More than one million new cases of skin cancer are diagnosed each year in the United States, making it the most commonly diagnosed type of cancer.Skin cancer is often categorized as melanoma or non-melanoma. Melanoma is a cancer that begins in melanocytes. It is less common than non-melanoma skin cancer, but tends to be more aggressive. In 2006 an estimated 62,000 individuals in the U.S. will be diagnosed with melanoma, and close to 8,000 will die of the disease.
The most common type of non-melanoma skin cancer is basal cell carcinoma. This type of cancer rarely spreads to distant sites in the body, but it can be disfiguring and may invade nearby tissues.
The second most common type of non-melanoma skin cancer is squamous cell carcinoma. Although this type of cancer is more likely to metastasize (spread to lymph nodes or other sites in the body) than basal cell carcinoma, metastasis is still rare. Both basal cell carcinoma and squamous cell carcinoma most commonly develop on sun-exposed parts of the skin, but can develop on other parts of the skin as well.
An alarming trend in both melanoma and non-melanoma skin cancers is that the frequency of these cancers in children and young adults appears to be increasing. This highlights the importance of prevention at all ages.
Thursday, April 30, 2009
Prostate Cancer
The prostate is a male sex gland responsible for producing fluid that forms semen. It is located below the bladder, in front of the rectum and surrounds the urethra. The prostate is divided into three zones enclosed by a capsule. The prostate capsule separates the prostate from the rest of the body.Prostate cancer occurs when the cells in the prostate gland grow out of control. When cells grow out of control, they initially spread within the prostate and then grow through the capsule that covers the prostate into neighboring organs, or break away and spread through the bloodstream and lymphatic system to other parts of the body. Prostate cancer can be relatively harmless or extremely aggressive.
Some prostate cancers are slow growing, causing few clinical symptoms. In these cases, a patient will often die with prostate cancer rather than from prostate cancer. Aggressive cancers spread rapidly to the lymph nodes, other organs and especially, bone.If cancer cells are present, the next step is to determine the stage or extent of spread of the cancer. Determining the extent of the stage of the cancer may require a number of procedures, including additional surgery (lymph node evaluation), blood tests, ultrasound, chest x-rays and occasionally, CT/MRI or bone scans. Cancer that is removed by surgical resection or needle biopsy will be classified according to the Gleason Grading System for prostate cancer. This grading system, on a scale of 2-10, helps physicians predict how rapidly the cancer is likely to spread. Higher Gleason scores are associated with more advanced and more rapidly growing cancers than lower scores.
All new treatment information concerning prostate cancer is categorized and discussed by stage. When patients have early stage cancer, the Gleason score and PSA blood level provide additional information that will help them make treatment decisions.
Some prostate cancers are slow growing, causing few clinical symptoms. In these cases, a patient will often die with prostate cancer rather than from prostate cancer. Aggressive cancers spread rapidly to the lymph nodes, other organs and especially, bone.If cancer cells are present, the next step is to determine the stage or extent of spread of the cancer. Determining the extent of the stage of the cancer may require a number of procedures, including additional surgery (lymph node evaluation), blood tests, ultrasound, chest x-rays and occasionally, CT/MRI or bone scans. Cancer that is removed by surgical resection or needle biopsy will be classified according to the Gleason Grading System for prostate cancer. This grading system, on a scale of 2-10, helps physicians predict how rapidly the cancer is likely to spread. Higher Gleason scores are associated with more advanced and more rapidly growing cancers than lower scores.
All new treatment information concerning prostate cancer is categorized and discussed by stage. When patients have early stage cancer, the Gleason score and PSA blood level provide additional information that will help them make treatment decisions.
Pancreatic Cancer
The pancreas is a glandular organ located in the posterior aspect of the abdomen. It lies between the liver and the spleen, and just below and behind the stomach. The pancreas produces digestive enzymes (exocrine function), which are emptied into the small bowel, as well as the hormone insulin (endocrine function), which enters the blood stream.
Adenocarcinoma is a type of cancer that begins in the cells that line the glands and ducts within the pancreas. It accounts for 90% of cancers originating in the pancreas. Other types of cancer, such as islet cell tumors, also originate in the pancreas, but are not included in this overview. This treatment overview deals only with adenocarcinoma of the exocrine pancreas, which will be referred to as pancreatic cancer. There are approximately 37,000 individuals diagnosed with cancer of the pancreas in the United States each year, and approximately 34,000 individuals succumb to the disease annually.
Pancreatic cancer is the fourth leading cause of cancer death in the United States. Pancreatic cancers may cause blockage of the pancreatic and biliary ducts and produce jaundice.. A gastroenterologist may attempt to relieve jaundice using a special procedure where a scope is passed through the stomach into the area of the blockage. This procedure is known as endoscopic retrograde cholangiopancreatography (ERCP). An ERCP can also be used to sample (biopsy) any suspicious lesions in the area. Determining the extent of the spread or the stage of the cancer is of initial importance to determine whether the cancer can be removed surgically.
Determining the stage of the cancer requires a number of tests including CT/MRI scans of the abdomen and other more-specialized procedures. Endoscopic ultrasound (EUS) may be used to determine the size of the cancer and whether surrounding lymph nodes may be enlarged. To exclude the possibility of blood vessel involvement, your physicians may pursue a visceral angiogram or MR angiography, which can detect irregularities in arteries.
Adenocarcinoma is a type of cancer that begins in the cells that line the glands and ducts within the pancreas. It accounts for 90% of cancers originating in the pancreas. Other types of cancer, such as islet cell tumors, also originate in the pancreas, but are not included in this overview. This treatment overview deals only with adenocarcinoma of the exocrine pancreas, which will be referred to as pancreatic cancer. There are approximately 37,000 individuals diagnosed with cancer of the pancreas in the United States each year, and approximately 34,000 individuals succumb to the disease annually.
Pancreatic cancer is the fourth leading cause of cancer death in the United States. Pancreatic cancers may cause blockage of the pancreatic and biliary ducts and produce jaundice.. A gastroenterologist may attempt to relieve jaundice using a special procedure where a scope is passed through the stomach into the area of the blockage. This procedure is known as endoscopic retrograde cholangiopancreatography (ERCP). An ERCP can also be used to sample (biopsy) any suspicious lesions in the area. Determining the extent of the spread or the stage of the cancer is of initial importance to determine whether the cancer can be removed surgically.
Determining the stage of the cancer requires a number of tests including CT/MRI scans of the abdomen and other more-specialized procedures. Endoscopic ultrasound (EUS) may be used to determine the size of the cancer and whether surrounding lymph nodes may be enlarged. To exclude the possibility of blood vessel involvement, your physicians may pursue a visceral angiogram or MR angiography, which can detect irregularities in arteries.
Ovarian Cancer
Ovarian cancer is a common malignancy in women in the United States, with about 21,650 new cases diagnosed each year. The ovaries are small female reproductive organs that reside in the pelvis. The ovary makes female hormones and stores all of the egg cells, which are released once a month during ovulation. There are two ovaries, one on each side of the uterus, or womb. Egg cells are delivered from the ovaries to the uterus by hollow organs called fallopian tubes.The optimal treatment of ovarian cancer requires a combination of surgery, chemotherapy and, in some rare cases, radiation therapy. When ovarian cancer is suspected because of pelvic growth, additional evaluation is necessary.
Ovarian cancers may spread to other organs in the pelvis, local or regional lymph nodes, the surface of the abdominal contents, or through the blood to other locations in the body, most frequently to the bowel, bladder, uterus, lungs, and liver. In order to effectively plan treatment, it is important to first determine the extent of the spread or the stage of the cancer. In order to gain the most information prior to surgery, a number of tests are performed. These may include an ultrasound of the abdomen and pelvis and several blood tests, including a CA-125 level.
Accurate surgical evaluation of ovarian cancer is necessary for nearly all patients and can only be accomplished during a laparotomy to determine the stage of the cancer and to remove as much cancer as possible. Patients who have already undergone surgery for ovarian cancer and know their stage of cancer may select from the options below. Patients who have not yet undergone surgery can select Surgical Management of Ovarian Cancer.
Ovarian cancers may spread to other organs in the pelvis, local or regional lymph nodes, the surface of the abdominal contents, or through the blood to other locations in the body, most frequently to the bowel, bladder, uterus, lungs, and liver. In order to effectively plan treatment, it is important to first determine the extent of the spread or the stage of the cancer. In order to gain the most information prior to surgery, a number of tests are performed. These may include an ultrasound of the abdomen and pelvis and several blood tests, including a CA-125 level.
Accurate surgical evaluation of ovarian cancer is necessary for nearly all patients and can only be accomplished during a laparotomy to determine the stage of the cancer and to remove as much cancer as possible. Patients who have already undergone surgery for ovarian cancer and know their stage of cancer may select from the options below. Patients who have not yet undergone surgery can select Surgical Management of Ovarian Cancer.
Lung Cancer
Lung cancer is characterized by the uncontrolled growth of abnormal cells in one or both of the lungs. The majority of lung cancers begin in the bronchial tubes that conduct air in and out of the lungs. Cancers of the lung are classified by how they appear under a microscope. While there are more than a dozen different kinds of lung cancer, the two main types of lung cancer are non small cell and small cell, which together account for over 90% of all lung cancers.
Non small cell lung cancer accounts for approximately 75% of these cancers and consists of squamous cell, adenocarcinoma and large cell types. Small cell lung cancer represents 20-25% of all lung cancers and is also referred to as "oat cell cancer" because of the shape of cells when examined under the microscope.When a diagnosis of lung cancer is confirmed, determining the stage or extent of spread of the cancer is essential in order to understand treatment options or interpret published cancer treatment information. Determining the stage of lung cancer may require many tests, which often include the following:
Mediastinoscopy:
A mediastinoscopy is a procedure that can indicate whether the cancer has spread to the lymph nodes in the chest. During a mediastinoscopy, a surgeon inserts a mediastinoscope (lighted tube) through a small incision in the neck while a patient is under general anesthesia. This mediastinoscope allows the surgeon to examine the center of the chest (mediastinum) and nearby lymph nodes, as well as remove a tissue sample.
Computed Topography or CT Scan:
A CT scan is a technique for imaging body tissues and organs, during which X-ray transmissions are converted to detailed images, using a computer to synthesize X-ray data. A CT scan is conducted with a large machine positioned outside the body that can rotate to capture detailed images of the oranges and tissues inside the body. This method is more sensitive and precise than the chest x-ray.
Magnetic Resonance Imagery or MRI:
During MRI, a powerful magnet linked to a computer makes detailed pictures of areas inside the body.
Positron emission tomography (PET):
Positron emission tomography (PET) scanning has been used to improve the detection of cancer in lymph nodes. One characteristic of living tissue is the metabolism of sugar. Prior to a PET scan, a substance containing a type of sugar attached to a radioactive isotope (a molecule that spontaneously emits radiation) is injected into the patient’s vein. The cancer cells “take up” the sugar and attached isotope, which emits positively charged, low energy radiation (positrons). The positrons react with electrons in the cancer cells, which creates the production of gamma rays. The gamma rays are then detected by the PET machine, which transforms the information into a picture. If no gamma rays are detected in the scanned area, it is unlikely that the mass in question contains living cancer cells. In one clinical study, PET scanning detected 85% of lymph nodes involved with cancer, which was significantly better than the detection rate with CT scanning.
Bone Scan:
A bone scan is used to determine whether cancer has spread to the bones. Prior to a bone scan, a surgeon injects a small amount of radioactive substance into a vein. This substance travels through the bloodstream and collects in areas of abnormal bone growth. An instrument called a scanner measures the radioactivity levels in these areas and records them on x-ray film.
Non small cell lung cancer accounts for approximately 75% of these cancers and consists of squamous cell, adenocarcinoma and large cell types. Small cell lung cancer represents 20-25% of all lung cancers and is also referred to as "oat cell cancer" because of the shape of cells when examined under the microscope.When a diagnosis of lung cancer is confirmed, determining the stage or extent of spread of the cancer is essential in order to understand treatment options or interpret published cancer treatment information. Determining the stage of lung cancer may require many tests, which often include the following:
Mediastinoscopy:
A mediastinoscopy is a procedure that can indicate whether the cancer has spread to the lymph nodes in the chest. During a mediastinoscopy, a surgeon inserts a mediastinoscope (lighted tube) through a small incision in the neck while a patient is under general anesthesia. This mediastinoscope allows the surgeon to examine the center of the chest (mediastinum) and nearby lymph nodes, as well as remove a tissue sample.
Computed Topography or CT Scan:
A CT scan is a technique for imaging body tissues and organs, during which X-ray transmissions are converted to detailed images, using a computer to synthesize X-ray data. A CT scan is conducted with a large machine positioned outside the body that can rotate to capture detailed images of the oranges and tissues inside the body. This method is more sensitive and precise than the chest x-ray.
Magnetic Resonance Imagery or MRI:
During MRI, a powerful magnet linked to a computer makes detailed pictures of areas inside the body.
Positron emission tomography (PET):
Positron emission tomography (PET) scanning has been used to improve the detection of cancer in lymph nodes. One characteristic of living tissue is the metabolism of sugar. Prior to a PET scan, a substance containing a type of sugar attached to a radioactive isotope (a molecule that spontaneously emits radiation) is injected into the patient’s vein. The cancer cells “take up” the sugar and attached isotope, which emits positively charged, low energy radiation (positrons). The positrons react with electrons in the cancer cells, which creates the production of gamma rays. The gamma rays are then detected by the PET machine, which transforms the information into a picture. If no gamma rays are detected in the scanned area, it is unlikely that the mass in question contains living cancer cells. In one clinical study, PET scanning detected 85% of lymph nodes involved with cancer, which was significantly better than the detection rate with CT scanning.
Bone Scan:
A bone scan is used to determine whether cancer has spread to the bones. Prior to a bone scan, a surgeon injects a small amount of radioactive substance into a vein. This substance travels through the bloodstream and collects in areas of abnormal bone growth. An instrument called a scanner measures the radioactivity levels in these areas and records them on x-ray film.
Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia (CLL) is a disease characterized by high numbers of circulating abnormal lymphocytes (B-Cells) in the peripheral blood. The disease often involves enlargement of lymph nodes in various parts of the body as well as enlargement of the spleen. In CLL the marked elevation of lymphocytes in the blood is partially due to a prolonged survival of abnormal lymphocytes compared to normal lymphocytes.
CLL is a heterogeneous disease with survival times measured in months or many years depending on risk factors at the time of diagnosis. The diagnosis of CLL is usually confirmed by tests for specific characteristics of B-cells in individuals with an absolute lymphocyte count above 5,000.There have been tremendous advances in the treatment of CLL over the past decade, especially over the past five years.
CLL was once described as a chronic disease with treatment being predominantly palliative (with the exception of allogeneic stem cell transplantation). Now, complete molecular remissions and long-term disease-free survival can sometimes be achieved with one of several combination treatment regimens. It has therefore become important to determine when patients should be treated and how aggressively. A comprehensive approach to treating patients with CLL now involves risk stratification for newly diagnosed patients, adherence to supportive care guidelines, attention to quality of care issues specific to patients with CLL and consideration of age, other health conditions, and quality of life in selection of therapy and disease management.
CLL is a heterogeneous disease with survival times measured in months or many years depending on risk factors at the time of diagnosis. The diagnosis of CLL is usually confirmed by tests for specific characteristics of B-cells in individuals with an absolute lymphocyte count above 5,000.There have been tremendous advances in the treatment of CLL over the past decade, especially over the past five years.
CLL was once described as a chronic disease with treatment being predominantly palliative (with the exception of allogeneic stem cell transplantation). Now, complete molecular remissions and long-term disease-free survival can sometimes be achieved with one of several combination treatment regimens. It has therefore become important to determine when patients should be treated and how aggressively. A comprehensive approach to treating patients with CLL now involves risk stratification for newly diagnosed patients, adherence to supportive care guidelines, attention to quality of care issues specific to patients with CLL and consideration of age, other health conditions, and quality of life in selection of therapy and disease management.
Chronic Myeloid Leukemia
Chronic myeloid leukemia (CML) is the abnormal growth of relatively mature myeloid (white blood) cells. Half of all patients with CML are diagnosed after the age of 67.
CML is associated with a chromosomal abnormality in which genetic material from chromosome 9 is transferred to chromosome 22. The chromosome containing the genetic switch is called the Philadelphia chromosome; this chromosome plays a role in the development of CML.Initially in CML, there is a gradual increase in mature, abnormal myeloid cells in the bone marrow. These cells eventually spill into the blood and other organs, causing symptoms such as fatigue from anemia or an enlarged spleen.
The increase in leukemic cell numbers occurs slowly at first and is referred to as the chronic phase, but these cells invariably begin to increase more rapidly and/or include less mature cells, resulting in the accelerated or blastic phase. In order to understand the best treatment options available for chronic myeloid leukemia, it is important to know the phase of leukemia, since all new treatment information concerning chronic myeloid leukemia is categorized and discussed by the phase of disease.When chronic myeloid leukemia is difficult to control with Gleevec® (imatinib) or other therapies, the white blood count begins to increase. New symptoms may appear and old symptoms may worsen. The spleen may enlarge and/or new abnormal chromosomes can be detected in the bone marrow cells. Eventually, the leukemia becomes completely resistant to treatment and the bone marrow becomes overburdened with large numbers of immature white blood cells known as "blasts". A diagnosis of accelerated phase requires at least one of the following:
The persistent presence of 10-30% myeloblasts in the bone marrow or peripheral blood
.A major increase of the white blood cell count to over 50,000, platelet counts that are increased or decreased and red blood cell levels that are low despite treatment.
Progressive enlargement of the spleen.
Growth of leukemia outside the bone marrow or spleen.
The presence of any cytogenetic abnormality in addition to a Philadelphia chromosome.
Persistent unexplained fever or bone pain.
CML is associated with a chromosomal abnormality in which genetic material from chromosome 9 is transferred to chromosome 22. The chromosome containing the genetic switch is called the Philadelphia chromosome; this chromosome plays a role in the development of CML.Initially in CML, there is a gradual increase in mature, abnormal myeloid cells in the bone marrow. These cells eventually spill into the blood and other organs, causing symptoms such as fatigue from anemia or an enlarged spleen.
The increase in leukemic cell numbers occurs slowly at first and is referred to as the chronic phase, but these cells invariably begin to increase more rapidly and/or include less mature cells, resulting in the accelerated or blastic phase. In order to understand the best treatment options available for chronic myeloid leukemia, it is important to know the phase of leukemia, since all new treatment information concerning chronic myeloid leukemia is categorized and discussed by the phase of disease.When chronic myeloid leukemia is difficult to control with Gleevec® (imatinib) or other therapies, the white blood count begins to increase. New symptoms may appear and old symptoms may worsen. The spleen may enlarge and/or new abnormal chromosomes can be detected in the bone marrow cells. Eventually, the leukemia becomes completely resistant to treatment and the bone marrow becomes overburdened with large numbers of immature white blood cells known as "blasts". A diagnosis of accelerated phase requires at least one of the following:
The persistent presence of 10-30% myeloblasts in the bone marrow or peripheral blood
.A major increase of the white blood cell count to over 50,000, platelet counts that are increased or decreased and red blood cell levels that are low despite treatment.
Progressive enlargement of the spleen.
Growth of leukemia outside the bone marrow or spleen.
The presence of any cytogenetic abnormality in addition to a Philadelphia chromosome.
Persistent unexplained fever or bone pain.
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