities. In this article, these categories are considered separately. Other, less common forms of childhood lymphoma (some of which are much more common in adults) are not discussed. Disease progression Most malignancies arise as disease localized in the organ or tissue of origin. They may then secondarily spread by means of local extension or distant metastases. In contrast, non-Hodgkin lymphoma is best regarded as a systemic disease, because of the unique anatomy of the lymphoid system and because of the physiology of lymphoid cells, which tend to migrate whether they are normal or malignant. The role of lymphoma stem cells in the genesis and maintenance of B-cell lymphomas remains speculative.(See Etiology.)[3] Non-Hodgkin lymphoma versus acute leukemia Childhood non-Hodgkin lymphoma generally manifests as bulky extramedullary (usually extranodal) disease with or without demonstrable dissemination. The distinction between non-Hodgkin lymphoma and acute leukemia is arbitrary. Therefore, these entities are best considered in terms of a spectrum ranging from clinically localized disease to overt leukemia. In most treatment protocols, acute leukemia is now defined on the basis of marrow involvement above some threshold (typically, a blast count of >25%) irrespective of the presence of bulky extramedullary disease. In contrast, an extramedullary tumor accompanied by marrow involvement below this threshold constitutes stage 4 lymphoma.

Lymphoma

2012-12-07T00:37:00.001-08:00

Lymphoma is a cancer that begins in the lymphocytes of the immune system and presents as a solid tumor of lymphoid cells. It is treatable with chemotherapy, and in some cases radiotherapy and/or bone marrow transplantation, and can be curable, depending on the histology, type, and stage of the disease. These malignant cells often originate in lymph nodes, presenting as an enlargement of the node (a tumor). Lymphomas are closely related to lymphoid leukemias, which also originate in lymphocytes but typically involve only circulating blood and the bone marrow (where blood cells are generated in a process termed haematopoesis) and do not usually form static tumors. There are many types of lymphomas, and in turn, lymphomas are a part of the broad group of diseases called hematological neoplasms. Lymphoma is the most common form of hematological malignancy, or "blood cancer", in the developed world. Taken together, lymphomas represent 5.3% of all cancers (excluding simple basal cell and squamous cell skin cancers) in the United States, and 55.6% of all blood cancers. According to the U.S. National Institutes of Health, lymphomas account for about five percent of all cases of cancer in the United States, and Hodgkin's lymphoma in particular accounts for less than one percent of all cases of cancer in the United States. Because the whole system is part of the body's immune system, patients with a weakened immune system, such as from HIV infection or from certain drugs or medication, also have a higher incidence of lymphoma. Thomas Hodgkin published the first description of lymphoma in 1832, specifically of the form named after him, Hodgkin's lymphoma. Since then, many other forms of lymphoma have been described, grouped under several proposed classifications. The 1982 Working formulation classification became very popular. It introduced the category non-Hodgkin lymphoma (NHL), divided into 16 different diseases. However, because these different lymphomas have little in common with each other, the NHL label is of limited usefulness for doctors or patients and is slowly being abandoned. The latest classification by the WHO (2001) lists 43 different forms of lymphoma divided in four broad groups. Some forms of lymphoma are categorized as indolent (e.g. small lymphocytic lymphoma), compatible with a long life even without treatment, whereas other forms are aggressive (e.g. Burkitt's lymphoma), causing rapid deterioration and death. However, most of the aggressive lymphomas respond well to treatment and are curable. The prognosis therefore depends on the correct classification of the disease, established by a pathologist after examination of a biopsy. Although older classifications referred to histiocytic lymphomas, these are recognized in newer classifications as of B, T or NK cell lineage. True histiocytic malignancies are rare and are classified as sarcomas. REAL In the mid 1990s, the Revised European-American Lymphoma (REAL) Classification attempted to apply immunophenotypic and genetic features in identifying distinct clinicopathologic NHL entities. WHO The WHO Classification, published in 2001 and updated in 2008, is the latest classification of lymphoma and is based upon the foundations laid within the "Revised European-American Lymphoma classification" (REAL). This system attempts to group lymphomas by cell type (i.e. the normal cell type that most resembles the tumor) and defining phenotypic, molecular or cytogenetic characteristics. There are three large groups: the B cell, T cell, and natural killer cell tumors. Other less common groups, are also recognized. Hodgkin's lymphoma, although considered separately within the WHO (and preceding) classifications, is now recognized as being a tumor of, albeit markedly abnormal, lymphocytes of mature B cell lineage. Mature B cell neoplasms Chronic lymphocytic leukemia/Small lymphocytic lymphoma B-cell prolymphocytic leukemia Lymphoplasmacytic lymphoma (such as Waldenström macroglobulinemia) Splenic marginal zone lymphoma Plasma cell neoplasms: Plasma cell myeloma Plasmacytoma Monoclonal immunoglobulin deposition diseases Heavy chain diseases Extranodal marginal zone B cell lymphoma, also called MALT lymphoma Nodal marginal zone B cell lymphoma (NMZL) Follicular lymphoma Mantle cell lymphoma Diffuse large B cell lymphoma Mediastinal (thymic) large B cell lymphoma Intravascular large B cell lymphoma Primary effusion lymphoma Burkitt lymphoma/leukemia Mature T cell and natural killer (NK) cell neoplasms T cell prolymphocytic leukemia T cell large granular lymphocytic leukemia Aggressive NK cell leukemia Adult T cell leukemia/lymphoma Extranodal NK/T cell lymphoma, nasal type Enteropathy-type T cell lymphoma Hepatosplenic T cell lymphoma Blastic NK cell lymphoma Mycosis fungoides / Sezary syndrome Primary cutaneous CD30-positive T cell lymphoproliferative disorders Primary cutaneous anaplastic large cell lymphoma Lymphomatoid papulosis Angioimmunoblastic T cell lymphoma Peripheral T cell lymphoma, unspecified Anaplastic large cell lymphoma Hodgkin lymphoma Classical Hodgkin lymphomas: Nodular sclerosis Mixed cellularity Lymphocyte-rich Lymphocyte depleted or not depleted Nodular lymphocyte-predominant Hodgkin lymphoma Immunodeficiency-associated lymphoproliferative disorders Associated with a primary immune disorder Associated with the Human Immunodeficiency Virus (HIV) Post-transplant Associated with methotrexate therapy Primary central nervous system lymphoma occurs most often in immunocomprimised patients,in particular those with AIDS,but it can occur in the immunocompetent as well.It has a poor prognosis,particulary in those with AIDS.Treatment can consist of corticosteroids,radiotherapy,and chemotherapy,often with methotrexate. Working formulation and Non-Hodgkin lymphoma The 1982 Working Formulation is a classification of Non-Hodgkin Lymphoma. It has since been replaced by other lymphoma classifications, the latest published by the WHO in 2001 (updated in September 2008), but is still used by cancer agencies for compilation of lymphoma statistics. As of early 2010, the working formulation is obsolete, as is the term Non-Hodgkin lymphoma. Other classification systems ICD-O (codes 9590-9999, details at (archive link, was dead) ICD-10 (codes C81-C96, details at [http://www3.who.int/icd/vol1htm2003/fr-icd.htm?gc81.htm+)

What is non-small cell lung cancer?

2012-12-07T00:36:00.001-08:00

Note: This document is specifically for the non-small cell type of lung cancer. The treatment for the 2 main types of lung cancer (small cell and non-small cell) is very different, so much of the information for one type will not apply to the other type. If you are not sure which type of lung cancer you have, ask your doctor so you can be sure the information you receive is correct. Lung cancer is a cancer that starts in the lungs. To understand lung cancer, it helps to know about the normal structure and function of the lungs. The lungs Your lungs are 2 sponge-like organs found in your chest. Your right lung is divided into 3 sections, called lobes. Your left lung has 2 lobes. The left lung is smaller because the heart takes up more room on that side of the body. When you breathe in, air enters through your mouth or nose and goes into your lungs through the trachea (windpipe). The trachea divides into tubes called the bronchi (singular, bronchus), which divide into smaller branches called bronchioles. At the end of the bronchioles are tiny air sacs known as alveoli. Many tiny blood vessels run through the alveoli. They absorb oxygen from the inhaled air into your bloodstream and pass carbon dioxide from the body into the alveoli. This is expelled from the body when you exhale. Taking in oxygen and getting rid of carbon dioxide are your lungs' main functions. A thin lining layer called the pleura surrounds the lungs. The pleura protects your lungs and helps them slide back and forth against the chest wall as they expand and contract during breathing. Below the lungs, a dome-shaped muscle called the diaphragm separates the chest from the abdomen. When you breathe, the diaphragm moves up and down, forcing air in and out of the lungs. Start and spread of lung cancer Lung cancers can start in the cells lining the bronchi and parts of the lung such as the bronchioles or alveoli. Lung cancers are thought to start as areas of pre-cancerous changes in the lung. The first changes happen in the genes of the cells themselves and may cause them to grow faster. The cells may look a bit abnormal if seen under a microscope, but at this point they do not form a mass or tumor. They cannot be seen on an x-ray and they do not cause symptoms. Over time, these pre-cancerous changes in the cells may progress to true cancer. As a cancer develops, the cancer cells may make chemicals that cause new blood vessels to form nearby. These new blood vessels nourish the cancer cells, which can continue to grow and form a tumor large enough to be seen on imaging tests such as x-rays. At some point, cells from the cancer may break away from the original tumor and spread (metastasize) to other parts of the body. Lung cancer is often a life-threatening disease because it tends to spread in this way even before it can be detected on an imaging test such as a chest x-ray. The lymph (lymphatic) system The lymph system is important to understand because it is one of the ways in which lung cancers can spread. This system has several parts. Lymph nodes are small, bean-shaped collections of immune system cells (cells that fight infections) that are connected by lymphatic vessels. Lymphatic vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the lungs. Lymph contains excess fluid and waste products from body tissues, as well as immune system cells. Lung cancer cells can enter lymphatic vessels and begin to grow in lymph nodes around the bronchi and in the mediastinum (the area between the 2 lungs). When lung cancer cells have reached the lymph nodes, they are more likely to have spread to other organs of the body as well. The stage (extent) of the cancer and decisions about treatment are based on whether or not the cancer has spread to the nearby lymph nodes in the mediastinum. These topics are discussed later in the section, "How is non-small cell lung cancer staged?" Types of lung cancer There are 2 major types of lung cancer: Small cell lung cancer (SCLC) Non-small cell lung cancer (NSCLC) (If a lung cancer has characteristics of both types it is called a mixed small cell/large cell cancer. This is uncommon.) These 2 types of lung cancer are treated very differently. This document focuses on non-small cell lung cancer. Small cell lung cancer is discussed in the separate document called Lung Cancer (Small Cell). Non-small cell lung cancer About 85% to 90% of lung cancers are non-small cell lung cancer (NSCLC). There are 3 main subtypes of NSCLC. The cells in these subtypes differ in size, shape, and chemical make-up when looked at under a microscope. But they are grouped together because the approach to treatment and prognosis (outlook) are very similar. Squamous cell (epidermoid) carcinoma: About 25% to 30% of all lung cancers are squamous cell carcinomas. These cancers start in early versions of squamous cells, which are flat cells that line the inside of the airways in the lungs. They are often linked to a history of smoking and tend to be found in the middle of the lungs, near a bronchus. Adenocarcinoma: About 40% of lung cancers are adenocarcinomas. These cancers start in early versions of the cells that would normally secrete substances such as mucus. This type of lung cancer occurs mainly in people who smoke (or have smoked), but it is also the most common type of lung cancer seen in non-smokers. It is more common in women than in men, and it is more likely to occur in younger people than other types of lung cancer. Adenocarcinoma is usually found in the outer region of the lung. It tends to grow slower than other types of lung cancer, and is more likely to be found before it has spread outside of the lung. People with the type of adenocarcinoma called adenocarcinoma in situ (previously called bronchioloalveolar carcinoma) tend to have a better outlook (prognosis) than those with other types of lung cancer. Large cell (undifferentiated) carcinoma: This type of cancer accounts for about 10% to 15% of lung cancers. It may appear in any part of the lung. It tends to grow and spread quickly, which can make it harder to treat. A subtype of large cell carcinoma, known as large cell neuroendocrine carcinoma, is a fast-growing cancer that is very similar to small cell lung cancer (see below). Other subtypes: There are also a few other subtypes of non-small cell lung cancer, such as adenosquamous carcinoma and sarcomatoid carcinoma. These are much less common. Small cell lung cancer About 10% to 15% of all lung cancers are small cell lung cancer (SCLC), named for the size of the cancer cells when seen under a microscope. Other names for SCLC are oat cell cancer, oat cell carcinoma, and small cell undifferentiated carcinoma. It is very rare for someone who has never smoked to have small cell lung cancer. SCLC often starts in the bronchi near the center of the chest, and it tends to spread widely through the body fairly early in the course of the disease. This cancer is discussed in the document called Lung Cancer (Small Cell). Other types of lung cancer Along with the 2 main types of lung cancer, other tumors can occur in the lungs. Carcinoid tumors of the lung account for fewer than 5% of lung tumors. Most are slow-growing tumors that are called typical carcinoid tumors. They are generally cured by surgery. Some typical carcinoid tumors can spread, but they usually have a better prognosis than small cell or non-small cell lung cancer. Less common are atypical carcinoid tumors. The outlook for these tumors is somewhere in between typical carcinoids and small cell lung cancer. For more information about typical and atypical carcinoid tumors, see the separate document, Lung Carcinoid Tumor. There are other, even more rare, lung tumors such as adenoid cystic carcinomas, hamartomas, lymphomas, and sarcomas. These tumors are treated differently from the more common lung cancers. They are not discussed in this document. Cancers that start in other organs (such as the breast, pancreas, kidney, or skin) can sometimes spread (metastasize) to the lungs, but these are not lung cancers. For example, cancer that starts in the breast and spreads to the lungs is still breast cancer, not lung cancer. Treatment for metastatic cancer to the lungs depends on where it started (the primary cancer site). For information on these primary cancers, see our separate documents on each.

What Is Lung Cancer?

2012-12-07T00:34:00.001-08:00

Lung cancer is the uncontrolled growth of abnormal cells that start off in one or both lungs; usually in the cells that line the air passages. The abnormal cells do not develop into healthy lung tissue, they divide rapidly and form tumors. As tumors become larger and more numerous, they undermine the lung’s ability to provide the bloodstream with oxygen. Tumors that remain in one place and do not appear to spread are known as “benign tumors”. Doctors viewing a lung x-ray for signs of lung cancer Malignant tumors, the more dangerous ones, spread to other parts of the body either through the bloodstream or the lymphatic system. Metastasis refers to cancer spreading beyond its site of origin to other parts of the body. When cancer spreads it is much harder to treat successfully. Primary lung cancer originates in the lungs, while secondary lung cancer starts somewhere else in the body, metastasizes, and reaches the lungs. They are considered different types of cancers and are not treated in the same way. According to the National Cancer Institute, by the end of 2012 there will have been 226,160 new lung cancer diagnoses and 160,340 lung-cancer related deaths in the USA. According to the World Health Organization (WHO), 7.6 million deaths globally each year are caused by cancer; cancer represents 13% of all global deaths. As seen below, lung cancer is by far the number one cancer killer. Total deaths worldwide caused by cancer each year: Lung cancer - 1,370,000 deaths Stomach cancer - 736,000 deaths Liver cancer - 695,000 deaths Colorectal cancer - 608,000 deaths Breast cancer - 458,000 deaths Cervical cancer - 275,000 deaths The American Cancer Society says that lung cancer makes up 14% of all newly diagnosed cancers in the USA today. It adds that annually, more patients die from lung cancer alone than prostate, breast and colon cancers combined (in the USA). An American man’s lifetime risk of developing lung cancer is 1 in 13; for a woman the risk is 1 in 16. These risk figures are for all US adults, including smokers, ex-smokers and non-smokers. The risk for a regular smoker is dramatically higher. Most lung cancer patients are over the age of 60 years when they are diagnosed. Lung cancer takes several years to reach a level where symptoms are felt and the sufferer decides to seek medical help. Female lung cancer rates set to rise rapidly Over the next three decades, female lung cancers will increase thirty-five times faster than male lung cancers, scientists from King’s College London reported in October 2012. In the UK, female lung cancer deaths will reach 95,000 annually in 2040, from 26,000 in 2010 – a rise of more than 350%. Male annual lung cancer deaths will increase by 8% over the same period, to 42,000 in 2040 from 39,000 in 2010. The authors of the report say that lung cancer will continue being the largest cancer killer over the next thirty years. Twice as many people will be living with lung cancer in 2040 compared to 2010. The main reason for the increase will be longer lifespans - the older you are, the higher your risk of cancer is, including lung cancer. How is lung cancer classified? Lung cancer can be broadly classified into two main types based on the cancer's appearance under a microscope: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer (NSCLC) accounts for 80% of lung cancers, while small cell lung cancer accounts for the remaining 20%. NSCLC can be further divided into four different types, each with different treatment options: Squamous cell carcinoma or epidermoid carcinoma. As the most common type of NSCLC and the most common type of lung cancer in men, squamous cell carcinoma forms in the lining of the bronchial tubes. Adenocarcinoma. As the most common type of lung cancer in women and in nonsmokers, adenocarcinoma forms in the mucus-producing glands of the lungs. Bronchioalveolar carcinoma. This type of lung cancer is a rare type of adenocarcinoma that forms near the lungs' air sacs. Large-cell undifferentiated carcinoma. A rapidly growing cancer, large-cell undifferentiated carcinomas form near the outer edges or surface of the lungs. Small cell lung cancer (SCLC) is characterized by small cells that multiply quickly and form large tumors that travel throughout the body. Almost all cases of SCLC are due to smoking. What causes cancer? Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control. Lung cancer occurs when a lung cell's gene mutation makes the cell unable to correct DNA damage and unable to commit suicide. Mutations can occur for a variety of reasons. Most lung cancers are the result of inhaling carcinogenic substances. Carcinogens Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. These free radicals damage cells and affect their ability to function and divide normally. About 87% of lung cancers are related to smoking and inhaling the carcinogens in tobacco smoke. Even exposure to second-hand smoke can damage cells so that cancer forms. Genes Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life. Genetic predispositions are thought to either directly cause lung cancer or greatly increase one's chances of developing lung cancer from exposure to certain environmental factors. How does lung cancer develop? - video A short video explaining how lung cancer develops. Video by eHow. What are the symptoms of lung cancer? Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Lung cancer symptoms may take years before appearing, usually after the disease is in an advanced stage. Many symptoms of lung cancer affect the chest and air passages. These include: Persistent or intense coughing Pain in the chest shoulder, or back from coughing Changes in color of the mucus that is coughed up from the lower airways (sputum) Difficulty breathing and swallowing Hoarseness of the voice Harsh sounds while breathing (stridor) Chronic bronchitis or pneumonia Coughing up blood, or blood in the sputum If the lung cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and broken. It is also possible for the cancer to infect the adrenal glands resulting in hormone level changes. As lung cancer cells spread and use more of the body's energy, it is possible to present symptoms that may also be associated with many other ailments. These include: Fever Fatigue Unexplained weight loss Pain in joints or bones Problems with brain function and memory Swelling in the neck or face General weakness Bleeding and blood clots How is lung cancer diagnosed and staged? Physicians use information revealed by symptoms as well as several other procedures in order to diagnose lung cancer. Common imaging techniques include chest X-rays, bronchoscopy (a thin tube with a camera on one end), CT scans, MRI scans, and PET scans. Doctor examining a patient Physicians will also conduct a physical examination, a chest examination, and an analysis of blood in the sputum. All of these procedures are designed to detect where the tumor is located and what additional organs may be affected by it. Although the above diagnostic techniques provided important information, extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose lung cancer. This procedure is called a biopsy. If the biopsy confirms lung cancer, a pathologist will determine whether it is non-small cell lung cancer or small cell lung cancer. After a diagnosis is made, an oncologist will determine the stage of the cancer by finding out how far the cancer has spread. The stage determines which choices will be available for treatment and informs prognosis. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumor, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example. For non-small cell lung cancer, TNM descriptions lead to a simpler categorization of stages. These stages are labeled from I to IV, where lower numbers indicate earlier stages where the cancer has spread less. More specifically: Stage I is when the tumor is found only in one lung and in no lymph nodes. Stage II is when the cancer has spread to the lymph nodes surrounding the infected lung. Stage IIIa is when the cancer has spread to lymph nodes around the trachea, chest wall, and diaphragm, on the same side as the infected lung. Stage IIIb is when the cancer has spread to lymph nodes on the other lung or in the neck. Stage IV is when the cancer has spread throughout the rest of the body and other parts of the lungs. Small cell lung cancer has two stages: limited or extensive. In the limited stage, the tumor exists in one lung and in nearby lymph nodes. In the extensive stage, the tumor has infected the other lung as well as other organs in the body. Screening for lung cancer - video A video tutorial discussing Lung Cancer and screening. Video by OncologyPodCasting. How is lung cancer treated? Lung cancer treatments depend on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. As there is usually no single treatment for cancer, patients often receive a combination of therapies and palliative care. The main lung cancer treatments are surgery, chemotherapy, and/or radiation. However, there also have been recent developments in the fields of immunotherapy, hormone therapy, and gene therapy. Surgery Surgery is the oldest known treatment for cancer. If a cancer is in stage I or II and has not metastasized, it is possible to completely cure a patient by surgically removing the tumor and the nearby lymph nodes. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgeons operating on patient Lung cancer surgery is performed by a specially trained thoracic surgeon. After removing the tumor and the surrounding margin of tissue, the margin is further studied to see if cancer cells are present. If no cancer is found in the tissue surrounding the tumor, it is considered a "negative margin." A "positive margin" may require the surgeon to remove more of the lung tissue. Lung cancer surgery can be curative or palliative. Curative surgery aims to cure a patient with early stage lung cancer by removing all of the cancerous tissue. Palliative surgery aims to remove an obstruction or open an airway, making the patient more comfortable but not necessarily removing the cancer. Surgery carries side effects - most notably pain and infection. Lung cancer surgery is an invasive procedure that can cause harm to the surrounding body parts. Doctors will usually provide several options for alleviating any pain from surgery. Antibiotics are commonly used to prevent infections that may occur at the site of the wound or elsewhere inside the body. Radiation Radiation treatment, also known as radiotherapy, destroys or shrinks lung cancer tumors by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilizes high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Radiation can be used as the main treatment for lung cancer, to kill remaining cells after surgery, or to kill cancer cells that have metastasized. Whorush: 8 sites by this AdSense ID Ads by Google Lung Cancer Causes - Are you a Health Care Professional researching Lung Cancer Causes? - www.inoncology.com Stop Pulmonary Fibrosis - 95% Success, Dissolve Scar Tissue Breathe Better & Increase Oxygen - www.pivotalhealth.info Blog: Share Your Thoughts - Let Others Know What You Think. Write Your Own Blog: BLOG BIG TIME - www.blogbigtime.com Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiation oncologists can focus the radiation in precise locations in the body for certain lengths of time, reducing the risk of damage to surrounding healthy tissue. Treatments occur intermittently over weeks or months depending on the size and extent of the tumor, the dosage of radiation, and how much damage is being done to noncancerous tissue. Common side effects of radiation therapy include fatigue, nausea, loss of appetite, hair loss, and skin affectations that cause skin to become dry, irritated, and sensitive. Chemotherapy Chemotherapy utilizes strong chemicals that interfere with the cell division process - damaging proteins or DNA - so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is considered systemic because its medicines travel throughout the entire body, killing the original tumor cells as well as cancer cells that have spread throughout the body. Doctor holding a chemotherapy drug A medical oncologist will usually prescribe chemotherapy drugs for lung cancer to be taken intravenously, but there are also drugs available in tablet, capsule, and liquid form. Chemotherapy treatment occurs in cycles so the body has time to heal between doses, and dosages are determined by the type of lung cancer, the type of drug, and how the person responds to treatment. Medicines may be administered daily, weekly, or monthly, and can continue for months or even years. Combination therapies often include multiple types of chemotherapy, and chemotherapy is also given as adjuvant therapy as a complement to surgery and radiation. Adjuvant therapy is designed to reduce the risk of cancer recurrence after surgery and killing any cancer cells that exist after surgery. Chemotherapy can be given before surgery, called neo-adjuvant therapy, to shrink tumors and to make surgery more successful. Chemotherapy carries several common side effects, but they depend on the type of chemotherapy and the health of the patient. These include nausea and vomiting, appetite loss, diarrhea, hair loss, fatigue from anemia, infections, bleeding, and mouth sores. Many of these side effects are only temporarily felt during treatment, and several drugs exist to help patients cope with the symptoms. Other lung cancer treatments Researchers continue to search for ways to improve lung cancer treatments and find new methods of treating the disease. Targeted therapies are designed to only treat cancer cells while leaving alone normal and healthy lung cells. These include monoclonal antibodies that travel directly to the cancer cells and release drugs or radiation, anti-angiogenesis agents that interfere with the blood supply creation mechanism of cancer cells, and growth factor inhibitors that block the effects of growth factors and disallow the cancerous cells to grow. There is also some research in the area of lung cancer vaccines that first transform cancer cells so they are no longer cancerous. However, the cells will exist such that the body's immune system can recognize the cancerous cells as foreign and attack them. These targeted therapies are also called immunotherapies because the treatment tweaks the body's natural immune responses. How can lung cancer be prevented? Cancers that are closely linked to certain behaviors are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lowers the risk of several types of cancer - most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer. The most important preventive measure you can take to avoid lung cancer is to quit smoking. Quitting smoking will also reduce your risk of several other types of cancer including esophagus, pancreas, larynx, and bladder cancer. If you quit smoking, you will usually reap additional benefits such as lower blood pressure, enhanced blood circulation, and increased lung capacity. Exposure to tobacco smoke is not the only risk factor for lung cancer though. Those who have come into contact with asbestos, radon, and secondhand smoke also have an increased risk of developing lung cancer. In addition, having a family member who developed lung cancer without being exposed to carcinogens could mean that you have a genetic predisposition for developing the disease, increasing your overall risk. Screening techniques are designed to find cancer at the earliest stage so that the most treatment options are available, increasing survival rates and avoiding highly invasive procedures. Most lung cancers are detected in the late stages of the disease after they have spread and are harder to treat. Although there currently do not exist approved screening tests for lung cancer that improve survival or detect localized disease, there is promising research underway. Advocates of screening recommend that certain high risk groups be screened. This includes persons age 60 or older with a history of smoking, previous lung tumors, or chronic obstructive pulmonary disease (COPD). Possible lung cancer screening tests include analysis of sputum cells, fiberoptic examination of bronchial passages (bronchoscopy), and low-dose spiral CT scans.

Lobular Carcinoma

2012-12-07T00:32:00.002-08:00

Lobular carcinoma in situ (LCIS) is an area (or areas) of abnormal cell growth that increases a person’s risk of developing invasive breast cancer later on in life. Lobular means that the abnormal cells start growing in the lobules, the milk-producing glands at the end of breast ducts. Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue. In situ or “in its original place” means that the abnormal growth remains inside the lobule and does not spread to surrounding tissues. People diagnosed with LCIS tend to have more than one lobule affected. Despite the fact that its name includes the term “carcinoma,” LCIS is not a true breast cancer. Rather, LCIS is an indication that a person is at higher-than-average risk for getting breast cancer at some point in the future. For this reason, some experts prefer the term “lobular neoplasia” instead of “lobular carcinoma.” A neoplasia is a collection of abnormal cells. LCIS is usually diagnosed before menopause, most often between the ages of 40 and 50. Less than 10% of women diagnosed with LCIS have already gone through menopause. LCIS is extremely uncommon in men. LCIS is viewed as an uncommon condition, but we don’t know exactly how many people are affected. That’s because LCIS does not cause symptoms and usually does not show up on a mammogram. It tends to be diagnosed as a result of a biopsy performed on the breast for some other reason.

Lip and Oral Cavity Cancer

2012-12-07T00:26:00.002-08:00

What is cancer of the lip and oral cavity? Cancer of the lip and oral cavity is a disease in which cancer (malignant) cells are found in the tissues of the lip or mouth. The oral cavity includes the front two thirds of the tongue, the upper and lower gums (the gingiva), the lining of the inside of the cheeks and lips (the buccal mucosa), the bottom (floor) of the mouth under the tongue, the bony top of the mouth (the hard palate), and the small area behind the wisdom teeth (the retromolar trigone). Cancers of the head and neck are most often found in people who are over the age of 45. Cancer of the lip is more common in men than in women, and is more likely to develop in people with light-colored skin who have been in the sun a lot. Cancer of the oral cavity is more common in people who chew tobacco or smoke pipes. A doctor should be seen if a person finds a lump in the lip, mouth, or gums, finds a sore in the mouth that doesn’t heal, or has bleeding or pain in the mouth. Another sign of a cancer of the mouth or gums is when dentures no longer fit well. Often lip and oral cavity cancers are found by dentists when examining the teeth. If there are symptoms, a doctor will examine the mouth using a mirror and lights. The doctor may order x-rays of the mouth. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy. The patient will be given a substance to take feeling away from the area for a short time (a local anesthetic) so no pain is felt. The doctor will also feel the throat for lumps. The chance of recovery (prognosis) depends on where the cancer is in the lip or mouth, whether the cancer is just in the lip or mouth or has spread to other tissues (the stage), and the patient’s general state of health. Stage Explanation Stage of cancer of the lip and oral cavity Once cancer of the lip and oral cavity is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following stages are used for cancer of the lip and oral cavity: Stage I The cancer is no more than 2 centimeters (about 1 inch) and has not spread to lymph nodes in the area (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells). Stage II The cancer is more than 2 centimeters, but less than 4 centimeters (less than 2 inches), and has not spread to lymph nodes in the area. Stage III Either of the following may be true: The cancer is more than 4 centimeters. The cancer is any size but has spread to only one lymph node on the same side of the neck as the cancer. The lymph node that contains cancer measures no more than 3 centimeters (just over one inch). Stage IV Any of the following may be true: The cancer has spread to tissues around the lip and oral cavity. The lymph nodes in the area may or may not contain cancer. The cancer is any size and has spread to more than one lymph node on the same side of the neck as the cancer, to lymph nodes on one or both sides of the neck, or to any lymph node that measures more than 6 centimeters (over 2 inches). The cancer has spread to other parts of the body. Recurrent Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the lip and oral cavity or in another part of the body. Treatment Option Overview How cancer of the lip and oral cavity is treated There are treatments for all patients with cancer of the lip and oral cavity. Two kinds of treatment are used: Surgery (taking out the cancer) Radiation therapy (using high-dosex-rays or other high-energy rays to kill cancer cells) Chemotherapy (using drugs to kill cancer cells) is being tested in clinical trials. Surgery is a common treatment of cancer of the lip and oral cavity. The doctor may remove the cancer and some of the healthy tissue around the cancer. The doctor may also remove the lymph nodes in the neck (lymph node dissection). Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors.Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes or needles in the area where the cancer cells are found (internal radiation therapy). If smoking is stopped before radiation therapy is started, the patient has a better chance of surviving longer. Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. If the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after an operation to a person who has no cancer cells that can be seen is called adjuvant chemotherapy. Chemotherapy given before surgery to try and shrink the cancer so it can be removed is called neoadjuvant chemotherapy. Hyperthermia is a new treatment being tested in certain patients. It uses a special machine to heat the body for a certain period of time to kill cancer cells. Because cancer cells are often more sensitive to heat than normal cells, the cancer cells die and the cancer shrinks. Because the lips and mouth are needed to eat and talk, a patient may need special help adjusting to the side effects of the cancer and its treatment. The doctor will consult with several kinds of doctors who can help determine the best treatment for the patient. Trained medical staff can also help a patient recover from treatment and adjust to new ways of eating and talking. A patient may need plastic surgery or help learning to eat and speak if a large part of the lip or mouth is taken out. Treatment by stage Treatment of cancer of the lip and oral cavity depends on where the cancer is, the stage of the disease, and the patient’s age and overall health. Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for patients with cancer of the lip and oral cavity. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. Stage I Lip and Oral Cavity Cancer Treatment depends on where the cancer is in the lip or mouth. Lip cancer If the cancer is in the lip, treatment may be one of the following: Surgery. Radiation therapy. Tongue cancer If the cancer is in the tongue, treatment may be one of the following: Surgery. Surgery followed by radiation therapy to the neck. Radiation therapy to the mouth and the neck. Buccal mucosa cancer If the cancer is in the lining of the inside of the cheeks and lips (buccal mucosa), treatment may be one of the following: Surgery. Radiation therapy. Floor of the mouth cancer If the cancer is in the bottom (floor) of the mouth, treatment may be one of the following: Surgery. Radiation therapy. Lower gum cancer If the cancer is in the lower gums (gingiva), treatment may be one of the following: Surgery. Radiation therapy. Retromolar trigone cancer If the cancer is in the small area behind the wisdom teeth, (retromolar trigone), treatment may be one of the following: Surgery to remove part of the jawbone. Radiation therapy followed (if needed) by surgery. Upper gums and hard palate cancer If the cancer is in the upper gums (gingiva) or the top bony part of the mouth (hard palate), treatment may be one of the following: Surgery. Surgery followed by radiation therapy. Stage II Lip and Oral Cavity Cancer Treatment depends on where the cancer is in the lip or mouth. Lip cancer If the cancer is in the lip, treatment may be one of the following: Surgery. External and/or internal radiation therapy. Tongue cancer If the cancer is in the tongue, treatment may be one of the following: Radiation therapy. Surgery and radiation therapy. Buccal mucosa cancer If the cancer is in the lining of the inside of the cheeks and lips (buccal mucosa), treatment may be one of the following: Radiation therapy. Surgery. Surgery plus radiation therapy. Floor of the mouth cancer If the cancer is in the bottom (floor) of the mouth, treatment may be one of the following: Surgery. Radiation therapy. Surgery followed by internal or external radiation therapy. Lower gum cancer If the cancer is in the lower gums (gingiva), treatment may be one of the following: Surgery. Radiation therapy. Retromolar trigone cancer If the cancer is in the small space behind the wisdom teeth (retromolar trigone), treatment may be one of the following: Surgery to remove part of the jawbone. Radiation therapy followed (if needed) by surgery. Upper gum or hard palate cancer If the cancer is in the upper gums or the top bony part of the mouth (hard palate), treatment will probably be surgery followed by radiation therapy. Stage III Lip and Oral Cavity Cancer Treatment depends on where the cancer is in the lip or mouth. In addition to the treatments listed below, a patient will probably have radiation therapy to the neck with or without surgery to remove lymph nodes in the neck (lymph node dissection). Lip cancer If the cancer is in the lip, treatment may be one of the following: Surgery to remove the cancer plus internal or external radiation therapy. Radiation therapy. A clinical trial of chemotherapy followed by surgery or radiation therapy. A clinical trial of surgery followed by chemotherapy. A clinical trial of surgery, radiation therapy, and chemotherapy. A clinical trial of a new radiation therapy technique (superfractionated). Tongue cancer If the cancer is in the tongue, treatment may be one of the following: External radiation therapy with or without internal radiation therapy. Surgery followed by radiation therapy. Buccal mucosa cancer If the cancer is in the lining of the inside of the cheeks and lips (buccal mucosa), treatment may be one of the following: Surgery to remove the cancer and the tissue around it. Radiation therapy. Surgery plus radiation therapy. A clinical trial of chemotherapy followed by surgery or radiation therapy. A clinical trial of surgery followed by chemotherapy. A clinical trial of surgery, radiation therapy, and chemotherapy. Floor of the mouth cancer If the cancer is in the bottom (floor) of the mouth, treatment may be one of the following: Surgery to remove the cancer and lymph nodes in the neck. Part of the jawbone may also be removed if necessary. External radiation therapy with or without internal radiation therapy. A clinical trial of chemotherapy followed by surgery or radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Lower gum cancer If the cancer is in the lower gums (gingiva), treatment will probably be radiation therapy given before or after surgery to remove the cancer. Retromolar trigone cancer If the cancer is in the small space behind the wisdom teeth (retromolar trigone), treatment may be one of the following: Surgery followed by radiation therapy. A clinical trial of chemotherapy followed by surgery or radiation therapy. A clinical trial of surgery followed by chemotherapy. A clinical trial of fractionated (smaller doses) radiation therapy. Upper gum or hard palate cancer If the cancer is in the top part of the gums (gingiva) or the top bony part of the mouth (the hard palate), treatment may be one of the following: Radiation therapy. Surgery plus radiation therapy. For all stage III lip and oral cavity cancers, clinical trials are testing chemotherapy combined with radiation therapy. Stage IV Lip and Oral Cavity Cancer Treatment depends on where the cancer is in the lip or mouth. In addition to the treatments listed below, a patient will probably have radiation therapy to the neck with or without surgery to remove lymph nodes in the neck (lymph node dissection). Lip cancer If the cancer is in the lip, treatment may be one of the following: Surgery to remove the cancer plus internal or external radiation therapy. A clinical trial of radiation therapy. A clinical trial of chemotherapy combined with radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Tongue cancer If the cancer is in the tongue, treatment may be one of the following: Surgery to remove the tongue and the voice box (larynx) below it followed by radiation therapy. Radiation therapy to relieve symptoms. A clinical trial of chemotherapy combined with radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Buccal mucosa cancer If the cancer is in the lining of the inside of the cheeks and lips (buccal mucosa), treatment may be one of the following: Surgery to remove the cancer and the tissue around it. Radiation therapy. Surgery plus radiation therapy. A clinical trial of chemotherapy combined with radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Floor of the mouth cancer If the cancer is in the bottom (floor) of the mouth, treatment may be one of the following: Surgery to remove the cancer followed by radiation therapy. Radiation therapy followed by surgery. A clinical trial of chemotherapy combined with radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Lower gum cancer If the cancer is in the lower gums (gingiva), treatment may be one of the following: Surgery, radiation therapy, or both. A clinical trial of chemotherapy combined with radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Retromolar trigone cancer If the cancer is in the small space behind the wisdom teeth (retromolar trigone), treatment may be one of the following: Surgery followed by radiation therapy. A clinical trial of chemotherapy combined with radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Upper gum or hard palate cancer If the cancer is in the top part of the gums (gingiva) or the top bony part of the mouth, treatment may be one of the following: Surgery plus radiation therapy. A clinical trial of chemotherapy combined with radiation therapy. A clinical trial of fractionated (smaller doses) radiation therapy. Recurrent Lip and Oral Cavity Cancer Treatment depends on the type of treatment the patient had before. If radiation therapy was given, the patient may have surgery when the cancer comes back. If surgery was used, the patient may have more surgery, radiation therapy, or both. Patients may want to consider taking part in a clinical trial of new chemotherapydrugs, chemotherapy plus additional radiation therapy, or hyperthermia.

Leukemia - Chronic Myeloid - CML

2012-12-07T00:24:00.000-08:00

eukemia is a cancer of the blood. Leukemia begins when normal blood cells change and grow uncontrollably. Chronic myeloid leukemia (CML) is a cancer of the blood-forming cells, called myeloid cells, found in the bone marrow (the spongy, red tissue in the inner part of large bones). CML most often causes an increase in the number of white blood cells (neutrophils or granulocytes that normally fight infection). It is also sometimes called chronic granulocytic, chronic myelocytic, or chronic myelogenous leukemia. CML makes up about 9% of leukemias. About the Philadelphia Chromosome People with CML have an acquired genetic abnormality or mutation in their bone marrow cells, in which part of one chromosome (a long strand of genes) breaks off and reattaches to another chromosome. This is called a translocation. In CML, part of chromosome 9 breaks off and bonds to a section of chromosome 22, resulting in what is called the Philadelphia chromosome or Ph chromosome. The translocation t(9;22) causes two genes called BCR and ABL to become one fusion gene called BCR-ABL. This mutation is found only in the blood-forming cells, not in other organs of the body, and it is not inherited. Therefore, there is no concern about an increased risk to other family members. The BCR-ABL gene causes myeloid cells to make an abnormal enzyme that allows white blood cells to grow out of control. About CML Ordinarily, the number of white blood cells is tightly controlled by the bodyâmore white blood cells are produced during infections or times of stress, but then the numbers return to normal when the infection is cured. In CML, the abnormal BCR-ABL enzyme is like a switch that is stuck in the “on” positionâit keeps stimulating the white blood cells to grow and multiply. In addition to increased white blood cells, the number of blood platelets (cells that help the blood to clot) often increase, and the number of red blood cells, which carry oxygen, may decrease.

Leukemia - Chronic Lymphocytic - CLL

2012-12-07T00:22:00.002-08:00

eukemia is a cancer of the blood. Leukemia begins when normal blood cells change and grow uncontrollably. Chronic lymphocytic leukemia (CLL) is a cancer of the lymphocytes, a type of white blood cell involved in the body's immune system. For about half of people with CLL, the disease grows and progresses slowly, and it may take years for symptoms to appear or for treatment to be needed. In fact, some patients may never need treatment for their CLL. The other half of people who develop CLL have a type of CLL that grows more quickly and need treatment sooner. About lymphocytes Lymphocytes circulate in the blood stream and are made in the lymph nodes, spleen, and bone marrow (the spongy, red tissue in the inner part of the large bones). There are three different types of lymphocytes: T cells, B cells, and natural killer (NK) cells. Generally, T cells fight infections by triggering other cells in the immune system and by destroying infected cells, B cells make antibodies, and NK cells fight microbes and cancer cells. About CLL In people with CLL, the abnormal cells crowd other types of cells in the bone marrow, preventing the production of red blood cells (which carry oxygen), other types of normal white blood cells (neutrophils or granulocytes that fight infection), and platelets (small cells in the blood needed for clotting). This means that people with CLL may be anemic (low levels of red blood cells), more likely to get infections (because they do not have enough of the white blood cells called neutrophils that fight bacteria), and bruise or bleed easily (because of a low level of platelets) There are two general types of CLL, and it is important for doctors to find out whether the disease is caused by the overgrowth of T cells or B cells. The T-cell type of CLL, (now called T-cell prolymphocytic leukemia) is much less common (about 1% of people with CLL have this type) than the B-cell type of the disease (more than 95% of people with CLL have the B-cell type). Most often, CLL is diagnosed when too many abnormal lymphocytes are found in the blood. However, the same disease can occur when the abnormal lymphocytes are mostly in the lymph nodes but not in the blood. This is called small lymphocytic lymphoma, but behaves very similarly to CLL.

Leukemia - Acute Myeloid - AML

2012-12-07T00:21:00.000-08:00

Leukemia is a cancer of the blood. Leukemia begins when normal blood cells change and grow uncontrollably. Acute myeloid leukemia (AML) is a disorder of the process that normally produces neutrophils, a type of white blood cell. AML may sometimes be called acute myelogenous leukemia, acute myelocytic leukemia, or acute nonlymphocytic leukemia. Unlike chronic leukemia, acute leukemia develops quickly and generally needs immediate treatment. AML occurs in people of all ages but is most common in adults older than 65. About neutrophils Neutrophils fight infections caused by bacteria. Mature neutrophils develop from immature (undeveloped) white blood cells in a process called differentiation. The production of mature neutrophils usually is highly regulated. For example, the body rapidly makes more neutrophils during an infection and returns to a regular level of production when the infection is controlled. About AML In AML, acquired mutations (damage to the genetic material or DNA) in the blood-forming cells cause problems with the normal process of differentiation. This results in the build-up of many immature cells called myeloblasts or blasts. Blasts do not act like fully developed, healthy blood cells. The large number of blasts also reduces the production of healthy red blood cells and platelets (cells that help the blood to clot). Therefore, people with AML are usually anemic (because they do not have enough red blood cells), more likely to get infections (because they do not have enough mature neutrophils), and bruise or bleed easily (because of a low level of platelets). AML is usually found in the blood and bone marrow (the spongy, red tissue in the inner part of the large bones), but it can sometimes also invade other parts of the body, such as the brain, skin, and gums. Occasionally, AML cells can form a solid tumor called a myeloid sarcoma or chloroma that can be develop anywhere in the body.

Lymphocytes

2012-12-07T00:19:00.002-08:00

Leukemia is a cancer of the blood. Leukemia begins when normal blood cells change and grow uncontrollably. Acute lymphocytic leukemia (ALL) is a cancer of the lymphocytes, a type of white blood cell involved in the body's immune system. ALL is also called acute lymphoid leukemia or acute lymphoblastic leukemia. Acute means that the disease begins and gets worse quickly; patients with ALL usually need immediate treatment. ALL is most common in young children and adults older than 50, but people of any age can develop ALL. Lymphocytes are made in the bone marrow, the spongy, red tissue in the inner part of the large bones. Lymphocytes are found in the blood, lymph nodes, and spleen. Healthy lymphocytes fight bacterial and viral infections. In people with ALL, new lymphocytes do not develop into mature cells, but stay as immature cells called lymphoblasts. There are three different types of lymphocytes: T cells, B cells, and natural killer (NK) cells. Generally, T cells fight infections by activating other cells in the immune system and by destroying infected cells, B cells make antibodies, and NK cells fight microbes and cancer cells. About 85% of people with ALL have the B-cell subtype and about 15% have the T-cell type. The NK-cell subtype is quite rare. About ALL In people with ALL, the abnormal cells crowd other types of cells in the bone marrow, preventing the production of red blood cells (which carry oxygen), other types of white blood cells, and platelets (parts of the blood needed for clotting). This means that people with ALL may be anemic (because they do not have enough red blood cells), more likely to get infections (because they do not have enough of the type of white blood cells called neutrophils that fight bacteria), and bruise or bleed easily (because of a low level of platelets). Lymphoblasts may also collect in a person's lymphatic system and cause swelling of the lymph nodes. Some cells may invade other organs, including the brain, liver, spleen, or the testicles in men. Unlike other types of cancer, the spread of ALL to other parts of the body does not mean the cancer is in an advanced stage because acute leukemia is usually found throughout the body when it is diagnosed.

Leukemia

2012-12-07T00:18:00.002-08:00

Cancer is a process of uncontrolled abnormal cell growth and development. Under normal circumstances, cells are formed, mature, carry out their intended function, and then die. New cells are constantly regenerated in the body to replace those cells and to maintain normal cellular function. Cancer represents the disturbance of this process, which can occur in several ways. Cells may grow and reproduce in a disorganized and out-of-control fashion. Cells may fail to develop properly, so they will not function normally. Cells may fail to die normally. One or a combination of these processes may occur when cells become cancerous. Leukemia is a cancer of blood-forming cells in the bone marrow. These deranged, immature cells accumulate in the blood and within organs of the body. They are not able to carry out the normal functions of blood cells. Normal blood contains white blood cells, red blood cells, and platelets. All three types of blood elements develop from one immature cell type, called blood/marrow stem cells, in a process called hematopoiesis. These stem cells divide and develop to a more developed, but still immature precursor, called a blast, which then develops through several more stages, into a mature blood cell. This process takes place in the bone marrow, which is the soft spongy material found in the center of most bones. Each type of blood element has its own different and essential function in the body. White blood cells (leukocytes) are part of the immune system and help fight a variety of infections. They also help in the healing of wounds, cuts, and sores. Red blood cells (erythrocytes) contain hemoglobin, which carries oxygen to, and removes carbon dioxide from, the cells throughout the various organs of the body. Platelets, along with certain plasma proteins, help form clots once blood vessels are damaged or cut. The first step in the process of stem cell maturation is differentiation into two groups: the myeloid stem cell line and the lymphoid stem cell line. The myeloid stem cells, or lineage, develop into red blood cells, platelets, and certain types of white blood cells (granulocytes or monocytes). The lymphoid stem cells, or lineage, develop into another type of white blood cell (lymphocytes). Either lineage can be affected by leukemia. Leukemias that affect the myeloid lineage are called myelocytic (also myelogenous, myeloblastic, or nonlymphocytic) leukemias. Leukemias that affect the lymphoid lineage are called lymphocytic (also lymphoblastic or lymphogenous) leukemias. Each of the two major types of leukemia, myelogenous and lymphocytic, include both acute and chronic forms. Acute essentially refers to a disorder of rapid onset. In the acute myelocytic leukemias, the abnormal cells grow rapidly and do not mature. Most of these immature cells tend to die rapidly. In the acute lymphocytic leukemias, growth is not as rapid as that of the myelocytic cells. Rather, the cells tend to accumulate. Common to both types of leukemia is their inability to carry out the functions of healthy white blood cells. Untreated, death occurs within weeks or a few months. In the chronic leukemias, the onset tends to be slow, and the cells generally mature abnormally and often accumulate in various organs, often over long intervals. Their ability to fight infections and assist in repairing injured tissues is impaired. However, unlike the acute forms of leukemia, untreated, these disorders may persist for many months or, as in the chronic lymphocytic group, many years. A distinctive feature of the chronic myelocytic type is its invariable conversion, if untreated, to a more rapidly fulminating acute type, leading to rapid death.

What is laryngeal cancer?

2012-12-07T00:14:00.001-08:00

Laryngeal cancer occurs when cancerous (malignant) cells form on the tissues of the larynx, or voice box. The larynx contains the vocal folds. The vocal folds vibrate. This makes sound when air is directed against them. A person's voice is heard when this sound echoes through the throat, mouth, and nose. What are some signs or symptoms of laryngeal cancer? A person with laryngeal cancer may notice: hoarseness or change in his or her voice difficulty swallowing a lump in the throat bad cough or chest infection shortness of breath bad breath (halitosis) weight loss prolonged earache How is laryngeal cancer diagnosed? You should visit a doctor if you have any of the above-mentioned symptoms. A doctor will feel your throat for lumps. He or she will also look down your throat with an endoscope, a tube with a special light, to see your larynx. This procedure is called a laryngoscopy. The doctor may need to cut out a small piece of tissue, if the larynx has tissue that does not look normal. The doctor will look at the tissue under a microscope to see if it contains any cancer cells. This procedure is called a biopsy, and it is the only way to diagnose cancer. What treatments are available for individuals with laryngeal cancer? One or more of the following approaches may be used depending on the size, location, and time of cancer detection: radiation therapy chemotherapy partial removal of the larynx (laryngectomy) total laryngectomy In these cases, the person may still be able to produce voice. However, the person's voice may not be the same because of removing parts of the larynx, changes to laryngeal tissue from radiation or chemotherapy, or removal of nearby neck muscles (to prevent or stop the spread of the cancer). In extreme cases, total laryngectomy, with or without radiation therapy or chemotherapy, may be the only life-saving solution. Patients who have undergone radiation treatment may have: dry and/or red skin at the site of the treatment sore throat dry mouth (xerostomia) sensitive mouth mouth sores difficulty swallowing decreased taste fatigue breathing difficulties from swelling Patients who have received chemotherapy, often for the treatment of metastasized cancer (i.e., cancer that has spread), may have: nausea or vomiting increased chance of infection bleeding or bruising fatigue shortness of breath These side effects often stop after the chemotherapy is discontinued. Speech-language pathologists (SLPs) play an important role both before and after surgery. See Laryngeal Cancer: Benefits of Speech-Language Pathology Services to learn more. To contact a speech-language pathologist, visit ASHA's Find a Professional. What is a laryngectomy? A laryngectomy is the removal of the voice box (larynx) from the neck, usually because of cancer. During this operation, a new route for breathing is surgically created. The end of the windpipe (trachea) is connected to a hole (stoma) made in the neck. Rather than using the mouth and the nose, the person will breathe through this hole. Because the patient with the laryngectomy breathes through a stoma, the air inhaled into the lungs is no longer warmed or moisturized by structures of the nose and mouth. As a result, the breathing tubes can become irritated and create a thick mucus. This mucus may also crust on the stoma and require routine removal. The patient may benefit from humidifiers and a cover to protect the stoma. What other organizations have information on laryngeal cancer? This list is not exhaustive and inclusion does not imply endorsement of the organization or the content of the Web site by ASHA.

What is Langerhans cell histiocytosis?

2012-12-07T00:13:00.001-08:00

Langerhans cell histiocytosis is a disorder in which excess immune system cells called Langerhans cells build up in the body. Langerhans cells, which help regulate the immune system, are normally found throughout the body, especially in the skin, lymph nodes, spleen, lungs, liver, and bone marrow. In Langerhans cell histiocytosis, excess immature Langerhans cells usually form tumors called granulomas. However, Langerhans cell histiocytosis is not generally considered to be a form of cancer. In approximately 80 percent of affected individuals, one or more granulomas develop in the bones, causing pain and swelling. The granulomas, which usually occur in the skull or the long bones of the arms or legs, may cause the bone to fracture. Granulomas also frequently occur in the skin, appearing as blisters, reddish bumps, or rashes which can be mild to severe. The pituitary gland may also be affected; this gland is located at the base of the brain and produces hormones that control many important body functions. Without hormone supplementation, affected individuals may experience delayed or absent puberty or an inability to have children (infertility). In addition, pituitary gland damage may result in the production of excessive amounts of urine (diabetes insipidus) and dysfunction of another gland called the thyroid. Thyroid dysfunction can affect the rate of chemical reactions in the body (metabolism), body temperature, skin and hair texture, and behavior. In 15 to 20 percent of cases, Langerhans cell histiocytosis affects the lungs, liver, or blood-forming (hematopoietic) system; damage to these organs and tissues may be life-threatening. Lung involvement, which appears as swelling of the small airways (bronchioles) and blood vessels of the lungs, results in stiffening of the lung tissue, breathing problems, and increased risk of infection. Hematopoietic involvement, which occurs when the Langerhans cells crowd out blood-forming cells in the bone marrow, leads to a general reduction in the number of blood cells (pancytopenia). Pancytopenia results in fatigue due to low numbers of red blood cells (anemia), frequent infections due to low numbers of white blood cells (neutropenia), and clotting problems due to low numbers of platelets (thrombocytopenia). Other signs and symptoms that may occur in Langerhans cell histiocytosis, depending on which organs and tissues have Langerhans cell deposits, include swollen lymph nodes, abdominal pain, yellowing of the skin and whites of the eyes (jaundice), delayed puberty, protruding eyes, dizziness, irritability, and seizures. About 1 in 50 affected individuals experience deterioration of neurological function (neurodegeneration). Langerhans cell histiocytosis is often diagnosed in childhood, usually between ages 2 and 3, but can appear at any age. Most individuals with adult-onset Langerhans cell histiocytosis are current or past smokers; in about two-thirds of adult-onset cases the disorder affects only the lungs. The severity of Langerhans cell histiocytosis, and its signs and symptoms, vary widely among affected individuals. Certain presentations or forms of the disorder were formerly considered to be separate diseases. Older names that were sometimes used for forms of Langerhans cell histiocytosis include eosinophilic granuloma, Hand-Schüller-Christian disease, and Letterer-Siwe disease. In many people with Langerhans cell histiocytosis, the disorder eventually goes away with appropriate treatment. It may even disappear on its own, especially if the disease occurs only in the skin. However, some complications of the condition, such as diabetes insipidus or other effects of tissue and organ damage, may be permanent. How common is Langerhans cell histiocytosis? Langerhans cell histiocytosis is a rare disorder. Its prevalence is estimated at 1 to 2 in 100,000 people. What genes are related to Langerhans cell histiocytosis? In one study, a somatic mutation in the BRAF gene was identified in the Langerhans cells of about half of tested individuals with this disorder. Somatic gene mutations are acquired during a person's lifetime and are present only in certain cells. These changes are not inherited. The BRAF gene provides instructions for making a protein that is normally switched on and off in response to signals that control cell growth and development. Somatic mutations cause the BRAF protein in affected cells to be continuously active and to transmit messages to the nucleus even in the absence of these chemical signals. The overactive protein may contribute to the development of Langerhans cell histiocytosis by allowing the Langerhans cells to grow and divide uncontrollably. Some researchers believe that other factors, such as viral infections, environmental toxins, and changes in other genes, may also influence the development of this complex disorder. Read more about the BRAF gene. How do people inherit Langerhans cell histiocytosis? Langerhans cell histiocytosis is usually not inherited and typically occurs in people with no history of the disorder in their family. A few families with multiple cases of Langerhans cell histiocytosis have been identified, but the inheritance pattern is unknown. Where can I find information about diagnosis or management of Langerhans cell histiocytosis? These resources address the diagnosis or management of Langerhans cell histiocytosis and may include treatment providers.

Renal Cell Cancer

2012-12-07T00:05:00.002-08:00

Renal cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney. Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which malignant (cancer) cells are found in the lining of tubules (very small tubes) in the kidney. There are 2 kidneys, one on each side of the backbone, above the waist. The tiny tubules in the kidneys filter and clean the blood, taking out waste products and making urine. The urine passes from each kidney into the bladder through a long tube called a ureter. The bladder stores the urine until it is passed from the body. Cancer that starts in the ureters or the renal pelvis (the part of the kidney that collects urine and drains it to the ureters) is different from renal cell cancer. Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer. Risk factors include the following: Smoking Misusing certain pain medicines, including over-the-counter pain medicines, for a long time. Having certain genetic conditions, such as von Hippel-Lindau disease or hereditary papillary renal cell carcinoma. Possible signs of renal cell cancer include blood in the urine and a lump in the abdomen. These and other symptoms may be caused by renal cell cancer. Other conditions may cause the same symptoms. There may be no symptoms in the early stages. Symptoms may appear as the tumor grows. A doctor should be consulted if any of the following problems occur: Blood in the urine A lump in the abdomen A pain in the side that doesn't go away Loss of appetite Weight loss for no known reason Anemia Tests that examine the abdomen and kidneys are used to detect (find) and diagnose renal cell cancer. The following tests and procedures may be used: Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken. Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells. Liver function test: A procedure in which a sample of blood is checked to measure the amounts of enzymes released into it by the liver. An abnormal amount of an enzyme can be a sign that cancer has spread to the liver. Certain conditions that are not cancer may also increase liver enzyme levels. Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer is present in these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages. Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. To do a biopsy for renal cell cancer, a thin needle is inserted into the tumor and a sample of tissue is withdrawn. Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The stage of the disease. The patient's age and general health. Stages of Renal Cell Cancer After renal cell cancer has been diagnosed, tests are done to find out if cancer cells have spread within the kidney or to other parts of the body. The process used to find out if cancer has spread within the kidney or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process: CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner. There are three ways that cancer spreads in the body. The three ways that cancer spreads in the body are: Through tissue. Cancer invades the surrounding normal tissue. Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body. Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body. When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer. Stage I In stage I, the tumor is 7 centimeters or smaller and is found only in the kidney. Stage II In stage II, the tumor is larger than 7 centimeters and is found only in the kidney. Stage III In stage III, cancer is found: in the kidney and in 1 nearby lymph node; or in an adrenal gland or in the layer of fatty tissue around the kidney, and may be found in 1 nearby lymph node; or in the main blood vessels of the kidney and may be found in 1 nearby lymph node. Stage IV In stage IV, cancer has spread: beyond the layer of fatty tissue around the kidney and may be found in 1 nearby lymph node; or to 2 or more nearby lymph nodes; or to other organs, such as the bowel, pancreas, or lungs, and may be found in nearby lymph nodes. Recurrent Renal Cell Cancer Recurrent renal cell cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back many years after initial treatment, in the kidney or in other parts of the body. Treatment Option Overview There are different types of treatment for patients with renal cell cancer. Different types of treatments are available for patients with renal cell cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Five types of standard treatment are used: Surgery Surgery to remove part or all of the kidney is often used to treat renal cell cancer. The following types of surgery may be used: Partial nephrectomy: A surgical procedure to remove the cancer within the kidney and some of the tissue around it. A partial nephrectomy may be done to prevent loss of kidney function when the other kidney is damaged or has already been removed. Simple nephrectomy: A surgical procedure to remove the kidney only. Radical nephrectomy: A surgical procedure to remove the kidney, the adrenal gland, surrounding tissue, and, usually, nearby lymph nodes. A person can live with part of 1 working kidney, but if both kidneys are removed or not working, the person will need dialysis (a procedure to clean the blood using a machine outside of the body) or a kidney transplant (replacement with a healthy donated kidney). A kidney transplant may be done when the disease is in the kidney only and a donated kidney can be found. If the patient has to wait for a donated kidney, other treatment is given as needed. When surgery to remove the cancer is not possible, a treatment called arterial embolization may be used to shrink the tumor. A small incision is made and a catheter (thin tube) is inserted into the main blood vessel that flows to the kidney. Small pieces of a special gelatin sponge are injected through the catheter into the blood vessel. The sponges block the blood flow to the kidney and prevent the cancer cells from getting oxygen and other substances they need to grow. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy. Targeted therapy Targeted therapy uses drugs or other substances that can find and attack specific cancer cells without harming normal cells. Antiangiogenic agents are a type of targeted therapy that may be used to treat advanced renal cell cancer. They keep blood vessels from forming in a tumor, causing the tumor to starve and stop growing or to shrink. New types of treatment are being tested in clinical trials. Below describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Stem cell transplant Stem cells (immature blood cells) are removed from the blood or bone marrow of a donor and given to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Treatment Options for Renal Cell Cancer Stage I Renal Cell Cancer Treatment of stage I renal cell cancer may include the following: Surgery (radical nephrectomy, simple nephrectomy, or partial nephrectomy). Radiation therapy as palliative therapy to relieve symptoms in patients who cannot have surgery. Arterial embolization as palliative therapy. A clinical trial of a new treatment. Stage II Renal Cell Cancer Treatment of stage II renal cell cancer may include the following: Surgery (radical nephrectomy or partial nephrectomy). Surgery (nephrectomy), before or after radiation therapy. Radiation therapy as palliative therapy to relieve symptoms in patients who cannot have surgery. Arterial embolization as palliative therapy. A clinical trial of a new treatment. Stage III Renal Cell Cancer Treatment of stage III renal cell cancer may include the following: Surgery (radical nephrectomy). Blood vessels of the kidney and some lymph nodes may also be removed. Arterial embolization followed by surgery (radical nephrectomy). Radiation therapy as palliative therapy to relieve symptoms and improve the quality of life. Arterial embolization as palliative therapy. Surgery (nephrectomy) as palliative therapy. Radiation therapy before or after surgery (radical nephrectomy). A clinical trial of biologic therapy following surgery. Stage IV and Recurrent Renal Cell Cancer Treatment of stage IV and recurrent renal cell cancer may include the following: Targeted therapy alone or after biologic therapy. Biologic therapy alone or after surgery (nephrectomy) to reduce the size of the tumor. Arterial embolization as palliative therapy to relieve symptoms and improve the quality of life. Radiation therapy as palliative therapy to relieve symptoms and improve the quality of life. Surgery (nephrectomy) as palliative therapy. Surgery (radical nephrectomy, with or without removal of cancer from other areas where it has spread). A clinical trial of chemotherapy. Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV renal cell cancer and recurrent renal cell cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site. For more information from the NCI, please write to this address: NCI Public Inquiries Office Suite 3036A 6116 Executive Boulevard, MSC8322 Bethesda, MD 20892-8322 U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. Information about ongoing clinical trials is available from the NCI Web site

Ocular Melanoma (Cancer of the Eye)

2012-12-07T00:00:00.002-08:00

Ocular melanoma, a rare cancer, is a disease in which cancer (malignant) cells are found in the part of the eye called the uvea. The uvea contains cells called melanocytes. When these cells become cancerous, the cancer is called a melanoma. The uvea includes the iris (the colored part of the eye), the ciliary body (a muscle in the eye), and the choroid (a layer of tissue in the back of the eye). The iris opens and closes to change the amount of light entering the eye. The ciliary body changes the shape of the lens inside the eye so it can focus. The choroid layer is next to the retina, the part of the eye that makes a picture. If there is melanoma that starts in the iris, it may look like a dark spot on the iris. If melanoma is in the ciliary body or the choroid, a person may have blurry vision or may have no symptoms, and the cancer may grow before it is noticed. Ocular melanoma is usually found during a routine eye examination, when a doctor looks inside the eye with special lights and instruments. The chance of recovery (prognosis) depends on the size and cell type of the cancer, where the cancer is in the eye, and whether the cancer has spread. Ocular Melanoma Locations Ocular melanoma can occur in a variety of ocular tissue. Iris Ocular melanomas of the iris occur in the front colored part of the eye. Iris melanomas usually grow slowly and do not usually spread to other parts of the body. Ciliary body/choroid (small size) Ocular melanomas of the ciliary body and/or choroid occur in the back part of the eye. They are grouped by the size of the tumor. Small size ciliary body or choroidal melanoma is 2 to 3 millimeters or less thick. Ciliary body/choroid (medium/large size) Ocular melanomas of the ciliary body and/or choroid occur in the back part of the eye. They are grouped by the size of the tumor. Medium/large size ciliary body or choroid melanoma is more than 2 to 3 millimeters thick. Extraocular extension The melanoma has spread outside the eye by extending through the wall of the eye, the sclera. Recurrent Recurrent disease means that the cancer has come back (recurred) after it has been treated. Metastatic Metastatic melanoma means that the tumor has spread far from the eye, usually to the liver. Symptoms Most melanomas of the iris, ciliary or choroid are initially completely asymptomatic. As the tumor enlarges, the tumor may cause distortion of the pupil (iris melanoma), blurred vision (ciliary body melanoma) or markedly decreased visual acuity from a secondary retinal detachment caused by a choroidal melanoma. Most melanomas are detected by routine ophthalmic examination which should include dilation of the pupil and detailed examination of the posterior aspect of the eye to detect choroidal melanomas. Like most early cancers, an early melanoma is usually a silent cancer. Determining that the Lesion is a Malignant Melanoma One of the difficulties in diagnosing small melanomas is that it can be very difficult to differentiate a small malignant melanoma from a benign pigmented tumor, such as an iris or choroidal nevus. At present there is no definitive test that clearly differentiates a nevus from a small malignant melanoma. Even with special biopsy techniques, such as fine needle aspiration of the lesion, it can be very difficult to differentiate a benign nevus from a malignant melanoma. A distinguishing feature of a small malignant melanoma from a nevus is that the malignant melanoma progressively grows and enlarges. Thus, small lesions may initially be observed to determine if the lesion remains static or shows evidence of progressive growth. The symptoms described above may not necessarily mean that you have ocular melanoma. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam. Treatment Once a definite diagnosis of malignant melanoma is made, possible therapies depend on the location and size of the tumor. Metastatic melanoma can be difficult to treat. In this situation, the ocular melanoma has spread far from the eye and typically has spread to the liver. Surgery Small melanomas of the iris or ciliary body can sometimes be successfully treated with surgery. An iridectomy refers to removal of part of the iris where the tumor is present. An iridocyclectomy refers to removal of part of the iris as well as the adjacent ciliary body where the tumor is present. With very large tumors, the only possible option is removal of the eye, which is called enucleation. Following removal of the eye, an artificial eye is placed in the socket. With today's techniques, it can be extremely difficult to differentiate the artificial eye from the adjacent normal eye. Radiation Therapy A special form of radiation therapy has shown to be very effective in treating malignant melanomas of the ciliary body or choroid. This special form of radiation therapy is called plaque therapy which consists of suturing a small metallic object, containing radioisotopes, to the wall of the eye adjacent to the base of the tumor. Once the tumor has received sufficient radiation to destroy the tumor, the plaque is again removed surgically. The Collaborative Ocular Melanoma Study The Collaborative Ocular Melanoma Study (COMS) is the largest study of the treatment therapies of ocular melanoma. The COMS initially addressed the question whether additive therapy (radiation therapy) would be of benefit to patients with large choroidal malignant melanoma. In patients with large melanomas, the only reasonable option is removal of the eye, which is called enucleation. Despite removal of the eye, these patients have an increased risk of subsequently developing metastatic disease and dying from their ocular melanoma. In COMS, with full patient agreement, patients were randomized to enucleation of the eye or preoperative radiation followed by enucleation of the eye. Unfortunately, both groups had essentially identical outcomes. The preoperative radiation did not reduce subsequent metastatic disease. Patients with medium tumors can be treated with either enucleation or a special form of radiation therapy, called plaque therapy. Plaque therapy consists of a small gold carrier (something like a small bottle cap), which contain radioactive seeds that can destroy or inactivate tumors. The plaque is sutured to the wall of the eye (sclera) in the operating room and is left in place until the tumor is destroyed. The COMS evaluated whether enucleation or plaque therapy would be more effective in preventing subsequent metastatic disease. With full patient agreement, patients were randomized to either enucleation or plaque therapy and followed for 10 years to determine which therapy would reduce metastatic disease and death. The study showed that plaque therapy is equally effective as removal of the eye in preventing metastatic disease and death. Thus plaque therapy has become the standard of care for most patients with ocular melanoma. Clinic Information

Hypopharyngeal Cancer

2012-12-06T23:58:00.003-08:00

Cancer of the hypopharynx is uncommon; approximately 2,500 new cases are diagnosed in the United States each year.[1] The peak incidence of this cancer occurs in males and females aged 50 to 60 years.[2] Excessive alcohol and tobacco use are the primary risk factors for hypopharyngeal cancer.[3,4] In the United States, hypopharyngeal cancers are more common in men than in women.[5] In Europe and Asia, high incidences of pharyngeal cancers, namely, oropharyngeal and hypopharyngeal, have been found among men in France, in the counties of Bas-Rhin and Herault; Switzerland, in the section of Vaud; Spain, in the Basque Country region; Slovakia, Slovenia, and India, in the cities of Bombay and Madras.[6] This cancer is extremely rare in children.[7] Upper hypopharyngeal cancers appear to be associated more with heavy drinking and smoking, whereas the lower hypopharyngeal, or postcricoid, cancers are more often associated with nutritional deficiencies.[1,8] Although earlier reports from northern Europe, particularly from Sweden, indicated a link between Plummer-Vinson syndrome, which consisted of sideropenic anemia and epithelial changes of the aerodigestive tract, and other nutritional deficiencies in women, cases of hypopharyngeal cancer among women are currently more likely to be associated with excessive use of alcohol and tobacco, rather than with deficiency diseases.[2,9,10,11] Anatomically, the hypopharynx extends from the plane of the hyoid bone above to the plane of the inferior border of the cricoid cartilage below. The hypopharynx is composed of the following three parts and does not include the larynx: The pyriform sinus. The postcricoid area. The posterior pharyngeal wall. The lymphatic drainage from the pharynx is into the jugulodigastric, jugulo-omohyoid, upper and middle deep cervical, and retropharyngeal nodes. In the United States and Canada, 65% to 85% of hypopharyngeal carcinomas involve the pyriform sinuses, 10% to 20% involve the posterior pharyngeal wall, and 5% to 15% involve the postcricoid area.[12] Pyriform sinus and postcricoid carcinomas are typically flat plaques with raised edges and superficial ulceration. In contrast, posterior hypopharyngeal wall tumors tend to be exophytic and are often large (i.e., 80% >5 cm) at presentation.[13] Hypopharyngeal carcinomas tend to spread within the mucosa, beneath intact epithelium, and are prone to skip metastasis and to resurface at various locations remote from the primary site.[1,13] Because of this fact and the abundant lymphatic network of the region, a localized hypopharyngeal tumor is the exception.[1] Almost all hypopharyngeal cancers are mucosal squamous cell carcinomas (SCCs).[1] Multiple primary tumors are not uncommon. Approximately 25% of patients in a retrospective study of 150 cases were found to have second primary tumors.[14] Field cancerization may be responsible, in part, for the multiple, synchronous, primary malignant neoplasms that occur in patients with hypopharyngeal cancer.[1,14,15,16] The concept of field cancerization, originally described in 1953, proposes that tumors develop in a multifocal fashion within a field of tissue that has been chronically exposed to carcinogens.[17]

What is Liver (Hepatocellular) Cancer

2012-12-06T22:37:00.002-08:00

Liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. The liver is one of the largest organs in the body. It has four lobes and fills the upper right side of the abdomen inside the rib cage. The liver has many important functions, including: Filtering harmful substances from the blood so they can be passed from the body in stools and urine. Making bile to help digest fats from food. Storing glycogen (sugar), which the body uses for energy. See the following PDQ summaries for more information about liver (hepatocellular) cancer: Liver (Hepatocellular) Cancer Screening Adult Primary Liver Cancer Treatment Childhood Liver Cancer Treatment Liver cancer is not common in the United States. Liver cancer is the fourth most common cancer and the third leading cause of cancer death in the world. In the United States, men, especially Chinese American men, have an increased risk of liver cancer. The number of new cases of liver cancer and the number of deaths from liver cancer continue to increase, especially among middle-aged black, Hispanic, and white men. People are usually older than 40 years when they develop this cancer. Finding and treating liver cancer early may prevent death from liver cancer. Being infected with certain types of the hepatitis virus can cause hepatitis and increase the risk of liver cancer. Hepatitis is most commonly caused by the hepatitis virus. Hepatitis is a disease that causes inflammation (swelling) of the liver. Damage to the liver from hepatitis that lasts a long time can increase the risk of liver cancer. There are six types of the hepatitis virus. Hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV) are the three most common types. These three viruses cause similar symptoms, but the ways they spread and affect the liver are different. The Hepatitis A vaccine and the hepatitis B vaccine prevent infection with hepatitis A and hepatitis B. There is no vaccine to prevent infection with hepatitis C. If a person has had one type of hepatitis in the past, it is still possible to get the other types. Hepatitis viruses include: Hepatitis A Hepatitis A is caused by eating food or drinking water infected with hepatitis A virus. It does not lead to chronic disease. People with hepatitis A usually get better without treatment. Hepatitis B Hepatitis B is caused by contact with the blood, semen, or other body fluid of a person infected with hepatitis B virus. It is a serious infection that may become chronic and cause scarring of the liver (cirrhosis). This may lead to liver cancer. Blood banks test all donated blood for hepatitis B, which greatly lowers the risk of getting the virus from blood transfusions. Hepatitis C Hepatitis C is caused by contact with the blood of a person infected with hepatitis C virus. Hepatitis C may range from a mild illness that lasts a few weeks to a serious, lifelong illness. Most people who have hepatitis C develop a chronic infection that may cause scarring of the liver (cirrhosis). This may lead to liver cancer. Blood banks test all donated blood for hepatitis C, which greatly lowers the risk of getting the virus from blood transfusions. Hepatitis D Hepatitis D develops in people already infected with hepatitis B. It is caused by hepatitis D virus (HDV) and is spread through contact with infected blood or dirty needles, or by having unprotected sex with a person infected with HDV. Hepatitis D causes acute hepatitis. Hepatitis E Hepatitis E is caused by hepatitis E virus (HEV). Hepatitis E can be spread through oral-anal contact or by drinking infected water. Hepatitis E is rare in the United States. Hepatitis G Being infected with hepatitis G virus (HGV) has not been shown to cause liver cancer.

What is Heart Cancer?

2012-12-06T22:34:00.000-08:00

Heart cancer (primary cardiac tumor) is cancer that arises in the heart. Cancerous (malignant) tumors that begin in the heart are most often sarcomas, a type of cancer that originates in the soft tissues of the body. The vast majority of heart tumors are noncancerous (benign). Heart cancer is extremely rare. For example, a review of more than 12,000 autopsies identified only seven cases of primary cardiac tumor — an incidence of less than 0.1 percent. At Mayo Clinic, on average only one case of heart cancer is seen each year. Although still rare, most cancers found in the heart have come from elsewhere in the body. These include lymphomas that originate in the chest near the heart. Other cancers that can spread to the heart include melanomas and sarcomas. Heart cancer may cause the following: Obstruction of blood flow through the heart Stiffening of the heart muscle (cardiac fibrosis) Interference with heart valves (marantic endocarditis) In cases of marantic endocarditis, the heart valves are damaged by the cancer, and it may cause the valves to malfunction. In severe cases, the heart valves may need to be replaced. Unfortunately, this is often a sign of very advanced cancer and carries a poor prognosis. Another rare type of cancer known as carcinoid tumor at times produces hormones that can damage heart valves. Cancer treatments also can affect the heart. Certain chemotherapy drugs can cause damage to the heart. Radiation therapy directed at or near the heart also can cause damage to the heart muscle and increase the risk of coronary artery disease later in life. Data also suggests that some hormonal cancer therapies may increase the risk of heart disease.

What is Hairy cell leukemia

2012-12-06T22:31:00.001-08:00

is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). Hairy cell leukemia is a cancer of the blood and bone marrow. This rare type of leukemia gets worse slowly or does not get worse at all. The disease is called hairy cell leukemia because the leukemia cells look "hairy" when viewed under a microscope. Normally, the bone marrow makes blood stem cells (immature cells) that develop into mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. The myeloid stem cell develops into one of three types of mature blood cells: Red blood cells that carry oxygen and other materials to all tissues of the body. White blood cells that fight infection and disease. Platelets that help prevent bleeding by causing blood clots to form. The lymphoid stem cell develops into a lymphoblast cell and then into one of three types of lymphocytes (white blood cells): B lymphocytes that make antibodies to help fight infection. T lymphocytes that help B lymphocytes make antibodies to help fight infection. Natural killer cells that attack cancer cells and viruses. Blood cell development. A blood stem cell goes through several steps to become a red blood cell, platelet, or white blood cell. In hairy cell leukemia, too many blood stem cells develop into lymphocytes. These lymphocytes are abnormal and do not become healthy white blood cells. They may also be called leukemic cells. The leukemic cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding. Some of the leukemia cells may collect in the spleen and cause it to swell. This summary is about hairy cell leukemia. See the following PDQ summaries for information about other types of leukemia: Adult Acute Lymphoblastic Leukemia Treatment. Childhood Acute Lymphoblastic Leukemia Treatment. Chronic Lymphocytic Leukemia Treatment. Adult Acute Myeloid Leukemia Treatment. Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment. Chronic Myelogenous Leukemia Treatment. Gender and age may affect the risk of developing hairy cell leukemia. Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. The cause of hairy cell leukemia is unknown. It occurs more often in older men. Possible signs of hairy cell leukemia include tiredness, infections, and pain below the ribs. These and other symptoms may be caused by hairy cell leukemia. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur: Weakness or feeling tired. Fever or frequent infections. Easy bruising or bleeding. Shortness of breath. Weight loss for no known reason. Pain or a feeling of fullness below the ribs. Painless lumps in the neck, underarm, stomach, or groin.

What is Head and Neck Cancer

2012-12-06T22:27:00.002-08:00

Childhood sarcomas often occur in the head and neck area and they are described in other sections. Unusual pediatric head and neck cancers include nasopharyngeal carcinoma, esthesioneuroblastoma, thyroid tumors, oral cancer, salivary gland cancer, laryngeal carcinoma, papillomatosis, and respiratory tract carcinoma involving the NUT gene on chromosome 15.[1] The prognosis, diagnosis, classification, and treatment of these head and neck cancers are discussed below. It must be emphasized that these cancers are seen very infrequently in patients younger than 15 years, and most of the evidence is derived from case series. Nasopharyngeal Carcinoma Nasopharyngeal carcinoma (NPC) arises in the lining of the nasal cavity and pharynx.[2,3] This tumor accounts for about one-third of all cancers of the upper airways. NPC is very uncommon in children younger than 10 years, but increases in incidence to 0.8 and 1.3 per million per year in children aged 10 to 14 years and in children aged 15 to 19 years, respectively.[4,5] NPC is overrepresented in black children in the United States when compared with other malignancies.[6] There is a higher frequency of this tumor in North Africa and Southeast Asia. Nasopharyngeal carcinoma occurs in association with Epstein-Barr virus (EBV), the virus associated with infectious mononucleosis.[7] The virus can be detected in biopsy specimens of these cancers, and tumor cells can have EBV antigens on their cell surface. Three histologic subtypes are recognized by the World Health Organization (WHO). Type 1 is squamous cell carcinoma, type 2 is nonkeratinizing carcinoma, and type 3 is undifferentiated carcinoma. Children with NPC are more likely to have WHO type 2 or type 3 disease.[5] This cancer most frequently spreads to lymph nodes in the neck, which may alert the patient, parent, or physician to the presence of this tumor. The tumor may also spread to the nose, mouth, and pharynx, causing snoring, epistaxis, obstruction of the eustachian tubes, or hearing loss; it may also invade the base of the skull, causing cranial nerve palsy or difficulty with movements of the jaw (trismus). Distant metastatic sites may include the bones, lungs, and liver. The location of the primary tumor can be determined by direct inspection of the nasopharynx. A diagnosis can be made from a biopsy of the primary tumor or of enlarged lymph nodes of the neck. Nasopharyngeal carcinomas must be distinguished from all other cancers that can present with enlarged lymph nodes and from other types of cancer in the head and neck area. Thus, diseases such as thyroid cancer, rhabdomyosarcoma, non-Hodgkin lymphoma, Hodgkin lymphoma, and Burkitt lymphoma must be considered, as should benign conditions such as nasal angiofibroma, which usually presents with epistaxis in adolescent males, and infections draining into the lymph nodes of the neck.

What is stomach Cancer?

2012-12-06T22:24:00.001-08:00

Stomach cancer, also called gastric cancer, is a malignant tumor arising from the lining of the stomach. There has been a significant decrease in the number of people diagnosed with stomach cancer in the past 60 years. According to the American Cancer Society, the estimated numbers of new cases (people diagnosed with the condition) and deaths from gastric cancer in the United States in 2012 will be: New cases: 21,320 Deaths: 15,070 Stomach cancers are classified according to the type of tissue where they originate. The most common type of stomach cancer is adenocarcinoma, which starts in the glandular tissue of the stomach and accounts for 90% to 95% of all stomach cancers. Other forms of stomach cancer include lymphomas, which involve the lymphatic system and sarcomas, which involve the connective tissue (such as muscle, fat, or blood vessels). Stomach Cancer Stomach cancer may often be cured if it is found and treated at an early stage. Unfortunately, the outlook is poor if the cancer is already at an advanced stage when discovered. In most cases, stomach cancer is found at later stages. What Is Your Cancer Risk? Take the WebMD Cancer Health Check What Causes Stomach Cancer? The exact cause of stomach cancer is unknown, but a number of factors can increase the risk of the disease, including: Gender -- men have more than double the risk of getting stomach cancer than women. Race -- being African-American or Asian may increase your risk. Genetics -- genetic abnormalities and some inherited cancer syndromes may increase your risk Geography -- stomach cancer is more common in Japan, the former Soviet Union, and parts of Central America and South America. Blood type -- individuals with blood group A may be at increased risk. Advanced age -- stomach cancer occurs more often around ages 70 and 74 in men and women, respectively. Family history of gastric cancer can double or triple the risk of stomach cancer. Lifestyle factors such as smoking, drinking alcohol, and eating a diet low in fruits and vegetables or high in salted, smoked, or nitrate-preserved foods may increase your risk Helicobacter pylori (H. pylori) infection of the stomach. H. pylori is a bacterium that infects the lining of the stomach and causes chronic inflammation and ulcers. Certain health conditions including chronic gastritis, pernicious anemia, gastric polyps, intestinal metaplasia, and prior stomach surgery. Work-related exposure due to coal mining, nickel refining, and rubber and timber processing and asbestos exposure. What Are the Symptoms of Stomach Cancer? In the early stages of stomach cancer, you may have very few symptoms. These may include: Indigestion and stomach discomfort A bloated feeling after eating Mild nausea Loss of appetite Heartburn These symptoms are similar to those caused by a peptic ulcer. If you are experiencing any of these symptoms you should see your health care provider so that a proper diagnosis can be made and timely treatment given. A stomach cancer can grow very large before it causes other symptoms. In more advanced cancer, you may have: Discomfort in the upper or middle part of the abdomen. Blood in the stool (which appears as black, tarry stools). Vomiting or vomiting blood. Weight loss. Pain or bloating in the stomach after eating. Weakness or fatigue associated with mild anemia (a deficiency in red blood cells).

What is Gallbladder Cancer

2012-12-06T22:17:00.000-08:00

General Information About Gallbladder Cancer Gallbladder cancer is a disease in which malignant (cancer) cells form in the tissues of the gallbladder. Gallbladder cancer is a rare disease in which malignant (cancer) cells are found in the tissues of the gallbladder. The gallbladder is a pear-shaped organ that lies just under the liver in the upper abdomen. The gallbladder stores bile, a fluid made by the liver to digest fat. When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct, which connects the gallbladder and liver to the first part of the small intestine. Anatomy of the gallbladder. The gallbladder is just below the liver. Bile is stored in the gallbladder and flows through the cystic duct and the common bile duct into the small intestine when food is being digested. The wall of the gallbladder has 3 main layers of tissue. Mucosal (innermost) layer. Muscularis (middle, muscle) layer. Serosal (outer) layer. Between these layers is supporting connective tissue. Primary gallbladder cancer starts in the innermost layer and spreads through the outer layers as it grows. Being female can increase the risk of developing gallbladder cancer. Anything that increases your chance of getting a disease is called a risk factor. Risk factors for gallbladder cancer include the following: Being female. Being Native American. Possible signs of gallbladder cancer include jaundice, pain, and fever. These and other symptoms may be caused by gallbladder cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur: Jaundice (yellowing of the skin and whites of the eyes). Pain above the stomach. Fever. Nausea and vomiting. Bloating. Lumps in the abdomen. Gallbladder cancer is difficult to detect (find) and diagnose early. Gallbladder cancer is difficult to detect and diagnose for the following reasons: There aren't any noticeable signs or symptoms in the early stages of gallbladder cancer. The symptoms of gallbladder cancer, when present, are like the symptoms of many other illnesses. The gallbladder is hidden behind the liver. Gallbladder cancer is sometimes found when the gallbladder is removed for other reasons. Patients with gallstones rarely develop gallbladder cancer. Tests that examine the gallbladder and nearby organs are used to detect (find), diagnose, and stage gallbladder cancer. Procedures that create pictures of the gallbladder and the area around it help diagnose gallbladder cancer and show how far the cancer has spread. The process used to find out if cancer cells have spread within and around the gallbladder is called staging. In order to plan treatment, it is important to know if the gallbladder cancer can be removed by surgery. Tests and procedures to detect, diagnose, and stage gallbladder cancer are usually done at the same time. The following tests and procedures may be used: Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An abdominal ultrasound is done to diagnose gallbladder cancer. Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver disease that may be caused by gallbladder cancer. Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of gallbladder cancer or other conditions. CA 19-9 assay: A test that measures the level of CA 19-9 in the blood. CA 19-9 is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of gallbladder cancer or other conditions. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it. Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). A dye may be injected into the gallbladder area so the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine will show up better in the image. This procedure is called MRCP (magnetic resonance cholangiopancreatography). To create detailed pictures of blood vessels near the gallbladder, the dye is injected into a vein. This procedure is called MRA (magnetic resonance angiography). ERCP (endoscopic retrograde cholangiopancreatography): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes gallbladder cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter (a smaller tube) is then inserted through the endoscope into the bile ducts. A dye is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken. Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The biopsy may be done after surgery to remove the tumor. If the tumor clearly cannot be removed by surgery, the biopsy may be done using a fine needle to remove cells from the tumor. Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples for biopsy. The laparoscopy helps to determine if the cancer is within the gallbladder only or has spread to nearby tissues and if it can be removed by surgery. PTC (percutaneous transhepatic cholangiography): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain bile into the small intestine or a collection bag outside the body.

Sri Lankan Aurvedic Docter found a medicine to cure Cancer

2012-12-06T18:42:00.001-08:00

An Ayurvedic medical practitioner from Kandy, Dr Mahanama Hapugoda recently announced that he has developed a formula to cure cancer. The formula has been administred on patients requiring cancer treatment and has has provided positive results. Dr Hapugoda was speaking at a press conference in Colombo, where he explianed and made public his cancer cure. The major medical bodies are yet to review its effectiveness. Displaying a sample of his purported cancer cure, which is a herbal liquid formula by using a syringe to withdraw some of its content, Dr Hapugoda said, “there is no need to fear cancer anymore as this will completely destroy cancer cells.” “The formula is made using over 200 wild plants and medicinal herbs. It is based on traditional Ayurveda,” he said.“It has medicinal prowess to starve cancer cells to death after about two months of treatment,” he explained and further elaborated that the treatment will rule out both chemotherapy and radiation which cause harmful side effects to patients. Asked if he had obtained a a patent for his cancer curing formula, he said first of all he wanted to help cancer patients and added that he has treated no less than 150 cancer patients since the development of the cure. “They have been healed,” he said. Pointing at two cancer patients and a son and a daughter of two other cancer patients treated by him at the press conference, Dr Hapugoda said, “there are only four cases to review how cancer treatment has worked for them with the formula in question. “There are at least 100 cancer patients with pathology reports who have been treated by me at Zaasi Medical Centre at Bangalawatta Junction, Lewella, Kandy, and who have recovered from the disease.” He said, “The treatment does not cost exorbitant sums as in the system of English medicine, which cannot cure the disease.” “I plan to heal cancer patients in the country. If I sell this formula to another country, then they might produce pills to be sold to us in return which our local patients will have to buy at exorbitant sums,” he said.

what is Extrahepatic Bile Duct Cancer?

2012-12-04T07:29:00.002-08:00

Extrahepatic bile duct cancer is a rare disease in which malignant (cancer) cells form in the part of bile duct that is outside the liver. A network of bile ducts (tubes) connects the liver and the gallbladder to the small intestine. This network begins in the liver where many small ducts collect bile, a fluid made by the liver to break down fats during digestion. The small ducts come together to form the right and left hepatic bile ducts, which lead out of the liver. The two ducts join outside the liver to become the common hepatic duct. The part of the common hepatic duct that is outside the liver is called the extrahepatic bile duct. The extrahepatic bile duct is joined by a duct from the gallbladder (which stores bile) to form the common bile duct. Bile is released from the gallbladder through the common bile duct into the small intestine when food is being digested. Anatomy of the extrahepatic bile duct. The extrahepatic bile duct is part of a network of small ducts in the liver that collects bile. Bile flows into the right and left hepatic ducts which join together to form the common hepatic duct. The extrahepatic bile duct is the part of the common hepatic duct that is outside the liver. Bile flows through the extrahepatic bile duct and into the cystic duct to the gallbladder where it is stored. When food is being digested, bile flows back through the cystic duct and into the common bile duct where it is released into the small intestine. Having colitis or certain liver diseases can increase the risk of developing extrahepatic bile duct cancer. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors include having any of the following disorders: Primary sclerosing cholangitis. Chroniculcerative colitis. Choledochal cysts. Infection with a Chinese liver fluke parasite. Possible signs of extrahepatic bile duct cancer include jaundice and pain. These and other symptoms may be caused by extrahepatic bile duct cancer or by other conditions. A doctor should be consulted if any of the following problems occur: Jaundice (yellowing of the skin or whites of the eyes). Pain in the abdomen. Fever. Itchy skin. Tests that examine the bile duct and liver are used to detect (find) and diagnose extrahepatic bile duct cancer. The following tests and procedures may be used: Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A spiral or helical CT scan makes detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). ERCP (endoscopic retrograde cholangiopancreatography): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes bile duct cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope is passed through the mouth, esophagus, and stomach into the first part of the small intestine. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A catheter (a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A dye is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken and checked under a microscope for signs of cancer. PTC (percutaneous transhepatic cholangiography): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain bile into the small intestine or a collection bag outside the body. Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. The sample may be taken using a thin needle inserted into the duct during an x-ray or ultrasound. This is called a fine-needle aspiration (FNA) biopsy. The biopsy is usually done during PTC or ERCP. Tissue may also be removed during surgery. Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver disease that may be caused by extrahepatic bile duct cancer.

What is Esophageal Cancer

2012-12-04T07:26:00.001-08:00

Esophageal cancer is a tumor that begins to grow in the lining of the esophagus, and then can grow through the wall of the esophagus. If the tumor grows through the esophageal wall, it can then spread to other parts of the body through the lymphatic system. Most of the length of the esophagus is lined with squamous cells. If a malignant tumor grows here, it's called squamous cell cancer. The areas at the bottom of the esophagus, and where the esophagus joins the stomach, are lined with columnar cells. If a malignant tumor grows here, it's called adenocarcinomas. Studies have shown a relationship between frequency of reflux symptoms and risk of adenocarcinoma. The constant acid reflux will irritate the lining of the esophagus, and complications can occur, such as Barrett's esophagus. Individuals who develop Barrett's esophagus are about 40 times more likely to develop esophageal cancer than individuals in the general population. Symptoms of esophageal cancer Heartburn Difficulty swallowing Inability to swallow solid foods (eventually liquids also) Pain with swallowing Food sticking in esophagus Weight loss Regurgitation of undigested food Vomiting blood or passing old blood with bowel movements Procedures used to diagnose esophageal cancer Endoscopy Barium x-rays Computed tomography Treatment of esophageal cancer Treatment of esophageal cancer will depend on the stage the cancer is in at the time of diagnosis, the overall condition of the patient, and whether the cancer has spread to other organs. If the cancer has not spread to other organs, surgery may be performed to remove the a portion of the esophagus. In some cases, the surgery will also involve removing the stomach, spleen, and lymph nodes inside the chest. Then another part of the lower bowel is pulled up and attached to the remaining section of esophagus. Patients may receive chemotherapy and radiotherapy treatments after the surgery. If the cancer has spread to other organs, combined chemotherapy and radiotherapy is the most common treatment. This form of treatment is also used in the cases where the patient can't have surgery. Prognosis for those with esophageal cancer If the cancer is diagnosed in it's earliest stages, the patient's chances of living and be cancer free five years after treatment is greatly inproved. Unfortunately, most cases of esophageal cancer is only discovered when the patient comes to their doctor because of swallowing difficulty, which doesn't happen until later stages of the cancer growth. The prognosis then is very poor.