Oncology-cancer

Uterine Cancer

2016-01-27T19:22:00.004-08:00

Uterine cancer is very common, occupying a moment after the fourth female breast cancer, and skin zheludochchyu tract. This form of cancer usually occurs between the ages of 40 to 60 years. The risk factors - diabetes, hypertension, smoking, infection with the human papilloma virus, HIV, early sexual activity, late menopause and menstrual irregularities, infertility, a large number of sexual partners, early first birth, sexually transmitted diseases, receiving oral contraceptives.

One of the risk factors is obesity: women with a body weight exceeding normal 10-25 kg, the risk of endometrial cancer is 3 times more than normal body weight, and in women with excess body weight more than 25 kg risk 9 times higher.

Widely known precancerous conditions, which play a significant role in causing cancer. This erosion, ulcers, scars after birth trauma, epithelial growths (warts, polyps) and leukoplakia and chronic inflammatory processes - endocervicitis and endometritis.

Accordingly, the nature of the various divisions of the uterine epithelium differentiate cervical squamous cell carcinoma and adenocarcinoma (adenocarcinoma) of the cervical canal and the uterine cavity. Adenocarcinoma - the main morphological variant (70%). It should be noted that a relatively rare tumor, affecting the uterus, is a sarcoma. There are three degrees of differentiation of the tumor (highly differentiated, moderately differentiated and undifferentiated).

In cancer of the uterus are 4 stages of development: Stage 1 - the location of the tumor in the body of the uterus, II stage - the defeat of the body and cervix, III stadiya- extended to metastasis or parametrial tissue in the vagina, IV stage - spread beyond the pelvis, the germination of the bladder or rectum.

Clinic.

Clinical symptoms consists of complaints against whites, bleeding and pain. However, all three of these symptoms occur in the period of the collapse of the tumor and the time of their appearance depends upon the beginning of ulceration. Therefore, in some cases for a long period of uterine cancer may not produce any symptoms.

Beli there are different character: watery, mucous, blood-colored, odorless and malodorous. The admixture of blood gives belyam kind of meat slops. Delay secretions in the vagina and join the infection leads to septic cables with the smell. In cancer stage III and IV from the genital tract are putrid character. Bleeding may be in the nature of small bleeding, as well as single or multiple heavy blood loss. For cervical cancer is very typical of the so-called contact bleeding (during sexual intercourse, douching, vaginal examination or after lifting weights). If a woman has stopped menstruating, the occurrence of bleeding from the vagina in most cases is a sign of cancer.

The pains are late symptoms suggestive of involvement in the process of cancer of the lymph nodes and tissue infiltration basin to form, compressing the nerve trunks and plexus. Common symptoms and, in particular, cachexia (weight loss) occur very late, in a very advanced stage, and usually women suffering from uterine cancer remain outwardly flourishing, healthy appearance.
Diagnostics.

Detection of cancer of the uterus begin with a study of patient complaints and course of the disease. All suspected by history cases, patients must be immediately examined by a gynecologist. It is totally unacceptable to assign any treatment of such patients without a detailed examination.

The survey includes a two-handed study of vaginal, rectal bimanual research and examination with the help of mirrors.

When vaginal examination in cases fairly pronounced tumor process can not identify certain changes in the cervix, depending on the type of tumor growth (exophytic, endophytic and mixed). As a rule, the study is accompanied by bleeding due to injury tumor exploring finger. With widespread cancer of the uterus further research is carried out through the rectum to clarify the transition of the tumor on the walls of the pelvis and sacrum-uterine ligaments.

To identify the early stages of cervical cancer can not be limited to vaginal examination; be sure to conduct the inspection with the help of mirrors. To detect early cancers in all cases of any changes in the cervix take swabs for cytology or biopsy. If you suspect a cancer of the cervical canal and the uterine cavity is performed separate diagnostic curettage of the cervical canal and the uterine cavity and subsequent histological examination.

All of these studies can be carried out already in the clinic with the necessary tools and aseptic conditions. To illustrate the importance of a comprehensive survey is sufficient to indicate that cervical cancer remains undiagnosed for more than half of the patients, the survey which took place only in the two-handed vaginal examination. At the same time, when viewed with the help of mirrors the number of errors in the diagnosis decreases by almost 5 times, and when using the biopsy they observed only in isolated cases.

In recent years, widespread and of great importance acquired ultrasound imaging (US), which allows to detect changes in the uterus inaccessible to other methods of investigation and method of investigation became mandatory for suspected all benign and malignant formation in the womb.

To determine lymph node metastasis, and that very often accompanies cancer of the cervix, resort to methods of X-ray - lymphography and ileokavagrafii. With the same purpose, to chest radiography, intravenous pyelography, ergography, cystoscopy and sigmoidoscopy. Perhaps a CT, MRI, limfangiografii, fine needle biopsy of the tumor.

These studies are very important in cancer of the uterus to develop a plan, or a combination of radiation therapy.

Treatment.

Tactics of treatment depends on the patient's age, general condition and clinical stage of the cancer. Treatment is mainly surgical (hysterectomy with appendages, and sometimes removal of pelvic lymph nodes). Perhaps the combination treatment - surgery, radiation and then remote area on the vaginal stump, intracavitary gamma therapy. Wires and preoperative radiotherapy mainly in stage III. Radiation therapy as an independent method is used when the local prevalence of tumor process, with contraindications to surgery. Anticancer drugs are effective in low-grade tumors in stage III and IV disease.

In cancer of the cervix with the same success as the treatment is carried out by combined radiotherapy and surgery (extended hysterectomy with appendages). Treatment depends on the stage of the disease. When Ia stage (microinvasive cancer) produce a hysterectomy with appendages. At stage Ib (cancer confined to the cervix) is shown the remote or intracavitary irradiation followed by extended hysterectomy with appendages, or, conversely, first make the operation, and then remote gammaterapiyu. In stage II (involvement of the upper part of the vagina, can pass on the body of the uterus and infiltration parameters without switching to the pelvic wall) the main treatment is radiotherapy, surgery is rarely used. At stage III (the transition to the lower part of the vagina, infiltration parameters with the transition to the pelvis) shows radiation treatment. Finally, in stage IV (transition to the bladder, rectum, or distant metastasis) apply only palliative radiation. In the later stages of symptomatic treatment, application of chemotherapy.

After treatment, mandatory periodic visits to the doctor for pelvic examination and swab. Also, studies include chest X-ray, ultrasound and intravenous pyelography. During the first year of visiting the doctor every 3 months, and then for 5 years - every 6 months. After 5 years, control is carried out annually.

When relapse, if the process is localized, conduct a partial or total pelvic exenteration (removal of a single block of the uterus, cervix, vagina, parametrium, urinary bladder and rectum). In the presence of distant metastases, patients usually receive chemotherapy. Radiation therapy may be used for the palliative treatment of painful metastases.

Metastasis.
The most common tumors metastasize to the pelvic lymph nodes, at least in the groin. Distant metastases are often in the kidneys, liver, lungs, have a poor prognosis.

Forecast.

In cancer of the uterus 5-year survival rate after surgery from 84 to 45% depending on the stage of the disease. When relapse 25% of patients initially underwent surgical treatment may be spared from relapse using pelvic radiotherapy. When metastatic relapse cures are extremely rare, and the therapeutic effect is unique and short. In stage IV disease 5-year survival rate - up to 9%.

Prevention.Early diagnosis and prevention of cervical cancer is possible only through systematic preventive examinations of all women over 30 years (at least 2 times per year). Regular inspection is desirable to start with the onset of sexual activity. Regular checkups, ultrasound imaging and cytology (every 2 years) facilitate the identification of precancerous diseases and their treatment - cancer prevention.

No less important is the timely and proper treatment of precancerous cervical disease. Especially characteristic features that are unique to precancerous diseases of the cervix, no, they proceed as normal inflammatory diseases. Common to predrakyuvyh disease symptoms are chronic long, persistence of symptoms, and most importantly the lack of effect of conservative (anti-inflammatory) treatment. Treatment of precancerous cervical disease should be radical and is electrosurgical, electrocautery lesions or even amputation of the cervix. Also resorted to radiation treatment method in the form of applicative radium therapy. Among patients radically treated for various precancerous lesions, the death rate from cervical cancer has decreased by 6 times.

It also requires giving up smoking, prevention of sexually transmitted infection.

Colon cancer

2015-09-01T10:18:00.002-07:00

arge intestine - is the final section of the digestive tract length of 1.5-2 meters. It consists of the cecum with the appendix, ascending colon, transverse colon, descending colon, sigmoid colon and rectum.
Colon cancer - a malignant tumor that grows in the mucous membrane lining the walls of the colon. In most cases, the tumor is located in the sigmoid, blind or rectum.
Bowel cancer is most common in the elderly. And every year these patients is becoming more and more, especially in developed countries with high living standards.Causes
The emergence of colon cancer is facilitated by:

the nature of power - the dominance of the diet of meat, fat and flour dishes, inadequate maintenance of plant products;
violation of stool (constipation);
colon diseases: colitis and polyps (cancer risk begins to increase after 7 years of onset, and every subsequent 10 years increased by 10% after 25 years reaching 30%);
genetic predisposition;
old age.

What's happening?
When excess in animal fat and protein in the food material produced in the intestines, promoting the development of a tumor (a carcinogen). At locks the exposure of these compounds on colon wall is significantly increased which may lead to the degeneration of normal cells into cancer cells.
Malignant tumors may also arise with prolonged ongoing inflammatory diseases in the intestines (colitis), and transform from polyps (benign outgrowths on the intestinal mucosa).
Ready cancer cells begin to multiply rapidly. The swelling gradually increases in size and eventually fills a lumen. As a result of developing intestinal obstruction. If the tumor invades the intestinal wall, it can destroy its vessels and cause intestinal bleeding.
In the later stages of the disease the tumor spreads beyond the colon: invades the intestinal wall and embedded in the surrounding organs; together with the current lymph enters the lymph nodes, and hits them; It is stored together with the blood to distant organs (liver, lungs, bones and brain), and forms new tumor (metastases) there. In the absence of the effect of treatment comes death.What are the symptoms?
In the early stages of colon cancer usually does not manifest itself. Only when the tumor becomes large, there is a whole bunch of unpleasant symptoms:

abdominal pain (long, dull, aching);
constipation;
bloating and rumbling in the stomach;
blood in the stool;
poor appetite,
pallor;
weakness, and weakness;
temperature rise;
weight loss.

Diagnostics
Any tumor is easier to treat, as it is small. That is why it is important to take preventive examination by a doctor, a gastroenterologist, which includes fecal occult blood. After 40 years of prophylactic medical examination must be held every three years, and to take the fecal occult blood test every year.
In some cases, can be assigned to the following procedures:

    Irrigoscopy - x-ray of his intestines with pre-filled contrast agent using an enema;
    Sigmoidoscopy - examination of the bowel (up to 30 cm) with a special device (sigmoidoscopy) introduced into the anus;
    Colonoscopy - a study similar to sigmoidoscopy, only to examine most of the bowel (up to one meter).
    During a sigmoidoscopy or colonoscopy, the doctor may do a biopsy - taking a small piece of the intestinal mucosa for detailed examination under a microscope. This procedure is almost painless. Biopsy is particularly necessary for patients who have intestinal polyps.
Treatment
The main treatment for colon cancer is surgery. In addition to the operations used radiotherapy, and chemotherapy.
Type of operation depends on the location of the tumor and its size. If the tumor is small and "conveniently located", it is removed entirely, while maintaining the normal functioning of the intestine. At large tumor sizes, as well as some of its specific location operation finishes creation of an artificial outlet ulcer - colostomy, which is displayed on the patient's abdomen.
In some cases, surgical treatment is carried out in two stages: first part of the colon is removed and form a colostomy, a few months later restore the normal functioning of the intestine.
Prognosis depends on the size of the tumor and timely surgical treatment. The smaller the size of the tumor, the more likely a complete cure of the disease.Prevention
For the prevention of colon cancer is necessary:

include a diet of more fruits and vegetables;
fight constipation;
promptly treat inflammatory bowel disease (colitis);
important time to remove colon polyps.

Cancer of the vulva and vagina

2015-08-26T15:14:00.001-07:00

The leading cause of these tumors is considered a viral infection transmitted through sexual contact and. Revealed strict dependence of cancer of the vagina and vulva cancer patients on the presence of genital warts in the past. In addition, the relationship proved occurrence of squamous cell carcinoma of the vagina from infection with the human papilloma virus (HPV). According to the cancer center of Lyon, viruses HPV-16 and 18 are responsible for 70% of cancers of the vagina and vulva 30-40% of tumors. To move infection to cancer are needed long-term hormonal contraceptives, smoking, sexual hyperactivity or chlamydial infection (Chlamydiatrashomatis).

Significantly more cancer vulva and vagina is caused by radiation therapy for cervical cancer and a long-term period, if such treatment is not carried out. The relationship is now forbidden receiving estrogen (17β-estradiol and diethylstilbestrol) during pregnancy by mothers (70 years) with cancer of the vulva and vagina of their daughters. Yet to identify the cause of cancer and etiologic factors have failed to do in all cases.

Vaginal Cancer: Symptoms and Treatment

Primary cancer of the vagina is considered to be a rare form of cancer zlokachestvennoyzhenskoy. It is 1-3% of all gynecologic tumors. In the US this type of cancer are diagnosed each year in 2 100-2 300 patients and ascertain 600-700 deaths. Cancer affects women 17 to 85 years with a peak interval of 50-60 years.

According to the International Federationof Gynaecologyand Obstetrics (International Federation of Gynecology and Obstetrics) survival rates of more than 5 years in oncology vlagalischav 80s were: I st - 61,5%, II Cm 33,7%, III Cm 25.5% , IVst - 8.9%. According to the University of Texas, the five-year survival rate in 2005 was: I st. - 85%, II art. - 78%, III-IV Art. - 58%, which is the result of applying new methods of treatment.Histologically, the majority of vaginal cancer (81-95%) - squamous cell carcinoma, adenocarcinoma, and sarcoma is not more than 3.5%, and even more rare melanoma. Precancers vaginal epithelium is its dysplasia.

The symptoms of vaginal cancer represented by the triad: bleeding (53%), whites and pain. In 15% of patients the tumor grows bessimptomno.Simptomy combined in 1 \ 3 patients. Dependence on the stage of the cancer symptoms are not observed. The spread of cancer to the urethra, bladder or rectum is accompanied by symptoms of urinary disorders and \ or chair. Violation of the general condition was observed in the IV century disease.

    Bleeding is not abundant, occur after sexual intercourse, or spontaneously, scarlet blood. You should alert menopausal bleeding.
    Beli similar to the allocation for thrush because their origin is largely due to the activation of the fungal flora and acceding inflammation.
    The pain may be accompanied by first sexual intercourse, gradually acquiring a permanent character.

Diagnosis of vaginal cancer (even if there are no symptoms) is available in normal gynecological examination. To clarify the diagnosis gynecologist takes suspicious areas mucosal epithelium for histological examination. To clarify the extent of the process used ultrasound cysto- and sigmoidoscopy, X-ray, and others.

Treatment of vaginal cancer carried out in accordance with step process. In stage 0 (preinvasive carcinoma mucous layer) are equally good wide excision, cryosurgery or laser removal, which give 100% five-year survival rate. When invasive (germinating) cancer therapy remains the primary method of radiation. Indications for surgical treatment of narrowed. Chemotherapy is used as an auxiliary method (fluorouracil). Favorable prognostic tumors of the upper third of the vagina.

Cancer of the vulva: Symptoms and TreatmentIn the United States each year become ill and 4000 die of 800 women with cancer of the vulva. They affect women over 55 years with a peak interval of 65-70 years. The risk of this cancer in their lifetime is 0.2%. Five-year survival of cancer patients in the United States - 67.9%. Histologically, 90% of vulvar cancers - squamous cell carcinoma.Almost 70% of cancer localized in the large and small labia. About 15% of tumors located in the crotch and 15% - in the clitoris. In stage III-IV tumor process spreads to the vagina, urethra, anus, pelvic bones.

The symptoms of vulvar cancer: pain, itching, burning, formation of tumor with ulceration and bleeding. 5% of patients the tumor grows asymptomatically. Cancer of the vulva is external to the tumor, which is not difficult to diagnose, but stage III-IV tumors detected in 30-50% of cancer patients, due to the late negotiability. Therefore, any suspicious spots, seals, changes in skin color in the area of the external genitalia should be examined by a doctor.

Treatment for vulvar cancer is always surgical: wide excision of the tumor and surrounding tissue, lymph nodes. In the pre- and postoperative periods prescribed courses of radiotherapy and chemotherapy.

Symptoms of Breast Cancer

2014-03-17T12:42:00.003-07:00

There are several forms of cancer of the breast, each of which has its own characteristic symptoms. For symptoms must be able to conduct breast self . Methods of self can be found here .

nodular form
Local tumor growth as a node occurs most frequently. On palpation of the breast unit is defined as a dense , rounded, lumpy painless education with indistinct contours , often with limited mobility due to infiltration ( germination ) surrounding tissues. To determine the connection of the tumor with skin taken last in a small fold over education . If this method fails as well as at some distance from the location of the tumor , we can say that the skin is not associated with it . When starting infiltration ( germination ) skin tumor compression of a small section of it leads to the formation of deeper folds , sometimes with inverted skin pores. Wrinkling of the skin over the tumor may occur in the early stages of cancer. As the size of the tumor node occurs skin retraction . Leather as a "lemon peel" - late symptom of the disease .

     The involvement of underlying tissues in the process of determining the tumor grasping fingers and shifting it in the longitudinal and transverse directions. Thereafter detected mobility tumor allocated to a right angle arm, and also at reduced hand tight . If this tumor has been reduced mobility can be considered proven germination . Complete immobility tumor indicates largely tumor invasion into the chest wall .

     To determine the relationship of the tumor with the nipple it is fixed fingers of one hand and the fingers of the other hand ( flat ) tumor pressed against the chest wall . By moving the nipple tumor remains stationary , therefore, there is no communication with the nipple , if the tumor is displaced together with sliding nipple , there germination infiltration ducts. Deformation nipple retraction revealed by his apparent tumor spreads to the milk ducts .
     Increase or seal axillary lymph nodes even at small mobile tumor with clear margins should raise suspicion for breast cancer .

edematous form
Edematous infiltrative form of cancer often develops in young women during pregnancy and lactation. During acute . No more pain . Rapidly increasing size of the compressed area ( node ) of the breast. Swelling characteristic of the breast tissue and skin. In the regional lymph nodes (especially axillary ) appear early metastases. Edematous form characterizes diffuse ( spread throughout the breast ) thickening and hyperemia (redness ) of the skin .

Rozhistopodobny cancer
This form of breast cancer is accompanied by pronounced redness of the skin with jagged edges tongue-shaped , outwardly resembles a flame or a geographical map . Tumor site is not detected by palpation . Hyperemia may spread to the chest wall . Most often the disease is acute , with high (up to 40 ° C) body temperature . For a malignant tumor rapidly metastasizes to lymph nodes and distant organs .

Mastitopodobnaya form
Mastitopodobny cancer is more common in young women , pregnant and lactating . The disease manifests itself rise in body temperature , and increase the density of the site or the entire breast , swelling , redness of the skin . The disease progresses rapidly , early metastases appear .

Cancer Paget
Localized cancer of the nipple and areola considered the most favorable form of breast cancer . Clinically manifested as phenomena maceration and ulceration of the nipple. As the disease progresses nipple destroyed and in its place there is a peptic ulcer surface.

Husk cancer
Husk cancer - a dense infiltration of the skin over the breast. The mammary gland is reduced in size and limited mobility , the skin over it is sealed , the surface is uneven , resembling shell. Sometimes the process extends to the second breast .

Hidden ( occult ) cancer
The first clinical symptom - an increase of affected axillary lymph nodes metastases without defined tumor in the gland itself . Often, patients are treated for a long time lymphadenitis (inflammation of lymph nodes) " infectious " nature and they fall to the oncologist has the appearance of distant metastases .

Fibroma of the breast

2014-03-15T12:22:00.004-07:00

Fibroma of the breast. Under the breast fibroma understood benign tumor that develops from connective tissue. Manifested in the form of a dense , painless seals , sometimes accompanied by a feeling of fullness in the chest , especially before menstruation . Upon detection of breast fibroma is obligatory to seek qualified help from a doctor , who is obliged to eliminate breast cancer , and then decide on the tactics of the patient and the ways of further treatment.classification of diseasesIt should be noted that to date, doctors often have to deal with benign tumors of the breast, which in most cases are diagnosed women themselves . In addition, fibroids are usually subdivided into fibroadenoma of the breast and diffuse fibroadenomatosis .In the first case refers to the localized form of fibroids , whereas diffuse fibroadenomatosis neoplasm characterized by tendency to the growth of fibrous tissue on the breast , and the presence of seals observed in iron and chest pains .Fibroadenoma of the breast is a dense consistency circular formation , detectable in the form of a movable , not connected to the wheel assembly , the diameter of which can vary from a few millimeters to seven centimeters.

In addition, breast fibroadenoma further be divided into:

Perikanalikulyarnuyu ( characterized by overgrowth of tissue around the ducts );
Filloidnuyu or leaf- ( able to develop into cancer , characterized by rapid tumor growth );
Intrakanalikulyarnuyu ( characterized by overgrowth in the lumen of the ducts );
Mixed ( characteristic signs and intrakanalikulyarnoy perikanalikulyarnoy form).

causesTo date, no clear theory that she could explain the occurrence of breast fibroids . But in the course of numerous scientific experiments it was observed that promotes hormonal failure disease in women , in which the blood was increased in the amount of estrogen . For this reason, there are women in menopause and puberty girls .Fibroid symptoms of breast cancer

The peak incidence occurs between the ages of 20-30 years , although in some cases physicians have to deal with the first identified cases of breast fibroids at a later age , which can be explained by the absence of symptoms.In most cases the tumor is detected as a single tumor , breast cancer, although sometimes you can meet multiple fibroids , which are simultaneously present in both breasts .

The clinical picture of the disease is characterized by:

Large fibroids are defined as subcutaneous tumor formation of breast cancer;
Located outside the areolar zone ( typical location in the upper outer quadrant of the breast );
On palpation the tumor is defined as a clearly demarcated and shifts tumor - tight elastic consistency , the amount of which may vary from a few millimeters to 7 centimeters.

Typically , the tumor is determined and the identity only one breast, although 10-15 % of cases develop fibroids in both mammary glands.diagnosticsDiagnosis of breast fibroma zhelezyDlya diagnosis compulsorily held :

    Clinical examination ;
    Palpation of the breast ;
    ultrasound ;
    Biopsy ( fine needle aspiration variation procedure) cytology material.When in doubt for billing diagnosis conducted further tolstoigolnaya biopsy , x-ray mammography and medical-diagnostic resection ( sectoral ) breast with compulsory intraoperative histological examination .When the diagnosis of breast fibroma conducted differential diagnosis of diseases such as :

    Lactocele ;
    Breast cancer;
    Tsistadenopapilloma .complications of the diseaseWhen breast fibroma rarely observed complications , which include the rapid growth of the tumor , followed by deformation of breast cancer and the possibility of rebirth benign growths in breast cancer, which is typical for leaf-shaped fibroma .Treatment of breast fibromaTactics of treatment fibroids breast is determined by two important points :

    Lack of clinical effect of conservative therapy;
    Rare incidence of malignancy of the tumor.It should be noted that the majority of breast fibroids are treated by surgical removal of tumors . With minor amounts of tumor (5-8 mm) can be assigned to conservative treatment , which is performed under ultrasound guidance . But even under strict medical appointments rarely enough to achieve the desired clinical effect and visible from the therapy.The operation to remove the breast fibroids . For this reason, the absolute indications for surgical resection are :

The rapid growth of education (an increase in tumor size by 2-3 times for 3-4 months );
Patient's wish to remove the fibroids ;
Plus Sizes education (over 2 inches );
Size of the tumor , causing cosmetic damage ;
Leaf-shaped structure of the tumor;
Pregnancy planning ( tumor overgrowth may block the milk ducts , causing inability to feed the baby and to the stagnation of milk, which can cause the development of breast cancer ) .

In other cases, fibroids can be observed , but only after the morphological findings.To date, tumor removal can be carried out according to two methods :

Sectoral resection ( for suspected cancer and the tumor is removed with the surrounding tissues );
Enucleation ( in the absence of suspicion of cancer and removed , husks , only tumor) .With proper and simple operation on the skin is left visible traces. The postoperative period was uneventful and requires prolonged treatment and hospitalization .
forecastThe prognosis is favorable . But we should remember that even with strict adherence to medical recommendations and destination is at risk of fibroids in the other breast .prophylaxisTo date, no specific measures devised prevention of breast fibroids . In the secondary prevention of the disease can be considered a regular breast examination by ultrasound .

Cervical cancer - the cost of treatment in Russia and the U.S.

2014-03-14T10:14:00.001-07:00

Objective comparison of modern Russian and American medicine (for example, cancer treatment )Russian woman 54 years emigrated from Russia to the United States. 3 months after arrival in the U.S., it appears the bleeding. She appealed for help to the American hospital .
"When visiting a gynecologist in the United States , once the doctor suspects I have a malignancy and biopsies . The results confirmed that I had cancer of the cervix. Gynecologist explained - cervical cancer does not appear suddenly. It caused by a virus and usually by regular inspections it can be prevented . "

In Russia, she also regularly went to the gynecologist . Russian doctor saw that something was wrong , and sent her to an oncologist for review. But somehow, the Russian oncologist did a biopsy and he said that everything is fine . This or negligence , or professionalism as a Russian gynecologist (in the U.S. itself gynecologist diagnosed ) and oncologist who is also unclear why could not recognize quite a common disease in the initial stage .Maybe it does not have a single case of individual professionalism of doctors , only statistics show that the mortality rate in Russia from cervical cancer is 2-3 times higher than in developed countries .

" I have a suspicion that if she stayed at home, it is likely that her cancer would never have recognized the time, and she would have filled up the sad Russian statistics . "What medical care received this woman in the U.S.? Here is the cost of each procedure ( and in brackets how much she paid for it in the U.S.. )

- A visit to the gynecologist : $ 156 ($ 0)
- Cytology $ 77 ($ 0)
- Ultrasonography $ 259.07 ($ 0)
- Re- visit to the gynecologist, and biopsy $ 236.23 ($ 50)
- Operation ( loop electro surgical resection ) under general anesthesia $ 1623 ( $ 262)
- Analyses / Research Tissue $ 246.05 ($ 0)
- Computed tomography of $ 274 ( $ 274 )
- Positron Emission Tomography $ 1200 ( $ 600). By the way, separately about this type of diagnosis . In the United States across the country more than 1000 modern PET - CT machines. Scanning can be done in just a day . In Russia , at least 10 of these machines all over the country , and they are all located in Moscow and St. Petersburg. Therefore, in Russia such testing is rarely done , and the record goes on the months ahead .
- A visit to the oncologist $ 250 ($ 50)
- Operation ( robotic hysterectomy ) $ 6300 ($ 0) . From the moment the first treatment to the doctor before the operation , it took 10 weeks.

Total : cost of treatment of cervical cancer, if this woman was treated in Russia, $ 10,631.35 , compared to $ 1,236.0 - the amount that it paid in the United States

Prices for cancer treatment in Germany

2014-03-14T09:47:00.005-07:00

Many would agree that the German medicine has been and remains the most successful both in terms of diagnosis and treatment in the field of cancer. The foundation of success is the fact that the German oncology clinics are held constantly more and more clinical research aimed at creating new therapies for cancer - and is even considering the fact that oncology is developing very actively today in many countries of the world! Given each year a growing number of cases of diagnosed cancers in humans - it is more than welcome.
German quality at all proverbial . Quality medicine - is not far behind . Oncology clinic in Germany welcome medical tourists from all over the planet. It is no secret that many of those who come to Germany for cancer treatment as a medical tourist, have already received the judgment of doctors in the country - too zapushchenno too hard , too unlikely ... But is that a reason to give up ? Of course not. With the help of the most modern computer technology , applying the latest drugs , based on the highest professionalism of doctors , medicine Germany gives people hope so - both at the stage of diagnosis and during treatment of oncology.

Qualitatively drawn diagnosis provides a lot of data about the health of the patient and accurately determine the type of tumor and its stage of development of the disease. With such data , a German physician is not difficulty to make his patient the best treatment program.
But, of course , all this is not free. But just think - what is money if we are talking about life and health ? In addition, as confirmed by many medical tourists , prices cancer treatment in Germany , though high, but still in moderation - and this is a serious and bold plus itself .

The cost of cancer treatment in GermanyProcedure name Price (in euros)Diagnostics patient 1 200 - 5000Chemotherapy , 1 year , excluding medicines 2000 - 6000Radiation therapy , 10 to 33 exposures 10,000Chemotherapy for malignant lymphoma (R-CHOP, CHOP) 8000Brain tumor : surgery from 25,000Stomach cancer metastasis in l / y and the liver : the operation , rehabilitation 28000Breast cancer : surgery , rehabilitation 18000Lung cancer : surgery , rehabilitation 28000Acute leukemia : preparatory course of chemotherapy , bone marrow transplantation , rehabilitation 250 000Thyroid cancer : surgery , rehabilitation 13000
* Prices in the table are for guidance only . Prices listed on the procedures vary

Breast cancer chemotherapy - DRUGS

2014-03-12T14:52:00.003-07:00

Chemotherapy - is a very effective method of treating tumors using poisons or toxins . Poison or toxin is then called the chemotherapeutic agents or chemotherapeutic agent .Chemotherapy - is a very effective method of treating cancer , chemotherapy because of rapidly act on the cells .The goal of chemotherapy , as well as other types of systemic therapy - this effect on all cancer cells that are in the body. This distinguishes it from methods of local treatment (e.g. radiotherapy ) , in which the effect exerted on a certain area of the body.Chemotherapy may be applied as before surgery to shrink a tumor , and thereafter , in order to prevent recurrence and metastasis of the tumor.

FDA approves new drug iksempra (ixempra - ixabepilone ) for the treatment of common forms of breast cancer when other chemotherapy drugs are no longer active . In particular , this new drug is used in combination with Xeloda ( capecitabine ) .

Iksempra belongs to a new group of drugs - epothilones . Their principle of operation is similar to taxanes , which include Taxol and Taxotere. And iksemra and taxanes affect the process of division and multiplication of cancer cells. Researchers believe that iksempra may be more effective in advanced breast cancer, since it is more difficult to develop resistance .

Studies have shown that the drug was effective iksempra in advanced breast cancer when standard chemotherapy did not give the desired effect. Compared with the individual application iksempry combination with Xeloda gave more lasting effect. However, so far it is not clear whether the use of the drug iksempra improve survival in patients with advanced breast cancer.

Before you choose the most suitable for you regimen , dosage and duration, the physician must carefully examine the results of histological examination of the tumor and history of the disease .

Ideally, the chemotherapy regimen should have the following properties:

Dispose of all kinds of cancerous cells in a particular part of the breast,

Use drugs , the effect of which reinforce each without side effects,

Should act so that cancer cells could not adapt to chemotherapy drugs ,

Have a level of side effects , which you can move .

Chemotherapy may be chosen as a combination of drugs ( ATS , TSMF , TSAF , FATS , or AT). The efficiency is from 35 to 60 %.

Chemotherapy may be in the form of only one drug - drug adriamycin or group of taxanes ( Tacola or Taxotere ) . The efficiency is 30 to 60 %. Also combinations of these and other commonly used .

The most frequent combination chemotherapy in patients with lymph node involvement is a course consisting of four cycles of AC ( adriamycin + cyclophosphamide ) and the next four cycles of Taxol or Taxotere .

It was revealed that more effective taxotere in patients with advanced cancer than Taxol , but has more severe side effects.

New chemotherapy drug Abraxane contains the same active ingredient as that of taxol . But unlike taxol basis of Cremophor Abraxane is created on the basis of protein . Cremophor - a derivative of castor oil, which is toxic to the body and may cause allergic reactions. For the prevention of these complications before using taxol used steroidal agents . Unlike Taxol Abraxane has such properties and is safer to use.

You can safely run your normal life , whether that is undergoing chemotherapy .

But before you start treatment , you should pay attention to some details :

Recommended fully examined by a dentist and , if necessary, carry out the treatment of carious teeth and treatment of other oral problems . This is due to the fact that during chemotherapy increased the risk of infection , especially when various medical manipulations.

Chemotherapy can affect the results of the smear from the cervix (called a Pap test ) .

There is the likelihood of such complications as hair loss ( alopecia ) . Different chemotherapy drugs have different influence on this phenomenon . Some drugs can cause a partial loss of hair , the other - complete .

Make sure that you helped someone at home on the course of chemotherapy. One of its side effects may be fatigue, so even simple exercises at home can be baffling for you .

STAGES OF CHEMOTHERAPY

During the first consultation with an oncologist

Before you start treatment , he will explain you everything in detail : the possible side effects of a chemotherapy , the benefits of different techniques. Before you opt for one or another scheme of therapy , the doctor will examine your medical history, conduct research to examine all the results of your analyzes and X-ray studies .

Planning cycles of chemotherapy better on Thursday or Friday. This allows you to use the weekend to relax and easily transfer various side effects .

On the day of the treatment cycle

The nurse will measure your blood pressure , pulse, respiratory rate and body temperature.

In addition, measured either weight and height , it is necessary for the selection of appropriate doses of medication.

Then you lie on the couch and you set an intravenous infusion system - in other words, a dropper .

During cycles of chemotherapy every time blood test to count white blood cells.

Preparing for chemotherapy infusion may take some time. Before chemotherapy drug is introduced , you will be given " sedation " - medications that help to eliminate or mitigate such side effects as nausea , anxiety, and inflammation.

With some products you need to drink plenty of liquids . This applies , for example, Cytoxan in tablet form , which is an extended delay in the bladder can cause irritation to him . So tablets Cytoxan wash down with plenty of water .

After the end of the intravenous infusion of chemotherapy , intravenous catheter is removed from the vein . After that you can go home .

In the case of uncontrollable vomiting , nausea, diarrhea , or fever should immediately notify the physician.

Symptoms and self-diagnosis of testicular cancer

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Testicular cancer is a relatively rare form of cancer , and is diagnosed in less than one percent of all cancer patients . Malignant cells can form inside or around one of the testicles, and may be felt as a lump or hardening of the testicle. Testicular cancer mainly affects men aged 20 to 34 years , although it can also occur in men younger or older .
Symptoms of testicular cancer may include a feeling of heaviness in the scrotum . The impression is that the scrotum is pulled down . Testicular cancer is often accompanied by pain in the testicles , penis or scrotum. Pain can be either tractive or discontinuous . Often with testicular cancer fluid accumulates in the scrotum , in connection with which she seems unusually large. Furthermore, men can also pay attention to abdominal pain.
If women often engaged in BSE , men rarely pay attention to the status of their testicles. However , monthly testicular self-examination can be very useful for the early diagnosis of testicular cancer . Monthly inspection can help a man to identify any unwanted changes .

Sometimes people mistakenly believe that they already have testicular cancer, because one testicle seems more than others. In fact, this is quite normal and if the difference between the testicles is not significant , it is not a cause for alarm. When self- men may also notice tubular structure located on the side of the anus. This parovarium , tubes that allow the sperm to flow out of the penis. Feel this parovarium when introspection is completely normal .
At the same time if you have any of the above symptoms , you should immediately consult a doctor. Early testicular cancer can be cured in 90 % of cases. Besides that testicular cancer is dangerous in itself , it may be the result of cancer in other parts of the body that has spread to the testicles .
An additional risk factor for testicular cancer is the presence of a sibling diagnosed with testicular cancer. Rare manifestations of mumps can cause well as testicular cancer . Since most people are immunized against mumps, this happens very rarely .
Normal examination by a doctor includes examination, ultrasound of the scrotum and blood tests. Sometimes biopsy , it is necessary to check the malignant cells or to determine the stage of cancer. Treatment may include surgical removal of the lump , and often involves the removal of the affected testicle. This is followed by radiation or chemotherapy .
Although testicular cancer is a deadly disease , nevertheless treatment usually results in a high survival rate. Men after surgery often continue to live a normal and healthy life, the removal of one testicle does not affect sexual life.

Immunotherapy for melanoma

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Immunotherapy stimulates the patient's immune system . This allows it to effectively recognize and destroy tumor cells.
Use of the drug ipilimumab

Ipilimumab (Yervoy) - is a drug based on monoclonal antibodies ( a synthetic version of immune system proteins ) . The drug effect on CTLA- 4 protein , which normally controls the function of cells of the immune system T lymphocyte . Ipilimumab increases the intensity of the immune response against melanoma cells , blocking the activity of CTLA- 4 protein .Every three weeks for 4 days the drug is administered intravenously. The drug increases the life expectancy of patients with melanoma , which can not be surgically removed or has spread to distant organs , for several months.The drug activates the body's immune system and helps fight against the tumor cells . At the same time it may lead to serious side effects. Sometimes the immune system begins to attack healthy tissue. In some cases, side effects can be fatal.Most often, the side effects of the immune system occur during treatment. But these effects may occur , and a few months after treatment ends. Should immediately inform your doctor about any side effects.

Application of cytokines

Activate the immune system protein compounds - cytokines. In the treatment of melanoma using synthetic analogs of natural cytokines : interleukin -2 and interferon -alpha . These drugs are administered intravenously at the beginning tarvpii and subsequently administered subcutaneously medications can a patient or care for them at home person . these drugs help reduce the size of melanoma progressing in 10-20% of patients. When tumors of stage IV cytokines can be administered concurrently with chemotherapy .Side effects include flu-like symptoms of cytokines , as well as decrease in the number of leukocytes. Interleukin -2 can cause fluid retention . This can lead to edema. IL-2 treatment is carried out only in specialized centers, due to the risk of serious side effects.Interferon -alpha as an adjuvant therapyOften accompanied by a large thickness of the melanoma tumor cells spread to distant organs . Even after surgical removal of all visible lesions of melanoma , some tumor cells persist in the body. In such cases, after the operation as an additional therapy may use an interferon -alpha . This helps prevent further growth and spread of melanoma. This treatment helps to delay tumor recurrence .Need to introduce the drug in high doses for efficacy of interferon. However, not all patients are able to endure side effects. Therefore, treatment with interferon should be under close medical supervision .BCGBCG prigottavlivaetsya based bacteria Mycobacterium bovis. This bacterium causes tuberculosis in cattle . In humans, BCG activates the immune system , increasing performance of the whole immune system. The vaccine does not directly affect the melanoma cells . Sometimes it is introduced into the tumor in the treatment of melanoma stage III.imiquimod creamImiquimod - a drug in the form of a cream . When applied to the skin imiquimod stimulates local immune response against melanoma cells . Imiquimod is applied at very early stages of melanoma located in sensitive areas of the face . But not all experts approved its application for melanoma .The cream is applied to the skin for about three months at varying intervals from once a day to twice a week. Imiquimod is not applicable in the treatment of advanced melanoma.

Endometrial Cancer

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Endometrial cancer is the most common cancer of the female reproductive organs, but ranks last among these diseases as a cause of death, as detected usually at an early stage when the disease responds well to treatment . Recent decades, the incidence of endometrial cancer has been steadily increasing, which is apparently due to the increase in life expectancy of women and their stay in the postmenopausal period . Uterine cancer mostly occurs in postmenopausal women , average age of the patients was 60-62 years . During the life of endometrial cancer sick 2-3 % of women.
There are two pathogenic variant of endometrial cancer - hormone-dependent and autonomous .

Hormone-dependent cancer of the uterus occurs in about 70 % of the observations in the pathogenesis of this cancer plays a role long giperestrogeniya . Giperestrogeniya may result from anovulation feminizing ovarian tumors , obesity , diabetes, while hormone replacement therapy and treatment of breast cancer with tamoxifen , etc. hormone-dependent cancer of the corpus uteri precedes sequential occurrence of hyperplastic and precancerous endometrial processes . Risk factors for hormone-dependent endometrial cancer include infertility, nulliparity , late menopause, obesity, diabetes , hypertension , family history on cancer with endocrine- metabolic pathogenesis (breast cancer , endometrial, ovarian , colon ) , hormone producing tumor ovarian estrogen replacement monotherapy in postmenopausal women , the use of tamoxifen in the treatment of breast cancer.
Stand-alone version of endometrial cancer occurs in less than 30 % of cases , occurs against a background of endometrial atrophy in the absence giperestrogenii patients without metabolic and endocrine disorders . It is believed that the development of an autonomous variant of endometrial cancer plays the role of T- severe depression of the immune system against the background of adaptive homeostasis disorders . Changes in immune comprised a significant reduction of the absolute and relative amount of T -lymphocytes, inhibition of T- lymphocyte subpopulations .
Autonomous uterine cancer develops in older age. For this option is not set risk factors. It generally develops in lean elderly women with no previous hyperplastic processes . In the history of bleeding can be observed in postmenopausal women against the background of atrophic endometrium . The tumor has a low differentiation, low sensitivity to the hormone , occur early in the myometrium invasion and metastasis .
Cause of cancer of the endometrium
Endometrial cancer , as hormone-dependent tumors , acts target for sex steroid hormones , providing normal phase change in the membrane of the body of the uterus. Of hormonal homeostasis arising from functional and anatomical changes in the system гипоталамогипофизарнояичниковой lead to proliferative processes in the endometrium , and further to the development of hyperplastic processes in it , creating a background for the development of malignant neoplasia. However, the cause of precancer and cancer on this background remains unclear to date .
Risk factors for endometrial cancer include:

endokrinnoobmennye disorders (eg , obesity, diabetes , hypertension );
gormonalnozavisimym dysfunction of female genital mutilation ( anovulation , hyperestrogenism , infertility );
gormonalnoaktivnye ovarian tumors ( granulezotekakletochnaya Brenner tumors and in 20 % of cases, followed by endometrial cancer );
genetic predisposition ;
lack of sexual activity, pregnancy , childbirth ;
later menarche , menopause (age 55 years) ;
hormonal therapy (tamoxifen ) .

SYMPTOMS of endometrial cancer
The most commonly observed symptom - atypical uterine bleeding - nepatognomonichen for endometrial cancer , as is typical for many gynecological diseases (eg , MM , adenomyosis ), especially in women of reproductive and perimenopausal periods . Patients of childbearing age more likely to seek help in the antenatal clinic , where for a long time observed and treated by gynecologists because of dysfunctional violations гипоталамогипофизарнояичниковой system. This is a common mistake in the diagnosis of endometrial cancer in young due to the lack of suspicion of cancer doctors polyclinics . The main clinical symptoms that lead young women to the doctor, there are primary acyclic uterine bleeding , infertility , ovarian dysfunction .
However, bleeding is the "classic" symptom only in postmenopausal women.
The appearance of abundant serous cables in older women without concomitant inflammatory diseases of the uterus , vagina , cervix, typical for endometrial cancer . Development of the disease may be accompanied by profuse watery discharge ( leucorrhea ) characteristic of the PMT .
Pain - late symptom of the disease . More often localized in the lower abdomen and poyasnichnokresttsovoy area are cramping or permanent. A significant proportion of patients go to the doctor too late , ie when there are signs of tumor dissemination process ( dysfunction of bladder, bowel ) . This is due to low medikoprosvetitelnoy work and lack of preventive inspections carried out among the population.

Treatment of endometrial cancerTactics of this kind of cure is dependent on :

    the age of the patient ,
    clinical stage of the cancer ,
    general condition.
Endometrial cancer is treatable in the early stages . The most common method is the surgical removal of the uterus , cervix , ovaries , and fallopian tubes. In order to identify possible further spread of the disease removed for analysis of the aortic and pelvic lymph nodes.
In the event of widespread cancer may further apply the following measures :
1.Himioterapiya to kill cancer cells.
2.Gormonalnaya therapy to block the further development of the disease.
3.Radioterapiya to kill cancer cells.
After the detection of cancer , the patient may experience fear , depressed mood , anger . For an immediate withdrawal of depressed state , it is recommended to communicate with people who have overcome the disease . It is also advisable to ask your doctor about the presence of the nearest support group cancer patients .

Symptoms and diagnosis of testicular cancer

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Testicular cancer is not always the manifestation. Usually the disease manifests itself in testicular tumor , which is the first symptom of cancer. When this tumor is painless. Furthermore, among the manifestations of testicular cancer can be noted as follows:

increase in testicular
seal eggs
Pain in the scrotum or lower abdomen.

For some types of testicular cancer , such as choriocarcinoma , leydigoma , sertolioma ) characterized by an increased production of hormones (eg , human chorionic gonadotropin ( hCG ) , estrogen , testosterone ) . Increased hCG , for example, may manifest as breast augmentation (eg, gynecomastia) . Elevated levels of estrogen can lead to decreased libido ( sex drive ), and increase the level of testosterone leads to premature puberty in boys , which is manifested , for example, hair growth on the face and body.

Most often, the tumor does not cause any painful sensation, they occur in the case where cancer proceeds to the spermatic cord , which elements are, in particular , the nerves . Later - egg becomes very dense , it is deformed . Then the boundary between the egg and its appendage disappears, and between egg shells accumulated liquid.

Approximately 3% of the tumor develops immediately in both testes , usually one and the same , but maybe her appearance on one side and a few years later .

Metastasis of cancer pain can be observed in their respective fields . For example, when metastases vertebra marked pain in the back , with metastases to the lungs - marked hemoptysis or shortness of breath and cough.

What you need to know about the diagnosis of testicular cancer

Diagnosis of testicular cancer involves the collection of complaints and questioning of the patient, physical examination and laboratory investigations ;
The doctor is conducting a survey of the testes , stomach and regional lymph nodes for the presence of tumor ;
Should rule out other conditions in which there may be a testicular tumor ;
To confirm the diagnosis of testicular cancer biopsy .

First , what is the diagnosis of any disease, including testicular cancer , is to ask the patient, where the doctor collects the patient's complaints . Detail should tell the doctor everything you are concerned , and not only because of the scrotum , as distant metastases may experience pain in very different areas.

Then the doctor collects the so-called history , the history of the patient's life and how the disease developed . It is necessary, first, to find out the possible contributing factors , as well as to evaluate the aggressiveness of the tumor and its rate of growth.

Next comes the inspection and palpation of the patient. The first doctor examines bodies scrotum . Ranked appearance, skin color. After that the doctor feels the scrotum , as well as areas of regional lymph nodes . It is this method of examination reveals a tumor , to assess its size, shape , density, soreness.

Next carefully palpated and abdomen , as testicular cancer and can metastasize to lymph nodes , located in the abdominal cavity.

Should be said about this is not less important in terms of preventive method of investigating how self-examination . When this man inspects his monthly scrotum and palpate her . If you suspect the presence of a tumor or seals should consult a urologist . Skills Training is especially recommended for people with high risk of testicular cancer .

The best time for self-examination - while taking a warm bath or shower or bath when the skin of the scrotum and testicles relaxed maximally lowered into the scrotum. Palpation should be gentle , not oppressive movement . Fingers should like skim the surface eggs, so you can catch changes its shape in the presence of a tumor.

Thus the patient may be noted that more than one egg a few other and located just below . This is the norm . Furthermore, on top of the posterior surface of the testicle can be felt in the form of epididymis cord , which should not be confused with the tumor. Appendage used to transport sperm to the seminal vesicles .

Very important tool in the diagnosis of testicular cancer are special methods and tests, such as ultrasound of the scrotum , biopsies and blood tests for tumor markers .

Scrotal ultrasound - an important method of diagnosis , including diseases of the scrotum . Unfortunately, only one ultrasound can not accurately set the diagnosis of testicular cancer , but it helps to determine which character has one or other pathology, show the presence of fluid in the scrotum , which simulates a tumor or cyst.

Blood tests. As we have said , in some forms of testicular cancer in the blood levels of certain hormones. Moreover , this disease increases in blood levels of certain substances, which are signs of cancer - the so called tumor markers . For example, for neseminomnyh tumors characterized by increased levels of so-called alpha- fetoprotein ( AFP) . Levels of certain hormones may increase as in seminoma and nonseminoma at . In some types of testicular cancer in the late stage may increase the level of enzymes (eg , LDH ) .

Among the radiological diagnostic methods play a special role urography and computed tomography .

In particular, intravenous urography can provide information about the state of the ureters , which are held in the retroperitoneal space - an area in which there are metastases of testicular cancer .

However , the most important method of diagnosis of testicular cancer is a biopsy , as only she can give a precise answer to the question , what kind of tumor in the patient. In this biopsy is that a doctor using a thick needle puncture produces tumor formation , during which a piece of testicular tissue is taken . She then examined under a microscope . The presence of malignant cells in the biopsy specimen is evidence of testicular cancer . In addition, only a biopsy reveals the tumor type , the nature of its current and aggressiveness.

Ovarian Cancer Symptoms

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Symptoms of ovarian cancer

In the early stages of ovarian cancer does not cause many symptoms . It is for this reason that most cases do not reveal until the cancer has not spread . For most women, the symptoms do emerge for 6 - 12 months before ovarian cancer . Symptoms that occur in the later stages , often caused by pressure, which has a growing tumor.Symptoms include :

Constant cramping and abdominal pain.

Constant pain in the pelvis and lower back.

Unusual vaginal bleeding, especially after menopause , if you are not using hormonal drugs .

Unusual vaginal discharge containing mucus, which can be painted with blood.

Pain or bleeding during sex.

Nausea, lack of appetite, or you can not eat normally .

Constant bloating or gas in the intestines, which can not facilitate treatment at home.

The larger size of the abdomen or swelling that can be felt in the abdomen.

Reducing energy.

Changing the rhythm of defecation , such as constipation or diarrhea .

Changing the rhythm of urination , such as urinary frequency or urgency to urinate.

Weight reduction .

Oncology and Psychosomatics

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It's no secret that emotions and stress and bad impact on the bodily health. Sometimes emotional pain is so strong that leads to cancer .
Many people mistakenly believe that the cancer - is a relatively new disease , and old people do not hurt them . In fact it is not. Modern molecular biology techniques that have been used to analyze the remains of ancient people and their predecessors, have enabled scientists to establish the fact that neoplastic diseases were among primitive people.
The mechanism of tumor scientists almost unknown. If you do not go into the details , the overall picture of the process is such that a normal ( healthy cell ) for one reason or another begins to multiply infinitely . That is, in the cell death program shuts down ( which is inherent in all healthy cells ) . Becoming " immortal " cell begins to continuously replicate , to reproduce itself . So there is a tumor that grows over time and metastasizes . It is worth noting that in healthy humans daily formed hundreds of millions of cells , however, our immune system is constantly followed by " watching " just neutralizes them . If the immune system fails, then starts the process of cancer development .

Psychological component of disease
If the mechanism of the development of illness today is more or less clear , the information about the possible causes of cancer is still shrouded in many mysteries and contradictions. For some forms of cancer (eg, cervical cancer) a clear link with viral infections . As for other types of tumors , it is believed that the reason for their occurrence is heredity, and poor environmental conditions and food , which may contain carcinogens - substances that can cause cancer. In addition, doctors noticed by a close relationship between the occurrence of cancer and various mental disorders and emotional experiences .
When you do not need anyone
Many therapists say that all sorts of diseases ( including cancer) originate from the time when a person feels the futility of his life, his " uselessness ." By the way , the elderly, which feel their importance in the family or in society live much longer than their peers.
The man who feels his unfitness , often sad and thinks about death. Nothing and no one in this world who have made it clear to him : " Do not go, I need you ."
Depressed mood , stress lead to significant changes in the immune system. Weakened immune system copes poorly with the elimination of cancer cells and eventually develop the disease .
In such situations, it is important to note close . Do not remain indifferent to the sad person close to you . It is best to consult a qualified psychologist or therapist for advice. Often in such situations without any professional assistance can not do, and the sooner it happens - the better.
It should be noted that the state of despair when the person ceases to feel the need for it is not the domain of the elderly, but also middle-aged and very young . Those or other life circumstances can drive a person to a standstill , causing dropped his hands , and the continued existence seems pointless .

Tumor markers may be normal even in the presence of cancer .

Other psychological causes of illness
Cause the development of cancer process can be strong bereavement . And not necessarily the person. You can lose a serious post at work, home or things that took a serious place in your life.
Perennial medical supervision of a physician to allocate specific psychological profiles of people with cancer . These include:

loss of contact with parents, lack of confidence, or the opposite - too close relationship ;
bereavement ( an important emotional connection );
feelings of helplessness and refusal to overcome difficulties in life ;
state of despair , when a person sees no way out of this situation ;
nursed a grudge ;
pessimism .

In other words , all of our experiences , fears, unresolved difficulties cargo information remain with us as a " bad " memories, dreams , depression, and then all this is reflected in the bodily health. It is very important not to get lost , and not allow trauma escalate into physical .

Types of experimental cancer treatment

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   High-intensity focused ultrasound (HIFU) - tumor destruction by high- intensity focused ultrasound .

    Gene therapy - for people who are genetically predisposed to malignant tumors . Gene therapy - an introduction to the tumor genes that cause cells to die ( either spontaneously or under the influence of chemotherapy ), or preventing them from multiplying.

    Cryoablation - local freezing process and devitalization of tissue , allowing aiming to create a zone of necrosis of the shape and size for the destruction of diseased tissue and adjacent to the edge of the healthy cells.

    Local hyperthermia . Session heating tumor tissue to a temperature that causes their death . Hyperthermia sessions require special equipment . Not to be confused with physiotherapy in the hot tub , which are sometimes referred to as " session Hyperthermia ."

    Angiostatic drugs - drugs that interfere with the formation of the capillaries in the tumor , then the tumor cells are killed , denied access nutrients. Some blockers Angiogenesis already used in oncology , but we continue our study of new pharmacological substances.

    Laser therapy - a method based on a transformation of the light energy of the laser beam into thermal temperature within the gland for a few seconds up to 60 ° C. Against this temperature rapidly evolving cell death .

    Using anaerobic bacteria to destroy the central part of the tumor, where the drug does not penetrate . Periphery of the tumor is well destroyed by chemotherapy.

    Vaccination against cancer cells .

    Multi-component systems in which both assigned several medications, a synergistic effect (Semicarbazide-Cadmium Therapy). This allows to obtain a therapeutic effect with lower doses of drugs than standard chemotherapy. Multicomponent system - attempts to unite the principles of classical and holistic medicine .

    Nanotherapy   - an introduction to the human body nanorobots that either deliver medicine to the desired point , or they themselves are attacking malignant tumor and its metastases (can be combined) , can also be used to monitor the status of the human body for a long time . Promising technology of the future, are currently ongoing development .

Neutron capture therapy (Neutron Capture Therapy). Administration of a special non-radioactive drugs that selectively accumulate in tumors. Thereafter, the tumor irradiated with weak neutron radiation. Medicines actively respond to this radiation and multiplies it inside the tumor itself . As a result, the cancerous cells are killed . At the same total dose of study that gets people is much lower than with conventional radiotherapy . Promising precision and safe therapy . Currently studies are associated with the creation of nanotechnology designed to improve the delivery of such drugs into the tumor.

Infographics about cancer

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Share with your girlfriends, because together we can make a difference in breast cancer prevention. SHARE ON!

Tumors of the vulva and vagina

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Tumors of the vulva and vagina:
Fibroma , a benign tumor that develops from the connective tissue of the labia majora , at least from the pelvic fascia and parametrial tissue .

Fibroids - benign tumor of the muscle fibers of the round ligament , ending in large labia .

Lipoma or fibrolipoma - benign tumors of fat and connective tissue.Diagnosis. Recognition of benign tumors of the vulva is not difficult. Tumor nodes located on a wide " basis or on a stem, can be significant and are available direct examination. When poor circulation , edema , hemorrhage , necrosis, joins a secondary infection .Treatment of surgery - removal of the tumor .The prognosis is favorable .

Gidradenoma - a benign tumor . Develops from the sweat glands is rare. Under the skin or in the thickness of the labia majora are arranged solitary or multiple nodules . There are cases of malignant growth hydradenitis .Operative treatment - removal of the tumor .Prognosis after removal of a benign tumor is favorable.

Vulvar cancer . Malignant epithelial tumor . Occurs in 1-2 % of cases of genital cancers at other sites . Histologically, vulvar cancer is squamous cell carcinoma with a tendency to keratinization , rarely observed glandular form of cancer . Cancer can be in the form of dense node infiltration cartilaginous consistency, papillary type cauliflower growths , ulcer crater with infiltrative flat base and uneven edges.

Diffusion stage . Stage I - the tumor up to 2 cm in diameter, localized in the surface layers . Stage II - superficial tumors or larger tumors with infiltration of the underlying tissue with movable metastasis to the inguinal lymph nodes. Phase III - fixed tumor with deep infiltration of the underlying tissues , metastasis to the inguinal lymph nodes. Stage IV - tumor spread to adjacent organs , metastases to distant organs .Pathogenesis. Initially, there is a slight thickening of the tissue , most often in the skin of the labia majora . Nodule begins to grow , sometimes quickly ulcerate . Tumor extends over the surface and depth of tissue often becomes the opposite side . In advanced cases of cancer affects the whole vulva . The last step in the process involves the tumor urethra. Swelling rapidly invades the inguinal lymph nodes , then there are metastases in the iliac and hypogastric nodes and distant organs . Frequent and rapid metastasis of cancer of the vulva caused richly developed lymphatic network of the external genitalia and the presence of lymph broad ties with other pelvic organs .

Clinic . Tumor often develops during menopause . In rare cases, the sick young woman. Vulvar cancer often occurs against a background of leukoplakia and kraurosis . Sick for a long time complaining of itching, burning then join in the vulva , pain, leukorrhea, spotting, sometimes offensive, with an admixture of pus (disintegration of the tumor, secondary infection ) . Marked weakness, malaise , weight loss , fatigue . If untreated, death occurs rapidly ' from cancer cachexia , urosepsis , pelvic thrombophlebitis or bleeding , especially cancer of the clitoris.

Fibroids , fibroids , uterine , vaginal lipoma . Rare. Benign tumors have the form of a single node on a broad basis , often coming from the front wall of the vagina. Tumor size can be varied, typically the consistency of thick . When degenerative changes may occur softening tumor.Clinic . Tumors develop in age from 20 to 50 years . Asymptomatic, only when there is a considerable extent , foreign body sensation , sexual intercourse difficult , disturbed urination and defecation . Possible occurrence of malignant tumor growth , decay and fester .

Hemangioma - a very rare vascular benign tumor having a blue color and soft texture , the cut reminds cavernosum .

Papilloma - single or multiple benign growths resembling cauliflower.Treatment of surgery - removal of the tumor .The prognosis is favorable .

Vaginal cancer . Malignant tumor of epithelial elements of primary vaginal cancer is 2 % of all malignant tumors of the female genitals . Vaginal cancer occurs as exophytic tumor has the appearance of papilloma or cauliflower , and endophytic form a dense infiltrate rapidly spreading to the underlying tissues . Severe infestation of cancer cells is very characteristic of endophytic vaginal cancer . Further the ulcer with raised edges are dense in E . Microscopically often find flat cell carcinoma , at least - adenocarcinoma .Clinic . Sick more often multiparous women older than 40 years. Symptoms appear relatively late. Patients complain of contact spotting and whites with an admixture of pus ; tumors arise from the decay of bleeding. Pain appear at germination in tumor tissue and to be compression of the nerve trunks. Often localized swelling on the back wall of the vagina , extending to the vaginal part of the cervix and plunges paravaginalnuyu fiber. Lumen narrowing of the vagina , cancer infiltration goes to the rectum (stenosis , fistulas ), and bladder. Metastases occur in the retroperitoneal and iliac and inguinal lymph nodes.Diffusion stage . Stage I - limited tumor diameter of 2 cm Stage II - a large tumor , there is infiltration paravaginalnoy fiber ; inguinal lymph node metastases determined by single moving . Stage III - Tumor extends to a large part of the vagina, infiltrates paravaginalnuyu fiber and goes to the pelvic wall , there are multiple metastases in the inguinal and iliac lymph nodes . Stage IV - tumor invades adjacent organs , there are distant metastases .The prognosis is poor .

Sarcoma of the vagina. Malignant neoplasm arising from the connective tissue . Microscopically veretenoobraznokletochnoe has rarely cell round structure with areas of necrosis and hemorrhage ; uncommon black cancer .Clinic . Tumor develops in postmenopausal women and girls . Sar coma vagina , observed in children , characterized by a very malignant course and has acinar or polypoid form . It grows fast , filling all the vagina breaks and bleeds easily . Often invades the bladder , urethra and cervix. In adult women sarcoma can develop in different parts of the vagina in the form of nodular or diffuse forms in neighboring organs will not germinate , but quickly arise metastasis to the inguinal and pelvic lymph nodes and distant organs , most commonly in the lungs. Swelling is accompanied by cables or sero - purulent krovyannstogo and urination disorder .

Symptoms of leukoplakia of the oral mucosa

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Leukoplakia usually localized in the mucosa of the cheek , mainly at the corners of the mouth, on the lower lip , at least in the language ( on the back or side of the surface) , alveolar bone , in the floor of the mouth . The clinical picture of the disease is heterogeneous , and therefore should be distinguished flat , warty , and erosive leukoplakia Tappeiner .
The clinical picture of leukoplakia depends not only on the form of the disease and the factors causing it , but also on the localization. For leukoplakia from its inception until the malignancy can be divided into several stages. The process usually begins with step predleykoplakicheskoy , characterized by inflammation of the small limited portion of the mucosa. After that, it happens very quickly even actinic . Later in the progression of the lesion process starts rise above the surrounding normal mucosa ( verrucous leukoplakia ) . In this period of illness to replace hyperplastic come metaplastic changes in connection with which it is in this form is often a malignancy . Erosive form has the greatest potential malignancy . Therefore, all clinical forms of leukoplakia is a single stage of the pathological process .

All forms of leukoplakia potentially ozlokachestvlyatsya , with the greatest frequency of malignancy observed in the localization process in the language .
Leukoplakia in some patients there may be years or even decades without malignancy , while others pretty quickly transformed into cancer. Duration leukoplakia flow until its eventual transformation into cancer is very individual and depends primarily on the shape of leukoplakia as the greatest potential malignancy have warty and erosive its shape.
Clinical symptoms by which to judge the beginning malignancy leukoplakia, depend on the form of the disease. Signs indicating malignancy flat leukoplakia are erozirovanie sudden appearance and seal at the base of the hearth leukoplakia . Especially suspicious appearance seals are not considered under the whole portion of keratinization , but only under one of its sides .
Clinical signs of malignancy erosive leukoplakia : the emergence of the seal at the base erosion , bleeding erosive surface when traumatizing , ulceration , education papillary growths on the surface erosion or rapid increase in its size.
However, in the early stages of malignancy , all these symptoms may be absent.
In this connection it is perhaps appropriate to earlier removal of lesions and verrucous leukoplakia erosive followed by histological examination .

Cancer of the vulva

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By the external genitalia ( vulva ) include pubis , large and small labia , clitoris , hymen (or its remnants ), the vestibule , and two (right and left ) great ( Bartholin ) gland and bulb ( horseshoe veniplex covering urethra and extending in the thickness of both small and large labia ) . External opening of the urethra is located under the clitoris in the vestibule .

Vulvar cancer is more common in women aged 65-75 years (mean age 68 years). However, vulvar cancer can occur at a young age. Vulvar cancer is up to 5 % of all malignant neoplasms of female genital mutilation .

Causes of vulvar cancer

In vulvar cancer cells with a high frequency (not less than 50 % of cases ) detecting DNA papilloma virus (HPV ) types. DNA from these viruses detected in epithelial dysplasia of the vulva, which is considered a precancerous condition . Often preceded by vulvar cancer and genital warts , the origin of which is also caused by HPV infection . In the development of vulvar cancer is of great importance given to the hormonal changes in menopause . This explains the fact that vulvar cancer - a disease of older women , occurs on the background of other pathological conditions of the external genitalia , which include sclerosing zoster ( kraurosis vulva ) , squamous hyperplasia ( leukoplakia ) and other dermatoses . These background states constitute a group of " non-neoplastic degenerative diseases." Epithelial dysplasia of the vulva , which arose on the background of kraurosis and leukoplakia in older women will inevitably be transformed into cancer , while at a young age dysplasia, developed on the background of normal intact skin or mucous membranes of the external genitalia may disappear on their own without treatment.

Risk factors for vulvar cancer :1. Age (see above).2 . HPV infection . There are more than 70 types of HPV ; different types of viruses cause papillomas or dysplastic epithelium of the palms and soles , lips and tongue , penis, cervix, vulva , vagina and anal canal . These viruses are sexually transmitted .3 . Human immunodeficiency virus ( HIV).4 . Non-tumor degenerative disease of the vulva (see above) .5 . Epithelial dysplasia of the vulva. It is now also adopted the term " vulvar intraepithelial neoplasia " or " vulvar intraepithelial neoplasia ," VIN. Distinguish grade 4 VIN.I WINE degree corresponds mild dysplasia ,Grade II - moderate dysplasia ,Grade III - severe dysplasia ,IV degree - is vulvar cancer in situ, or intraepithelial cancer.6. Frequent change of sexual partners.7. Smoking.

Symptoms of vulvar cancer

Patients with dysplasia and vulvar cancer in situ ( or intraepithelial which is only within the epithelial layer - see above) , the only complaint may be itchy . With further progression of the malignant process , patients complain of a tumor , usually in the form of warts, cauliflower or ulcer that does not heal . Later join pain , bloody or purulent discharge , painful urination , increased inguinal lymph nodes due to their metastatic lesions .As stated above, vulvar cancer can develop on the background of non-neoplastic degenerative diseases. Sclerosing zoster ( kraurosis ) leads to a thinning of the subcutaneous tissue of the vulva. The skin becomes pale yellowish color , shiny , " parchment ", cracks , vagina narrows . Foci of leukoplakia may occur not only in the vulvar area , but also in the vagina and on the cervix . They are flat or raised above the surface of the skin or mucous membranes , single or multiple , are not removed by using cotton balls , have the form of films or plaques with white pearl shade . Kraurosis and leukoplakia , and their combination ( degenerative changes of the mixed type ) accompanied by paroxysmal itching , often unbearable , cracking , pain during sexual intercourse .On clinical manifestations and affects tumor localization . In decreasing order of frequency localization of the tumor located on the major and minor sexual lip clitoris and perineum. Sometimes there are mirrored, or " kissing " of the tumor on the labia lips, resembling a butterfly.

Classification of vulvar cancer in stages :

Stage I - Tumor limited to the vulva only or is located on the area of skin between the vagina and anal canal ( at the crotch ) and not more than 2 cm in diameter ;Stage II - location of the tumor as well as in stage I , but the tumor is larger than 2 cm;Stage III - tumor of any size goes on the urethra , vagina (their lower thirds ) and the anal canal or has metastasized to the lymph nodes ;Stage IV - tumor of any size extending to the upper part of the urethra or vagina , the mucosa of the bladder, rectum, soldered to the pelvis or have distant metastases ( liver , lungs, and other organs )

Diagnosis of cancer of the vulva

Begins with a thorough survey of patient complaints , the time of their appearance , and these prior diseases. For suspected cancer of the vulva doctor examines female external genitalia in good daylight using a magnifying glass or a colposcope ( device for inspection of the cervix under magnification ) . In this case, the procedure is called vulvoskopiey . In case of non-neoplastic diseases of the vulva dystrophy ( leukoplakia, kraurosis and other dermatoses ) doctors should not start treatment without further diagnosis using cytological (taken smears ) or histological ( biopsy) . Vulvoskopiya allows you to perform biopsy , ie produce fence material for histological examination with suspected cancer of the vulva sites . This is especially important if there vulval cancer in situ or at the stage of a shallow germination underlying tissues . In case of severe tumor biopsy is also needed to confirm the diagnosis . The survey is complemented by bimanual examination , chest X-ray , clinical analyzes , and other methods .

Treatment of vulvar cancer

On the choice of treatment affect the patient age and general condition, and location of the tumor stage , histology and differentiation grade ( low, moderate or high degree of malignancy ) neoplasms, depth of invasion ( tumor spread to the underlying tissues ) , the presence or absence of metastases in the inguinal and pelvic lymph nodes , etc.Main treatment of vulvar cancer is surgical. In the embodiment of self- it is used only for stage I vulvar cancer . If the tumor is small and depth of invasion of 1 mm , only the tumor was excised . In other cases, surgery is the removal of the external genitalia ( large and small labia, clitoris, subcutaneous fat ) and is called vulvectomy . If you suspect the presence of lymph node metastases vulvectomy complement the removal of lymph nodes ( lymphadenectomy ) . In this case, the operation is called the extended vulvectomy .At stages II and III shows the combined treatment: surgery ( extended vulvectomy ) complement irradiation or, conversely, to begin operation after irradiation. If surgical treatment is contraindicated due to comorbidities , applies only radiotherapy .At stage IV conduct comprehensive treatment : chemotherapy combined with radiation and surgery. Chemotherapy is administered to reduce the tumor volume at the common stages of the disease , thereby reducing stage and operation. Drugs administered intravenously , orally and in lymphatics. Each of these methods of treatment may be accompanied by certain complications.

Figures 5-year survival of patients after treatment of vulvar cancer :

Stage 0 ( intraepithelial cancer, or cancer in situ, or VIN IV degree ) - 100%Stage I - 90%II - 70-80%III - 30-70% ( depending on the number of affected lymph node metastasis )IV -10-20%Similarly, other malignancies , these figures suggest the need for early diagnosis of cancer of the vulva.After treatment, all patients should be under the supervision of cancers , visit mode which is set individually .

Prevention of vulvar cancer is :

1. In the prevention of diseases , sexually transmitted diseases. This prevention should begin at a young age , with onset of sexual activity .

2 . In cases of non-neoplastic dystrophic diseases of the vulva ( leukoplakia, kraurosis , etc. ) the doctor must show oncological alertness and should not start treatment without further diagnosis using cytological and / or histological examination . In identifying vulvar dysplasia should consider surgical treatment .

3 . Treatment of degenerative diseases of the vulva with no effect should not be long - need to raise the question of surgical treatment .If symptoms listed in this article , timely seek medical help .

Symptoms and diagnosis of cervical leukoplakia

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Taken to distinguish between the two villa cervical leukoplakia :

simple - fine education, not rising above the surface epithelium of the cervix ;
coarse ( scaly ) - Dense education, rising above the epithelium of the cervix.
See simple leukoplakia uterine cervix with the naked eye is almost impossible. In turn , rough leukoplakia may be manifested in the form of isolated or grouped white patches on the surface of a pale pink uterine cervix. In most cases, the disease is asymptomatic , the clinical manifestations of this disease are completely absent. However pronounced leukoplakia gynecologist finds no difficulty in the mirror during a routine checkup .

In the diagnosis of cervical leukoplakia used :

    cytology ;
    extended colposcopy ;
    conduct specific epithelial and vascular samples;
    histological examination .
In the course of cytological examination of scrapings taken from the cervical canal and the surface of the cervix, at the micro level allows to evaluate and characterize the cellular composition of the lesion . In turn, under diseased state colposcopy portions cervix is assessed in the study if they thirtyfold magnification.
During the taking of samples of epithelial and vascular uterine cervix treated with Lugol's Iodine and three percent solution of acetic acid. This procedure allows to identify the boundaries and sharpness of relief of the affected area .
In most cases of cervical leukoplakia regarded as benign , but revealing it during cytology atypical cells indicates the risk of malignancy and the transition in the cancer process . However , a definitive diagnosis precancerous condition can be put exclusively after histological examination of uterine cervical biopsy (ie , after researching withdrawn from the body of the sick woman particles diseased tissue ) .

Treatment leukoplakia of the cervix

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In each case the treatment of uterine cervical leukoplakia conducted individually by separate treatment plan that takes into account the type and form of pathology, its severity and scope, as well as the age of the patient and her reproductive function.

Upon detection of inflammatory processes or acceded to the disease infection, patients assigned course of treatments aimed at their elimination. Changed uterine cervical pathology tissue subjected to destruction by cryogenic exposure or laser destruction diathermocoagulation .

In the presence of cervical intraepithelial neoplasia is appointed , usually surgery. If a woman has been diagnosed with CIN III degree, further treatment should be supervised by an oncologist . When combined with leukoplakia pronounced hypertrophy and changes in the appearance of cervical patients , surgical treatment of the disease : laser , knife , radio wave or ultrasonic cone biopsy or excision , diathermy , removal of the cervix or conduct reconstructive plastic surgery.

During treatment and for 1.5-2 months after the end of the patient is necessary to refuse sex : it is necessary for full recovery of the epithelium covering the uterine cervix. In addition, within 12 months after the end of treatment, women who have had cervical leukoplakia should undergo examination by a gynecologist no less frequently than every three months .

Protect themselves from unwanted pregnancies in the postoperative period is recommended using hormonal contraceptives and condoms. Strictly forbidden to use the diaphragm , cervical , caps and spermicides : any chemical exposure during this period entails erosion cervical epithelium .

Kraurosis and leukoplakia vulva

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Kraurosis and leukoplakia vulva - clinical concepts. Vulvar cancer on the background of these diseases occur in 20-50 % of cases. Kraurosis and leukoplakia vulva occurs more often in women in the period of pre-and postmenopausal women . Causes and pathogenesis of these diseases is not entirely clear , but many researchers have noted in these patients gipoestrogeniya and / or exchange- endocrine disorders (diabetes ) .

Vulvar kraurosis - atrophy of the stratified squamous epithelium ( from the Greek craurosis - dry, wrinkled ) .

Leukoplakia vulva characterized by proliferation ( hyperplasia ) of the squamous epithelium , a violation of its differentiation and maturation .

The main complaint of patients with leukoplakia and kraurosis vulva - painful thrust itching , worse at night, when overheating and exertion. Itching often lasts for years and lead to neuropsychiatric disorders , disability and sometimes suicidal thoughts .

Mucocutaneous covers the vulva at kraurosis thinner , they are brilliant , dry, depigmented , easily vulnerable to resemble parchment .

Clinically with dry patches of leukoplakia note whitish or yellowish , located in restricted areas or apply to the entire vulva . Often seen scratching the vulva , sometimes associated infection ( pronounced hyperemia and edema).

Diagnosis and examination of patients with leukoplakia and kraurosis vulva begin with a detailed examination vulvoskopiey ( use a colposcope ) . All patients showed some sugar in the blood, cytology prints or surface scrapings from ulcer sites. In cases of doubt, or when the results of cytology testifying cell atypia , tissue biopsy is necessary followed by histological examination . Place determined by biopsy vulvoskopii .

Treatment kraurosis and leukoplakia vulva. Leukoplakia and kraurosis vulva are intractable diseases. One of the most effective and promising treatments now considered low-intensity laser radiation. Already after 4-5 sessions of laser therapy improves the health of patients , pruritus weakens. Subsequently, skin and mucous membrane become normal properties . In the absence of the possibility of laser therapy for the treatment of kraurosis vulva thoroughly recommend hygiene vulva, lacto-vegetarian diet , sedatives ( valerian , etc.) , antihistamines ( diphenhydramine, suprastin , tavegil etc.) , hormone ( estrogensoderzhaschie ointments - ovestin ) glucocorticosteroid ointment , vitamin therapy (vitamins C, E, A, group B ) , procaine blockade pudendal nerve , surgical denervation . With the ineffectiveness of conservative therapy perform surgical excision of affected areas .

When vulvar leukoplakia used destructive methods of treatment ( cryo , elektrodestruktsiya , laser treatment ) .

Immunotherapeutic drugs. Anti-TNF drugs. Dosage and contraindications

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Immunotherapeutic agents currently represented by four groups of drugs
• Immunosuppressive
• Anti -TNF drugs
• intravenous immunoglobulin ( IVIG )
• IFN .
ANTI -TNF DRUGS
Tumor necrosis factor a ( TNFos ) - pro-inflammatory cytokine that plays an important role in the pathogenesis of rheumatic and inflammatory diseases. New data on the value of TSP axes in the pathophysiology of rheumatoid arthritis and Crohn's disease led to the development of a new class of anti - TNFa preparations.

Infliximab ( humanized monoclonal anti FNOos AT ) - approved for the treatment of rheumatoid arthritis and Crohn's disease in the active phase
• Dosage: 5 mg / kg for 2 h / in
• Side effects : viral infection , bronchitis, pneumonia, sinusitis, urinary tract infections , vomiting, diarrhea, headache , dizziness , hypertension
• Contraindications: sepsis, symptomatic infection, abscess, pregnancy, age younger than 17 years .

What is immunotherapy ?

Breast cancer treatments

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Breast cancer treatment begins after a complete examination women establish tumor stage, general condition of the woman, the presence of comorbidities .

At the moment there are the following treatments for breast cancer :
Operative technique for breast cancer depends on many factors: the stage of the disease , the distribution process, tumor size, age of the patient.

The following methods of breast surgery :

Organo -sparing surgery :
Lumpectomy ( wide resection ) , the surgeon removes the tumor to the surrounding healthy tissue , in this case remains undamaged part of the gland. The operation is possible only at stage 0 cancer , usually complemented by radiation therapy. Used to treat cancer in young women.
Sector breast resection (removal of the breast) , removing the lymph nodes under the arm . Such an operation is possible with 0 and 1 -stage cancer . In order to eliminate possible remaining cancer cells after surgery , and radiation therapy .

Operations in which the breast is removed :
Simple mastectomy ( breast completely removed with a part of the lymph nodes, but left pectoral muscle and enough skin to close the wound ) .
Extended mastectomy ( breast completely removed with the lymph nodes under the armpit and collarbone ) .
These two operations are executed most often.
breast Massage

Extended radical mastectomy ( breast removed , as well as the lymph nodes under the arm , below the clavicle and part of the chest muscles , sternum , ribs). This operation is performed with tumor invasion into neighboring tissue.
Surgical treatments .

    Chemotherapy is assigned to kill those cancer cells that may have spread throughout the body . Chemotherapy is usually given after 2-10 weeks after surgery and continued for 3 to 6 months. Means, used for chemotherapy , have the ability to kill cancer cells , but also have many side effects . They are introduced into the body in the form of tablets or intramuscular and intravenous injections. Spreading through the bloodstream , these drugs affect the whole body .

    Hormone therapy is used to stop the effects on cancer cells of female sex hormones (particularly estrogen ) , which is enhanced under the influence of their growth. Assigned drug tamoxifen, which has an anti-estrogen effect. In some cases, resorting to surgery remove the ovaries , which are the main source of the hormone estrogen .

    Radiation therapy - local effects on breast lesions and lymph outflow tract . Before the surgery, radiation therapy aims to reduce the size of the tumor and destroy the most malignant its cells to during surgery reduce the likelihood of " contamination" of the wound tumor cells. Postoperative radiation therapy is aimed at the destruction of possible remaining tumor cells in the area of operations and in the body as a whole. With the use of radiation therapy may develop the following complications : radiation burns to the skin , the development of lung inflammation may occur rib fractures .
If a close relative had breast cancer , ranging from 20 years once a year must pass a screening examination of mammary glands.

As a rule, treatment of breast cancer conducted in a complex, ie, a combination of surgical technique with radiation , hormone therapy and chemotherapy . Forecast full recovery depends on many factors :
Whether involved in the process of regional lymph nodes ( axillary , subclavian). This is determined by examining the distant lymph nodes during surgery . If they do not find cancer cells in the prognosis of full recovery ratio more favorable .

Tumor size (the smaller the size of the tumor , the better the prognosis .)
Histological characteristics of the tumor. After removal of the tumor is necessarily subjected to histological examination . Sections were diseased tissue examined under a microscope and the amount and nature of atypical (cancerous cells).
Hormone receptors . Breast cancer cells have normal receptors for female sex hormones , whereby iron characteristic changes in response to varying levels of hormones. The study showed that approximately two thirds of all breast tumors have estrogen receptors . At the same time there is a positive effect of hormonal treatment .

Proliferative activity of tumor cells (the ability of tumor cells to proliferate ) . Cancer cells that have a high proliferative capacity , divide more frequently and is therefore more aggressive.

Skin melanoma Treatment

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The choice of treatment depends on the stage of melanoma disease. In the initial stages of the disease treatment is limited to surgical removal of the tumor. In the propagation of tumors in the skin or regional (ie, located close to the nevus ) lymph nodes except for surgical treatment and adjuvant therapy use - after surgery is irradiated or biological treatment. In cases of advanced cancer treatments combine all depending on the number of lesions and their locations. Unfortunately, the presence of metastases not fully curative treatment, and the goal of treatment in this case is to prolong life and decrease tumor -induced complaints.

Skin melanoma Treatment

surgical treatmentSurgical treatment is the first choice for all stages of melanoma .Treatment at an early stage melanoma is limited to surgical removal of the primary tumor. Tumor is removed along with the surrounding healthy tissues . The vastness of removing healthy tissue depends on the thickness of the tumor focus , how deep the tumor has penetrated the skin , and whether it has ulceration . With small tumors, treatment is limited to a small surgical procedure that is performed for diagnostic purposes . In case of the removal of large tumors more extensive , often to cover the skin defect requires plastic skin.If the tumor has spread to regional lymph nodes are surgically removed .If the tumor has spread through the bloodstream to other organs or tissue metastases is surgically removed , if possible.

chemotherapy

Chemotherapy is used in the treatment of melanoma when the tumor has spread to many lymph nodes or other organs / Stage IV /

radiation

Irradiation is used in the treatment of melanoma after surgery when the tumor has spread to many lymph nodes. In the case of an advanced tumor , this method is used as an independent , if there are metastases , for example, in the brain , bones and other places.

immunological treatment

For immunological treatment used drugs that are similar to those produced by the immune system substances , their goal is to destroy tumor cells. The body produces cytokines to fight infectious diseases and tumors. Cytokine normally produced by the body is not enough to destroy the tumor.Immunological treatments are used as additional therapy after surgery in the case of melanomas with a high risk of metastasis , or if detected in lymph nodes metastases. The aim of this treatment is to reduce the risk of recurrence of the disease. In combination with chemotherapy used in the immunological treatment of melanoma metastasis , i.e. when the melanoma has spread to other organs.

Observation after treatment

If diagnosed with melanoma , one can never be sure that the tumor does not give metastases.In the case of treating the disease at an early stage of development, the risk of metastasis is low, but if the melanoma has spread to the skin or ulceration has , there's always the risk of recurrence of the disease. The risk of recurrence of the disease persists lifetime , so you need to visit an oncologist for follow-up research . If recurrence of the disease is diagnosed at an early stage of development , the treatment options are considered good . If the disease has spread into many organs , the recovery is not possible.

Frequency control studies prescribed by a doctor , depending on the risk of recurrence

Melanoma