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.
Acute Myeloid Leukemia
Acute myeloid leukemia (AML) is a cancer of the bone marrow and blood characterized by the rapid uncontrolled growth of immature white blood cells known as myelocytes. The disease is more common in adults than in children, with the average age at diagnosis being more than 65 years. However, diagnostic procedures and treatment of children and adults are similar.Changes in chromosomes in leukemia cells can be identified in 80% of children with AML. These distinct chromosomal changes detected on cytogenetic examination are often associated with different outcomes of treatment. With current treatment, 30-50% of children with AML are cured. It is important to identify those children who can be cured with standard treatments and those who should receive more individualized treatment. The distinct type of chromosomal abnormality present at diagnosis has been shown to help identify patients with a "good" or "bad" outcome.
Patients with leukemia containing cytogenetic abnormalities can often be tested after treatment for the detection of small numbers of leukemia cells that cannot be detected under the microscope. The technique used is called polymerase chain reaction (PCR). PCR can detect very small numbers of leukemia cells, thereby indicating the need for more treatment, as small numbers of leukemia cells inevitably lead to a relapse. PCR is useful for the monitoring of treatment results of both children and adults with AML.
Patients with leukemia containing cytogenetic abnormalities can often be tested after treatment for the detection of small numbers of leukemia cells that cannot be detected under the microscope. The technique used is called polymerase chain reaction (PCR). PCR can detect very small numbers of leukemia cells, thereby indicating the need for more treatment, as small numbers of leukemia cells inevitably lead to a relapse. PCR is useful for the monitoring of treatment results of both children and adults with AML.
Leukemia
Leukemia is a cancer of the blood cells. There are many different types of leukemia, depending upon which specific blood cells are affected. Each leukemia has different disease characteristics and therefore different treatment options. Several clinical diagnostic tests are utilized in order to determine the type and extent of leukemia. In order to better understand leukemia and its treatment, a basic understanding of normal blood cell production is useful.When leukemia occurs, the body produces large numbers of abnormal or immature blood cells. Leukemia cells look different and act different than normal blood cells and are often unable to perform their intended functions.
Most leukemias occur in white blood cells and are classified as either myelocytic or lymphocytic, depending upon the type of white blood cell is affected. Leukemia is further classified by how fast the disease develops. When leukemia develops quickly and is composed of immature cells that do not properly mature, it is called acute leukemia. When leukemia is referred to as chronic, the cells are more mature and the accumulation of the abnormal cells occurs less rapidly.
Most leukemias occur in white blood cells and are classified as either myelocytic or lymphocytic, depending upon the type of white blood cell is affected. Leukemia is further classified by how fast the disease develops. When leukemia develops quickly and is composed of immature cells that do not properly mature, it is called acute leukemia. When leukemia is referred to as chronic, the cells are more mature and the accumulation of the abnormal cells occurs less rapidly.
Cancer Of The Larynx
The larynx contains the vocal cords, which vibrate to make sound when air is directed against them. The sound echoes through the pharynx, mouth and nose to make a persons voice. The muscles in the pharynx, face, tongue and lips help people form words with sounds to make them understandable. Symptoms of laryngeal cancer include a persistent sore throat, pain when swallowing, change in voice, hoarseness in the voice, pain in the ear or a lump in the neck. The larynx can be observed with a lighted mirror but is usually examined with a laryngoscope, which is a lighted tube.
Laryngeal cancer is diagnosed by taking a small piece of tissue (biopsy) from the suspected cancer through a laryngoscope. This tissue is evaluated under the microscope to determine if cancer is present. A laryngoscope is used to visualize the mouth, throat, larynx and upper esophagus. A thorough examination is necessary, even if the primary cancer is obvious, because approximately six percent of cases involve a second primary cancer. The incidence of new cancers in patients with laryngeal cancer is not linked to the site, size, staging or grade of differentiation of the index cancer. The size and extent of spread of cancer (stage) at the time of diagnosis predicts outcome. Early stage cancers of the larynx may be treated effectively with surgery and/or radiation therapy while more advanced stages with spread to lymph nodes in the neck are often treated together with other head and neck cancers on clinical trials. The goal of therapy is to eradicate the cancer while preserving speech. Surgery and/or radiation therapy is highly effective in the treatment of early Stage I-II laryngeal cancers with minimal to moderate effects on speech. However, 30 to 50 percent or more of patients present with advanced local, regional and/or metastatic disease requiring multi-modality treatment. Despite aggressive therapy, only 30 to 50 percent of patients with advanced laryngeal cancer live three years or more.
Laryngeal cancer is diagnosed by taking a small piece of tissue (biopsy) from the suspected cancer through a laryngoscope. This tissue is evaluated under the microscope to determine if cancer is present. A laryngoscope is used to visualize the mouth, throat, larynx and upper esophagus. A thorough examination is necessary, even if the primary cancer is obvious, because approximately six percent of cases involve a second primary cancer. The incidence of new cancers in patients with laryngeal cancer is not linked to the site, size, staging or grade of differentiation of the index cancer. The size and extent of spread of cancer (stage) at the time of diagnosis predicts outcome. Early stage cancers of the larynx may be treated effectively with surgery and/or radiation therapy while more advanced stages with spread to lymph nodes in the neck are often treated together with other head and neck cancers on clinical trials. The goal of therapy is to eradicate the cancer while preserving speech. Surgery and/or radiation therapy is highly effective in the treatment of early Stage I-II laryngeal cancers with minimal to moderate effects on speech. However, 30 to 50 percent or more of patients present with advanced local, regional and/or metastatic disease requiring multi-modality treatment. Despite aggressive therapy, only 30 to 50 percent of patients with advanced laryngeal cancer live three years or more.
Throat Cancer
Cancer of the throat is one of many head and neck cancers. The throat is a hollow tube about 5 inches long that starts behind the nose and roof of the mouth then merges into the windpipe and becomes the esophagus further down the neck.
The majority of throat cancers are related to tobacco and/or excessive alcohol exposure. However, in 25% of cases, cancer of the throat is not associated with any known risk factor. Recent research has raised the possibility of a connection between viral infection by the human papilloma virus (HPV) and cancer of the mouth and throat.
Treatment for patients with throat cancer is extremely variable and depends largely on the stage of disease. Surgery or radiation therapy is highly effective in the treatment of most early stage cancers. However, the advanced stages of cancer that involve lymph nodes in the neck are more difficult to treat. More than 70% of patients with throat cancer have advanced cancers at the time of initial diagnosis.
The majority of throat cancers are related to tobacco and/or excessive alcohol exposure. However, in 25% of cases, cancer of the throat is not associated with any known risk factor. Recent research has raised the possibility of a connection between viral infection by the human papilloma virus (HPV) and cancer of the mouth and throat.
Treatment for patients with throat cancer is extremely variable and depends largely on the stage of disease. Surgery or radiation therapy is highly effective in the treatment of most early stage cancers. However, the advanced stages of cancer that involve lymph nodes in the neck are more difficult to treat. More than 70% of patients with throat cancer have advanced cancers at the time of initial diagnosis.
Head And Neck Cancers
Head and neck cancers originate in the throat, larynx (voice box), pharynx, salivary glands, or oral cavity (lip, mouth, tongue). In 1999, there were 500,000 cases of head and neck cancers worldwide. Most head and neck cancers involve squamous cells, which are cells that line the mouth, throat, or other structures. Also, these cancers are often preceded by non-cancerous sores or an unusual patch of white tissue that cannot be rubbed off, called a leukoplakia.Patients with head and neck cancers should consider being carefully evaluated in a medical center that treats many patients with these cancers. Patients with head and neck cancer require a multidisciplinary team approach that is often only available at specialty medical centers. A multidisciplinary team may be comprised of a head and neck surgeon, a radiation oncologist, a medical oncologist, a pathologist, a dentist, and social services personnel. Evaluation and treatment by an experienced team is essential for determining optimal treatment.
Gastric Cancer
Cancer of the stomach is called gastric cancer. Gastric adenocarcinoma is the most common cancer of the stomach and it arises from the cells (columnar epithelium) lining the surface of the stomach. The primary risk factor associated with gastric cancer is infection with the bacteria, Helicobacter Pylori (H. pylori). In fact, 85% to 95% of all gastric cancers are believed to be caused by this infection. H. pylori is easily eradicated with antibiotics, which may prevent the development of this cancer.
There has been a marked decline in the incidence of gastric cancer in the United States and many other industrialized nations over the past 20-30 years. However, there has been an increase in cancers arising at the junction of the esophagus with the stomach. Approximately 22,600 new cases of gastric cancer are diagnosed in the United States each year, with approximately 13,700 yearly deaths from gastric cancer. Gastric cancer ranks 14th in incidence and is the 9th leading cause of cancer death in the US.
Gastric cancer is more common and is the major cause of cancer-related death in Asian countries such as Korea, China, Taiwan and Japan. Thus, much of the knowledge about treatment, especially surgery, comes from these countries. The incidence of gastric cancer is so high in these countries that they perform routine screening by esophagoscopy for detection of early gastric cancer. Early detection programs, such as those implemented in Japan, are not practiced elsewhere in the world because of the lower incidence of gastric cancer. For this reason, gastric cancer is detected at a later stage (extent of spread) in the U.S. and Europe than in Japan.
There has been a marked decline in the incidence of gastric cancer in the United States and many other industrialized nations over the past 20-30 years. However, there has been an increase in cancers arising at the junction of the esophagus with the stomach. Approximately 22,600 new cases of gastric cancer are diagnosed in the United States each year, with approximately 13,700 yearly deaths from gastric cancer. Gastric cancer ranks 14th in incidence and is the 9th leading cause of cancer death in the US.
Gastric cancer is more common and is the major cause of cancer-related death in Asian countries such as Korea, China, Taiwan and Japan. Thus, much of the knowledge about treatment, especially surgery, comes from these countries. The incidence of gastric cancer is so high in these countries that they perform routine screening by esophagoscopy for detection of early gastric cancer. Early detection programs, such as those implemented in Japan, are not practiced elsewhere in the world because of the lower incidence of gastric cancer. For this reason, gastric cancer is detected at a later stage (extent of spread) in the U.S. and Europe than in Japan.
Colon Cancer
The colon and rectum are parts of the body's digestive system and together form a long, muscular tube called the large intestine. The colon is the first 6 feet of the large intestine and the rectum is the last 8-10 inches. Treatment approaches differ between cancers of the colon or rectum and are, therefore, discussed separately. A separate section has been created for Rectal Cancer.
Adenocarcinoma refers to cancer that begins in the cells that line the colon or large intestine and accounts for over 90%-95% of cancers originating in the colon. Other cancers, including carcinoid tumors and leiomyosarcoma, also originate in the colon, but are not referred to as colon cancer. This treatment overview deals only with adenocarcinoma of the colon, which will be referred to as colon cancer.
The treatment of colon cancer typically consists of surgery and/or chemotherapy and may involve several physicians, including a gastroenterologist, a surgeon, a medical oncologist and other specialists. Care must be carefully coordinated between the various treating physicians involved in managing the cancer.
Colon cancer begins in cells that line the colon. As the cells increase in number, they spread circumferentially around the colon like a "napkin ring." If detected early, cancer cells may only be found in the colon. If not detected early, the cancer may invade adjacent organs and spread through the lymph and blood systems throughout the body to the liver, lungs and other organs.
Surgery
Upon completion of the clinical staging evaluation, surgery is performed to remove the cancer along with part of the normal adjacent colon and determine the level of spread within the colon and abdomen. Surgery is performed through an abdominal incision or through a laparoscope. Laparoscopic surgery is less invasive and involves the insertion of surgical instruments through very small incisions in the abdomen. Patients experience faster healing times compared with traditional abdominal surgery, and their outcomes with regard to cancer recurrence and survival have been shown in some trials to be similar. It is important for patients to discuss the risks and benefits of the two techniques with their doctor, as laparoscopic surgery is not yet the standard of care, but is still considered investigational.
Adenocarcinoma refers to cancer that begins in the cells that line the colon or large intestine and accounts for over 90%-95% of cancers originating in the colon. Other cancers, including carcinoid tumors and leiomyosarcoma, also originate in the colon, but are not referred to as colon cancer. This treatment overview deals only with adenocarcinoma of the colon, which will be referred to as colon cancer.
The treatment of colon cancer typically consists of surgery and/or chemotherapy and may involve several physicians, including a gastroenterologist, a surgeon, a medical oncologist and other specialists. Care must be carefully coordinated between the various treating physicians involved in managing the cancer.
Colon cancer begins in cells that line the colon. As the cells increase in number, they spread circumferentially around the colon like a "napkin ring." If detected early, cancer cells may only be found in the colon. If not detected early, the cancer may invade adjacent organs and spread through the lymph and blood systems throughout the body to the liver, lungs and other organs.
Surgery
Upon completion of the clinical staging evaluation, surgery is performed to remove the cancer along with part of the normal adjacent colon and determine the level of spread within the colon and abdomen. Surgery is performed through an abdominal incision or through a laparoscope. Laparoscopic surgery is less invasive and involves the insertion of surgical instruments through very small incisions in the abdomen. Patients experience faster healing times compared with traditional abdominal surgery, and their outcomes with regard to cancer recurrence and survival have been shown in some trials to be similar. It is important for patients to discuss the risks and benefits of the two techniques with their doctor, as laparoscopic surgery is not yet the standard of care, but is still considered investigational.
Wednesday, April 22, 2009
Cervical Cancer
The cervix is a female reproductive organ that forms the lower portion of the uterus or womb. The uterus and cervix lie in the pelvis, on top of the vagina, in between the rectum and bladder. The cervix forms the part of the birth canal that opens to the vagina.
The surface layer of the cervix is mostly composed of squamous cells. The squamous cells of the cervix merge with the glandular cells lining the cervical canal of the uterus. The area of merging is called the squamo-columnar junction and the area on the cervix outside of this junction is called the transformation zone. Cervical cancer occurs when cervical cells grow out of control, typically in the transformation zone. When cells grow out of control, they spread and grow throughout the cervix and may invade and destroy neighboring organs or break away and spread through the bloodstream and lymphatic system to other parts of the body.
Doctors who care for women routinely perform pelvic examinations and a Papanicolaou (Pap) smear to screen for cancer in the cells on the surface of the cervix. During a Pap smear, a sample of cells from the cervix is taken with a small wooden spatula or brush and examined under the microscope. Women may first become aware that they have cervical cancer when a suspicious area is identified during a pelvic examination or an abnormal Pap smear. If a suspicious or a precancerous lesion is found, additional tests will be recommended to determine whether a precancerous lesion or invasive cancer exists.
Cells taken from the surface of the cervix can appear abnormal, but may not be cancer. These abnormal cells, however, may be the first step in a series of changes that lead to cancer. Doctors refer to the abnormal cells as "precancerous" and have used different terms to refer to them, such as squamous intraepithelial lesions, dysplasia, cervical intraepithelial neoplasia or carcinoma in situ. Precancerous disease involves only the surface of the cervix. When the abnormal cells begin to spread deeper into the cervix, they are referred to as invasive cancer of the cervix.
The surface layer of the cervix is mostly composed of squamous cells. The squamous cells of the cervix merge with the glandular cells lining the cervical canal of the uterus. The area of merging is called the squamo-columnar junction and the area on the cervix outside of this junction is called the transformation zone. Cervical cancer occurs when cervical cells grow out of control, typically in the transformation zone. When cells grow out of control, they spread and grow throughout the cervix and may invade and destroy neighboring organs or break away and spread through the bloodstream and lymphatic system to other parts of the body.
Doctors who care for women routinely perform pelvic examinations and a Papanicolaou (Pap) smear to screen for cancer in the cells on the surface of the cervix. During a Pap smear, a sample of cells from the cervix is taken with a small wooden spatula or brush and examined under the microscope. Women may first become aware that they have cervical cancer when a suspicious area is identified during a pelvic examination or an abnormal Pap smear. If a suspicious or a precancerous lesion is found, additional tests will be recommended to determine whether a precancerous lesion or invasive cancer exists.
Cells taken from the surface of the cervix can appear abnormal, but may not be cancer. These abnormal cells, however, may be the first step in a series of changes that lead to cancer. Doctors refer to the abnormal cells as "precancerous" and have used different terms to refer to them, such as squamous intraepithelial lesions, dysplasia, cervical intraepithelial neoplasia or carcinoma in situ. Precancerous disease involves only the surface of the cervix. When the abnormal cells begin to spread deeper into the cervix, they are referred to as invasive cancer of the cervix.
Breast Cancer
Breast cancer is a common malignancy, with ~180,000 new cases diagnosed in the United States each year. The disease occurs most frequently in women and rarely, in men. The breasts are glands that produce and release milk in women in association with pregnancy. Breast cancer develops from cells in the breast.
The normal breast has 6 to 9 overlapping sections called lobes and within each lobe are several smaller lobules that contain the cells that produce milk. The lobes and lobules are linked by thin tubes called ducts, which lead to the nipple in the center of the breast. The spaces around the lobules and ducts are filled with fat. Lymph vessels carry colorless fluid called lymph, which contains important immune cells. The lymph vessels lead to small bean-shaped structures called lymph nodes. Clusters of lymph nodes are found in the axilla (under the arm), above the collarbone, and in the chest.
The suspicion of breast cancer first arises when a lump is detected in the breast during breast examination or a suspicious area is identified during screening mammography. In order to diagnose the cause of the suspicious area or lump in the breast, a physician will perform a biopsy. A biopsy can be performed on an outpatient basis. During a biopsy, a physician removes cells for examination in the laboratory to determine whether cancer is present. Other information obtained from the biopsy sample will play an important role in treatment decisions. If the biopsy indicates that cancer is present, additional surgery may be performed after the patient and doctor select a course of treatment.
The normal breast has 6 to 9 overlapping sections called lobes and within each lobe are several smaller lobules that contain the cells that produce milk. The lobes and lobules are linked by thin tubes called ducts, which lead to the nipple in the center of the breast. The spaces around the lobules and ducts are filled with fat. Lymph vessels carry colorless fluid called lymph, which contains important immune cells. The lymph vessels lead to small bean-shaped structures called lymph nodes. Clusters of lymph nodes are found in the axilla (under the arm), above the collarbone, and in the chest.
The suspicion of breast cancer first arises when a lump is detected in the breast during breast examination or a suspicious area is identified during screening mammography. In order to diagnose the cause of the suspicious area or lump in the breast, a physician will perform a biopsy. A biopsy can be performed on an outpatient basis. During a biopsy, a physician removes cells for examination in the laboratory to determine whether cancer is present. Other information obtained from the biopsy sample will play an important role in treatment decisions. If the biopsy indicates that cancer is present, additional surgery may be performed after the patient and doctor select a course of treatment.
Brain Tumors
An abnormal growth of cells in the brain is called a brain tumor. Brain tumors may be malignant (cancerous) or benign (non-cancerous).
Suspicions of a brain tumor may first arise from abnormal behavior or other symptoms. Symptoms are typically investigated with a series of tests aimed at making a diagnosis. If a brain tumor is the diagnosis, further information about the cancer cells is necessary to determine the best possible approach to treatment. There are many types of brain tumors that differ based on which type of cells make up the tumor. Also, determining the extent of the cancer helps the doctor to understand the likelihood that the tumor will spread into other brain tissues, a characteristic which may also be referred to as the aggressiveness of the cancer.
Symptoms of Brain Tumors
Symptoms of brain tumors vary widely depending on the type and location of the tumor. However, some of the most common symptoms are nausea, vomiting, and headaches. These are often caused by increased intracranial pressure, or increased pressure within the skull, which causes compression of the brain tissue.
In addition to increasing pressure, tumors encroach on and/or damage surrounding normal tissue as they grow. In the case of brain tumors, this can result in impaired cognitive functions and associated symptoms. The symptoms associated with brain tumors depend largely on where the tumor is located. The different areas of the brain, called lobes, are responsible for different brain functions. For example, memory is performed primarily in the frontal lobe of the brain (the front part of the brain, located right behind the forehead). A brain tumor in the frontal lobe may be associated with memory loss. However, the areas of the brain perform a variety of functions, therefore, symptoms may be diverse.
Suspicions of a brain tumor may first arise from abnormal behavior or other symptoms. Symptoms are typically investigated with a series of tests aimed at making a diagnosis. If a brain tumor is the diagnosis, further information about the cancer cells is necessary to determine the best possible approach to treatment. There are many types of brain tumors that differ based on which type of cells make up the tumor. Also, determining the extent of the cancer helps the doctor to understand the likelihood that the tumor will spread into other brain tissues, a characteristic which may also be referred to as the aggressiveness of the cancer.
Symptoms of Brain Tumors
Symptoms of brain tumors vary widely depending on the type and location of the tumor. However, some of the most common symptoms are nausea, vomiting, and headaches. These are often caused by increased intracranial pressure, or increased pressure within the skull, which causes compression of the brain tissue.
In addition to increasing pressure, tumors encroach on and/or damage surrounding normal tissue as they grow. In the case of brain tumors, this can result in impaired cognitive functions and associated symptoms. The symptoms associated with brain tumors depend largely on where the tumor is located. The different areas of the brain, called lobes, are responsible for different brain functions. For example, memory is performed primarily in the frontal lobe of the brain (the front part of the brain, located right behind the forehead). A brain tumor in the frontal lobe may be associated with memory loss. However, the areas of the brain perform a variety of functions, therefore, symptoms may be diverse.
Bone Cancer
The two types of bone cancer are primary and secondary. Primary bone cancer originates in the bone or tissues adjoined to the bone such as connective tissue. Secondary bone cancers, also known as bone metastases, are cancers that originated in another place in the body and then spread to the bone. The cells in bone metastases resemble the cells from the cancer's origin. They are not bone cells that have become cancerous, as in the case of primary bone cancers.
Primary bone cancers: The most common types of primary bone cancers include Osteosarcoma, Chondrosarcoma, and Ewing's sarcoma. Osteosarcoma develops in new tissue of growing bones and occurs most commonly in children or adolescents. Chondrosarcoma originates in cartilage, which is a type of connective tissue that serves as a protective layer between bones ends. Ewing 's sarcoma originates in immature nerve tissue within bone marrow. This type of bone cancer also occurs more frequently in children and adolescents. Less common bone cancers include malignant fibrous histocytoma and fibrosarcoma. These cancers are similar to Osteosarcoma in that they occur mainly in the extremities, except they occur in adults.
Cancers Metastatic to Bone or (Secondary bone cancers): Although most cancers can spread to or invade bone, the most common cancers that spread to bone are multiple myeloma, breast, prostate, lung, kidney, and thyroid cancer. The ribs, pelvis and spine are normally the first bones impacted by bone metastases, while bones more distant from the central skeleton are less frequently affected. It is not well understood why certain cancers metastasize to bone more than others. However, some general observations about bone metastases are as follows:
Breast cancer is the most common type of cancer to spread to bone, followed by prostate, then lung.Carcinomas, or cancers that arise from tissues that line or cover organs, are much more likely to metastasize to bone than sarcomas, cancers that originate in connective tissue (cartilage, fat, or muscle).Bone metastases from kidney cancer may occur many years after the primary cancer has been treated.The first symptom of bone cancer is usually pain or tenderness near the cancer. Bone pain is caused by stretching of the periosteum (thick membrane that covers bone) by the cancer, or by stimulation of nerves within the bone. Bone pain may be hard to differentiate from ordinary low back pain or arthritis. Usually the pain due to bone metastasis is fairly constant, even at night. It can be worse in different positions, such as standing up, which may compress the cancer in a weight bearing bone. If pain lasts for more than a week or two, doesn't seem to be going away, and is unlike other pain that may have been experienced, it should be evaluated by a physician.
Primary bone cancers: The most common types of primary bone cancers include Osteosarcoma, Chondrosarcoma, and Ewing's sarcoma. Osteosarcoma develops in new tissue of growing bones and occurs most commonly in children or adolescents. Chondrosarcoma originates in cartilage, which is a type of connective tissue that serves as a protective layer between bones ends. Ewing 's sarcoma originates in immature nerve tissue within bone marrow. This type of bone cancer also occurs more frequently in children and adolescents. Less common bone cancers include malignant fibrous histocytoma and fibrosarcoma. These cancers are similar to Osteosarcoma in that they occur mainly in the extremities, except they occur in adults.
Cancers Metastatic to Bone or (Secondary bone cancers): Although most cancers can spread to or invade bone, the most common cancers that spread to bone are multiple myeloma, breast, prostate, lung, kidney, and thyroid cancer. The ribs, pelvis and spine are normally the first bones impacted by bone metastases, while bones more distant from the central skeleton are less frequently affected. It is not well understood why certain cancers metastasize to bone more than others. However, some general observations about bone metastases are as follows:
Breast cancer is the most common type of cancer to spread to bone, followed by prostate, then lung.Carcinomas, or cancers that arise from tissues that line or cover organs, are much more likely to metastasize to bone than sarcomas, cancers that originate in connective tissue (cartilage, fat, or muscle).Bone metastases from kidney cancer may occur many years after the primary cancer has been treated.The first symptom of bone cancer is usually pain or tenderness near the cancer. Bone pain is caused by stretching of the periosteum (thick membrane that covers bone) by the cancer, or by stimulation of nerves within the bone. Bone pain may be hard to differentiate from ordinary low back pain or arthritis. Usually the pain due to bone metastasis is fairly constant, even at night. It can be worse in different positions, such as standing up, which may compress the cancer in a weight bearing bone. If pain lasts for more than a week or two, doesn't seem to be going away, and is unlike other pain that may have been experienced, it should be evaluated by a physician.
Bladder Cancer
The bladder is a hollow organ in the lower abdomen. Its primary function is to store urine, the waste that is produced when the kidneys filter the blood. Urine passes from the two kidneys into the bladder through two tubes called ureters and urine leaves the bladder through another tube called the urethra. The bladder has a muscular wall that allows it to get larger and smaller as urine is stored or emptied.The most common sign of bladder cancer is hematuria or blood in the urine, which will turn the urine rust or red in color. Other signs of bladder cancer may include pain during urination and frequent urination. Most patients with bladder cancer do not have symptoms other than hematuria.
Unfortunately, most bladder cancers are not diagnosed until they have become very large. As a result, research is ongoing in order to develop urine tests that would enable earlier detection of bladder cancer when it is small and more easily treated. There are several promising tests under evaluation, but currently none are reliable enough for routine use.
Cancers confined to the inner lining of the bladder are called "superficial" and comprise 70-80% of all bladder cancers. Cancers that have spread into the bladder wall are called "deep" bladder cancers and those that have spread to lymph nodes and/or distantly to lungs, liver or other organs are referred to as "metastatic.”
Unfortunately, most bladder cancers are not diagnosed until they have become very large. As a result, research is ongoing in order to develop urine tests that would enable earlier detection of bladder cancer when it is small and more easily treated. There are several promising tests under evaluation, but currently none are reliable enough for routine use.
Cancers confined to the inner lining of the bladder are called "superficial" and comprise 70-80% of all bladder cancers. Cancers that have spread into the bladder wall are called "deep" bladder cancers and those that have spread to lymph nodes and/or distantly to lungs, liver or other organs are referred to as "metastatic.”
General Information
Cancer is not one disease, but many diseases that occur in different areas of the body. Each type of cancer is characterized by the uncontrolled growth of cells. Under normal conditions, cell reproduction is carefully controlled by the body. However, these controls can malfunction, resulting in abnormal cell growth and the development of a lump, mass, or tumor. Some cancers involving the blood and blood-forming organs do not form tumors but circulate through other tissues where they grow.
A tumor may be benign (non-cancerous) or malignant (cancerous). Cells from cancerous tumors can spread throughout the body. This process, called metastasis, occurs when cancer cells break away from the original tumor and travel in the circulatory or lymphatic systems until they are lodged in a small capillary network in another area of the body. Common locations of metastasis are the bones, lungs, liver, and central nervous system.
The type of cancer refers to the organ or area of the body where the cancer first occurred. Cancer that has metastasized to other areas of the body is named for the part of the body where it originated. For example, if breast cancer has spread to the bones, it is called "metastatic breast cancer" not bone cancer.
A tumor may be benign (non-cancerous) or malignant (cancerous). Cells from cancerous tumors can spread throughout the body. This process, called metastasis, occurs when cancer cells break away from the original tumor and travel in the circulatory or lymphatic systems until they are lodged in a small capillary network in another area of the body. Common locations of metastasis are the bones, lungs, liver, and central nervous system.
The type of cancer refers to the organ or area of the body where the cancer first occurred. Cancer that has metastasized to other areas of the body is named for the part of the body where it originated. For example, if breast cancer has spread to the bones, it is called "metastatic breast cancer" not bone cancer.
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