Cancer Information

What type of Treatments available

2011-08-24T07:28:00.000-07:00

Had cancer removed from my Bladder 2 weeks ago. Stage 1, High Grade.
Physician said he removed all the tumor. Told me we would have to keep a
close eye on this bladder. I had to stop smoking, said it would give me a 2 or
3 times higher chance of recurring cancer. Said i did not have to take treatments at this time. I was wondering what are the treatment options.
Can anyone out there give me any information on Treatments for Bladder
cancer after surgery. Thanks for any info.
(P.S.) I had no symptons until I started Bleeding. No Pain, I was walking about
8 miles per week. Had 1 cancer.

Cervical Cancer

2011-08-24T07:27:00.000-07:00

Causes and risk factors for cervical cancer have been identified and include human papillomavirus (HPV) infection, having many sexual partners, smoking, taking birth control pills, and engaging in early sexual contact. HPV infection may cause cervical dysplasia, or abnormal growth of cervical cells. Regular pelvic exams and Pap testing can detect precancerous changes in the cervix. Precancerous changes in the cervix may be treated with cryosurgery, cauterization, or laser surgery. The most common symptoms and signs of cervical cancer are abnormal bleeding and pelvic pain. Cervical cancer can be diagnosed using a Pap smear or other procedures that sample the cervix tissue. Chest X-rays, CT scan, MRI, and a PET scan may be used to determine the stage of cervical cancer. Cancer of the cervix requires different treatment than cancer that begins in other parts of the uterus. Treatment options for cervical cancer include radiation therapy, surgery, and chemotherapy. Two vaccines, Gardasil and Cervarix, are available to prevent HPV infection. The prognosis of cervical cancer depends upon the stage and type of cervical cancer and the tumor size. When you get a diagnosis of cancer, it's natural to wonder what may have caused the disease. Doctors cannot always explain why one woman develops cervical cancer and another does not. However, we do know that a woman with certain risk factors may be more likely than others to develop cervical cancer. A risk factor is something that may increase the chance of developing a disease. Studies have found a number of factors that may increase the risk of cervical cancer. For example, infection with HPV (human papillomavirus) is the main cause of cervical cancer. HPV infection and other risk factors may act together to increase the risk even more: HPV infection: HPV is a group of viruses that can infect the cervix. An HPV infection that doesn't go away can cause cervical cancer in some women. HPV is the cause of nearly all cervical cancers. HPV infections are very common. These viruses are passed from person to person through sexual contact. Most adults have been infected with HPV at some time in their lives, but most infections clear up on their own. Some types of HPV can cause changes to cells in the cervix. If these changes are found early, cervical cancer can be prevented by removing or killing the changed cells before they can become cancer cells. The NCI fact sheet Human Papillomaviruses and Cancer: Questions and Answers has more information. A vaccine for females ages 9 to 26 protects against two types of HPV infection that cause cervical cancer. The NCI fact sheet Human Papillomavirus (HPV) Vaccines: Questions and Answers has more information. Lack of regular Pap tests: Cervical cancer is more common among women who don't have regular Pap tests. The Pap test helps doctors find abnormal cells. Removing or killing the abnormal cells usually prevents cervical cancer. Smoking: Among women who are infected with HPV, smoking cigarettes slightly increases the risk of cervical cancer. Weakened immune system (the body's natural defense system): Infection with HIV (the virus that causes AIDS) or taking drugs that suppress the immune system increases the risk of cervical cancer. Sexual history: Women who have had many sexual partners have a higher risk of developing cervical cancer. Also, a woman who has had sex with a man who has had many sexual partners may be at higher risk of developing cervical cancer. In both cases, the risk of developing cervical cancer is higher because these women have a higher risk of HPV infection. Using birth control pills for a long time: Using birth control pills for a long time (5 or more years) may slightly increase the risk of cervical cancer among women with HPV infection. However, the risk decreases quickly when women stop using birth control pills. Having many children: Studies suggest that giving birth to many children (5 or more) may slightly increase the risk of cervical cancer among women with HPV infection. DES (diethylstilbestrol): DES may increase the risk of a rare form of cervical cancer in daughters exposed to this drug before birth. DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.) Having an HPV infection or other risk factors does not mean that a woman will develop cervical cancer. Most women who have risk factors for cervical cancer never develop it. edited spam links left information as it maybe a source

Eat Fruit and Veggies to Cut Lung Cancer Risk

2011-06-14T04:54:00.001-07:00

Eat Fruit and Veggies to Cut Lung Cancer Risk

Eating five portions of fruit and vegetables per day is one of the means that experts most frequently recommend for preventing cancer.

In November of 2010, the European EPIC study carried out by researchers from ten countries showed that, in the case of lung cancer, the important thing is not just the quantity but also the variety of fruit consumed, which can reduce the risk by up to 23%.

"This research looks more deeply into the relationship between diet and lung cancer", María José Sánchez Pérez, co-author of the study and director of the Granada Cancer Registry at the Andalusian School of Public Health, tells SINC.

She says: "Aside from the amount consumed, it's also important to take into account the variety. A varied diet reduces the risk of developing this cancer, above all in smokers".

The results of this study, which have been published in the journal Cancer Epidemiology, Biomarkers & Prevention, show that eating "more than eight sub-groups" of vegetables cuts this risk by 23% compared with eating "less than four sub-groups". In addition, this risk falls by a further 4% for each unit added to the diet from another sub-group.

"A significant link was only found in smokers", the researcher stresses. "For every two additional units of different kinds of fruits and vegetables in the diet, the risk of lung cancer falls significantly by 3%. So if smokers increase the variety of fruit they eat they could have a lower risk of developing this type of cancer".

The European Prospective Investigation into Cancer and Nutrition (EPIC) involves 23 centres from 10 European countries (Germany, Denmark, Spain, France, Greece, Holland, Italy, Norway, the United Kingdom and Sweden, working with a sample of 500,000 European subjects (41,000 of whom live in the Spanish regions of Asturias, Granada, Guipúzcoa, Murcia and Navarre).

Lung cancer continues to be one of the most common cancers in developed countries. For this reason, despite the encouraging results of this study, Sánchez Pérez concludes that "the most effective way of preventing it continues to be reducing the prevalence of tobacco consumption among the populace".

THE EFFECT BY TYPE OF CANCEROUS TISSUE

Greater variety in fruit and vegetable consumption is associated with a lower risk of developing epidermoid carcinoma of the lung, with an additional two units of fruit and vegetable consumption leading to a 9% reduction in risk. This effect is clearer among smokers (where the risk falls by 12%).

No significant association between fruit and vegetable consumption and the risk of developing lung cancer was seen for the other kinds of tissues affected (adenocarcinoma and small and large cell carcinoma).

The Causes and Risk Factors for Liver Cancer

2011-06-14T04:52:00.002-07:00

The Causes and Risk Factors for Liver Cancer

Author: Cancer Treatment

Hepatitis B virus (HBV) disease is the main causes of liver cancer. Liver cancer relates to the regularity of chronic hepatitis B virus disease. Studies in animals also have provided that hepatitis B virus can cause liver cancer. For example, liver cancer develops in other mammals that are obviously infected with hepatitis B virus-related viruses. As a final point, by infecting transgenic mice with certain parts of the hepatitis B virus, scientists caused liver cancer to develop in mice that do not usually develop liver cancer.

It is not easy to find out what causes cancer from one person to another, but researchers have found several factors that add to a person's likelihood of developing liver cancer. Some risk factors for liver cancer include:

Viral hepatitis – Researchers have linked the disease of hepatitis-B virus (HBV) and hepatitis-C virus (HCV) with the progress of liver tumor. It is estimated that 10-20 percent of people with HBV will increase liver malignancy, and HBV is present in about one fourth of cases of liver cancer in the United States.
Exposure to aflatoxin – This is a carcinogenic body that can be found in molds that may infect peanuts, corn, grains and seeds. In tropical and subtropical regions, measures have been taken to change and get better storage in order to decrease exposure to aflatoxins.
Cirrhosis – The Countrywide Cancer Institute estimates that 5-10 percent of people with cirrhosis will develop liver tumor. Cirrhosis caused by viral hepatitis B and C, alcohol abuse and certain genetic disorders puts people at higher risk for developing liver malignancy.
Exposure to vinyl chloride and thorium dioxide – Revelation to these chemicals is more to be expected to cause angiosarcoma of the liver, a different type of tumor than HCC. They add to the risk of developing HCC to a far lesser degree.
Birth control pills – Types of by word of mouth contraceptives used in the past was linked to some varieties of liver cancer, but infrequently to HCC. Most of these types of oral contraceptives are no longer available, and it is unknown if those now in use increase risk for HCC.
Anabolic steroids – Long-term steroid use can a little increase the risk for liver tumor.
Arsenic – In some parts of the world, drinking water contaminated with arsenic causes increased risk for developing liver malignancy.

Treatment of liver cancer
The treatment of liver malignancy is overall condition of the patient. First action if liver tumor is Chemotherapy. Chemotherapy is a powerful drug to kill cancer cells. Chemotherapy is a not effective not some cases of liver malignancy but type of chemotherapy is known as chemoembolization is an central part of treatment for HCC. Chemoembolization causes many of the same side special effects as other forms of chemotherapy, as well as abdominal pain, nausea and sickness. Second treatment is surgery.

Surgery is best treatment for local resectable tumor is usually an operation known as surgical resection. In some cases, the area of the liver where the malignancy is found can be completely indifferent. Alcohol injection has been shown to improve survival in people with small hepatocellular tumors. It may also be used to help reduce symptoms in cases of metastatic liver cancer. The most common side effect is leaking of alcohol onto the liver or into the abdominal cavity.

Article Source: http://www.articlesbase.com/cancer-articles/the-causes-and-risk-factors-for-liver-cancer-3418181.html

Breast Inflammation Key to Cancer Growth

2011-06-14T04:52:00.001-07:00

Breast Inflammation Key to Cancer Growth

PHILADELPHIA – It took 12 years and a creation of a highly sophisticated transgenic mouse, but researchers at Kimmel Cancer Center at Jefferson have finally proven a long suspected theory: Inflammation in the breast is key to the development and progression of breast cancer.

In the December 15, 2010, issue of Cancer Research, the scientists say they can now definitively show that an inflammatory process within the breast itself promotes growth of breast cancer stem cells responsible for tumor development.

They also demonstrate that inactivating this inflammation selectively within the breast reduced activity of these stem cells, and stopped breast cancer from forming.

"These studies show for the first time that inactivating the NFKB inflammatory pathway in the breast epithelium blocks the onset and progression of breast cancer in living animals," says Richard G. Pestell, M.D., Ph.D., Director, Kimmel Cancer Center and Chairman of Cancer Biology.

"This finding has clinical implications," says co-author Michael Lisanti, Leader of the Program in Molecular Biology and Genetics of Cancer at Jefferson. "Suppressing the whole body's inflammatory process has side effects. These studies provide the rationale for more selective anti-inflammatory therapy directed just to the breast."

Dr. Pestell and his colleagues show the "canonical" NFKB pathway promotes breast cancer development: the first "insult" is provided by the HER2 oncogene, which then activates NFKB (nuclear factor kappa-light-chain-enhancer of activated B cells). NFKB turns on inflammation via tumor-associated macrophages (TAM), which produce tumor growth promoting factors.

Although inflammation, mediated by NFKB, has long been thought to be important in breast cancer development, the theory had been untestable because NF-?B is essential to embryonic development, Dr. Pestell says. "When you try to knock out NFKB genes in mice, they die."

He addressed this problem by creating a mouse in which the inflammatory system within the adult animal's normal breast could be regulated. This allows selective inactivation of NFKB in different cell types and took 12 years to accomplish, Dr. Pestell says. "These mice have five co-integrated transgenes."

The mice are programmed to develop breast cancer, but the researchers found that if they selectively blocked inflammation just in the breast, tumors would not develop. "This is a very novel finding," Dr. Pestell says.

They then demonstrated that this inactivation also reduced the number of cancer stem cells in the breast. "That told us that inflammation, through the action of NF-?B, is important to the growth and activity of cancer stem cells," Dr. Pestell says. "The transgenic mice are a new technology that can be used by the scientists and the pharmaceutical industry to understand the role of NFKB in different diseases including heart disease, neurodegeneration and other cancers."

Cancer Vaccines

2011-06-14T04:51:00.001-07:00

Cancer Vaccines

Vaccines boost the immune system’s natural ability to defend the body against infection and to protect it from dangers posed by certain types of damaged or abnormal cells, including cancer cells.

Some cancer vaccines, known as cancer preventive vaccines, are designed to prevent cancer from developing in healthy people. Other cancer vaccines, known as cancer treatment vaccines, are intended to treat cancers that have already occurred.

The U.S. Food and Drug Administration (FDA) has approved two types of cancer preventive vaccines: A vaccine against the hepatitis B virus, which can cause liver cancer in chronically infected people, and a vaccine against human papillomavirus types 16 and 18, which are responsible for about 70 percent of all cases of cervical cancer

Cancer treatment vaccines are designed to treat cancer by stimulating the immune system to recognize and attack cancer cells.

Effective cancer treatment vaccines are difficult to develop because some cancers can escape detection by the immune system or weaken natural immune responses against cancer cells

The side effects of cancer vaccines vary from patient to patient and according to the type of vaccine being used. Most of the side effects reported thus far have been mild and limited to inflammation at the site of the vaccine injection.

Vaccines are medicines that boost the immune system’s natural ability to protect the body against “foreign invaders” that may cause disease. These invaders are primarily microbes, which can be seen only under a microscope. Microbes include bacteria, viruses, parasites, and fungi.

The immune system is a complex network of organs, tissues, and specialized cells that act collectively to defend the body. When a particular type of microbe invades the body, the immune system recognizes it as foreign, destroys it, and “remembers” it to prevent another infection. Vaccines take advantage of this response.

Traditional vaccines usually contain harmless versions of microbes—killed or weakened microbes, or parts of microbes—that do not cause disease but are able to stimulate an immune response. When the immune system encounters these substances through vaccination, it responds to them, eliminates them from the body, and develops a memory of them. This vaccine-induced memory enables the immune system to act quickly to protect the body if it becomes infected by the same microbe in the future.

The immune system’s role in defending against disease-causing microbes has long been recognized. Scientists have also discovered that the immune system can protect the body against threats posed by certain types of damaged, diseased, or abnormal cells, including cancer cells.

Vaccines stimulate the immune system
White blood cells, or leukocytes, play the main role in immune responses. These cells carry out the many tasks required to protect the body against disease-causing microbes and abnormal cells.

Some types of leukocytes patrol the body, seeking foreign invaders and diseased, damaged, or dead cells. These white blood cells provide a general—or nonspecific—level of immune protection.

Other types of leukocytes, known as lymphocytes, provide targeted protection against specific threats, whether from a specific microbe or a diseased or abnormal cell. The most important groups of lymphocytes responsible for carrying out immune responses against such threats are B cells and cytotoxic (cell-killing) T cells.

B cells make antibodies, which are large proteins secreted by B cells that bind to, inactivate, and help destroy foreign invaders or abnormal cells. Most preventive vaccines, including those aimed at hepatitis B virus (HBV) and human papillomavirus (HPV), stimulate the production of antibodies that bind to specific, targeted microbes and block their ability to cause infection. Cytotoxic T cells, which are also known as killer T cells, kill infected or abnormal cells by releasing toxic chemicals or by prompting the cells to self-destruct (apoptosis).

Other types of lymphocytes and leukocytes play supporting roles to ensure that B cells and killer T cells do their jobs effectively. Cells that help fine-tune the activities of B cells and killer T cells include helper T cells and dendritic cells, which help activate killer T cells and enable them to recognize specific threats.

Cancer treatment vaccines work by activating B cells and killer T cells and directing them to recognize and act against specific types of cancer. They do this by introducing one or more molecules known as antigens into the body, usually by injection. An antigen is a substance that stimulates a specific immune response. An antigen can be a protein or another type of molecule found on the surface of or inside a cell.

Microbes carry antigens that “tell” the immune system they are foreign—or “non-self”—and, therefore, represent a potential threat that should be destroyed. In contrast, normal cells in the body have antigens that identify them as “self.” Self antigens tell the immune system that normal cells are not a threat and should be ignored.

Cancer cells can carry both types of antigens. They have self antigens, which they share in common with normal cells, but they may also have antigens that are unique to cancer cells. These cancer-associated antigens mark cancer cells as abnormal, or non-self, and can cause B cells and killer T cells to mount an attack against the cancer.

Cancer cells may also make much larger than normal amounts of certain self antigens. These overly abundant self antigens may be viewed by the immune system as being foreign and, therefore, may trigger an immune response against the cancer.

Cancer vaccines
Cancer vaccines are medicines that belong to a class of substances known as biological response modifiers. Biological response modifiers work by stimulating or restoring the immune system’s ability to fight infections and disease. There are two broad types of cancer vaccines:

Preventive (or prophylactic) vaccines, which are intended to prevent cancer from developing in healthy people; and

Treatment (or therapeutic) vaccines, which are intended to treat already existing cancers by strengthening the body's natural defenses against cancer.

Cancer preventive vaccines in Action
Cancer preventive vaccines target infectious agents that cause or contribute to the development of cancer (8). They are similar to traditional vaccines, which help prevent infectious diseases such as measles or polio by protecting the body against infection. Both cancer preventive vaccines and traditional vaccines are based on antigens that are carried by the infectious agents and that are relatively easy for the immune system to recognize as foreign.

Other microbes associated with cancer
Microbes cause or contribute to between 15 percent and 25 percent of all cancers diagnosed worldwide each year, with the percentages being lower in developed countries than in developing countries (4, 8, 13, 14). The International Agency for Research on Cancer (IARC) has classified several microbes as carcinogenic (causing or contributing to the development of cancer in people), including HPV and HBV (15). These infectious agents—bacteria, viruses, and parasites—and the cancer types with which they are most strongly associated are listed in the table below.

Infectious Agents	Type of Organism	Associated Cancer(s)
hepatitis B virus (HBV)	virus	hepatocellular carcinoma (a type of liver cancer)
hepatitis C virus (HCV)	virus	hepatocellular carcinoma (a type of liver cancer)
human papillomavirus (HPV) types 16 and 18, as well as other HPV types	virus	cervical cancer; vaginal cancer; vulvar cancer; oropharyngeal cancer (cancers of the base of the tongue, tonsils, or upper throat); anal cancer; penile cancer
Epstein-Barr virus	virus	Burkitt lymphoma; non-Hodgkin lymphoma; Hodgkin lymphoma; nasopharyngeal carcinoma (cancer of the upper part of the throat behind the nose)
human T-cell lymphotropic virus 1 (HTLV1)	virus	acute T-cell leukemia
Helicobacter pylori	bacterium	stomach cancer
schistosomes (Schistosoma hematobium)	parasite	bladder cancer
liver flukes (Opisthorchis viverrini)	parasite	cholangiocarcinoma (a type of liver cancer)

Cancer treatment vaccines
Cancer treatment vaccines are designed to treat cancers that have already occurred. They are intended to delay or stop cancer cell growth; cause tumor shrinkage; prevent cancer from coming back; or eliminate cancer cells that are not killed by other forms of treatment, such as surgery, radiation therapy, or chemotherapy.

Developing effective cancer treatment vaccines requires a detailed understanding of how immune system cells and cancer cells interact. The immune system often does not “see” cancer cells as dangerous or foreign, as it generally does with microbes. Therefore, the immune system does not mount a strong attack against the cancer cells.

There are many reasons the immune system does not easily recognize the threat posed by an already growing cancer. Most important is the fact that cancer cells carry normal self antigens in addition to any cancer-associated antigens. Furthermore, cancer cells sometimes undergo genetic changes that lead to the loss of cancer-associated antigens. Finally, cancer cells can produce chemical messages that suppress specific anticancer immune responses by killer T cells. As a result, even when the immune system recognizes a growing cancer as a threat, the cancer may still escape a strong attack by the immune system.

Side effects seen in cancer vaccines
Vaccines intended to prevent or treat cancer appear to have safety profiles comparable to those of traditional vaccines . However, the side effects of cancer vaccines can vary widely from one vaccine formulation to another and from one person to another.

The most commonly reported side effect of cancer vaccines is inflammation at the site where the vaccine is injected into the body. Reported symptoms include redness, pain, swelling, heightened temperature (the skin surrounding the injection site feels hot to the touch), itchiness, and occasionally a rash.

People sometimes experience flulike symptoms after receiving a cancer vaccine, including fever, chills, weakness, dizziness, nausea or vomiting, muscle ache, fatigue, headache, and occasional breathing difficulties. Blood pressure may also be affected.

Other, more serious health problems have been reported in smaller numbers of people after receiving a cancer vaccine. These problems may or may not have been caused by the vaccine. The reported problems have included asthma, appendicitis, pelvic inflammatory disease, and certain autoimmune diseases, including arthritis and systemic lupus erythematosus.

Vaccines, like any other medication affecting the immune system, can cause adverse effects that may prove life threatening. For example, severe hypersensitivity (allergic) reactions to specific vaccine ingredients have occurred following vaccination. However, such severe reactions are quite rare.

The Anti-Cancer Diet

2011-06-14T04:50:00.001-07:00

The Anti-Cancer Diet

By Dr. Ben Kim
DrBenKim.com

In response to an article on ways to prevent cancer that I wrote a few weeks ago, several subscribers sent in letters asking for a specific anti-cancer diet, one that can be followed after receiving chemotherapy.

I recommend the following guidelines to people who visit our clinic looking to get stronger and healthier after a bout with chemotherapy:

Set up a support system among family and friends that ensures that you have access to freshly pressed vegetable juices every day
All juices should contain at least 50 percent green vegetables by volume, the best choices being dark green, leafy vegetables like romaine lettuce, kale, Swiss chard, and collard greens
If your life circumstances are such that you cannot arrange to have daily access to fresh vegetable juices, take 3 heaping tablespoons of a high quality green food product every day, mixed with water
Until you crave animal products, stick to eating fresh vegetables, their juices, and fruits only
Eat fruits and vegetables that are naturally rich in antioxidants
Take 1 teaspoon of a high quality cod liver oil per 40-50 pounds of body weight on a daily basis
Eat only when you are hungry and chew well when you do

A typical day would look something like the following:

Breakfast

Blueberries, mango, apple, avocado, celery sticks, and romaine lettuce

Mid-morning snack

Glass of freshly pressed vegetable juice - 8 leaves of romaine lettuce, handful of parsley, 2 ribs of celery, 2 carrots

Lunch

Large vegetable salad made with romaine lettuce, tomatoes, celery, bell peppers, carrots, avocado, and raw walnuts

Dressing, if desired: freshly pressed juice of 1/2 an orange

Mid-afternoon snack

Glass of freshly pressed vegetable juice - 4 large leaves of Swiss chard, 4 leaves of romaine lettuce, small piece of raw red beet, 3 ribs of celery

Dinner

Large plate of steamed vegetables - Chinese cabbage, broccoli, green beans, sweet potatoes
1 whole avocado on the side

Evening snack

Any ripe fruit in season or a handful of raw walnuts and organic raisins

I have found that this type of diet satisfies most chemotherapy recipients for at least a month, sometimes for as long as a year.

When cravings for animal foods surface, I recommend eating small amounts of organic eggs, wild fish such as wild salmon or anchovies, and any flesh meats that are raised with organic feed and in a free-range environment. Small amounts of raw dairy products that are obtained from organic and hygienic sources are also fine for people who can tolerate dairy. When eating animal foods, I recommend striving to make them no more than 30 percent of each meal. Vegetables should always be the biggest portion of every meal.

Beyond dietary guidelines to fight cancer, here are a few critical lifestyle recommendations:

Be in the presence of fresh air as much as possible
Without getting burned, let your skin see sunshine for at least 15 minutes every day
Spend your emotional energy on things that make you feel loved, loving, and peaceful
Get as much physical rest as you possibly can - if you've been abusing your body for years, then taking a year off from work and other major responsibilities may be just what you need to restore your health

Most importantly, an anticancer regimen must include constant reminders about why you want to be healthy again. Think about your reasons for wanting to be at your best. Take as much time as is necessary to become crystal clear on your reasons. Then, write your reasons down on paper and review them every day.

Remember: no one in this world can accurately tell you what your prognosis is. Your life is not a statistic. Your thoughts and daily choices are the most significant determinants of your health today and in the future.

Bone Cancer Treatment

2011-06-14T04:49:00.001-07:00

Bone Cancer Treatment

Author: Cancer Treatment

Bone cancers are rare forms of cancer that can affect any bone in the body. Two types of bone cancer are multiple myeloma and bone sarcomas. Bone cancers can also happen when tumors that start in other organs, such as breasts, lung, and prostate, metastasize (spread) to the bone. Multiple myeloma is the most common type of bone cancer. Basic information about Bone cancer symptoms and treatment.

Blood tests, X-rays, CT scans, MIRs and ultrasound can all be used in the diagnosis of bone cancer and cancer of the bone marrow. Ultimately however, only a bone biopsy can provide a definitive diagnosis. By examining a sample of tissue, a Pathologist can determine whether cancer is present and how fast it's growing, crucial information in determining the best course of treatment.

Types of Bone Cancer: Osteosarcoma is the most common bone cancer. It rarely occurs in adults older than 25 years old. Osteosarcoma is usually found in the bones of the arms, legs and pelvis, and in bones that grow rapidly, such as the shoulders and knees.

Ewing's sarcoma is commonly found in children ages 4 to 15, and is rare in adults older than 30. It is an aggressive cancer typically found in the center of the long bones of the arms and legs.

Chondrosarcoma is found in cartilage cells and accounts for about 25 percent of bone tumors, making it the second most common type. Unlike most other bone cancers, it is most common in people older than 40. It is typically found in the large bones of the hips and pelvis.

Bone Cancer Symptoms:

Pain
Swelling or tenderness of the joints
Fractures
Fatigue, fever, weight loss, anemia
Bone dysplasia with medullary fibrosarcoma
Eosinophilic granuloma
Multiple Myeloma

The symptoms of bone cancer vary from one person to another according to the location and size of the bone cancer. Pain is one of the most common bone cancer symptoms. Generally, there is a gradual increase in the severity of the symptoms with time. At first, the pain may only be felt with activity or at night.

These are common types of Bone Cancer Treatment:

Surgery

How bone cancer is treated depends on the type of tumor, how aggressive it is, the location of the tumor and whether or not the cancer has spread to other areas of the body. Options include surgery, radiation and chemotherapy, or a combination of the three.
Risks include infection, damage to surrounding muscles, nerves and blood vessels, and recurrence of the cancer. Patients are often prescribed a course of physical therapy after surgery to help them regain full use and strength in the limb where the tumor was removed.

Chemotherapy

Chemotherapy is administered by an oncologist, and comprises a series of powerful intravenous drug treatments aimed at stopping and reversing the growth of cancer cells. Chemotherapy is often used before surgery to shrink the tumor, making surgery less invasive. After surgery, it is used as a safeguard to kill any remaining cancer cells. The drugs kill cancer cells, but also affect hair, digestive tract cells and blood-forming cells. Loss of hair, nausea, loss of appetite, anemia and low energy are common side effects of chemotherapy. These side effects usually go away quickly after chemotherapy stops. Chemotherapy patients are sometimes referred to nutritionists to help with the anemia and loss of appetite.

Radiation Therapy

Radiation therapy is administered by a radiation oncologist, and comprises a series of high-energy X-rays aimed at the site of the tumor. This treatment is given in small doses over several days, sometimes months. The most common side effects are loss of appetite, fatigue and damage to the skin and other soft tissue at the site of the treatment. Patients who undergo surgery near the site of radiation therapy sometimes are slow to heal because of damage to the blood vessels at the site. Most side effects go away quickly after radiation therapy is over, but problems with slow healing may persist.

Article Source: http://www.articlesbase.com/cancer-articles/bone-cancer-treatment-2793236.html

About the Author

Sarasota Interventional Radiology using Radiofrequency Ablation (RFA) for Bone cancer treatment. Interventional radiology technique has really proved to be helpful to diagnose some of the most dangerous diseases like cancer. More Info Visit http://www.sivr.net

Scientists reverse stance on sun and cancer: Now they admit sunlight can prevent skin cancer

2011-06-14T04:48:00.001-07:00

(NaturalNews) Since the 1980s, physicians and cancer groups have regularly warned the public against the potential health dangers of direct sunlight on skin. As a result, many people have stayed out of the sunlight completely, covered their limbs even in warm weather or slathered themselves with UV protection products, all in the interest of lowering their risk of melanomas.

However, more recent findings indicate that this kind of nearly vampiric avoidance of the sun may not benefit your cancer odds after all.

A 2009 study by a group of Leeds University researchers found that higher levels of Vitamin D were linked to improved skin cancer survival odds. Other studies have found that Vitamin D has a connection to a strong immune response in the body. In fact, Vitamin D may hasten the death of tumor cells.

Unfortunately, most people have low levels of Vitamin D, leaving them at higher risk for a host of diseases including breast cancer, prostate cancer, bowel cancer, cervical cancer, rickets and osteoporosis. (For more in-depth information on this, see this report: http://www.naturalnews.com/rr-sunli...)

"It's common for the general public to have low levels of vitamin D in many countries," said Professor Julia Newton Bishop of the Leeds Institute of Molecular Medicine and author of the Leeds study. "Melanoma patients tend to avoid the sun as sunburn is known to increase the risk of melanoma. We use sunshine to make vitamin D in the skin, so melanoma patients' levels of vitamin D may be especially low."

Bishop also noted that people can get more Vitamin D through dietary sources such as fatty fish. She points out that balance is key, as extremely high levels of Vitamin D can have a negative effect on health.

The mainstream media continues to run stories every summer warning people against the sun even two years after the Leeds study. While hours of sunbathing may be risky behavior for your long-term health, receiving a moderate amount of sunlight while out gardening or walking is actually as good for you as eating a low-fat diet and engaging in regular exercise. In fact, laying off the sunscreen may help you not only absorb sunshine into your skin to help fight tumors, but also helps you avoid the chemicals in most commercial sun blocking products. Some studies have indicated that these chemicals can actually generate harmful free radicals in the body.

So this summer, relax, and enjoy the sunshine.

Sources for this article include:

http://www.dailymail.co.uk/health/a...
http://www.leeds.ac.uk/news/article...
http://www.skinbiology.com/toxicsun...

Learn more: http://www.naturalnews.com/032533_sun_exposure_skin_cancer.html#ixzz1PFZgW8D4

Does drinking lots of coffee really help to prevent breast cancer?

2011-06-14T04:47:00.001-07:00

(NaturalNews) Coffee addiction may not be the detriment to health many people think it is, according to a new study published in the journal Breast Cancer Research. Postmenopausal women over 50 who drink five or more cups of coffee every day may be as much as 57 percent less likely to develop estrogen-receptor (ER) negative tumors, say researchers from the Karolinska Institute (KI) in Sweden.

Dr. Jingmei Li and her colleagues from KI evaluated 6,000 women, some of whom drank no coffee, and others who drank five cups or more. After adjusting for outside factors like age at menopause, weight, family history of breast cancer, and others that affect results, the research team observed that women who drank the most coffee were least likely to develop some of the most serious forms of breast cancer.

On the other hand, coffee consumption played no role in reducing the risk of ER-positive cancers, indicating that something unique to the ER-negative varieties is sensitive to coffee. ER-negative breast cancers are typically the most difficult to treat with conventional medicine, as many breast cancer drugs have no effect on them.

"A high daily intake of coffee was found to be associated with a significant decrease in ER-negative breast cancer among postmenopausal women," wrote the team in their report. "We believe that this may have something to do with the way the coffee was prepared, or the type of bean preferred."

Previous research has shown that drinking coffee may also help to reduce the risk of developing liver fibrosis, hepatitis, type-2 diabetes, prostate cancer, stroke, and Alzheimer's disease (http://www.naturalnews.com/028033_c...).

However, drinking too much coffee can lead to dehydration, hypertension, and even mineral leeching from the bones (http://www.naturalnews.com/000677.html). The high acidity of coffee can also upset proper digestive function, leading to various other health problems.

Sources for this story include:

http://www.foxnews.com/health/2011/...

Learn more: http://www.naturalnews.com/032479_coffee_breast_cancer.html#ixzz1PFZGnpDd

Stomach Cancer

2011-06-11T16:56:00.000-07:00

Stomach (Gastric) Cancer: The Facts

What is it?

Stomach Cancer, which is also called Gastric Cancer, is the term used for cancer that originates in the lining of the stomach. The stomach is the J-shaped organ in the upper abdomen, and is part of the digestive system. It is connected to the esophagus (food-pipe) and the small intestine. Food travels down the esophagus and into the stomach. There it is mixed with digestive juices from the lining of the stomach and broken down. Two or three hours later, the partially digested food moves into the small intestine, and then to the large intestine (colon).

Stomach Cancer usually begins in the lining of the stomach. The stomach has four layers of lining. The innermost lining, the mucosa, contains the glands that produce the digestive juices. Ninety to ninety-five percent of Stomach Cancers begin in the mucosa layer. The second layer, the submucosa, contains blood vessels that feed blood and oxygen to the glands of the mucosa. The third layer, the muscularis, contains muscles, which contract to make a rippling motion. This motion moves the food through the stomach and mixes it with the digestive juices. The fourth and outermost layer, the serosa, protects the other layers and keeps the acidic digestive juices confined to the stomach.

The different types of Stomach Cancer are usually identified by how they grow and spread. If left untreated, Stomach Cancer can eventually spread to many other organs. Stomach Cancer is normally associated with four typical growth patterns:

Superficial Spread: The Cancer forms only a thin layer over the mucosa. This is the least aggressive type of Stomach cancer.
Ulcer Forming: The Cancer creates an ulcer in the stomach wall. A biopsy can tell whether or not an ulcer is cancerous.
Polypoid: The Cancer forms tumors that resemble a cauliflower.
Infiltrating: This type of Cancer is the most common and the most aggressive.

Stomach Cancer is also classified using a staging system. This system is based on the extent that the cancer has spread and to what areas of the body. This classification system ranges from “stage 0” (cancer that is localized in the stomach) through “stage IV” (cancer that has spread to lymph nodes and distant organs).

Who gets it?

Annually in the United States, approximately 21,500 people will be diagnosed with Stomach Cancer. Most Stomach Cancer patients are in their 60’s and 70’s. Men are twice as likely to get Stomach Cancer as women. The disease is also more common in African-Americans than in Caucasians.

Near the beginning of the 20^th century, Stomach Cancer was a leading cause of death in the United States. With improvements in food production, preservation, and preparation, Stomach Cancer has become relatively uncommon in the United States. It is most common in Japan, Eastern Europe, and Latin America. Rhode Island has a 25% higher rate of Stomach Cancer cases than the national average.

The exact cause of Stomach Cancer is still unknown, but certain factors can place you at a higher risk:

· Helicobacter Pylori Infection: A bacterial infection that can injure and shrink the stomach lining.

· Diet: A diet high in smoked or salted meat and fish, high starch/low fiber foods, pickled vegetables, and nitrate preservatives

· Smoking and Alcohol: Smoking and excess alcohol use have been linked to Stomach Cancer

· Prior Stomach Surgeries

· Pernicious Anemia: A condition in which no acidic digestive juices are produced.

· Sex: Males are at higher risk

· Family History: People with 3 or more first degree relatives (parents, sisters and brothers) who have had stomach cancer are at a higher risk.

· Blood Type: People with type A blood are at higher risk. Researchers have no idea why this is so.

· Occupational Hazards: Exposure to substances of coal mining and industrial processing of nickel, rubber, and timber.

How is it detected?

There is no officially accepted screening test for Stomach Cancer. If a physician suspects Stomach Cancer, he or she will usually perform a physical exam, a chest X-ray, and one or more of the following diagnostic tests:

Upper GI Series: The patient swallows a barium mixture and a series of x-rays of the digestive tract are taken. The barium makes abnormal tissues, ulcers, and tumors more visible on the screen.
Upper Endoscopy: The patient is sedated. A lighted probe is sent down through the esophagus and into the stomach. The doctor can examine the stomach and its lining for abnormal tissue. A sample of stomach tissue is usually taken and sent to a lab, where it is examined under a microscope by a pathologist for the presence of Cancer cells. This is called a biopsy.
CT Scan: A computer image of the abdomen, pelvis, or chest that can be used to determine if Cancer has spread to other organs.
Endoscopic Ultrasound (EUS): The patient is sedated. A probe is inserted through the esophagus that uses sound waves to make a screen image of the stomach that can be used to detect tumors or abnormal tissues. The EUS, unlike the CT scan or Upper GI Series, allows the doctor to see how deep the tumor is and how many layers of the stomach it has invaded.
Laparoscopic Ultrasound (LUS): The patient is given a local anesthetic. A small incision is made near the belly button, and a probe is inserted directly into the abdomen. An ultrasound is done from inside the body to create a screen image, which can then be used to locate tumors and abnormal tissue.
Fecal Occult Blood Test: A stool sample is analyzed to determine if there are microscopic amounts of blood present.

Symptoms

Early stages of Stomach Cancer usually show no symptoms, making it difficult to diagnose and treat. All of the following symptoms have been associated with Stomach Cancer, but none definitely indicate that Cancer is present:

· Unexplained weight loss

· Abdominal pain or vague pain above the belly button

· Indigestion/vomiting

· Weakness/fatigue

· Blood in vomit or stool

· Feelings of fullness

If the cancer has spread to the liver:

· Jaundice: Yellowing of the skin

· Ascites: Enlarged belly from fluid

Symptoms normally do not appear until Stomach Cancer has begun to develop into later stages. Report any symptoms to your doctor immediately! The earlier the cancer is detected, the better the chances of survival.

Is it curable?

Stomach Cancer is a very difficult disease to treat. Since the early cancer stages show few symptoms, Stomach Cancer is usually diagnosed in advanced stages. It is relatively uncommon in the U.S., so there are not routine screenings of the population for Stomach Cancer. RI has a 50% higher death rate from stomach cancer than the national average.

If detected early, Stomach Cancer can be successfully treated with no serious lasting effects. Advanced stages involve more extensive treatments, but can sometimes still be cured if the cancer hasn’t spread too much. In cases in which the cancer has spread to multiple organs, treatment of these other areas must be considered as well. The more the cancer has spread, the more difficult it is to treat successfully.

When detected in a late stage, the 5-year survival rate for Stomach Cancer is low. However, every case is different so patients with Stomach Cancer should not base their chances of survival on statistics alone. The seriousness of this disease must be kept in mind, but there are always new treatments that may offer hope.

It is easier to prevent cancer than to cure it…

Certain lifestyle changes can help decrease your risk of developing Stomach Cancer (as well as other types of cancer):

· A well balanced diet that avoids salted or smoked foods, avoids excess starch, and includes sufficient daily fiber.

· Prepare and refrigerate food properly

· Not smoking

· Use alcohol in moderation

· Avoid exposure to coal, nickel, or rubber processing

Cancer Symptoms Ignored

2011-06-11T16:55:00.000-07:00

Cancer Symptoms Ignored

The 20 Cancer Symptoms Women Are Most Likely to Ignore

Don't rely on routine tests alone to protect you from cancer. It's just as important to listen to your body and notice anything that's different, odd, or unexplainable. Here are some signs that are commonly overlooked:

1. Wheezing or shortness of breath
One of the first signs many lung cancer patients remember noticing is the inability to catch their breath.

2. Chronic cough or chest pain
Several types of cancer, including leukemia and lung tumors, can cause symptoms that mimic a bad cough or bronchitis. Some lung cancer patients report chest pain that extends up into the shoulder or down the arm.

3. Frequent fevers or infections
These can be signs of leukemia, a cancer of the blood cells that starts in the bone marrow. Leukemia causes the marrow to produce abnormal white blood cells, sapping your body's infection-fighting capabilities.

4. Difficulty swallowing
Trouble swallowing is most commonly associated with esophageal or throat cancer, and is sometimes one of the first signs of lung cancer, too.

5. Swollen lymph nodes or lumps on the neck, underarm, or groin
Enlarged lymph nodes indicate changes in the lymphatic system, which can be a sign of cancer.

6. Excessive bruising or bleeding that doesn't stop
This symptom usually suggests something abnormal happening with the platelets and red blood cells, which can be a sign of leukemia. Over time, leukemia cells crowd out red blood cells and platelets, impairing your blood's ability to carry oxygen and clot.

7. Weakness and fatigue
Generalized fatigue and weakness is a symptom of so many different kinds of cancer that you'll need to look at it in combination with other symptoms. But any time you feel exhausted without explanation and it doesn't respond to getting more sleep, talk to your doctor.

8. Bloating or abdominal weight gain
Women diagnosed with ovarian cancer overwhelmingly report unexplained abdominal bloating that came on fairly suddenly and continued on and off over a long period of time.

9. Feeling full and unable to eat
This is another tip-off to ovarian cancer; women say they have no appetite and can't eat, even when they haven't eaten for some time.

10. Pelvic or abdominal pain
Pain and cramping in the pelvis and abdomen can go hand in hand with the bloating that often signals ovarian cancer. Leukemia can also cause abdominal pain resulting from an enlarged spleen.

11. Rectal bleeding or blood in stool
This is a common result of diagnosing colorectal cancer. Blood in the toilet alone is reason to call your doctor and schedule a colonoscopy.

12. Unexplained weight loss
Weight loss is an early sign of colon and other digestive cancers; it's also a sign of cancer that's spread to the liver, affecting your appetite and the ability of your body to rid itself of wastes.

13. Upset stomach or stomachache
Stomach cramps or frequent upset stomachs may indicate colorectal cancer.

14. A red, sore, or swollen breast
These symptoms can indicate inflammatory breast cancer. Call your doctor about any unexplained changes to your breasts.

15. Nipple changes
One of the most common changes women remember noticing before being diagnosed with breast cancer is a nipple that began to appear flattened, inverted, or turned sideways.

16. Unusually heavy or painful periods or bleeding between periods
Many women report this as the tip-off to endometrial or uterine cancer. Ask for a transvaginal ultrasound if you suspect something more than routine heavy periods.

17. Swelling of facial features
Some patients with lung cancer report noticing puffiness, swelling, or redness in the face. Small cell lung tumors commonly block blood vessels in the chest, preventing blood from flowing freely from your head and face.

18. A sore or skin lump that doesn't heal, becomes crusty, or bleeds easily
Familiarize yourself with the different types of skin cancer -- melanoma, basal cell carcinoma, and squamous cell carcinoma -- and be vigilant about checking skin all over your body for odd-looking growths or spots.

19. Changes in nails
Unexplained changes to the fingernails can be a sign of several types of cancer. A brown or black streak or dot under the nail can indicate skin cancer, while newly discovered "clubbing"-- enlargement of the ends of the fingers with nails that curve down over the tips -- can be a sign of lung cancer. Pale or white nails can sometimes be a sign of liver cancer.

20. Pain in the back or lower right side
Many cancer patients say this was the first sign of liver cancer. Breast cancer is also often diagnosed via back pain, which can occur when a breast tumor presses backward into the chest, or when the cancer spreads to the spine or ribs.

Sources:

MSN Health

Dr. Mercola’s comments:

Whether you are a man or a woman, it’s important to watch for any unusual changes in your body and energy levels in order to detect any signs of cancer early on. The sooner you notice there’s a problem, the sooner you can begin to take the steps necessary to promote healing within your body.

Of course, ideally you should follow an anti-cancer lifestyle even before you notice any symptoms, as prevention is the best route when it comes to most chronic diseases. It is not unusual for 10 or more years to pass between exposure to a cancer-causing agent (tobacco, chemicals, radiation, cell phones, poor nutrition, etc.) and detectable cancer.

So during this time you have a chance to alter the progression of the disease.

Cancer is actually a group of diseases characterized by uncontrolled growth and spread of abnormal cells. The “cure” lies in controlling this abnormal growth and stopping the spread.

Your body has a remarkable capacity to do just that -- to heal -- and that ability is fueled largely by your lifestyle. If you eat well, exercise, get enough sleep and sun exposure and address your emotional stress, your body should be able to maintain a healthy balance.

The problem with cancer often lies not only with ignoring these health principles but also with the invasive and highly risky treatments that conventional medicine relies on to treat it -- surgery, chemotherapy and radiation.

This may surprise you to hear, but a recent landmark study found some cancers, even invasive cancers, may go away without treatment, and it may happen more often than anyone thought.

On the contrary, many experts now say cancer patients are more likely to die from cancer treatments like chemotherapy than the cancer itself.

The alarming rates of cancer deaths across the world -- cancer has a mortality rate of 90 percent, according to Italian oncologist Dr. Tullio Simoncini -- speak volumes about the effectiveness, or lack thereof, of these treatments, yet they are still regarded as the gold standard of cancer care.

Cancer Rates Continue to Rise in 2009

Nearly 1.5 million new cancer cases are expected to be diagnosed in the United States in 2009, not including the over 1 million cases of basal and squamous cell skin cancers that are also expected to be diagnosed this year, according to American Cancer Society data.

In all, more than 1,500 people will die from cancer each day, accounting for nearly one out of every four U.S. deaths.

The latest estimates show that by 2030, over 26 million people a year may be diagnosed with cancer, with 17 million people dying from it.

Many of these cancer cases and deaths can be prevented, however.

Even the American Cancer Society states that about one-third of the more than 562,000 cancer deaths expected to occur in 2009 will be related to overweight or obesity, physical inactivity and poor nutrition. Another 169,000 will be caused by tobacco use.

There is another widely overlooked cause of cancer deaths, one that could easily be changed as well, and that is a lack of vitamin D from sun exposure.

We now know that well in excess of half of cancer cases would simply disappear if vitamin D levels were optimized.

If You Suspect You Have Cancer, What Should You Do?

First and foremost I would suggest you seek the guidance of a knowledgeable natural health care practitioner. From there the choice is a highly personal decision but one I would urge you to keep an open mind on.

Many people turn to conventional cancer treatments like chemotherapy because they think they are the ONLY option. Well, there are other safer options to consider, including one that you may have in your kitchen pantry: baking soda.

Sodium bicarbonate delivers a natural form of chemotherapy in a way that effectively kills cancer cells -- without the side effects and costs of standard chemotherapy treatments. The only problem with the treatment, according to Dr. Mark Sircus, is that it’s too cheap. Since no one is going to make money from it, no one will promote it.

Dr. Simoncini’s quite amazing experience has shown that 99 percent of breast and bladder cancers can heal in just six days, entirely without the use of surgery, chemo or radiation, using just a local infiltration device (such as a catheter) to deliver the sodium bicarbonate directly to the infected site in your breast tissue or bladder.

You can watch actual before and after footage of the treatment working in this video.

Another such approach is Dr. Hamer’s German New Medicine (GNM), which operates under the premise that every disease, including cancer, originates from an unexpected shock experience, and that all disease can be cured by resolving these underlying emotional traumas.

Dr. Hamer has spent time in prison for refusing to disavow his medical findings and stop treating his patients with his unorthodox techniques, and is currently living in exile, seeking asylum from persecution.

Make Sure Your Vitamin D Levels are in the Optimal Range

It is also very important for cancer patients to optimize their vitamin D levels into a high range, and you can find out the correct levels by watching my one-hour vitamin D lecture.

Calcitriol, the most potent steroid hormone in your body, is produced in large amounts in your tissues when you have sufficient amounts of vitamin D. However, most cancer patients are vitamin D deficient.

Calcitrol -- the activated form of vitamin D -- has been shown to protect against cancer by inducing cell differentiation and controlling cell proliferation.

People with a low vitamin D level are less able to make activated vitamin D in an amount sufficient to exert the controls over cell proliferation that are needed to reduce cancer.

Not only is this approach almost without any side effects, but the treatment is virtually free.

So, again, if you have or suspect you have cancer please watch my free vitamin D lecture now to find out how to optimize your levels to the therapeutic range.

12 Tips to Reduce Your Risk of Cancer Now

As I said earlier, living an anti-cancer lifestyle now will help your body to stay healthy and in balance, and avoid developing cancer in the first place. Here are the top tips I recommend to start living your healthier lifestyle now:

1. Normalize your vitamin D levels by getting plenty of sunlight exposure and consider careful supplementation when this is not possible. If you take oral vitamin D and have a cancer, it would be very prudent to monitor your vitamin D blood levels regularly.

2. Reduce or eliminate your processed food, sugar and grain carbohydrate intake. Yes, this is even true for whole unprocessed organic grains, as they tend to rapidly break down and drive your insulin and leptin levels up, which is the last thing you need to have happening if you are seeking to resolve or prevent cancer.

3. Control your fasting insulin and leptin levels. This is the end result, and can be easily monitored with the use of simple and relatively inexpensive blood tests.

4. Normalize your ratio of omega-3 to omega-6 fats by taking a high-quality animal-based omega-3 fat like krill oil and reducing your intake of most processed vegetable oils.

5. Get regular exercise. One of the primary reasons exercise works is that it drives your insulin levels down. Controlling insulin levels is one of the most powerful ways to reduce your cancer risks.

6. Get regular, good sleep.

7. Eat according to your nutritional type. The potent anti-cancer effects of this principle are very much underappreciated. When we treat cancer patients in our clinic this is one of the most powerful anti-cancer strategies we have.

8. Reduce your exposure to environmental toxins like pesticides, household chemical cleaners, synthetic air fresheners and air pollution.

9. Limit your exposure and provide protection for yourself from radiation produced by cell phones, cell phone towers, base stations and WiFi stations.

10. Avoid frying or charbroiling your food. Boil, poach or steam your foods instead.

11. Have a tool to permanently reprogram the neurological short-circuiting that can activate cancer genes. Even the CDC states that 85 percent of disease is caused by emotions. It is likely that this factor may be more important than all the other physical ones listed here, so make sure this is addressed. One of the best approaches and my particular favorite tool is the Meridian Tapping Technique.

12. Eat at least one-third of your food raw. Personally my goal is 85% raw and I am usually able to achieve that.

You won’t read or hear much about these cancer-preventive techniques elsewhere because they have not been formally "proven" by conservative researchers. However, were you aware that 85 percent of therapies currently recommended by conventional medicine have never been formally proven either?

Now that’s something to think about.

With little effort on your part, these relatively simple risk reduction strategies can help you to virtually eliminate your cancer risk, and radically improve your chances of recovering from cancer if you currently have it. So go ahead and give them a try; you have nothing to lose and potentially everything, including your life, to gain.

Cancer Treatment for Dogs and Cats

2011-06-11T16:51:00.000-07:00

Cancer Treatment for Dogs and Cats

By Kim Hillers, DVM, MS, DACVIM (Oncology)

Due to advanced diagnostics and improved health care, more animals are being diagnosed with cancer each day. Some cancers can be completely eradicated using combined methods of treatment. Although other cancers are not curable, we can temporarily reverse animals’ clinical signs of illness and dramatically improve their quality of life. As pets become more integral parts of our families, veterinary medicine has become more advanced to provide the best care for your furry family members. Just as in human medicine, “oncologists,” doctors with advanced training in cancer treatment, are available to help your pet.

What is a veterinary oncologist?

A veterinary oncologist is a veterinarian who specializes in cancer treatment for dogs and cats. A veterinary oncologist sees only patients with cancer and spends each day educating others and treating dogs and cats with cancer.

Veterinary oncologists have undergone specialized training in cancer diagnosis and treatment. Following veterinary school, most oncologists pursue a one-year internship working with specialists in the areas of internal medicine, surgery, and other fields of medicine (i.e. dentistry, cardiology, etc.). Another aspect of the internship includes an emphasis on emergency medicine. If an internship was not pursued, then two to three years of general practice were completed before applying for a three-year residency in oncology.

Usually less than 10 to 15 openings nationwide are available for specialized training in oncology. These positions are highly coveted and competitive. Once accepted, for the next three years, these veterinarians treat animals with cancer under the guidance and supervision of board certified veterinary oncologists, specialists who have earned national certification in their field. Most programs offer multidisciplinary experience in chemotherapy, surgery, radiation therapy, pathology, and novel treatments like immunotherapy. Some academic university settings also require their residents to complete a masters program, which involves additional coursework and research in veterinary cancer.

At the end of the second and third year, oncology residents must pass two rigorous exams: one in the area of internal medicine, and one specializing in veterinary oncology and even aspects of human oncology. Veterinary oncologists are trained not only in the clinical aspects of cancer, but also in the molecular aspects of cancer to help better understand the rationale for various treatments.

My dog was just diagnosed with cancer. I don’t think I’m going to pursue further treatment. Do I need to see an oncologist?

As veterinary oncologists, our goals are to provide more information and education about your pet’s specific cancer. Not all cancers are alike. Some cancers behave in a very benign fashion and are unlikely to be fatal. On the other hand, some cancers are very aggressive and are associated with a poor prognosis if there is no further treatment.

Before final decisions are made, it may be beneficial to speak with someone who has treated your pet’s type of cancer more often than your family veterinarian. The oncologist can provide a more complete list of treatment options and prognostic information. Even if you elect not to pursue treatment, the information gained from meeting with an oncologist may provide more peace of mind with your decision. Furthermore, you will have a better idea of what to expect long-term.

My cat was just diagnosed with cancer, and my vet is sending me to a surgeon. Should I see an oncologist first?

Ideally, we think it is wise that you have as much information as possible before a potentially expensive and even risky surgery is performed. That way expectations and goals are understood before big decisions are made. There are times that the surgeon is not able to remove a tumor completely. What does that mean? That means that the tumor will return, and the long-term goal of getting rid of the cancer may not be attained. A veterinary oncologist can help give you more prognostic information as to whether the tumor can be completely removed, what further diagnostics may help ensure the best outcome, and what treatment options may be necessary if the tumor cannot be removed completely with surgery alone.

What is the difference between a “medical” veterinary oncologist and a “radiation” veterinary oncologist?

Veterinary medical oncologists have completed specialized training in cancer treatment, focusing mostly on chemotherapy and novel therapies. Throughout their training, they worked closely with surgeons and radiation oncologists, but they were not trained to perform advanced procedures in those areas.

Veterinary radiation oncologists pursued advanced training in physics, radiation safety, and radiation therapy for dogs and cats. Radiation therapy is generally used to help treat a specific area, while chemotherapy is used to treat the whole body. Throughout their training, radiation oncologists worked with medical oncologists and surgeons, but they did not receive extensive training in chemotherapy or surgery.

A board certified veterinary medical oncologist will have the following letters behind his/her name: DACVIM. ACVIM is an acronym for the American College of Veterinary Internal Medicine (www.acvim.org). A board certified veterinary radiation oncologist will have the following letters behind his/her name: DACVR. ACVR is an acronym for the American College of Veterinary Radiation (www.acvr.org).

I’ve spoken with someone who regretted treating his pet for cancer. I don’t want my dog to suffer.

Everyone has different experiences, each animal responds differently, and expectations of treatment vary. The goal of veterinary oncology is to extend your pet’s life while maintaining the pet’s quality of life. For those of us who have lost a family member to cancer, we tend to remember the “end” the most. Most animals experience improved quality of life once treatment is started. Animals rarely die because of their treatment; they die because their cancer was stronger than the treatment. Thus, their quality of life was not destroyed by the treatment, but by their disease. If it appears that our treatment is no longer effective, then options are discussed, and further treatment is not mandatory.

Southwest Veterinary Oncology was the first practice in Arizona to offer specialized cancer treatment for dogs and cats. Our oncologists have trained at some of the best programs in the nation, and they consult with each other and other specialists to offer the best care possible. Three offices are available to help serve our community Tucson, Gilbert, and Glendale.

Dr. Mary Kay Klein is located in Tucson, AZ. She is double-boarded in medical and radiation oncology. Dr. Kate Vickery (medical oncology) will be joining the Tucson practice in September. 520-888-3177, select 1 then option 3. http://www.southernazvets.com/

At the Gilbert office (Arizona Veterinary Specialists), Dr. Pamela Jones is also double boarded in medical and radiation oncology. Dr. Lynda Beaver (medical oncology) is located at the Gilbert office as well. 480-635-1100, option 2. http://www.azvs.com/

At the Glendale office, Dr. Kim Hillers and Dr. Suzanne Shelly Waltman are both board-certified medical oncologists. 623-298-5354, option 2. http://www.swvets.com/

If your pet has sadly been diagnosed with cancer, we understand the trauma associated with that diagnosis. Our goal is to help you and your pet get through this difficult time and together determine an optimal course of action. Please visit our website for more information and call if you would like to set up an appointment.

Basic Principles of Cancer Pathophysiology

2011-06-10T14:23:00.000-07:00

Basic Principles of Cancer Pathophysiology

Most common and deadly cancers include lung, breast, prostate, and colorectal.

Microenvironment of the metastatic tumor can modify its biology and response to drugs.

Mechanism of Metastasis

(Raymond removed an image describing the mechanism of metastasis: primary tumor, proliferation & angiogenesis, detachment & invasion of the circulation, transport to a distant site, arrest, adherence to and extravasation through vessel wall, establishment of a microenvironment, and repeat.)

Formation of the primary tumor

Tumor cells invade stroma and communicate with stromal cells. Tumor is avascular.

Both tumor and host cells promote metastasis by activating growth factor pathways, allowing invasion, and promoting angiogenesis.

Tumors inhibit metastasis by being antigenic, by cohesion (via e-cadherin), and by inhibiting angiogenesis.

Host cells inhibit metastasis by putting up tissue barriers, sending immune cells to kill tumor, and inhibiting angiogenesis.

Progressive growth and angiogenesis

Angiogenesis occurs when tumors secrete angiogenic agents such as VEGF and FGF, and by their recruiting lymphocytes and macrophages to secrete these agents as well. The capillary BM degrades locally, creating a vascular deformity and allowing new endothelial modeling.

The tumor or macrophages may also secrete anti-angiogenesis agents such as angiostatin, endostatin, and thrombospondin.

Invasion

Tumor cells invade host stroma using enzymes, then enter blood stream or lymphatics (which have thinner walls).

The host reaction to this invasion is a fibrous ECM called the “desmoplastic response.”

Transport of cancer cells

Single cells or aggregates detach. Blood stream is very hostile to cancer cells, so aggregates survive better, and become trapped in microvasculature downstream. Adhere to endothelial cells or even the BM and invade distant tissue.

Interestingly, presence of cancer cells in circulating blood and bone marrow is not associated with worse clinical outcome!

Cancer cells deposit based on circulation mechanics and chemokines in target tissue. GI cancers go to liver, breast cancers to lungs. Cancer then has to set up new microenvironment – this is an inefficient step. Growth factors supporting new cancer include TGF-β and IGF1.

Remember, tumor cells express chemokine receptors complementary to target organ chemokines. Therefore, chemokines influence patterns of spread between organs.

Dormancy

One model for relapse is that dormancy has persistent tiny pre-angiogenic metastases, in which tumor cell growth is balanced by apoptosis.

gastric cancer

2011-06-10T14:22:00.000-07:00

gastric cancer

Epidemiology

The incidence of gastric cancer is high in countries such as Japan, China and those in South America. The incidence is low in North America, Australia, and Western Europe. In North America there has been a steady decline in both incidence and mortality since accurate records have been kept. At the present time in North America the mortality is 7 per 100,000 for men and 4 per 100,000 for women. Nevertheless, despite this fall, it is still a relatively commonly encountered type of malignancy and represents approximately 3 % of all cancer deaths. In British Columbia cancer of the stomach is mainly (but not exclusively) encountered in immigrants, particularly those from SE Asia and Eastern Europe. Population data from San Francisco suggests that the children of immigrants are much less likely to develop gastric cancer than their parents, and that the grandchildren of immigrants have the same incidence as the general population. In the United States gastric cancer is commoner among poor people (especially African Americans). In all population groups studied, it is commoner in men than women.

Gastric cancer occurs most commonly in the elderly. Nevertheless it is not confined to that age group and may affect individuals between the ages of 40 and 60. Carcinoma of the stomach occurring under the age of 40 is regarded as a rarity. Because most gastric cancers are aggressive neoplasms and because they tend to present late in the course of the disease when metastasis has already occurred and the prognosis is poor even when radical surgery has been performed.

Classification

A simple classification of gastric cancer is given in the accompanying figure.

Classification of Gastric Neoplasms

Benign

Adenoma

Benign stromal tumors

Malignant

Distal gastric adenocarcinoma

Diffuse carcinoma

Cardiac carcinoma

MALT lymphoma, small and large cell types

Sarcoma

Distal gastric cancer

This still accounts for approximately 55 % of all gastric cancers diagnosed in British Columbia. As the name suggests, it occurs predominantly in the distal portion of the stomach, especially antrum but also in the distal body. Grossly it consists usually of a well-circumscribed lesion that may be polypoid or ulcerated. Microscopically the tumor is an adinocarcinoma composed of poorly formed tubules. Because of its resemblance to colon cancer it is sometimes referred to as an intestinal type of cancer. Distal gastric cancer may present with non-specific generalized symptoms such as weight loss or iron deficiency anemia (due to bleeding). Occasionally, the mass effect may cause pyloric obstruction. Metastatic spread is in three directions: a) to regional lymph nodes and later to more distal lymph nodes such as those in the neck; b) via the blood stream to the liver and later to the lungs; c) trans coelomically resulting in ascites or metastases to the ovaries.

The term “early gastric cancer” refers to a neoplasm which has its growth confined to the gastric mucosa and submucosa. These neoplasms have a much better prognosis than advanced carcinomas (greater than 80% 5-year survival). Early cancers are commonly diagnosed in Japan where endoscopic surveillance programs exist, but are rare in Canada where late diagnosis is the rule.

A reduction in distal gastric cancer accounts almost entirely for the overall reduced incidence of gastric cancer in westernized countries. The reasons for this are discussed below.

Diffuse gastric cancer

This disease accounts for approximately 10 – 15% of cases of gastric cancer. It has a worldwide distribution and is less heavily concentrated in the older age groups. The name diffuse was given because this cancer spreads throughout the stomach in a single cell infiltrating pattern that often has no grossly or microscopically identifiable border. The tumor is often accompanied by a proliferative fibrosis of the surrounding tissues which results in shrinkage of the stomach to form a rigid “leatherbottle” appearance. An old fashioned name for this type of tumor is linitis plastica. This type of tumor often has no definite mucosal lesion and its presence can only be suspected endoscopically by the presence of either enlarged mucosal folds or flattened folds.

Microscopically the tumor grows as individual cells. These may contain globules giving rise to the appearance of “signet ring cells”. Diffuse tumors spread widely and have an extremely poor prognosis. Metastatic signet ring cell carcinoma to the ovary is termed “Krukenbergs tumor”.

Cardiac gastric cancer

Cardiac cancer now accounts for approximately 35 – 40% of gastric cancers diagnosed in British Columbia. The incidence of this tumor appears to be increasing. Unlike distal gastric cancer it is a disease associated with affluence, not poverty. The incidence is considerably higher (possibly up to 7 times) in men as it is in women. Grossly and microscopically this tumor resembles distal gastric cancer. However, it is located either at the gastroesophagial junction or very close to it. These tumors may present insidiously, but are often accompanied by dysphagia.

Gastric lymphoma

The vast majority of gastric lymphomas arise from MALT. Both low-grade and high-grade lymphomas are recognized and occur in approximately equal numbers. High-grade lymphomas clinically present like and grossly resemble carcinomas. The distinction may only be made on biopsy. They metastasize to regional lymph nodes and are treated by gastrectomy combined with chemo/radiotherapy. Low-grade gastric lymphomas are relatively indolent, but may evolve into high-grade lymphomas. At the present time it is considered that all gastric lymphomas arise as a result of lymphoid proliferation secondary to gastric infection by Helicobacter pylori.

On the Origin of Cancer Cells

2011-06-10T14:20:00.000-07:00

On the Origin of Cancer Cells

Otto Warburg

Our principal experimental object for the measurement of the metabolism of cancer cells is today no longer the tumor but the ascites cancer cells (1) living free in the abdominal cavity, which are almost pure cultures of cancer cells with which one can work quantitatively as in chemical analysis. Formerly, it could be said of tumors with their varying cancer cell content, that they ferment more strongly the more cancer cells they contain, but today we can determine the absolute fermentation values of the cancer cells and find such high values that we come very close to the fermentation values of wildly proliferating Torula yeasts.

What was formerly only qualitative has now become quantitative. What was formerly only probable has now become certain. The era in which the fermentation of the cancer cells or its importance could be disputed is over, and no one today can doubt that we understand the origin of cancer cells if we know how their large fermentation originates, or, to express it more fully, if we know how the damaged respiration and the excessile fermentation of the cancer cells originate.

Energy of Respiration and Fermentation

We now understand the chemical mechanism of respiration and fermentation almost completely, but we do not need this knowledge for what follows, since energy alone will be the center of our considerations. We need to know no more of respiration and fermentation here than that they are energy-producing reactions and that they synthesize the energy-rich adenosine triphosphate, through which the energy of respiration and fermentation is then made available for life. Since it is known how much adenosine triphosphate can be synthesized by respiration and how much by fermentation, we can write immediately the potential, biologically utilizable energy production of any cells if we have measured their respiration and fermentation. With the ascites cancer cells of the mouse, for example, we find an average respiration of 7 cubic, millimeters of oxygen consumed per milligram, per hour, and fermentation of 60 cubic millimeters of lactic acid produced per milligram, per hour. This, converted to energy equivalents, means that the cancer cells can obtain approximately the same amount of energy from fermentation as from respiration, whereas the normal body cells obtain much more energy from respiration than from fermentation. For example, the liver and kidney of an adult animal obtain about 100 times as much energy from respiration as from fermentation.

I shall not consider aerobic fermentation, which is a result of the interaction of respiration and fermentation, because aerobic fermentation is too labile and too dependent on external conditions. Of importance for the considerations that follow are only the two stable independent metabolic processes, respiration and anaerobic fermentation-respiration, which is measured by the oxygen consumption of cells that are saturated with oxygen, and fermentation, which is measured by the formation of lactic acid in the absence of oxygen.

Injuring of Respiration

Since the respiration of all cancer cells is damaged, our first question is, How can the respiration of body cells be injured? Of this damage to respiration, it can be said at the outset that it must be irreversible, since the respiration of cancer cells never returns to normal. Second, the injury to respiration must not be so great that the cells are killed, for then no cancer cells could result. If respiration is damaged when it forms too little adenosine triphosphate, it may be either that the oxygen consumption has been decreased or that, with undiminished oxygen consumption, the coupling between respiration and the formation of adenosine triphosphate has been broken, as was first pointed out by Feodor Lynen (2).

One method for the destruction of the respiration of body cells is removal of oxygen. If, for example, embryonal tissue is exposed to an oxygen deficiency for some hours and then is placed in oxygen again, 50 percent or more of the respiration is usually destroyed. The cause of this destruction of respiration is lack of energy. As a matter of fact, the cells need their respiratory energy to preserve their structure, and if respiration is inhibited, both structure and respiration disappear.

Another method for destroying respiration is to use respiratory poisons. From the standpoint of energy, this method comes to the same result as the first method. No matter whether oxygen is withdrawn from the cell or whether the oxygen is prevented from reacting by a poison, the result is the same in both cases-namely, impairment of respiration from lack of energy. I may mention a few respiratory poisons. A strong, specific respiratory poison is arsenious acid, which, as every clinician knows, may produce cancer. Hydrogen sulfide and many of its derivatives are also strong, specific respiratory poisons. We know today that certain hydrogen sulfide derivatives, thiourea and thioacetamide, with which citrus fruit juices have been preserved in recent times, induce cancer of the liver and gall bladder in rats.

Urethane is a nonspecific respiratory poison. It inhibits respiration as a chemically indifferent narcotic, since it displaces metabolites from cell structures. In recent years it has been recognized that subnarcotic doses of urethane cause lung cancer in mice in 100 percent of treatments. Urethane is particularly suitable as a carcinogen, because, in contrast to alcohol, it is not itself burned up on the respiring surfaces and, unlike ether or chloroform, it does not cytolyze the cells. Any narcotic that has these properties may cause cancer upon chronic administration in small doses.

The first notable experimental induction of cancer by oxygen deficiency was described by Goldblatt and Cameron (3), who exposed heart fibroblasts in tissue culture to intermittent oxygen deficiency for long periods and finally obtained transplantable cancer cells, whereas in the control cultures that were maintained without oxygen deficiency, no cancer cells resulted. Clinical experiences along these lines are innumerable: the production of cancer by intermittent irritation of the outer skin and of, the mucosa of internal organs, by the plugging of excretory ducts of glands, by cirrhoses of tissues, and so forth. In all these cases, the intermittent irritations lead to intermittent circulatory disturbances. Probably chronic intermittent oxygen deficiency plays a greater role in the formation of cancer in the body than does the chronic administration of respiratory poisons.

Any respiratory injury due to lack of energy, however, whether it is produced by oxygen deficiency or by respiratory poisons, must be cumulative, since it is irreversible. Frequent small doses of respiratory poisons are therefore more dangerous than a single large dose, where there is always the chance that the cells will be killed rather than that they will become carcinogenic.

Grana

If an injury of respiration is to produce cancer, this injury must, as already mentioned, be irreversible. We understand by this not only that the inhibition of respiration remains after removal of the respiratory poison but, even more, that the inhibition of respiration also continues through all the following cell divisions, for measurements of metabolism in transplanted tumors have shown that cancer cells cannot regain normal respiration, even in the course of many decades, once they have lost it.

This originally mysterious phenomenon has been explained by a discovery that comes from the early years of cell physiology (4). When liver cells were cytolyzed by infusion of water and the cytolyzate was centrifuged, it was found that the greater part of the respiration sank to the bottom with the cell grana. It was also shown that the respiration of the centrifuged grana was inhibited by narcotics at concentrations affecting cell structures, from which it was concluded already in 1914 that the respiring grana are not insoluble cell particles but autonomous organisms, a result that has been extended in recent years by the English botanist Darlington (5) and particularly by Mark Woods and H. G. du Buy (6) of the National Cancer Institute in Bethesda, Md. Woods and du Buy have experimentally expanded our concepts concerning the self-perpetuating nature of mitochondrial elements (grana) and have demonstrated the hereditary role of extranuclear aberrant forms of these in the causation of neoplasia. The autonomy of the respiring grana, both biochemically and genetically, can hardly be doubted today.

If the principle Omne granum e grano is valid for the respiring grana, we understand why the respiration connected with the grana remains damaged when it has once been damaged; it is for the same reason that properties linked with genes remain damaged when the genes have been damaged.

Furthermore, the connection of respiration with the grana (7) also explains a carcinogenesis that I have not mentioned previously, the carcinogenesis by x-rays. Rajewsky and Pauly have recently shown that the respiration linked with the grana can be destroyed with strong doses of x-rays, while the small part of the respiration that takes place in the fluid protoplasm can be inhibited very little by irradiation. Carcinogenesis by x-rays is obviously nothing else than a destruction of respiration by elimination of the respiring grana.

It should also be mentioned here that grana, as Graffi has shown (8), fluoresce brightly if carcinogenic hydrocarbons are brought into their surroundings, because the grana accumulate the carcinogenic substances. Probably this accumulation is the explanation for the fact that carcinogenic hydrocarbons, although almost insoluble in water, can inhibit respiration and therefore have a carcinogenic effect.

Increase of Fermentation by no means immediately result. For cancer formation there is necessary not only an irreversible damaging of the respiration but also an increase in the fermentation-indeed, such an increase of the fermentation that the failure of respiration is compensated for energetically. But how does this increase of fermentation come about?

The most important fact in this field is that there is no physical or chemical agent with which the fermentation of cells in the body can be increased directly; for increasing fermentation, a long time and many cell divisions are always necessary. The temporal course of this increase of fermentation in carcinogenesis has been measured in many interesting works, among which I should like to make special mention of those of Dean Burk (9).

Burk first cut out part of the liver of healthy rats and investigated the metabolism of the liver cells in the course of the ensuing regeneration, in which, as is well known, the liver grows more rapidly than a rapidly growing tumor. No increase of fermentation was found. Burk then fed rats for 200 days on butter yellow, whereupon liver carcinomas were produced, and he found that the fermentation slowly increased in the course of 200 days toward values characteristic of tumors.

The mysterious latency period of the production of cancer is, therefore, nothing more than the time in which the fermentation increases after a damaging of the respiration. This time differs in various animals; it is especially long in man and here often amounts to several decades, as can be determined in the cases in which the time of the respiratory damage is known - for example, in arsenic cancer and irradiation cancer.

The driving force of the increase of fermentation, however, is the energy deficiency under which the cells operate after destruction of their respiration, which forces the cells to replace the irretrievably lost respiration energy in some way. They are able to do this by a selective process that makes use of the fermentation of the normal body cells. The more weakly fermenting body cells perish, but the more strongly fermenting ones remain alive, and this selective process continues until the respiratory failure is compensated for energetically by the increase in fermentation. Only then has a cancer cell resultedfrom the normal body cell.

Now we understand why the increase in fermentation takes such a long time and why it is possible only with the help of many cell divisions. We also understand why the latency period is different in rats and in man. Since the average fermentation of normal rat cells is much greater than the average fermentation of normal human cells, the selective process begins at a higher fermentation level in the rat and, hence, is completed more quickly than it is in man.

It follows from this that there would be no cancers if there were no fermentation of normal body cells, and hence we should like to know, naturally, from where the fermentation of the normal body cells stems and what its significance is in the body. Since, as Burk has shown, the fermentation remains almost zero in the regenerating liver growth, we must conclude that the fermentation of the body cells has nothing to do with normal growth. On the other hand, we have found that the fermentation of the body cells is greatest in the very earliest stages of embryonal development and that it then decreases gradually in the course of embryonal development. Under these conditions, it is obvious, since ontogeny is the repetition of phylogeny that the fermentation of body cells is the inheritance of undifferentiated ancestors that have lived in the past at the expense of fermentation energy.

Structure and Energy

But why-and this is our last question-are the body cells dedifferentiated when their respiration energy is replaced by fermentation energy? At first, one would think that it is immaterial to the cells whether they obtain their energy from respiration or from fermentation, since the energy of both reactions is transformed into the energy of adenosine triphosphate, and yet adenosine triphosphate = adenosine triphosphate. This equation is certainly correct chemically and energetically, but it is incorrect morphologically, because, although respiration takes place for the most part in the structure of the grana, the fermentation' enzymes are found for a greater part in the fluid protoplasm. The adenosine triphosphate synthesized by respiration therefore involves more structure than the adenosine triphosphate synthesized by fermentation. Thus, it is as if one reduced the same amount of silver on a photographic plate by the same amount of light, but in one case with diffused light and in the other with patterned light. In the first case, a diffuse blackening appears on the plate, but in the second case, a picture appears; however, the same thing happens chemically and energetically in both cases. Just as the one type of light energy involves more structure than the other type, the adenosine triphosphate energy involves more structure when it is formed by respiration than it does when it is formed by fermentation.

In any event, it is one of the fundamental facts of present-day biochemis try that adenosine triphosphate can be synthesized in homogeneous solutions with crystallized fermentation enzymes, whereas so far no one has succeeded in synthesizing adenosine triphosphate in homogeneous solutions with dissolved respiratory enzymes, and the structure always goes with oxidative phosphorylation.

Moreover, it was known for a long time before the advent of crystallized fermentation enzymes and oxidative phosphorylation that fermentation-the energy-supplying reaction of the lower organisms-is morphologically inferior to respiration. Not even yeast, which is one of the lowest forms of life, can maintain its structure permanently by fermentation alone; it degenerates to bizarre forms. However, as Pasteur showed, it is rejuvenated in a wonderful manner, if it comes in contact with oxygen for a short time. "I should not be surprised," Pasteur said in 1876 (10) in the description of these experiments, "if there should arise in the mind of an attentive hearer a presentiment about the causes of those great mysteries of life which we conceal under the words youth and age of cells." Today, after 80 years, the explanation is as follows: the firmer connection of respiration with structure and the looser connection of fermentation with structure.

This, therefore, is the physicochemical explanation of the dedifferentiation of cancer cells. If the structure of yeast cannot be maintained by fermentation alone, one need not wonder that highly differentiated body cells lose their differentiation upon continuous replacement of their respiration with fermentation.

I would like at this point to draw attention to a consequence of practical importance. When one irradiates a tissue that contains cancer cells as well as normal cells, the respiration of the cancer cells, already too small, will decline further. If the respiration falls below a certain minimum that the cells need unconditionally, despite their increased fermentation, they die; whereas the normal cells, where respiration may be harmed by the same amount, will survive because, with a greater initial respiration, they will still possess a higher residual respiration after irradiation. This explains the selective killing action of x-rays on cancer cells. But still further: the descendants of the surviving normal cells may in the course of the latent period compensate the respiration decrease by fermentation increase and, thence, become cancer cells. Thus it happens that radiation, which kills cancer cells can also at the same time produce cancer or that urethane, which kills cancer cells, can also at the same time produce cancer. Both events take place from harming respiration: the killing, by harming an already harmed respiration; the carcinogenesis by the harming of a not yet harmed respiration.

Maintenance Energy

When dedifferentiation of the body cells has occurred and cancer cells have thereby developed, there appears a phenomenon to which our attention has been called by the special living conditions of the ascites cancer cells. In extensively progressed ascites cancer of the mouse, the abdominal cavity contains so many cancer cells that the latter cannot utilize thier full capacity to respire and ferment because of the lack of oxygen and sugar. Nevertheless, the cancer cells remain alive in the abdominal cavity, as the result of transplantation proves.

Recently we have confirmed this result by direct experiments in which we placed varying amounts of energy at the disposal of the ascites outside the body, in vitro, and then transplanted it. This investigation showed that all cancer cells were killed when no energy at all was supplied for 24 hours at 38°C but that one-fifth of the growth energy was sufficient to preserve the transplantability of the ascites. This result can also be expressed by saying that cancer cells require much less energy to keep them alive than they do for growth. In this they resemble other lower cells, such as yeast cells, which remain alive for a long time in densely packed packets-almost without respiration and fermentation.

In any case, the ability of cancer cells to survive with little energy, if they are not growing, will be of great importance for the behavior of the cancer cells in the body.

Sleeping Cancer Cells

Since the increase in fermentation in the development of cancer cells takes place gradually, there must be a transitional phase between normal body cells and fully formed cancer cells. Thus, for example, when fermentation has become so great that dedifferentiation has commenced, but not so great that the respiratory defect has been fully compensated for energetically by fermentation, we may have cells which indeed look like cancer cells but are still energetically insufficient. Such cells, which are clinically not cancer cells, have lately been found, not only in the prostate, but also in the lungs, kidney, and stomach of elderly persons. Such cells have been referred to as "sleeping cancer cells" (II, 12).

The sleeping cancer cells will possibly play a role in chemotherapy. >From energy considerations, I could think that sleeping cancer cells could be killed more readily than growing cancer cells in the body and that the most suitable test objects for finding effective killing agents would be the sleeping cancer cells of skin-that is, precancerous skin.

Summary

Cancer cells originate from normal body cells in two phases. The first phase is the irreversible injuring of respiration. Just as there are many remote causes of plague-heat, insects, rats-but only one common cause, the plague bacillus, there are a great many remote causes of cancer-tar, rays, arsenic, pressure, urethane-but there is only one common cause into which all other causes of cancer merge, the irreversible injuring of respiration.

The irreversible injuring of respiration is followed, as the second phase of cancer formation, by a long struggle for existence by the injured cells to maintain their structure, in which a part of the cells perish from lack of energy, while another part succeed in replacing the irretrievably lost respiration energy by fermentation energy. Because of the morphological inferiority of fermentation energy, the highly differentiated body cells are converted by this into undifferentiated cells that grow wildly-the cancer cells.

To the thousands of quantitative experiments on which these results are based, I should like to add, as a further argument, the fact that there is no alternative today. If the explanation of a vital process is its reduction to physics and chemistry, there is today no other explanation for the origin of cancer cells, either special or general. From this point of view, mutation and carcinogenic agent are not alternatives, but empty words, unless metabolically specified. Even more harmful in the struggle against cancer can be the continual discovery of miscellaneous cancer agents and cancer viruses, which, by obscuring the underlying phenomena, may hinder necessary preventive measures and thereby become responsible for cancer cases.

Thyroid Cancer

2011-06-10T14:16:00.000-07:00

Thyroid Cancer

Papillary Thyroid Cancer

Definitions

Thyroid gland: Located at the base of the throat, an organ that makes hormones affecting heart rate, blood pressure, body temperature, and weight.

Papillary: Refers to an architectural pattern of growth similar to an arborizing pattern of a tree.

Goiter: Non-cancerous enlargement of the thyroid gland.

Nodules: Cellular growths in the thyroid gland. These growths are usually benign but may be cancerous.

Pathologist: A physician who examines tissues and fluids to diagnose disease in order to assist in making treatment decisions.

What is papillary thyroid cancer?

About 44,670 Americans are diagnosed with thyroid cancer each year, according to the National Cancer Institute. Thyroid cancer incidence is increasing at a faster rate among American men and women than any other type of cancer.

Papillary thyroid cancer, which accounts for about 80 percent of these cases, is a cancer of thyroid follicular cells. Most people diagnosed with papillary thyroid cancer at an early stage can be cured. About 1,500 Americans die from all types of thyroid cancer each year. This relatively low death rate is due to successful early detection and treatment in most cases.

Who is likely to have papillary thyroid cancer?

Women are three times more likely than men to have papillary thyroid cancer. Most cases afflict individuals between the ages of 30 and 50. Associated risk factors include radiation exposure, a family history of thyroid cancer, and too much iodine in the diet. Less often, papillary thyroid cancer is associated with having a goiter, benign thyroid nodule, or multiple colon growths (familial polyposis). Also, papillary thyroid cancer has been linked to nuclear weapons testing in the western United States and to accidents in nuclear power plants and atomic weapons production facilities (for example, the Chernobyl nuclear facility accident).

What characterizes papillary thyroid cancer?

Papillary thyroid cancer is characterized by its papillary architectural growth pattern but more importantly by the changes in the appearance of the nuclei of the tumor. Any cancerous nodule can become life-threatening by spreading via lymphatic spaces or blood vessels to lymph nodes or nearby bones and other organs. However, among all malignant neoplasms, there is a low death rate for papillary thyroid cancer.

Nodules can be detected when your primary care physician checks your neck and throat and feels the thyroid for lumps. Otherwise, early thyroid cancer does not have symptoms. If the cancer grows, symptoms may include a lump in the front of the neck, hoarseness or voice changes, swollen lymph nodes in the neck, trouble swallowing or breathing, or throat or neck pain.

How does the pathologist make the diagnosis?

If your symptoms suggest the possibility of thyroid cancer, your physician will order a blood test that the pathologist will check for abnormal levels of thyroid-stimulating hormone (TSH). Too much or too little TSH shows that the thyroid is not working well. Blood test results also can show a changed RET (Rearranged during Transfection) gene passed from parent to child.

(continued on next page)

(continued from previous page)

What else does the pathologist look for?

Your primary care physician may order an ultrasound and thyroid scan for review by radiologists. Cells removed by fine-needle aspiration (FNA) or tissue removed by a biopsy are sent to the pathologist to examine. An ultrasound or thyroid scan creates images of thyroid nodules that the radiologist can view for signs of cancer. An FNA or a biopsy, however, are the only potential sure ways to diagnose cancer.

What is meant by the stage of the cancer?

Your pathologist and primary care doctor determine the cancer’s stage to plan the best treatment. This process involves determining the size of the cancerous nodule, whether or not the cancer has spread and, if so, to what parts of the body. Thyroid cancer spreads most often to the lymph nodes, and much less often to the lungs and to bones. Stage 1 cancers are small and confined to the thyroid, and stage 4 tumors have spread well beyond the thyroid. Stages 2 and 3 describe conditions in between these two extremes.

Staging may involve tests such as ultrasound, CT or MRI scans, chest x-rays, or whole body scans. These tests enable the pathologist to determine where the cancer has spread and its stage.

How do doctors determine what treatment will be necessary?

Your treatment will depend on the size of the nodule, your age, and whether or not the cancer has spread. The pathologist consults with your primary care physician or specialist. Together, using their combined experience and knowledge, they determine treatment options most appropriate for your condition. It’s important to learn as much as you can about your treatment options and make the decision that’s right for you.

What kinds of treatments are available for papillary thyroid cancer?

Papillary thyroid cancer may be treated with surgery, external radiation therapy, thyroid hormone treatment, radioactive iodine therapy, or chemotherapy. Many patients receive a combination of these treatments.

Surgery and external radiation therapy are local therapies that remove or destroy cancer in the thyroid. When the cancer has spread beyond the thyroid, these two therapies can control the disease in the thyroid. Common surgical procedures are the total thyroidectomy (removal of the entire thyroid gland), the lobectomy (removal of part of the thyroid), and lymphectomy, which removes lymph nodes where the cancer has spread. External radiation therapy is generally used after surgery; this therapy uses high-energy beams projected from outside the body to destroy any remaining cancer.

Thyroid hormone treatment, radioactive iodine therapy, and chemotherapy are systemic therapies delivered through the bloodstream to destroy or stop the progression of cancer cells present throughout the body. These therapies also can reduce pain.

Any of these treatments may cause side effects and alter your normal activities. Ask your primary care physician or specialist to explain possible side effects thoroughly. If your treatment removes or destroys your entire thyroid, or a large portion of your thyroid, you will be required to take thyroid hormone pills for the rest of your life to replace the natural thyroid hormone. If the surgeon removes the parathyroid glands, located behind the thyroid, you will need to take calcium and vitamin D supplements for the rest of your life.

Follow-up care is very important because thyroid cancer comes back in up to 30 percent of all cases. Also, if you receive radioactive iodine therapy or external radiation therapy, you have an increased chance of developing other cancers later in your life. You should receive regular blood tests to check your levels of TSH and thyroglobulin (thyroid hormone stored in the thyroid). Your physicians also may recommend repeating some of the diagnostic and staging tests to see if the cancer has returned.

Clinical trials of new treatments for thyroid cancer may be found at www.cancer.gov/clinicaltrials. These treatments are highly experimental in nature but may be a potential option for advanced cancers. Some trials may involve biologic therapy, which uses the natural defenses of the immune system to fight cancer.

For more information, go to www.cancer.gov (National Cancer Institute), www.medicinenet.com (owned and operated by Web MD), or www.thyca.org (Thyroid Cancer Survivors’ Association). Type the keywords thyroid cancer into the search box.

(continued on next page)

(continued from previous page)

What kinds of questions should I ask my doctors?

Ask any question you want. There are no questions you should be reluctant to ask. Here are a few to consider:

• Please describe the type of cancer I have and what treatment options are available.

• What is the stage of my cancer?

• What are the chances for full remission?

• What treatment options do you recommend? Why do you believe these are the best treatments?

• What are the pros and cons of these treatment options?

• What are the side effects?

• Is your medical team experienced in treating the type of cancer I have?

• Can you provide me with information about the physicians and others on the medical team?

• If I want a second opinion, could you provide me with the names of physicians and/or institutions that you would recommend?

Breast Cancer

2011-06-10T14:14:00.000-07:00

Breast Cancer
Cancer cells are abnormal cells. Cancer cells grow and divide more
quickly than healthy cells. Some cancer cells may form growths called
tumors. All tumors increase in size, but some tumors grow quickly,
others slowly. Cancer cells can spread to other parts of the body
through the blood and lymph systems. This is called metastasis.
Breast cancer is when cancer starts in the breast. Breast cancer can be
found by mammogram, by a woman feeling a lump or by a doctor’s
exam. To find breast cancer, it is important to:
• Do monthly self breast exams.
• Have a yearly exam by your doctor if you are over 40. These are
done less often for younger women.
• Have a mammogram each year after age 40.

Breast Tissue
A woman’s breasts may feel more firm and lumpy before menopause.
A woman has less estrogen after menopause, so the breasts feel much
softer and less lumpy.
The firm, lumpy tissue can hide a small lump making it hard to feel.
By checking your breasts each month, you become familiar with your
breast tissue and notice changes. Small lumps can also be found by a
mammogram or by a doctor during your exam. Some lumps are so
small that only a mammogram can find them.

Testicular Cancer: Quick Facts

2011-05-31T15:38:00.000-07:00

Testicular Cancer: Quick Facts

What is Testicular Cancer?

About 8,000 men are diagnosed with testicular cancer and 390 die each year in the US. Testicular cancer originates in the part of the male reproductive system known as the testes, or testicles. The various types of testicular cancer differ by types of cells where cancer begins. Over 90% of testicular cancer cases are germ cell carcinoma, which begins in the germ cells that are located in the testes and are precursors to sperm cells. The two main types of germ cell carcinoma are seminoma (normally grow slowly and rarely metastasize) and nonseminoma (normally occur at an early age and grow more aggressively). Stromal cell tumors arise from the stroma, which is the hormone-producing tissue of the testicles. The two main types of stromal tumors are Leydig cell tumors and Sertoli cell tumors. Leydig cell tumors develop from cells that produce androgen (male sex hormone) and rarely metastasize. Sertoli cell tumors develop from cells that nourish & support germ cells and rarely spread. However, when Leydig or Sertoli cell tumors do spread, they are tough to treat.

Who’s at risk?

Age: Most common in men 15-40 years old.

Caucasians at greater risk than Asians or African-Americans

Family history of testicular cancer

Personal history of testicular cancer

Occupation: Miners, oil/gas workers, janitors, & utility workers are at high risk due to exposure to certain chemicals.

Carcinoma in situ: Symptom-less condition that almost always progresses to cancer.

Cryptorchidism: “Undescended testicle” is a condition that affects about 3% of newborns. Even men who have the condition corrected early in life are at higher risk.

Prevention

Certain lifestyle & dietary habits can reduce your risk, including:

Not smoking

Regular exercise

Moderate, if any, alcohol consumption

Low fat, high fiber diet

Symptoms

Testicular cancer normally is detected by the patient himself. Other symptoms include:

Heaviness or aching in the lower back or scrotum

Breast tenderness or growth

Fluid accumulation in the scrotum

How is it diagnosed?

If the patient or doctor suspects testicular cancer, a number of tests can be done to determine if cancer is present, including:

Self-Exams: Periodic self-exams of the testicles are an important way to detect changes/abnormalities. Males should begin performing self-exams in adolescence.

Ultrasound: Sound waves used to create an image of the testicle and surrounding tissue; normally used to rule out non-cancerous causes of the symptoms.

MRI: An imaging test that allows the physician to see the structure of the testicle & identify any abnormalities.

Blood test: High levels of certain proteins indicate cancer.

Biopsy: A tissue sample is removed surgically & examined for presence of cancer cells. Sometimes a testicle is removed.

Lymphangiography: A special dye injected into the lymph vessels travels to the lymph nodes. This helps the doctor determine if the cancer has spread.

CT scan: X-ray beams are used from a variety of angles to create an image of the infected area.

Treatment options

Treatment options for testicular cancer vary with stage of diagnosis. Treatment plans differ by individual, but surgery is usually part of the treatment. Here are several common options:

Radical Inguinal Orchiectomy: A testicle is removed by making an incision through the groin and cutting the spermatic cord, which attaches the testicle to the body.

Retroperitoneal Lymph Node Dissection: A large incision is made in the abdomen to access the affected area and remove lymph nodes from the groin area. Often this is done at the same time as radical inguinal orchiectomy or is performed later.

Radiation Therapy: External beam radiation or x-rays are used to kill or shrink cancer cells. It affects only a specific area of the groin where the tumor is located.

Chemotherapy: Drugs given by mouth or injection enter the blood stream & kill cancer cells; affects all areas of the body.

Clinical Trials: Experimental treatments are always being tested. The effectiveness & side effects aren’t always known. They can offer hope, especially for end-stage patients. Talk to your doctor or the RI Cancer Council for more information.

Testicular Cancer Facts

2011-05-31T15:36:00.000-07:00

· This disease occurs most often in men between the ages of 20 and 39. It accounts for only 1 percent of all cancers in men.

· Risk factors include having an undescended testicle, previous testicular cancer, and a family history of testicular cancer.

· Symptoms include a lump, swelling, or enlargement in the testicle; pain or discomfort in a testicle or in the scrotum; and/or an ache in the lower abdomen, back or groin.

· Diagnosis generally involves blood tests, ultrasound, and biopsy.

· Treatment can often cure testicular cancer, but regular follow-up exams are extremely important.

CHILDHOOD CANCER FACTS

2011-05-31T15:30:00.000-07:00

CHILDHOOD CANCER FACTS

► Presently there are 10,000 children living with cancer in Canada today, that is 10,000 too many!

► Each year, about 1500 new cases of childhood cancer are diagnosed in Canada.

► Cancer is the leading disease related cause of death among kids in Canada after the first year of life. More deaths than asthma, diabetes, cystic fibrosis and AIDS combined.

► In contrast to many of the cancers affecting adults, the causes of cancer in childhood are largely unknown.

► Leukemias, tumours of the brain and nervous system, the lymphatic system, kidneys, bones and muscles are the most common childhood cancers.

► Childhood cancers have close to a 75% cure rate, with leukemia leading the success charge with close to 90% overall cure rate.

► One in four children who are diagnosed with cancer will die of the disease.

► With a mortality rate of close to 25%, Canada loses tens of thousands of years of potential life each year to childhood cancer. In terms of potential life saved, childhood cancer ranks second only to breast cancer.

► Approximately 2/3 of survivors of childhood cancer face late effects of their disease and treatment, including neurocognitive impairments, sterility and secondary cancers.

► 1 in 330 individuals under the age of 20 will be diagnosed with a malignant disease.

► Studies show that treatment related out-of-pocket costs add up to approximately 1/3 of after tax income annually which relates to hundreds of millions of dollars on already emotionally and financially burdened families.

► More than 82 percent of children diagnosed with cancer become long-term survivors and the majority of them are considered cured.

► Long-term effects of surviving the treatments for childhood cancer can affect these children's futures.

► In the early 1950s, less than 10 percent of childhood cancer patients could be cured.

► Children are most affected by acute leukemia, tumours of the brain and nervous system, the lymphatic system, kidneys, bones and muscles.

► Lymphomas and cancers of the central nervous system are the second most diagnosed children's cancer, at 17% of total cancers diagnosed.

► Sarcomas, or cancers of the muscles, bones, nerves, fat, blood or connective tissue are next at 12%, with boys 25-30% more likely to contract this form of cancer.

► Neuroblastoma, which represents 95% of tumours in the sympathetic nervous system, represents 5% of all childhood cancers.

► Because of significant advances in therapy, 82% of these children will survive 5 years or more, an increase of almost 46% since the early 1960s.

► Cancer begins with the transformation of a single cell. We have yet to understand why-if we only knew!

Non-Hodgkin Lymphoma

2011-05-27T18:15:00.000-07:00

Non-Hodgkin Lymphoma

Definitions

Bone marrow: The bone’s inner, spongy core that produces blood cells.

Immune system: Cells whose function is to fight infections and disease.

Lymph nodes: Part of the immune system, lymph nodes store white blood cells and trap and remove bacteria and other harmful substances. Lymph nodes are located in the neck, underarms, chest, abdomen, and groin and connect to lymph vessels, which circulate white blood cells throughout the body.

White blood cells: Cells that make up the immune system.

Pathologist: A physician who examines tissues and fluids to diagnose disease in order to assist in making treatment decisions.

What is non-Hodgkin lymphoma?

A cancer of the immune system, non-Hodgkin lymphoma often causes enlarged lymph nodes, fever, and weight loss. Some forms of this cancer are aggressive and fast-growing while others are indolent and slow-growing. Each year, about 66,000 new cases of non-Hodgkin lymphoma occur in the United States, making it the fifth most common cancer. About 19,000 Americans die each year from this disease.

While survival rates depend on the type of lymphoma and how much it has spread, the

five-year average survival rate for people with non-Hodgkin lymphoma is 63 percent and 10-year survival is 51 percent. Recent treatment advancements are likely to improve survival rates for newly diagnosed patients.

Who is likely to have non-Hodgkin lymphoma?

Certain risk factors increase the chances of an individual developing this disease. These risk factors include a weakened immune system caused by a medical condition; certain types of infections including HIV, Epstein-Barr virus, H. pylori, (which causes stomach ulcers), hepatitis C, and human T-cell leukemia/lymphoma virus type 1 (HTLV-1); and autoimmune diseases such as rheumatoid arthritis and lupus. Researchers are studying other possible risk factors including obesity and exposure to herbicides. While non-Hodgkin lymphoma can occur at any age, most people with this cancer are older than 60.

Having one or more risk factors does not mean that a person will develop non-Hodgkin lymphoma. Most people who have risk factors never develop cancer.

What characterizes non-Hodgkin lymphoma?

Symptoms include swollen, painless lymph nodes; weight loss; fever; and night sweats.

(continued on next page)

How does the pathologist make the diagnosis?

If you have enlarged lymph nodes or another symptom suggesting non-Hodgkin lymphoma, your primary care doctor may ask about your personal and family medical history, perform a physical exam, and order a blood test to check your white cell count. Your doctor may also order a chest x-ray. The pathologist may assist in the review of these test results.

In a procedure known as a biopsy, a pathologist examines an entire lymph node or part of one under a microscope, checking the tissue for lymphoma cells. If lymphoma is found, the pathologist reports the type, including whether the lymphoma is fast- or slow-growing.

What else does the pathologist look for?

If lymphoma is found, the pathologist will help evaluate tests that examine if the primary tumor in the lymph node has spread to the liver, lungs, bone, or bone marrow. These tests may include a bone marrow biopsy or spinal tap.

What is meant by the stage of the cancer?

Your pathologist and primary care doctor determine the cancer’s stage to plan the best treatment. Stage I cancers are small and confined to one lymph node group, and stage IV tumors have spread into other parts of the body. Stages II and III describe states in between these two extremes.

How do doctors determine what treatment will be necessary?

Your treatment will depend on the type of non-Hodgkin lymphoma you have, its stage, how quickly the cancer is growing, your age, and whether or not you have other health problems. Medical professionals, including pathologists, oncologists, and radiologists, use their combined experience and knowledge and recommend treatment options most appropriate for your condition It’s important to learn as much as you can about your treatment options and make the decision that’s right for you.

What kinds of treatments are available for non-Hodgkin lymphoma?

If you have slow-growing non-Hodgkin lymphoma without symptoms, you may not need to undergo treatment right away. Instead, your physician will watch your health closely and begin treatment after symptoms begin. This approach is called watchful waiting.

If you have slow-growing lymphoma with symptoms, your physician may recommend chemotherapy and biological therapy. Physicians prescribe cancer-killing drugs delivered through oral or IV medicines, which can kill or slow the progression of tumor cells and reduce symptoms. These drugs are usually given in outpatient treatment cycles scheduled three or four weeks apart. The most common combination of drugs is called CHOP–cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), vincristine (Oncovin), and prednisone. Another common combination called CVP leaves out doxorubicin. Other chemotherapy drugs used to treat this cancer are chlorambucil, fludarabine, and etoposide.

(continued on next page)

Biological therapy activates the natural defenses of the immune system–or uses versions of natural substances made in the laboratory–to kill lymphoma cells and slow their growth. Pathologists may request and interpret a special laboratory test that helps the medical team to determine your cancer’s likely response to specialized biologic therapies.

If the slow-growing tumor is in stage I or II, your physician may recommend radiation therapy–pinpointed high-energy beams that can shrink tumors or destroy cancer cells remaining after surgery.

For fast-growing lymphomas, physicians often recommend a combination of chemotherapy and biological therapy and sometimes include radiation therapy.

If a non-Hodgkin lymphoma patient experiences a relapse or recurrence of the cancer after treatment, physicians may recommend high doses of chemotherapy, radiation therapy, or both followed by stem cell transplantation. In this procedure, lymphoma cells destroyed by cancer treatment are replaced by stem cells that produce healthy blood cells and help the bone marrow to recover.

Non-Hodgkin lymphoma and its treatment can lead to other health problems, such as anemia and infections. Drugs or blood transfusions are used to treat anemia, and your physician may prescribe antibiotics or other drugs to manage infections. Any infection you develop can be serious, and you will need treatment as soon as possible.

Complementary and alternative medicine approaches may contribute to healing by helping patients to manage stress and pain. These approaches include massage, behavioral therapy, meditation, and spirituality. Eating right and staying physically active are also very important, even though on some days you will feel tired and not have an appetite.

Patients should consider enrolling in a clinical trial, which tests new treatments. These treatments are experimental in nature but may be an option, especially for advanced cancers. Clinical trials for non-Hodgkin lymphoma may be found at www.cancer.gov/clinicaltrials or by calling NCI’s Cancer Information Service at

800-4-CANCER (800-422-6237).

For more information, go to www.cancer.gov (National Cancer

Institute) or www.cancer.org (American Cancer Society). Type the keywords non- Hodgkin lymphoma into the search box.

(continued on next page)

What kinds of questions should I ask my doctors?

Ask any question you want. There are no questions you should be reluctant to ask. Here are a few to consider:

• Please describe the type of cancer I have and what treatment options are available.

• What is the stage of my cancer?

• What are the chances for full remission?

• What treatment options do you recommend? Why do you believe these are the best treatments?

• What are the pros and cons of these treatment options?

• What are the side effects?

• Is your medical team experienced in treating the type of cancer I have?

• Can you provide me with information about the physicians and others on the medical team?

• If I want a second opinion, could you provide me with the names of physicians and/or institutions that you would recommend?

Pancreatic Cancer -3

2011-05-27T18:14:00.000-07:00

PANCREATIC CANCER

4^th leading cause of cancer deaths in G and E. 25,000 cases/yr in the U.S. and nearly that # of deaths. Vast majority of pts present w/unresectable disease & 5 yr survival is ~ 5%.

Cause of tumor is unknown. Risk factors include smoking & chronic pancreatitis.

1/2 of pancreatic Ca arise in the head, 1/2 in the body and tail.

Distal common bile duct runs through pancreatic head. Pancreatic Ca most often occur in this area making this tumor the most commonly associated w/malignant biliary obstruction.

Courvoisier' s law: Obstructing malignancies of the distal CBD produce a palpable non-tender gallbladder. Why? Because common duct stones (the main DDx) are usually associated w/chronic cholecystitis à contracted gallbladder.

Pancreatic Adenocarcinoma

Clinical manifestations depend on location where the tumor arises. Does not announce its presence unless bile duct is obstructed.

1. Arising in the head: tend to obstruct the common bile duct, causing jaundice or distended, non-tender gall bladder. May be able to palpate bile duct in thin patient.

2. Otherwise non-specific: weight loss and pain (due to neural invasion of the tumor).

3. Laboratory tests are not specific.

Imaging studies:

Endoscopic US

MRI

Dilated bile duct & pancreatic duct may suggest mass in pancreas.

CEA and CA 19-9 tend to be

Although US and radiologic imaging have diagnostic accuracy, it is not easy to make diagnosis in an early stage. Because of the difficulty of diagnosis, only 10-15% are candidates for surgery.

Treatment:

Surgical resection: Potentially "curative" surgery is only possible in 10-15% of pts who present w/early tumors à jaundice due to bile duct obstruction.

1. Whipple's procedure: proximal pancreatectomy, duodenectomy, partial gastrectomy and gastrojejunostomy.

2. Palliation: biliary bypass, chemotherapy, radiation.

Prognosis: Dismal. 5 year survival is approximately 5%. 5-year survival of patients who under surgical resection for cure is only 10%. The mean survival for patients with surgically unresectable tumors is 5 months. Palliative treatment is aimed at relieving biliary obstruction and treating pain.

Pancreatic Islet Cell Tumors

Tumors arising in endocrine portion of the pancreas are rare compared to adenocarcinomas. They can be benign or malignant, and functional (release hormones) or non-functional. Distinct clinical syndromes associated with hyperfunctioning islet cells include insulinoma, gastrinoma (Zollinger-Ellison syndrome), glucagonoma, and somatostatinoma

Pancreatic Cancer

2011-05-27T18:13:00.000-07:00

THE PANCREAS

The pancreas is located in the abdomen, tucked behind the stomach. between the upper part of your small intestine (duodenum) and the spleen. It is shaped somewhat like a tadpole - fat at one end and slender at the other - and is around 25cm in length.

The pancreas serves two distinct and vital functions;

1. The exocrine pancreas

Once food has been mulched and partially digested by the stomach, it is pushed into the duodenum (first part of the small intestine). The pancreas helps to digest food, particularly protein. Most of the pancreas is compose of cells called exocrine cells that produce digestive enzymes. Pancreatic enzymes flow from these cells through small ducts into the main pancreatic duct, which leads to the duodenum. Pancreatic juices contain enzymes that only become activated once they reach the duodenum. This is to prevent the protein-digesting enzyme trypsin from 'eating' the protein-based pancreas or its duct. Other enzymes produced by the pancreas include amylase (to break down carbohydrate) and lipase (to break down fats).

The exocrine pancreas also makes sodium bicarbonate, which helps to neutralise stomach acid entering the duodenum.

2. The endocrine pancreas

The pancreas makes the hormone insulin, which helps to control blood sugar levels. Insulin is manufactured by a small clump of pancreatic cells called the 'islets of Langerhans'. High blood sugar levels prompt the release of insulin, so that the sugars can pass into cells. The endocrine pancreas also
makes glucagon, another hormone involved in the regulation of blood sugar.

DIAGNOSIS OF PANCREATIC DISEASE

Diagnostic methods depend on the disorder under investigation, but may include:

· General tests - such as blood tests, physical examination and x-rays.

· Ultrasound - sound waves form a picture of the pancreas.

· Computerised tomography (CT) scan - a specialised x-ray takes three-dimensional pictures of the pancreas.

· Magnetic resonance imaging (MRI) - similar to a CT scan, but
magnetism is used to build three-dimensional pictures.

· Endoscopy (ERCP) - a thin telescope is inserted down the throat. This device may be used to inject contrasting dye into the pancreatic duct prior to x-rays.

· Laparoscopy - the pancreas is examined through a slender instrument
inserted into the abdomen.

· Biopsy - a small tag of pancreatic tissue is taken out with a needle and examined in a laboratory.

PANCREATITIS

The pancreas plays important roles in both digestion and metabolism. These functions may be affected by pancreatitis, an inflammatory condition that occurs when pancreatic digestive enzymes become active within the gland and attack the pancreas itself.

Pancreatitis can be acute — appearing suddenly and lasting for a few days — or it can be chronic, developing gradually and persisting over many years. Both acute and chronic pancreatitis are marked by mild to severe abdominal pain, often with nausea, vomiting and fever. Both can lead to serious complications.

Heavy alcohol use and gallstones are the primary causes of pancreatitis, but other factors, including certain medical conditions, some drugs and genetic mutations also can lead to the disorder. Sometimes the cause is never found..

ACUTE PANCREATITIS

Acute pancreatitis is inflammation of the pancreas. This is a medical emergency and requires prompt treatment. It occurs when the pancreas suddenly becomes inflamed - the enzymes can't leave the pancreas and so cause irritation and burning. Enzymes may also leech into the abdominal cavity.

The two most common causes for pancreatitis are:

· Drinking too much alcohol

· Gallstones

Other causes include:

· Medications such as corticosteroids, nonsteroidal anti-inflammatory drugs, thiazides used for blood pressure lowering, antibiotics including tetracyclines and sulphonamides and immunosuppression with azathioprine and 6-mercaptopurine.

· Increased levels of triglycerides (fats) or calcium in the blood.

· Viral infections including mumps

· Damage or trauma to the pancreas

· Pancreatic cancer

Acute pancreatitis comes on suddenly, usually with mild to severe pain in the upper abdomen that may radiate through to the back and occasionally to the chest. The pain may be nearly constant for hours or even days and is likely to be worse with food. Bending forward or curling into a fetal position may provide some temporary relief.

Apart from pain the presentation may feature:

· Nausea and vomiting

· Fever

· Rapid pulse

· Swollen, tender abdomen

When severe, dehydration, internal bleeding, low blood pressure or shock

DIAGNOSIS

If acute pancreatitis is suspected, the doctor will arrange blood tests to look for:

· Elevated levels of pancreatic enzymes—amylase or lipase

· Elevated white cell count

· High blood sugar

· Elevated liver enzymes and bilirubin

· Low calcium levels

· Oxygen status

Because laboratory tests can't confirm a diagnosis of acute pancreatitis, the doctor may request an ultrasound or computerized tomography (CT) scan of your abdomen to examine your pancreas and to check for gallstones, a duct problem, or destruction of the gland. You may also have X-rays of your abdomen and chest to rule out other reasons for your symptoms.

COMPLICATIONS

Severe cases of acute pancreatitis may lead to a number of complications:

· Infection A damaged pancreas may become infected with bacteria that spread from the bowel into the inflamed pancreas. The infection may also spread to the blood-stream. Signs of infection include fever and an elevated white blood cell count. Pancreatic infections can be fatal without intensive treatment which may include drainage and surgical removal to remove infected and/or dead tissue. Sometimes multiple such operations are needed. Multi-organ failure may also occur.

· Pseudocysts These are collections of pancreatic fluid and tissue debris that form within the pancreas or in an obstructed duct. If small no specific treatment may be necessary but if large, bleeding or infected then urgent measures are needed.

· Abscess A collection of pus in or near the pancreas. Treatment involves drainage by needle, catheter or surgery.

· Respiratory failure Chemicals circulating in the blood can effect lung function, causing the level of oxygen in the blood to fall to low levels.

TREATMENT

Acute pancreatitis usually requires admission to hospital. Severe cases or those with complications often need admission to an Intensive Care Unit. Treatment goals include controlling the pain, allowing the pancreas to rest, careful fluid balance and maintaining full respiratory function.

Because the pancreas goes into action whenever you eat, you won't be able to eat or drink for a few days. Instead, you'll receive fluids and nutrition through a vein (intravenously). Your doctor may also feed you through a tube that's been passed into your stomach and intestine so that it goes past the pancreas. Placing the tube in the bowel beyond the pancreas ensures that the pancreas is not stimulated, yet you can still receive the nutrition you need.

When gallstones block the pancreatic duct, your doctor may recommend a procedure to remove the stones. You may eventually need surgery to remove your gallbladder if gallstones continue to pose problems.

Mild cases of acute pancreatitis generally improve in a week or less. Moderate to severe cases take longer.

CHRONIC PANCREATITIS

Chronic pancreatitis means recurring bouts of inflammation, even when known triggers (such as alcohol) are eliminated. Alcoholics are at increased risk of developing this condition. The relentless inflammation eventually damages or destroys parts of the pancreas, reducing its function. Symptoms include digestive upsets and passing fatty, foul-smelling stools.

In addition to pain, one may experience the following with chronic pancreatitis:

· Nausea and vomiting

· Fever

· Weight loss, even when appetite and eating habits are normal

· Oily, malodorous stools resulting from poor digestion and malabsorption of nutrients, particularly fats (steatorrhea)

· Diabetes

DIAGNOSIS

Diagnosing chronic pancreatitis can be challenging because some tests may yield normal results. It can also be difficult to distinguish acute from chronic pancreatitis. Even so, certain tests can help rule out other problems and aid in the diagnosis.

These include:

· Blood tests.

· Stool test. This measures the fat content in feces. Chronic pancreatitis often causes excess fat in the stool because the fat isn't digested and absorbed normally by the small intestine.

· Pancreatic function test. If there is weight lost or the doctor suspects a malabsorption problem, a pancreatic function test can be used. Several tests exist but are not commonly used.

· Ultrasound. In standard (external) ultrasound, a wand-like device (transducer) is placed on the body. It emits inaudible sound waves that are reflected to the transducer and then translated into a moving image by a computer.

· Endoscopic ultrasound may provide images of the pancreas and bile and pancreatic ducts that are superior to those produced by standard ultrasound.

· ERCP (X-ray of bile and pancreatic ducts). The doctor gently threads an endoscope down the throat and through the stomach to the opening of the bile and pancreatic ducts in the duodenum. A dye passed through a thin, flexible tube (catheter) inside the endoscope allows for X-ray images of the ducts.

The complications common to acute pancreatitis can also occur in the chronic form of the disease. In addition, chronic pancreatitis can lead to:

· Bleeding. Ongoing inflammation and damage to the blood vessels surrounding the pancreas can cause potentially fatal bleeding.

· Malnutrition and weight loss. Lack of digestive enzymes prevents your body from absorbing nutrients from food. The result is often unintended weight loss and malnutrition.

· Diabetes. Damage to insulin-producing cells can lead to diabetes, a disease that affects the way your body uses blood sugar.

· Drug addiction. Because medical treatments for severe pancreatic pain aren't always effective, people with pancreatitis may become addicted to pain medications.

· Pancreatic cancer. Long-term inflammation of the pancreas increases your risk of pancreatic cancer, one of the most serious of all malignancies.

TREATMENT

The main goals of treatment for chronic pancreatitis are to help stop alcohol and drug abuse, control pain and improve malabsorption problems.

. Pain relief. Unlike acute pancreatitis, in which the pain often disappears within a few days to weeks, chronic pancreatitis pain can linger. However, conventional pain relievers can be ineffective and pose a real risk of addiction. Using potent pancreatic enzymes to treat pain has proved effective for some people. Enzyme therapy works by increasing the levels of enzymes in the duodenum, which in turn decreases the secretion of enzymes by the pancreas. This is thought to reduce secretion pressure — and hence, pain — within the pancreas. For severe pain that can't be controlled, treatment options include surgery to remove damaged tissue or procedures to block pain signals or deaden the nerves transmitting the pain.

Enzyme therapy. Enzyme supplements such as pancreatic lipase (Pancrease) can help treat malabsorption problems. By replacing missing enzymes, these tablets help restore normal digestion and improve steatorrhea, leading to weight gain and enhanced well-being. These supplements are generally taken before and during meals and snacks.

Dietary changes. Your doctor may recommend eating smaller meals and limiting fats, which will help reduce your need for as many digestive enzymes.

Diabetes
Chronic pancreatitis can cause diabetes in some people. Treatment usually involves maintaining a healthy diet and getting regular exercise. Some people also need insulin injections, although insulin must be used cautiously because of the risk of low blood sugar (hypoglycemia).

Therapy for alcohol dependency. This may be the most important step in treating alcohol-related pancreatitis. In the early stages of the disease, simply stopping drinking may relieve even severe pain. People who don't stop drinking have a significantly higher chance of dying of pancreatitis

Pancreatic Cancer

2011-05-27T18:12:00.001-07:00

Pancreatic Cancer

Endocrine Pancreatic Cancer

Definitions

Endocrine: Relating to the endocrine glands and the hormones, such as insulin, which are secreted by those glands.

Islet cells: Pancreatic cells that produce insulin and other hormones.

Malignant: Cancerous and capable of spreading.

Pathologist: A physician who examines tissues and fluids to diagnose disease in order to assist in making treatment decisions.

What is endocrine pancreatic cancer?

Endocrine pancreatic cancer, also known as islet cell cancer, is a rare cancer. Only about 5 percent of the more than 37,000 annual cases of pancreatic cancers begin in the islet cells. When islet cells become neoplastic, they may make too much insulin and other types of hormones. Different types of endocrine pancreatic cancer have different names. The three most common types are:

· Gastrinoma, which makes large amounts of the gastrin hormone, causing increased stomach acid and leading to ulcers.

· Insulinoma, which makes too much insulin, causing the body to store sugar rather than burn it for energy. Insulinoma can cause hypoglycemia (low blood sugar levels).

· Glucagonoma, which produces too much of the glucagons hormone, causing too much blood sugar, resulting in a condition called hyperglycemia.

Who is most likely to have endocrine pancreatic cancer?

Endocrine pancreatic cancer is more common among men and African-Americans. Risk factors include smoking, long-standing diabetes, chronic pancreatitis, and certain hereditary conditions including hereditary pancreatitis, multiple endocrine neoplasia type 1 syndrome, hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome), von Hippel-Lindau syndrome, ataxia-telangiectasia, and the familial atypical multiple mole melanoma syndrome. Other risk factors include a family history of pancreatic cancer, older age, and obesity. Exposure to certain pesticides, dyes, or chemicals related to gasoline is another risk.

What characterizes endocrine pancreatic cancer?

Endocrine pancreatic cancer is difficult to detect early because its symptoms are similar to other illnesses and because the pancreas is hidden behind other organs. Often, this type of cancer is not detected until it has spread. Symptoms include abdominal pain, diarrhea, chronic fatigue, fainting, or weight gain without eating too much. These symptoms, coupled with the risk factors described earlier, warrant a trip to see a doctor as soon as possible.

(continued on next page)

How does the pathologist diagnose endocrine pancreatic cancer?

Your primary care physician will order blood and urine tests for the pathologist to examine for the amounts of endocrine hormones in the body. Your medical team also may order imaging tests such as chest x-rays; CT, PET or MRI scans; or endoscopic ultrasound (EUS) to view inside the body.

Laparoscopy allows physicians to view inside the body using a thin, lighted tube inserted through small incisions in the abdominal wall. Endoscopic retrograde cholangiopancreatography (ERCP) examines the bile ducts for narrowing or blockages sometimes associated with pancreatic cancer. Biopsy specimens, or tissue samples, can be gathered during these procedures.

What else does the pathologist look for?

The pathologist reviews the biopsy specimens and the results of all tests to make a diagnosis. If cancer is found, the pathologist will determine the stage of the cancer. Stage 1 endocrine pancreatic cancers are small and confined to the pancreas, and stage 4 tumors have spread beyond areas near the pancreas. Stages 2 and 3 describe conditions in between these two extremes. The chance of recovery depends on the type of endocrine pancreatic cancer, how far the cancer has spread, and your overall health.

How do doctors determine what treatment will be necessary?

The pathologist consults with your primary care physician or specialist after reviewing the test results and determining the stage of the cancer. Together, using their combined experience and knowledge, they determine treatment options most appropriate for your condition. It’s important to learn as much as you can about your treatment options and make the decision that’s right for you.

What kinds of treatments are available for endocrine pancreatic cancer?

Endocrine pancreatic cancer can be treated with surgery, chemotherapy, hormone therapy, or a combination of these methods. In addition, patients may have treatment to control pain or ease emotional or practical problems.

Surgery, the most common treatment, removes the cancerous tumor, part or all of the pancreas, and sometimes other tissues or organs. Surgical options include:

· The Whipple procedure, in which the head of the pancreas, the gallbladder, the bile duct, and parts of the stomach and small intestine are removed

· Total pancreatectomy, which removes the entire pancreas, the common bile duct, the gallbladder, the spleen, and parts of the stomach and small intestine

· Distal pancreatectomy, which involves removing the body and tail of the pancreas and usually the spleen

If the cancer has spread and cannot be removed, other surgical procedures may be used to relieve pain and other symptoms.

(continued on next page)

If the cancer has spread outside the pancreas–or if there is a chance it has–your doctor may recommend chemotherapy. This treatment delivers drugs throughout the body, and may slow the cancer’s progression and reduce pain. Systemic chemotherapy delivers drugs throughout the body, while regional chemotherapy directs the drugs into a particular organ or area of the body, such as the pancreas or abdomen.

The most commonly used chemotherapy drug is 5-fluorouracil (5-FU). Recent studies, however, show gemcitabine to be more effective. Further studies comparing the effectiveness of these two drugs in treating various types of cancers are in progress, as well as other studies combining these two drugs with each other or other chemotherapy drugs.

Hormone therapy may stop cancer cells from growing and relieve pain and other symptoms caused by excessive hormone production. Octreotide is the most commonly used hormone-related medication. Scientists continue to investigate the effectiveness of other treatment approaches.

Clinical trials of new treatments for endocrine pancreatic cancer may be found at www.cancer.gov/clinicaltrials. These treatments are highly experimental in nature but may be a potential option for advanced cancers. Some trials may involve biologic therapy, which uses the natural defenses of the immune system to fight cancer.

For more information, go to www.cancer.gov (National Cancer Institute) or www.cancer.org (American Cancer Society). Type the keywords pancreatic cancer or islet cell cancer or into the search box.

What kinds of questions should I ask my doctors?

Ask any question you want. There are no questions you should be reluctant to ask. Here are a few to consider:

• Please describe the type of cancer I have and what treatment options are available.

• What is the stage of my cancer?

• What are the chances for full remission?

• What treatment options do you recommend? Why do you believe these are the best

treatments?

• What are the pros and cons of these treatment options?

• What are the side effects?

• Should I receive a second opinion?

• Is your medical team experienced in treating the type of cancer I have?

• Can you provide me with information about the physicians and others on the

medical team?

Thyroid Cancer

2011-05-26T01:53:00.000-07:00

Thyroid Cancer

Medullary Thyroid Cancer

Definitions

Thyroid gland: Located at the base of the throat, an organ that makes hormones affecting heart rate, blood pressure, body temperature, and weight.

Calcitonin: A hormone found in the “C cells” that controls calcium and phosphorus levels in the blood.

Nodules: Cellular growths in the thyroid gland. These growths are usually benign but may be cancerous.

Pathologist: A physician who examines tissues and fluids to diagnose disease in

order to assist in making treatment decisions.

What is medullary thyroid cancer?

About 33,500 Americans are diagnosed with thyroid cancer each year, with incidence rates increasing by about 11 percent annually. Medullary thyroid cancer makes up about 3 percent of these cases. Because medullary thyroid cancer can spread to the lymph nodes and to other organs early in its progression, it is easier to control if found and treated before it spreads. This type of cancer begins in the C cells of the thyroid and makes abnormally high levels of calcitonin. About 1,500 Americans die from all types of thyroid cancer each year. This relatively low death rate is due to successful early

detection and treatment in most cases.

Who is likely to have medullary thyroid cancer?

Women are more likely than men to have medullary thyroid cancer. Most cases afflict individuals between the ages of 30 and 60. Another risk factor includes having a family history of multiple endocrine neoplasia syndrome. This includes tumors/cancers of various endocrine organs such as the thyroid gland, parathyroid glands, pancreas, and adrenal glands. Medullary thyroid cancer may occur in patients without a family history of endocrine organs cancers, as well, however.

What characterizes medullary thyroid cancer?

Medullary thyroid cancer is a unique type of thyroid cancer arising from the neuroendocrine cells of the thyroid gland referred to as C cells. Due to its malignant nature, this cancer can become life-threatening by spreading via blood vessels and lymphatic channels to lymph nodes or distant organs such as the lungs and bones, as well as to other tissues.

(continued on next page)

Nodules can be detected when your primary care physician checks your neck and throat and feels the thyroid for lumps. Otherwise, early thyroid cancer does not have symptoms. If the cancer grows, symptoms may include a lump in the front of the neck, hoarseness or voice changes, swollen neck lymph nodes, trouble swallowing or breathing, or throat or neck pain.

How does the pathologist make the diagnosis?

If your symptoms suggest the possibility of thyroid cancer, your primary care physician will order a blood test that the pathologist will check for abnormal levels of calcitonin. The pathologist will also check for a high level of calcitonin. Blood test results also can show a changed RET (Rearranged during Transfection) gene passed from parent to child; almost everyone with this changed gene develops medullary thyroid cancer. If you have the RET gene, you should have your children evaluated for medullary thyroid cancer. Your primary physician may recommend the option of having their thyroids surgically removed before cancer develops and having them take thyroid hormone pills throughout their lives.

What else does the pathologist look for?

Your primary care physician may also order an ultrasound and thyroid scan, which are reviewed by radiologists. The removal of cells by fine-needle aspiration (FNA) or tissue by a biopsy are sent to the pathologist for examination. An ultrasound or thyroid scan can create images of thyroid nodules that the radiologist can view for signs of cancer. An FNA or a biopsy, however, are the only potential sure ways to diagnose cancer.

What is meant by the stage of the cancer?

Your pathologist and primary care doctor determine the cancer’s stage to plan the best treatment. This process involves finding out the size of the cancerous nodule, whether or not the cancer has spread and, if so, to what parts of the body. Thyroid cancer spreads most often to the lymph nodes, lungs, and bones. Stage 1 cancers are small and confined to the thyroid, and stage 4 tumors have spread well beyond the thyroid. Stages 2 and 3 describe conditions in between these two extremes.

Staging may involve tests including ultrasound, CT or MRI scans, chest x-rays, or whole body scans. These tests enable the pathologist to determine where the cancer has spread and its stage.

How do doctors determine what treatment will be necessary?

(continued on next page)

What kinds of treatments are available for medullary thyroid cancer?

Medullary thyroid cancer may be treated with surgery, external radiation therapy, thyroid hormone treatment, or chemotherapy. Many patients receive a combination of these treatments. Surgery and external radiation therapy are local therapies that remove or destroy cancer in the thyroid. When the cancer has spread beyond the thyroid, these two therapies can control the disease in the thyroid. Medullary thyroid cancer patients receive a total thyroidectomy (removal of the thyroid). A surgeon also removes all fatty tissue and lymph nodes in the central neck area near the tumor. External radiation therapy is generally used after surgery; this therapy uses high-energy beams projected from outside the body to destroy any remaining cancer.

Thyroid hormone treatment and chemotherapy are systemic therapies that are delivered through the bloodstream to destroy or stop the progression of cancer cells present throughout the body. These therapies also can reduce pain.

Any of these treatments may cause side effects and alter your normal activities. Ask your primary care physician to explain possible side effects thoroughly so that you know what to expect. Because your treatment will remove your thyroid, you will be required to take thyroid hormone pills for the rest of your life to replace the natural thyroid hormone. Because the surgeon may remove the parathyroid glands, located behind the thyroid, you may need to take calcium and vitamin D supplements for the rest of your life.

Follow-up care is very important because thyroid cancer comes back in up to 30 percent of all cases. Also, if you receive external radiation therapy, you have an increased chance of developing other cancers later in your life. You should receive regular blood tests to check your levels of TSH and thyroglobulin (thyroid hormone stored in the thyroid). Your physicians also may recommend repeating some of the diagnostic and staging tests to see if the cancer has returned.

Clinical trials of new treatments for medullary thyroid cancer may be found at www.cancer.gov/clinicaltrials. These treatments are highly experimental in nature but may be a potential option for advanced cancers. Some trials may involve biologic therapy, which uses the natural defenses of the immune system to fight cancer.

(continued on next page)

What kinds of questions should I ask my doctors?

Ask any question you want. There are no questions you should be reluctant to ask. Here are a few to consider:

• Please describe the type of cancer I have and what treatment options are available.

• What is the stage of my cancer?

• What are the chances for full remission?

• What treatment options do you recommend? Why do you believe these are the best treatments?

• What are the pros and cons of these treatment options?

• What are the side effects?

• Is your medical team experienced in treating the type of cancer I have?

• Can you provide me with information about the physicians and others on the medical team?

• If I want a second opinion, could you provide me with the names of physicians and/or institutions that you would recommend?

Cancer Information

What type of Treatments available

Cervical Cancer

Eat Fruit and Veggies to Cut Lung Cancer Risk

Eat Fruit and Veggies to Cut Lung Cancer Risk

The Causes and Risk Factors for Liver Cancer

The Causes and Risk Factors for Liver Cancer

Breast Inflammation Key to Cancer Growth

Breast Inflammation Key to Cancer Growth

Cancer Vaccines

Cancer Vaccines

The Anti-Cancer Diet

The Anti-Cancer Diet

By Dr. Ben Kim DrBenKim.com

Bone Cancer Treatment

Bone Cancer Treatment

Scientists reverse stance on sun and cancer: Now they admit sunlight can prevent skin cancer

Does drinking lots of coffee really help to prevent breast cancer?

Stomach Cancer

Symptoms

It is easier to prevent cancer than to cure it…

Cancer Symptoms Ignored

Cancer Treatment for Dogs and Cats

Cancer Treatment for Dogs and Cats

Basic Principles of Cancer Pathophysiology

gastric cancer

Classification

Classification of Gastric Neoplasms

Benign

Malignant

Distal gastric cancer

Cardiac gastric cancer

Gastric lymphoma

On the Origin of Cancer Cells

On the Origin of Cancer Cells

Energy of Respiration and Fermentation

Injuring of Respiration

Grana

Structure and Energy

Sleeping Cancer Cells

Summary

Thyroid Cancer

Breast Cancer

Testicular Cancer: Quick Facts

What is Testicular Cancer?

Who’s at risk?

Prevention

Symptoms

How is it diagnosed?

Treatment options

Testicular Cancer Facts

CHILDHOOD CANCER FACTS

Non-Hodgkin Lymphoma

Pancreatic Cancer -3

Pancreatic Cancer

Pancreatic Cancer

Thyroid Cancer

By Dr. Ben Kim
DrBenKim.com