Newyork Cancer Information

Eating disorders common in diabetic girls

2007-12-12T14:46:00.000-08:00

By Michelle Rizzo

NEW YORK (Reuters Health) - There is a high prevalence of disturbed eating behavior and eating disorders among girls with type 1 diabetes, according to Canadian researchers. They also found that eating disturbances in these patients start young and are likely to persist over time.

In the current issue of Diabetes Care, Dr. Patricia A. Colton, of University Health Network, Toronto, Ontario, and colleagues report the findings of a 5-year study of eating disturbances in girls with type 1 diabetes.

At the beginning of the study, higher rates of disturbed eating behavior were observed in 126 girls with type 1 diabetes who were between the ages of 9 and 13 years than in their counterparts without diabetes (8 percent versus 1 percent).

At 5-year follow-up, 98 diabetic girls remained in the study. The average age was 11.8 years at the beginning and 16.5 years at the end of the study.

Colton's group found that 48 of the 98 girls (49.0 percent) still had disturbed eating behavior. Specifically, 43 of the 98 girls reported that they restricted their eating, 6 reported binge-eating episodes, 3 reported self-induced vomiting, and 25 reported intense, excessive exercise for weight control. Another 3 girls reported that they skipped their insulin doses.

A total of 13 girls met the criteria for eating disorders.

The authors note that blood glucose levels were not higher in the subjects with disturbed eating behavior (8.7 percent versus 8.4 percent). However, a trend for higher blood glucose levels was observed among the girls with eating disorders compared with those without (9.1 percent versus 8.5 percent).

The subjects with disturbed eating behavior had a significantly higher average body mass index, at 26.1 versus 23.5 in the other girls. A body mass index (BMI) is the ratio of height to weight used to determine if someone is overweight or underweight. An average weight is between 18.5 and 24.9, and a BMI between 25.0 and 29.9 is overweight. Individuals with a BMI of 30.0 or higher are obese and those with a BMI lower than 18.5 are underweight.

"Eating disturbances early in the study, in the pre-teen years, were very likely to persist over time; 92 percent of girls with eating disturbances detected early in the study continued to report eating disturbances later in their teen years," Colton said in an interview with Reuters Health.

"This study contributes to the growing understanding of the close relationship between physical health and mental health in individuals with diabetes," Colton continued. "In particular, eating disturbances are very common and persistent in girls and women with type 1 diabetes, and can arise in even pre-teen girls," she noted.

These results suggest that screening for eating disturbances in individuals with type 1 diabetes should start in the pre-teen years. "Individuals with diabetes who are struggling with eating disturbances should receive early support and treatment to prevent the development of full-syndrome eating disorders and the medical risks associated with them," Colton advised.

"It is often hard for individuals to tell someone that they have an eating disorder, and so sensitivity to body image issues, body dissatisfaction and eating disturbances, both at home and in the clinic setting, is crucial to helping these individuals seek appropriate help and support in optimizing their health and reaching their full potential," she concluded.

SOURCE: Diabetes Care, November 2007.

What is A Heart Attack Anyway?

2007-12-09T09:13:00.000-08:00

A heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn’t restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.

Heart attack is a leading killer of both men and women in the United States. But fortunately, today there are excellent treatments for heart attack that can save lives and prevent disabilities. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone you’re with is having a heart attack, call 9–1–1 right away.

Overview

Heart attacks occur most often as a result of a condition called coronary artery disease (CAD). In CAD, a fatty material called plaque (plak) builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery.

Heart With Muscle Damage and a Blocked Artery

Figure A is an overview of a heart and coronary artery showing damage (dead heart muscle) caused by a heart attack. Figure B is a cross-section of the coronary artery with plaque buildup and a blood clot.

During a heart attack, if the blockage in the coronary artery isn’t treated quickly, the heart muscle will begin to die and be replaced by scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.

Severe problems linked to heart attack can include heart failure and life-threatening arrhythmias (irregular heartbeats). Heart failure is a condition in which the heart can’t pump enough blood throughout the body. Ventricular fibrillation is a serious arrhythmia that can cause death if not treated quickly.

Get Help Quickly

Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment is most effective when started within 1 hour of the beginning of symptoms.

The most common heart attack signs and symptoms are:

Chest discomfort or pain—uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.
Upper body discomfort in one or both arms, the back, neck, jaw, or stomach.
Shortness of breath may occur with or before chest discomfort.
Other signs include nausea (feeling sick to your stomach), vomiting, lightheadedness or fainting, or breaking out in a cold sweat.

If you think you or someone you know may be having a heart attack:

Call 9–1–1 within a few minutes—5 at the most—of the start of symptoms.
If your symptoms stop completely in less than 5 minutes, still call your doctor.
Only take an ambulance to the hospital. Going in a private car can delay treatment.
Take a nitroglycerin pill if your doctor has prescribed this type of medicine.
Put an aspirin under your tongue. Aspirin reduces blood clotting and can help keep a heart attack from getting worse. But don’t delay calling 9–1–1 to take an aspirin.

Outlook

Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die. CAD, which often results in a heart attack, is the leading killer of both men and women in the United States.

Many more people could recover from heart attacks if they got help faster. Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.

http://www.nhlbi.nih.gov

Is Alcohol Really Good for You?

2007-12-07T10:34:00.000-08:00

Just a glass or two raises your risks for some scary diseases—and lowers them for others. What’s right and wrong with drinking?

When you toast the New Year with a flute of champagne or down a glass of your favorite red wine on the weekends, it can actually be good news for your body: One glass a day (or less) can make your heart stronger and may boost your memory. But have a few too many, and your risks for breast cancer, uterine cancer, and osteoporosis rise fast. So when it comes to drinking, should you or shouldn’t you? Here, experts make sense of the contradictions and help four drinkers (and one abstainer) find the healthiest imbibing strategy.

Can a glass a day keep the doctor—and the pounds—away?

Gabrielle Studenmund, age 31, of Southern Pines, North Carolina, is trying to lose 10 to 20 pounds from her five-foot-five, 155-pound figure. She takes three-mile walks every day and watches calories carefully, but wonders whether giving up the glass of white wine (or sometimes two) that she has every night with dinner would make losing weight easier. At the same time, she doesn’t want to say no if wine is really helping her stave off Alzheimer’s, a heart attack, or some other scary disease.

What the experts say
The wine is probably doing more good than ill. In a study of almost 50,000 women, those who drank moderately (one drink per day) gained less weight than women who abstained—and less than those who had two or more drinks per day. It’s not clear why, but study author Eric Rimm, associate professor of epidemiology and nutrition at Harvard School of Public Health, thinks that alcohol may help burn calories. Plus, alcoholic beverages have no fat and typically have fewer calories than popular non-alcoholic beverages. A 5-ounce glass of red wine has 125 calories, for instance, but a Venti Cappuccino from Starbucks weighs in at 180.

Still, Gabrielle needs to watch what she eats when she’s drinking. Since alcohol often lowers inhibitions, she runs the risk of noshing to excess. To avoid that problem, it’s best to portion out your goodies beforehand and put away leftovers quickly, says Katherine Zeratsky, a registered dietitian for the Mayo Clinic.

Down the road, Gabrielle’s well-behaved taste for wine should pay off in a lower risk for dementia, heart disease, and certain cancers. Alcohol may keep her brain sharp by increasing blood flow upstairs, says David Hanson, founder of AlcoholInformation.org and professor emeritus of sociology at the State University of New York at Potsdam. Moderate drinking also seems to raise HDL (good) cholesterol and lower LDL (bad) cholesterol, while decreasing blood pressure. It may even cut the risk of type 2 diabetes by improving the body’s sensitivity to insulin. How does alcohol pull all that off? Nobody knows for sure, Hanson says, although the calorie burning and improvements in blood chemistry linked to drinking may explain it.

Will drinking too much make me age faster?

Lisa Concepcion Giassa, 36, of Bogota, New Jersey, goes out every other night during the week with the girls for a pitcher of margaritas or sangria, and downs two to three drinks per outing. On the weekends she gets a little more crazy. “For me,” she says, “it’s five drinks and three shots, with water in between.” She prides herself on being the one who can put it away and still have her wits about her. Lisa isn’t oblivious to the immediate dangers—like car accidents or simply falling down—but she’s more worried about premature aging and the risks of a disease like breast cancer or osteoporosis.

What the experts say
Alcohol by itself won’t make Lisa look old before her time. However, Rimm says, “Partyers tend to eat miscellaneous things at the bar (like greasy nachos, cheesy potato skins, and chicken wings) that aren’t great for them,” which can lead to that chunky, middle-aged look. People who drink this way are also more likely than nondrinkers to smoke and to breathe in secondhand smoke in bars, which contributes to wrinkles and higher risks of heart disease and cancer. (Alcohol may also dehydrate you, and that’s never good for the skin.)

But the real problem with binge drinking—or even just two drinks a day for women—is the toll it takes on the inside of your body, not the outside. “If you have more than seven drinks per week, it actually reduces bone mass,” says Janet Greenhut, MD, MPH, senior medical consultant at HealthMedia, which provides online behaviorial help, like alcohol counseling, for health plans and employers. “Also, if someone is in the habit of binge drinking—having four or more drinks in a two-hour period—she’s more prone to falls, and she’s at higher risk for fracture because her bone mass is lower.”

Studies clearly show, too, that more than one drink a day makes you more prone to breast cancer. Researchers at the European Cancer Conference recently reported that the risk rises 10 percent for women who have between one and two drinks a day, compared with women who have less than one, and the risk increases by 30 percent at more than three drinks per day. And don’t think you lower the risk by drinking wine instead of beer or something harder. The same research says any kind of alcohol ups the risk. Uterine-cancer risks go up at two or more drinks per day, as well. What does alcohol have against breasts and uteruses? Experts say it seems to boost estrogen levels, which in some cases cranks up cancer risks.

Does having a drink or two take a toll on my energy?

Eliana Agudelo, 33, of San Francisco loves rock climbing, hiking, and marathons. “It’s part of who I am,” she says. “Being outdoors makes me feel alive, energetic, and connected to the Earth.” She also loves a good microbrew after a day outdoors and a glass of wine a few nights a week. She wants to know if she’d stay in better shape or have more energy if she didn’t drink at all.

What the experts say
A few drinks a week shouldn’t affect Eliana’s performance, says Eric Rimm, a professor at Harvard School of Public Health, whether she’s at the gym, in a road race, or on the trail. However, if alcoholic drinks end up cutting into her water intake during the day, she may get dehydrated. That can leave anyone feeling tired and less eager to work out. One more thing: Eliana should deep-six any drinking right before an athletic event or outing, as it takes four to six hours for the body to break down alcohol. Leave the beer at home, in other words, when you’re rock climbing, and get high on nature when you’re hiking. Otherwise, the risk of a bad fall rises fast.

Could my drinking lead to alcoholism?

The latest numbers from the National Institute on Alcohol Abuse and Alcoholism are discouraging: one in three people will become hooked, to some degree, on alcohol at some point in their lives, and only one-quarter of people with a problem will get treated. Connie Stelter, 41, of St. Paul, Minnesota, has often wondered whether she might need help. She currently has just two drinks a week, but it wasn’t long ago when four or five drinks three times a week was her norm. The heavy drinking happened after she suffered a divorce, two job layoffs, a burglary, and then more relationship turmoil. Now she worries she’ll end up like her brother, an alcoholic. “I know my drinking has really curbed my potential,” she says. Connie wants to know how to tell if she really has a problem, and, if so, what to do next.

What the experts say
Just wondering if you have a problem is a strong hint that you might, says Kevin Wildenhaus, PhD, director of behaviorial science for HealthMedia. (To take a quick test, click on Do I Have a Drinking Problem?). Connie’s family history is another red flag. “People who have a family history of alcoholism have about three times the risk of becoming alcoholics,” Rimm says. “Some say that it could be that you grew up in a setting exposed to alcohol, but even those who grew up apart from their parents have a higher risk.” Most experts classify alcoholism as a disease because of the genetic component and the tendency of some people to become psychologically and physically addicted. They say that Connie shouldn’t blame her brother for a personal failing. That attitude may lead her to blame herself and not seek help if she really does have a problem. Instead, Connie should talk to her doctor or a counselor.

Am I missing out on the benefits of drinking?

Laura Faeth, 44, of Boulder, Colorado, stopped drinking three years ago after experiencing a ton of abdominal pain during a night of partying. “I took it as a sign that my body didn’t want alcohol anymore,” she says. Now she finds socializing just as much fun when she’s sober. But since her father died of pancreatic cancer at age 53 and his mom died of breast cancer at 50, Laura can’t stop wondering whether she could lower her cancer risks by having some red wine every few days.

What the experts say
Women who don’t drink at all do have a slightly higher risk for certain diseases than women who drink just a little. But that’s no reason for Laura to start having wine with dinner in place of, say, water, or to throw down a few at the holiday party while toasting good health. (For tips on avoiding alcohol, click on Sneaky Ways to Just Say ‘No’) “We know so much about how to be healthy already,” Rimm says. “If you’re worried about the risk of diabetes and you’re eating right, for example, adding alcohol won’t do much more for you.”

The same goes for cancer: Ditching cigarettes, eating more fruits and veggies, avoiding too much sun exposure, keeping your weight under control, and getting regular exercise pack a lot more prevention than a bottle of Bordeaux.

by Linda Formichelli
Source: http://www.health.com

Always aroused: A good thing gone awry

2007-12-07T10:21:00.000-08:00

Suze has begun conversations with doctors this way: "I want to talk to you about something, but you have to give me your word you will not laugh or give a flippant response because it is a serious situation."

In short, Suze has too much of a good thing. For days, sometimes weeks at a time, she feels constantly aroused, but can't get any satisfaction.

Despite the preamble, though, "one doctor looked at me and said, 'What a lucky man your husband is! I wish my wife had this,'" says Suze, 63, a retired nurse in Florida. Others have asked, "So, is this like being a nymphomaniac?"

Hardly. Suze, who asked that her last name not be published, has what is now called persistent genital arousal disorder, or PGAD. It was first named by sex therapist Sandra Leiblum in 2001 as persistent sexual arousal syndrome, but as Leiblum and others have begun studying patients, she decided that it was more a disorder than a syndrome, a syndrome being a constellation of symptoms that suggest the presence of true disease.

In a recent article in the Journal of Sexual Medicine, Leiblum and her co-authors identified a series of medical and psychological traits, including depression and panic attacks, that can accompany PGAD. Though some women are helped by psychiatric drugs, Leiblum strenuously resists the idea that the problem is necessarily psychological. “I do think there is always some organic contribution, but we just do not know what it is.”

Exactly what it is remains murky, but Suze’s symptoms, like that of other sufferers, involves a feeling of "fullness" — a constant engorgement — of the genitals that is unprompted by erotic thoughts or feelings.

"I could be in the middle of a tennis game [or] playing canasta," Suze says, "and then suddenly have this intense urge for intimacy. I could masturbate five times or 105 times and it would only make it worse."

Leiblum, who is now in private practice in Bridgewater, N.J., and treats a wide variety of sexual and relationship complaints, says her description of the disorder did not occur until 2001 because, like most sex therapists (and sex columnists), she heard many more complaints about lack of desire and arousal than she ever heard about too much of it.

Some women with PGAD tried approaching doctors, Leiblum says, but “I took it seriously and listened to what women were telling me. I said to myself, ‘This is bizarre and different from anything else I have heard of,’ but I believed what women told me rather than writing them off.”

Nobody knows how many women might suffer from PGAD. And the feeling of genital arousal is not always unwelcome. Some women like it. But if it is not causing distress, it is not considered a disorder, and so such women cannot be said to truly have PGAD. The ones who do describe a living hell.

Just repressed?
Heather Dearmon, a 33-year-old housewife and mother in South Carolina, became so desperate she voluntarily had herself committed — twice — to psychiatric institutions. “One psychiatrist said I must be sexually repressed and needed to experiment more," she says. "He suggested I try lesbianism.”

Her symptoms began during her pregnancy with her son. She asked her ob-gyn, who suggested that the pregnancy may have played havoc with Dearmon’s hormones and advised waiting it out, hoping the urges would subside after the birth. “But the day after I gave birth they came back,” she recalls.

The feelings were so intense and so persistent that she was unable to ignore them or even carry out daily functions. “It got to the point where morning, afternoon and night I had to take care of it. But the more you masturbate, the more you desensitize yourself so it would take a good hour to have three orgasms. This is at the point when I started to become suicidal. My whole life was being robbed from me.” She began pushing her husband away because she treasured any time she was not feeling aroused.

Finally, with her fears mounting over plans for a long family car trip, a doctor prescribed the anti-anxiety medication Paxil. Soon after beginning dosing herself, she found the urges became less frequent. Now, she can go up to 10 days without having to masturbate, though by day seven the arousal, focused on her clitoris, is often severe.

Why this happens remains a mystery. Research is still at an early stage, but some tantalizing hints have begun to emerge. One of Leiblum’s collaborators in England has found that some women complaining of PGAD can have concomitant conditions like a yeast infection or a dermatological outbreak around the genitals. But Leiblum stresses that the only thing for sure is that both can happen at the same time, not that one causes the other.

Sometimes biofeedback techniques can help, suggests sex researcher Beverly Whipple. “A couple of women were very successful,” she says.

Sex and the brain
Whipple, Leiblum and Rutgers University psychology professor Barry Komisaruk (Whipple’s co-author of their 2006 book, "The Science of Orgasm") are currently using MRIs to examine the brains of women suffering from PGAD in hopes of discovering how the central nervous system might play a role.

The PGAD mystery is just one of several linking the brain with too much arousal. One woman had spontaneous orgasms while brushing her teeth though she did not have orgasms while having intercourse or masturbating. The tooth brushing apparently triggered epileptic seizures that, in turn, caused the orgasms. (People with epilepsy sometimes do experience what is called “orgasmic aura.” In some cases, patients have been known to refuse treatment because they like the sensations.) Another woman had orgasms due to a vascular abnormality in her brain.

Men with obsessive-compulsive disorder have been known to have unwanted and unexpected erections. Parkinson’s patients can become hypersexual. So can people with brain injuries.

Men with a condition called priapism also can have too much of a good thing. Those constant reminders at the end of commercials for impotence drugs tell men that if they have an erection lasting four hours or longer they should seek medical advice. What they don’t say is that you might have priapism, an erection that simply won’t go away. Unlike PGAD, priapism does not usually result in a man craving release, it’s just very painful, a hydraulic malfunction that can be treated by — have a seat men — sticking a needle into the penis to draw blood out.

But even that gruesome scenario is nothing compared to what some of the women suffering from PGAD say they have experienced.

As Dearmon says, we should all be careful what we wish for when we are wishing for more feelings of desire. “Anything unrelenting is torture.”

By Brian Alexander
Source: http://www.msnbc.msn.com

Penile Cancer, Cancer of The Penis

2007-12-07T07:08:00.001-08:00

Description of Penile Cancer

Cancer of the penis, a rare kind of cancer in the United States, is a disease in which cancer (malignant) cells are found on the skin and in the tissues of the penis.

Men who are not circumcised at birth may have a higher risk for getting cancer of the penis. A circumcision is an operation in which the doctor takes away part or all of the foreskin from the penis. The foreskin is the skin which covers the tip of the penis. A circumcision is done on many baby boys before they go home from the hospital.

Like most cancers, cancer of the penis is best treated when it is found (diagnosed) early. You should see a doctor if you have any of the following problems: growths or sores on your penis, any unusual liquid coming from your penis (abnormal discharge), or bleeding.

If you have symptoms of cancer, your doctor will examine your penis and feel for any lumps. If the penis doesn't look normal or if your doctor feels any lumps, a small sample of tissue (called a biopsy) will be cut from the penis and looked at under a microscope to see if there are any cancer cells.

Your prognosis (chance of recovery) and choice of treatment depend on the stage of your cancer (whether it is just in the penis or has spread to other places), and your general state of health.

Stages Of Cancer Of The Penis

Once cancer of the penis is found, more tests will be done to find out if the
cancer has spread from the penis to other parts of the body (staging). Your
doctor needs to know the stage of your disease to plan treatment. The
following stages are used for cancer of the penis:

Stage I
Cancer cells are found only on the surface of the glans (the head of the penis)
and on the foreskin (the loose skin that covers the head of the penis).

Stage II
Cancer cells are found in the deeper tissues of the glans and have spread to
the shaft of the penis (the long, slender cylinders of tissue inside the penis
that contain spongy tissue and expand to produce erections).

Stage III
Cancer cells are found in the penis and have spread to nearby lymph nodes in
the groin. (Lymph nodes are small bean-shaped structures that are found
throughout the body; they produce and store infection-fighting cells).

Stage IV
Cancer cells are found throughout the penis and the lymph nodes in the groin
and/or have 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 same area or in another place.

How Cancer Of The Penis Is Treated

There are treatments for all patients with cancer of the penis. Four kinds of
treatment are used:
surgery (taking out the cancer in an operation)
radiation therapy (using high-dose x-rays or other high-energy rays to
kill cancer cells and shrink tumors)
chemotherapy (using drugs to kill the cancer cells)
biological therapy (using your immune system to fight cancer).

Surgery is the most common treatment for all stages of cancer of the penis.
Your doctor may take out the cancer using one of the following operations:

Wide local excision takes out only the cancer and some normal tissue on
either side.

Microsurgery is an operation that removes the cancer and as little normal
tissue as possible. During this surgery, the doctor uses a microscope to
look at the cancerous area to make sure all the cancer cells are removed.

Laser surgery uses a narrow beam of light to remove cancer cells.

Circumcision is an operation that removes the foreskin.

Amputation of the penis is an operation that takes out the penis. It is the
most common and most effective treatment for cancer of the penis. In a
partial penectomy, part of the penis is taken out. In a total penectomy,
the whole penis is removed. Lymph nodes in the groin may be taken out
during surgery.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells
and shrink tumors. Radiation may come from a machine outside the body
(external radiation) or from putting materials that contain radiation through
thin plastic tubes into the area where the cancer cells are (internal
radiation). Radiation may be used alone or after surgery.

Chemotherapy uses drugs to kill cancer cells. Fluorouracil cream (a
chemotherapy drug put on the skin of the penis) is sometimes used for very
small surface cancers of the penis. Chemotherapy may also be given by pill or
by a needle in a vein. When chemotherapy is given in this way, it is called a
systemic treatment because the drugs enter the bloodstream, travel through the
body, and can kill cancer cells outside the penis.

Biological therapy tries to get your own body to fight cancer. It uses
materials made by your own body or made in a laboratory to boost, direct, or
restore your body's natural defenses against disease. Biological treatment is
sometimes called biological response modifier (BRM) therapy.

Treatment By Stage

Treatment for cancer of the penis depends on the stage of your disease, the
type of disease, your age, and your overall condition.

You may receive treatment that is considered standard based on its
effectiveness in a number of patients in past studies, or you may choose to go
into a clinical trial. 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
going on in many parts of the country for most stages of cancer of the penis.

If you want more information, call the Cancer Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

STAGE I PENILE CANCER

If your cancer is limited to the foreskin, your treatment will probably be wide
local excision and circumcision.

If your cancer begins in the glans and does not involve other tissues, your
treatment may involve:
Fluorouracil cream
Microsurgery

If your tumor begins in the glans and involves other tissues, your treatment may involve:
Amputation of the penis (partial penectomy). Lymph nodes in the groin may
also be removed.
External radiation therapy
Microsurgery

Clinical trials of laser therapy for stage I penile cancer are also being
conducted.

STAGE II PENILE CANCER

Your treatment may be amputation of the penis (partial, total, or radical
penectomy) or radiation therapy followed by amputation of the penis. Clinical
trials of laser therapy for stage II penile cancer are also being conducted.

STAGE III PENILE CANCER

Your treatment may be amputation of the penis, followed by removal of lymph
nodes on both sides of the groin or amputation of the penis followed by
radiation therapy. Clinical trials of chemotherapy and chemotherapy with
radiation therapy are also being conducted.

STAGE IV PENILE CANCER

Your treatment will be designed to reduce your symptoms and may include wide
local excision, microsurgery, amputation of the penis, or radiation therapy.
Clinical trials of chemotherapy combined with surgery or radiation therapy are
also being conducted.

RECURRENT PENILE CANCER

If the cancer has come back (recurred), your treatment may include amputation
of the penis or radiation therapy. Clinical trials of chemotherapy or
biological therapy are also being conducted.

Common Cancer Terms and Words

2007-12-07T07:05:00.000-08:00

Antibody A substance, probably made by lymphocytes and certain other specialized cells, which helps defend the body against infections due to viruses, bacteria, and other foreign organisms.

Benign Not cancer. A noncancerous growth that does not spread to other parts of the body. Recovery is favourable with treatment.

Biopsy The removal and microscopic examination of tissue from the living body for purposes of diagnosis.

Bone Marrow The marrow is the spongy material which fills the cavities of the bones and is the substance in which many of the blood elements are produced. In order to determine the condition of the marrow, a doctor may take a small sample from the breast bone or the pelvis. Such examinations are performed under local anaesthesia.

Cancer A general term for about 100 diseases characterized by abnormal and uncontrolled growth of cells. The resulting mass, or tumour, can invade and destroy surrounding normal tissues. Cancer cells from the tumour can spread through the blood or lymph (the clear fluid that bathes body cells) to start new cancers in other parts of the body.

Chemotherapy Treatment with anticancer drugs.

Immunotherapy Treatment by stimulation of the body's immune defence system. Doctors are doing research on immunotherapy as a possible treatment for cancer.

Malignant Cancerous. A growth of cancer cells (see definition of cancer).

Metastases Cancer growths that started from cancer cells from another part of the body.

Metastasis The spread of cancer from one part of the body to another. Cells in the new cancer are like those in the original cancer.

Multiple Myeloma A cancer of the plasma cells, the white blood cells found in the bone marrow.

Plasma Cells White blood cells.

Platelets One of the main components of the blood that forms clots sealing up injured areas and preventing haemorrhage.

Radiation Therapy Treatment using high-energy radiation from X-ray machines, cobalt, radium, or other sources.

Red Blood Cells that carry oxygen to all the various organs and tissues of the body.

Remission The decrease or disappearance of cancer symptoms. Also the period during which this occurs.

Tumour Abnormal growth of tissue.

X-rays High-energy radiation used in high doses to treat cancer or in low doses to diagnose the disease.

Adult Brain Tumour

2007-12-07T07:02:00.000-08:00

Description of Adult Brain Tumour

Adult brain tumour is a disease in which cancer (malignant) cells begin to grow in the tissues of the brain. Your brain controls memory and learning, senses (hearing, sight, smell, taste, and touch), and emotion. It also controls other parts of the body, including muscles, organs, and blood vessels.

This PDQ statement covers tumours that start in the brain (primary brain tumours). Often cancer found in the brain has started somewhere else in the body and has spread (metastasized) to the brain. This is called brain metastasis (see the PDQ patient information statement on brain metastasis).

Like most cancer, adult brain tumour is best treated when it is found (diagnosed) early. You should see your doctor if you have headaches often, vomiting, or difficulty walking or speaking.

If you have symptoms, your doctor may order a computed tomographic scan, a special x-ray that uses a computer to make a picture of your brain. A magnetic resonance imaging scan, which uses magnetic waves to make a picture of your brain, may also be done. Often surgery is required to determine if you have a brain tumour and to see what type of tumour you have.

Your chance of recovery (prognosis) and choice of treatment depend on your general state of health and the type of brain tumour you have.

Types Of Adult Brain Tumour

Once adult brain tumour is found, more tests will be done to find out the type of tumour you have. Your doctor will also need to know how different the tumour cells are from the cells that are near it, which is called the histologic grade of the tumour. To plan treatment, your doctor needs to know the type and grade of brain tumour you have. The following types are used to group adult brain tumours.

Astrocytomas

Astrocytomas are tumours that start in brain cells called astrocytes. There are different kinds of astrocytomas, which are defined by how the cancer cells look under a microscope.

No infiltrating Astrocytoma No infiltrating astrocytomas are tumours that grow slowly and usually do not grow into the tissues around them.

Well-differentiated Mildly And Moderately Anaplastic Astrocytoma Well-differentiated mildly and moderately anaplastic astrocytomas are slow growing, but grow more quickly than no infiltrating astrocytomas. They start to grow into other tissues around them.

Anaplastic Astrocytoma Anaplastic astrocytomas have cells that look very different from normal cells and that grow more rapidly.

Glioblastoma Multiforme are tumours that grow very quickly and have cells that look very different from normal cells. Glioblastoma multiforme is also called grade IV astrocytoma.

Brain Stem Gliomas

Brain stem gliomas are tumours located in the bottom part of the brain that connects to the spinal cord (the brain stem).

Cerebellar Astrocytoma

Cerebellar astrocytoma occurs in the area of the brain called the cerebellum, which is just above the back of the neck. Cerebellar astrocytomas usually grow slowly and do not usually spread from where they began to other parts of the brain or body.

Ependymal Tumours

Ependymal tumours are tumours that begin in the ependyma, the cells that line the passageways in the brain where special fluid that protects the brain and spinal cord (called cerebrospinal fluid) is made and stored. There are different kinds of ependymal tumours, which are defined by how the cells look under a microscope.

Well-differentiated Ependymoma Well-differentiated ependymomas have cells that look very much like normal cells and grow quite slowly.

Anaplastic Ependymoma Anaplastic ependymomas are ependymal tumours that do not look like normal cells and grow more quickly than well-differentiated ependymal tumours.

Ependymoblastoma Ependymoblastomas are rare cancers that usually occur in children. They may grow very quickly.

Oligodendroglial Tumours

Oligodendroglial tumours begin in the brain cells called oligodendrocytes, which provide support and nourishment for the cells that transmit nerve impulses. There are different types of oligodendroglial tumours, which are defined by how the cells look under a microscope.

Well-differentiated Oligodendroglioma Well-differentiated oligodendrogliomas are slow-growing tumours that look very much like normal cells.

Anaplastic Oligodendroglioma Anaplastic oligodendrogliomas grow more quickly, and the cancer cells look very different from normal cells.

Other Brain Tumours

Mixed Gliomas Mixed gliomas are brain tumours that occur in more than one type of brain cell, including cells of astrocytes, ependymal cells, and/or oligodendrocytes.

Medulloblastoma Medulloblastomas are brain tumours that begin in the lower part of the brain. They are almost always found in children or young adults. This type of cancer may spread from the brain to the spine.

Pineal Parenchymal Tumors Pineal region Tumors are Tumors found in or around a tiny organ located near the center of the brain (the pineal gland). The Tumors can be slow growing (pineocytomas) or fast growing (pineoblastomas). Astrocytomas may also start here.

Germ Cell Tumors Germ cell tumors arise from the sex cells. There are different kinds of germ cells, including germinomas, embryonal carcinomas, choriocarcinomas, and teratomas.

Craniopharyngioma Craniopharyngiomas are tumors that occur near the pituitary gland. The pituitary gland is a small organ about the size of a pea; this gland is located just above the back of the nose and controls many of the body's functions.

Meningioma Meningiomas are tumors that occur in the membranes that cover and protect the brain and spinal cord (the meninges). Meningiomas usually grow slowly.

Malignant Meningioma Malignant meningioma is a rare tumor that grows more quickly than other meningiomas.

Choroid Plexus Tumors The choroid plexus is tissue located in the spaces inside the brain called ventricles. The choroid plexus makes the fluid that fills the ventricles and surrounds the brain and spinal cord. Tumors of the choroid plexus can grow slowly (choroid plexus papilloma) or grow more rapidly (anaplastic choroid plexus papilloma). The rapidly growing tumors are more likely to spread to other places in the brain and to the spinal cord.

Recurrent Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the brain or in another part of the body.

How Adult Brain Tumors Are Treated

There are treatments for all patients with an adult brain tumor. Three kinds of treatment are used: surgery radiation therapy chemotherapy. Biological therapy (using your body's immune system to fight cancer) is being studied in clinical trials.

Surgery is the most common treatment for adult brain tumors. To take out the cancer from the brain, your doctor will cut a part of the bone from the skull to get to your brain. This operation is called a craniotomy. After your doctor removes the cancer, the bone will be put back or a piece of metal or fabric will be used to cover the opening in the skull.

Radiation therapy uses x-rays produced by a machine called a linear accelerator or a cobalt machine to kill cancer cells from the outside and shrink tumors (external-beam radiation therapy). Radiation therapy may also be used by putting materials that produce radiation (radioisotopes) through thin plastic tubes into the tumor to kill cancer cells from the inside (internal radiation therapy).

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 the 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.

Biological therapy tries to get your own body to fight cancer. It uses materials made by your own body or made in a laboratory to boost, direct, or restore your body's natural defenses against disease. Biological therapy is sometimes called biological response modifier therapy or immunotherapy.

Treatment By Type

Treatment for adult brain tumor depends on the type and stage of your disease, your age, and your overall health.

You may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to go into a clinical trial. 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 going on in most parts of the country for most types of adult brain tumor. If you want more information, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

ADULT NONINFILTRATING ASTROCYTOMA

Your treatment may be one of the following: 1. Surgery to remove the cancer. 2. Surgery followed by external-beam radiation therapy. 3. If anaplastic astrocytoma comes back (recurs) after surgery, treatment may be radiation therapy if it was not given before. If radiation therapy was given before, clinical trials of chemotherapy or biological therapy should be considered.

ADULT WELL-DIFFERENTIATED MILDLY AND MODERATELY ANAPLASTIC ASTROCYTOMA

Your treatment may be one of the following: 1. Surgery followed by external-beam radiation therapy. 2. Surgery alone. 3. A clinical trial of surgery followed by radiation therapy and chemotherapy.

ADULT ANAPLASTIC ASTROCYTOMA

Your treatment may be one of the following: 1. Surgery followed by external-beam radiation therapy. 2. Surgery followed by external-beam radiation therapy and chemotherapy. 3. A clinical trial of new forms of radiation therapy, such as internal radiation, radiation given during surgery, or radiation given with drugs to make the cancer cells more sensitive to radiation. 4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

ADULT GLIOBLASTOMA MULTIFORME

Your treatment may be one of the following: 1. Surgery followed by external-beam radiation therapy and chemotherapy. 2. Surgery followed by external-beam radiation therapy. 3. A clinical trial of new forms of radiation therapy, such as internal radiation, radiation given during surgery, or radiation given with drugs to make the cancer cells more sensitive to radiation. 4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

ADULT BRAIN STEM GLIOMA

Your treatment may be one of the following: 1. External-beam radiation therapy. 2. A clinical trial of chemotherapy or biological therapy.

ADULT WELL-DIFFERENTIATED EPENDYMOMA

Your treatment may be one of the following: 1. Surgery to remove the cancer. 2. Surgery to remove the cancer followed by external-beam radiation therapy. 3. A clinical trial of chemotherapy or biological therapy.

ADULT MALIGNANT EPENDYMOMA

Your treatment may be one of the following: 1. Surgery to remove the cancer followed by external-beam radiation therapy. 2. A clinical trial of external-beam radiation therapy with chemotherapy. 3. A clinical trial of chemotherapy or biological therapy.

ADULT WELL-DIFFERENTIATED OLIGODENDROGLIOMA

Your treatment may be one of the following: 1. Surgery to remove the cancer followed by external-beam radiation therapy. 2. Surgery to remove the cancer. 3. A clinical trial of radiation therapy plus chemotherapy.

ADULT ANAPLASTIC OLIGODENDROGLIOMA

Your treatment may be one of the following: 1. Surgery to remove the cancer followed by external-beam radiation therapy. 2. Surgery followed by external-beam radiation therapy and chemotherapy. 3. A clinical trial of new forms of radiation therapy, such as internal radiation, radiation given during surgery, or radiation given with drugs to make the cancer cells more sensitive to radiation. 4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

MIXED GLIOMAS

ADULT MEDULLOBLASTOMA

Your treatment may be one of the following: 1. Surgery to remove the cancer plus external-beam radiation therapy. 2. A clinical trial of surgery plus external-beam radiation therapy and chemotherapy.

See the PDQ patient information statement on childhood brain tumor for more information.

ADULT PINEAL PARENCHYMAL TUMOR

Your treatment may be one of the following: 1. Surgery plus external-beam radiation therapy. 2. Surgery plus external-beam radiation therapy plus chemotherapy. 3. A clinical trial of new forms of radiation therapy, such as internal radiation, radiation given during surgery, or radiation given with drugs to make the cancer cells more sensitive to radiation. 4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

ADULT CENTRAL NERVOUS SYSTEM GERM CELL TUMOR

Treatment depends on whether the cancer can be removed in an operation, the kind of cells, the location of the tumor, and other factors.

ADULT CRANIOPHARYNGIOMA

Your treatment may be one of the following: 1. Surgery to remove the cancer. 2. Surgery to remove the cancer followed by radiation therapy.

ADULT MENINGIOMA

Treatment usually consists of surgery to remove the tumor. If all of the tumor cannot be removed in an operation, you may also receive external-beam radiation therapy after surgery.

ADULT MALIGNANT MENINGIOMA

Your treatment may be one of the following: 1. Surgery followed by external-beam radiation therapy. 2. A clinical trial of new forms of radiation therapy, such as internal radiation, radiation given during surgery, or radiation given with drugs to make the cancer cells more sensitive to radiation. 3. A clinical trial of chemotherapy or biological therapy following radiation therapy.

RECURRENT ADULT BRAIN TUMOR

Your treatment may be one of the following: 1. Surgery alone. 2. Surgery followed by chemotherapy. 3. External-beam radiation therapy alone, if not used during previous treatment, with or without chemotherapy. 4. Internal radiation therapy. 5. A clinical trial of chemotherapy.

Complementary/ Integrative Medicine Education Resources

2007-12-07T06:58:00.002-08:00

Complementary and alternative medicine (CAM) and complementary and integrative medicine (CIM) are therapies of proven or unproven efficacy that have been used to promote wellness, to manage symptoms associated with cancer and its treatment or to treat cancer. When properly combined with standard cancer treatments, some complementary therapies can enhance wellness and quality of life, but others may be harmful during or after treatment for cancer. Most, but not all, are natural products. M. D. Anderson Cancer Center’s Complementary/Integrative Medicine Education Resources (CIMER) Web site is offered to help patients and physicians decide how best to integrate such therapies into their care, as described in our Mission and Objectives. We subscribe to the code principles of the Health on the Net (HON) Foundation.

Is it safe? Is it effective?
What do studies show? Our Reviews of Therapies contain evidence-based reviews of published research studies on a variety of complementary/integrative or alternative cancer therapies such as alternative medical systems (e.g., traditional Chinese medicine), herbal/plant (e.g., essiac), other biologic/organic/pharmacologic substances (e.g., cartilage), nutrition and special diets (e.g., macrobiotic), body-manipulative therapies (e.g., massage), energy (e.g., tai chi) and mind-body approaches (e.g., support groups). Short summaries of each therapy are provided in both English and Spanish. Continuing education and additional evidence-based reviews are provided by Natural Standard, an international, multidisciplinary collaboration of clinicians and researchers from over 100 eminent institutions. Potential interactions between some drugs and herbal or other supplements are posted in Drug Interaction & FDA Advisories as provided by the Food and Drug Administration (FDA) and other authoritative sources.

Causes of disease

2007-12-07T06:16:00.001-08:00

Many different factors intrinsic or extrinsic to a person (or plant or animal) can cause disease. Examples of intrinsic factors are genetic defects or nutritional deficiencies. An environmental exposure, such as second-hand smoke is an example of an extrinsic factor. Many diseases result from a combination of intrinsic and extrinsic factors. For many diseases no cause or set of causes has been identified.

There are many different factors that can cause disease. These can be broadly categorized into the following categories like social, psychological, chemical and biological. Some factors may fall into more than one category. Biochemical causes of disease can be considered as a spectrum where at one extreme disease is caused entirely by genetic factors (e.g. CAG repeats in the Huntingtin gene that causes Huntington's Disease) and at the other extreme is caused entirely by environmental factors. Environmental factors include toxic chemicals (e.g. acetaldehyde in cigarette smoke and dioxins released from the breakdown of Agent Orange) and infectious agents (e.g. smallpox virus and poliovirus). In between these extremes genes (e.g. NOD2/CARD15) and environmental factors (e.g. Gut microbiota) interact to cause disease, as seen for example in the inflammatory bowel disease Crohn's Disease

Absence of the genetic or environmental factors in this case results in disease not being manifest. Koch's postulates can be used to determine whether a disease is caused by an infectious agent.

To determine whether a disease is caused by genetic factors, researchers study the pattern inheritance of the disease in families. This provides qualitative information about the disease (how it is inherited). A classic example of this method of research is inheritance of hemophilia in the British Royal Family. More recently this research has been used to identify the Apoliprotein E (ApoE) gene as a susceptibility gene for Alzheimer's Disease, though some forms of this gene - ApoE2 - are associated with a lower susceptibility. To determine to what extent a disease is caused by genetic factors (quantitative information), twin studies are used. Monozygotic twins are genetically identical and likely share a similar environment whereas dizygotic twins are genetically similar and likely share a similar environment. Thus by comparing the incidence of disease (termed concordance rate) in monozygotic twins with the incidence of disease in dizygotic twins, the extent to which genes contribute to disease can be determined. Candidate disease genes can be identified using a number of methods. One is to look for mutants of a model organism (e.g. the organisms Mus musculus,Drosophila melanogaster, Caenhorhabditis elegans,Brachydanio rerio and Xenopus tropicalis) that have a similar phenotype to the disease being studied. Another approach is to look for segregation of genes or genetic markers (e.g. single nucleotide polymorphism or expressed sequence tag)

A large number of SNPs spaced throughout the genome have been identified recently in a large project called the HapMap project^[1]^[2]). The usefulness of the HapMap project and SNP typing and their relevance to society was covered in the 27 October 2005 issue of the leading international science journal Nature (journal).

A large number of genes have been identified that contribute to human disease. These are available from the US National Library of Medicine, which has an impressive range of biological science resources available for free online. Amongst these resources is Online Mendelian Inheritance in Man - OMIM that provides a very, very comprehensive list of all known human gene mutations associated with, and likely contributing to, disease. Each article at OMIM is regularly updated to include the latest scientific research. Additionally, each article provides a detailed history of the research on a given disease gene, with links to the research articles. This resource is highly valuable and is used by the world's top science researchers. WHO defines heatlh as a, State of physically,mentally,socially,economically and spiritually well being not merely the absence of disease or infirmity.

Avian Influenza (Bird Flu) / Flu Burung

2007-12-06T19:02:00.000-08:00

Avian influenza (AI) or bird flu (in Indonesia known as Flu Burung) is a group of viruses that occur naturally in birds. A virus is pathogenic if it can cause illness or death. Some AI viruses can infect birds but not cause many bird illnesses or death. Other AI viruses, termed highly pathogenic avian influenza (HPAI), can cause large numbers of bird illnesses and deaths. Currently there is concern about one of these viruses, known as highly pathogenic H5N1, because it is causing severe disease in chickens and other poultry in several continents . It has also been found in wild birds in the same areas. In some instances, people who have had close contact with sick poultry have also become infected and gotten very sick. Approximately half of the people known to be infected have died.

Although officials are watching closely, this severe form of bird flu has not been found in the United States. It is important to remember that right now almost everyone who got sick with avian flu had close contact with infected poultry.

Both human and avian influenza viruses are constantly changing. There is concern that highly pathogenic H5N1 could change into a form easily spread from birds to humans and then from human to human.

If this were to happen, what is known as an influenza pandemic could occur.