FAQ's

FAQ's

Adrenal Cancer

What is Adrenal Cancer?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start in adrenal gland, they cause adrenal cancer.

Anatomy of adrenal glands

Anatomy of Adernal Cancer

Copyright © The McGraw- Hill Companies, Inc. The above image is used for educational purpose only.

What are the general symptoms of Adrenal Cancer?

In about 50% of the people, the symptoms appear due to hormone secretions by the tumour. In other cases, the tumour has grown large enough to press against other organs and cause discomfort.

Symptoms caused by androgen or estrogen production

These are usually seen in children. The most common symptoms are as follows:

  • Excessive growth of facial and body hair
  • Male hormones may also enlarge the penis in boys or the clitoris in girls.

Symptoms caused by cortisol production

  • Weight gain, usually greatest above the collar bone and around the abdomen
  • Fat deposits behind the neck and shoulders
  • Purple stretch marks on the abdomen
  • Excessive hair growth on the face, chest, and back in women
  • Menstrual irregularities
  • Weakness and loss of muscle mass in the legs
  • Easy bruising
  • Depression and/or moodiness
  • Weakened bones (osteoporosis), which can lead to fractures
  • High blood sugar, often leading to diabetes
  • High blood pressure

Symptoms caused by aldosterone production

  • High blood pressure
  • Weakness
  • Muscle cramps
  • Low blood potassium levels

Symptoms due to large size of tumour

  • Pain near the tumour
  • A feeling of fullness in the abdomen
  • Trouble eating because of a feeling of filling up easily.

What are the general causes of Adrenal cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • Genetic syndromes
  • Smoking
  • Sedentary lifestyle
  • High-fat diet
  • Exposure to cancer-causing substances

Can Adrenal Cancer be prevented?

It can be prevented to a certain extent by avoiding the risk factors.

What are the stages of Adrenal cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In Adrenal cancer, the stage depends on whether it is confined to the origin of the cancer (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Adrenal cancer?

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

 

Medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

 

Can Adrenal Cancer be detected early?

It is difficult to diagnose Adrenal Cancer early, especially in adults. In children, it is usually much easier because the effects of the hormonal changes start to appear early. The best bet is to pay attention to the signs and symptoms and visit a doctor.

What are the Treatments available?

Based on the type and stage of the cancer and other factors, primary treatment options include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Other drugs

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should probably visit a doctor. You can also get your genetic make-up tested to see if you are prone to adrenal cancer.
 

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Bile Duct Cancer

What is Bile Duct Cancer?

Bile Duct

The Bile Ducts are a series of thin tubes that collect bile from the liver and gall bladder and pass it to the small intestine. Two Bile Ducts originate from the liver and one comes from the gallbladder, they join to form the common Bile Duct.

Bile Ducts collect this bile, draining it into the gallbladder and finally into the small intestine where it aids in the digestion process.

Functions:

  • The major function of the Bile Ducts is to move a fluid called bile from the liver and gallbladder to the small intestine.
  • Bile is needed for digesting food. Its main role is to break down fats.

Bile Duct Cancer

Bile Duct Cancer also known as Cholangiocarcinoma is a rare form of cancer that arises from the cells that line the Bile Ducts . Cholangiocarcinoma occurs when cells in the Bile Ducts develop mutations in their DNA. Due to which, cells may begin to grow out of control and eventually develop into a tumor. Cholangiocarcinoma are most commonly found just outside the liver in the perihilar area. It is a slow-growing cancer that invades local structures, so the diagnosis is often delayed till the Bile Duct gets blocked. This blockade prevents bile drainage from the liver into the gallbladder and intestine. Depending upon where the blockage occurs, this can lead to inflammation of the liver (hepatitis) and/or pancreas (pancreatitis).

Types of Bile Duct Cancer

Bile Duct Cancer can start anywhere along the Bile Ducts . It is classified into different types depending on the location of origin.

  • Intrahepatic cholangiocarcinoma : It develops in the smaller Bile Duct branches inside the liver. They contribute only a small number of total occurrences of Bile Duct Cancers.

  • Extrahepatic Bile Duct Cancers
    The extrahepatic Bile Duct is made up of the hilum region and the distal region. Cancer can form in either region:

    • Perihilar Bile Duct Cancer : It occurs in the hilum region. Perihilar Bile Duct Cancer is also called Klatskin tumor or perihilar cholangiocarcinoma.
    • Distal extrahepatic Bile Duct Cancer : These cancers are found further down the Bile Duct, closer to the small intestine.

    • Multifocal Bile Duct Cancer : means that there's more than one tumor and they're in different sections of the bile.

Anatomy of Bile Duct Cancer

bile-duct-anatomy

(We can add link to the next topic i.e. Symptoms of Bile Duct Cancer)

What are the general symptoms of Bile Duct Cancer?

Bile Duct Cancer is a rare form of cancer and the signs and symptoms are not specific to Bile Duct Cancer only. They may be triggered by some other illness as well. The initial symptoms of Bile Duct Cancer occur mostly because of the blockage that interrupts bile to drain normally from the liver. Unfortunately, Bile Duct tumors may not cause any symptoms until they have grown in size and the cancer has spread beyond its original location. Some of the symptoms of Bile Duct Cancer include:

  • Jaundice
    Jaundice is often the most common symptom of Bile Duct Cancer. Jaundice occurs when the liver can’t get rid of bile, which contains a greenish-yellow chemical called bilirubin.
  • Light-colored/greasy stools
    Bilirubin contributes to the brown color of bowel movements. If the cancer blocks the release of bile and pancreatic juices into the intestine, the digestion of fatty foods becomes difficult. The undigested fat can also cause stools to be unusually pale. They might also be bulky, greasy and float in the toilet.
  • Dark urine
    When bilirubin levels in the blood get high, it can also come out in the urine giving it a dark shade.
  • Itching
    Most people with Bile Duct Cancer notice itching caused by the excess bilirubin.
  • Abdominal (belly) pain
    Early Bile Duct Cancers usually do not cause pain, but more advanced cancers may cause abdominal pain, especially below the ribs on the right side.
  • Loss of appetite/weight loss
  • Fever
  • Nausea and vomiting

Bile Duct Cancer is a rare form of Cancer and there is a possibility of encountering these symptoms in many other health problems including gall stones.

What are the general causes of Bile Duct Cancer?

For most cases of Bile Duct Cancer, it is very difficult to trace the exact cause of the disease. However, there are certain factors that are known to have increased the risk. People with long-term swelling or irritation in the Bile Ducts are more likely to get this cancer. People with a bowel disease called ulcerative colitis are also at higher risk. Infection with the liver fluke parasite is also a cause of large number of Bile Duct Cancers. Some other risk factors are discussed below:

  • Chronic liver disease :
    Scarring of the liver caused by a history of chronic liver disease increases the risk of cholangiocarcinoma. Primary Sclerosing Cholangitis that causes long-term inflammation of the liver, Biliary Stones within the Liver are some common liver troubles that end up in Cancer.
  • Choledochal cyst :
    It causes dilated and irregular Bile Ducts , and increases the risk of developing cholangiocarcinoma severely.
  • Older age :
    Cholangiocarcinoma occurs most often in adults over age 50.
  • Inflammatory bowel disease :
    Inflammatory bowel disease includes ulcerative colitis and Crohn’s disease. People with these diseases have an increased risk of Bile Duct Cancer.
  • Family history :
    A history of Bile Duct Cancer in the family seems to increase a person’s chances of developing this cancer, but the risk is still low because this is a rare disease.
  • Exposure to certain chemicals and toxins,
    including thorotrast (a special dye that used to be used in medical scans)
  • Other possible risk factors :
    Studies have found several other factors that might increase the risk of Bile Duct Cancer, but the links are not as clear. These include:
    • Smoking
    • Alcohol
    • Diabetes
    • Obesity
    • Infection with HIV
    • Exposure to chemicals and other radioactive chemicals

Can Bile Duct Cancer be prevented?

There is no proven theory to prevent Bile Duct Cancers. As with all diseases that tend to develop at an older age, living a healthy lifestyle may extend one’s lifespan. This includes not smoking, eating a balanced diet, keeping physically active, and maintaining a healthy weight.

Many of the known risk factors for Bile Duct Cancer, such as age, ethnicity, and Bile Duct abnormalities, are beyond our control. However, there are certain factors that could definitely be checked to keep the risk low. Some of them are:

  • Getting vaccinated against the hepatitis B virus (HBV) to prevent infection with this virus and the cirrhosis it can cause.
  • Take precautions to avoid blood-borne or sexually transmitted infections by HBV and other viruses to help prevent cirrhosis.
  • Treat hepatitis infections.
  • Avoid exposure to certain chemicals

What are the stages of Bile Duct Cancer?

Stage of cancer refers to the severity and spread of cancer cells. Once the specific type of cancer is diagnosed, it is assigned a particular stage ranging from 0 to IV. Stage 0 is also referred as carcinoma in situ. Depending on several factors and based on the stage, most effective treatment is planned.

Stages of Intrahepatic Bile Duct Cancer

  • Stage 0: Abnormal cells are found in the innermost layer of tissue lining the intrahepatic Bile Duct. These abnormal cells may become cancer and spread into nearby normal tissue.
  • Stage I: A tumor is spotted in the intrahepatic Bile Duct.
  • Stage II: This stage is assigned either when a tumor has spread through the wall of the Bile Duct and into a blood vessel, or there are multiple tumors that may have spread into blood vessel.
  • Stage III: The tumor has spread through the tissue that lines the abdominal wall or has spread to organs or tissues near the liver such as the duodenum, colon, and stomach.
  • Stage IV:
    • Stage IVA: The cancer has spread along the outside of the intrahepatic Bile Ducts or the cancer has spread to nearby lymph nodes.
    • Stage IVB: The cancer has spread to organs in other parts of the body.

Stages of Perihilar Bile Duct Cancer

  • Stage 0: Abnormal cells are found in the innermost layer of tissue lining the perihilar Bile Duct. These abnormal cells may become cancer and spread into nearby normal tissue.
  • Stage I: Cancer has formed in the innermost layer of the wall of the perihilar Bile Duct and has spread into the muscle layer or fibrous tissue layer of the wall.
  • Stage II: Cancer has spread through the wall of the perihilar Bile Duct to nearby fatty tissue or to the liver.
  • Stage III:
    • Stage IIIA: Cancer has spread to branches on one side of the hepatic artery or of the portal vein.
    • Stage IIIB: Cancer has spread to nearby lymph nodes. Cancer may have spread into the wall of the perihilar Bile Duct or through the wall to nearby fatty tissue, the liver, or to branches on one side of the hepatic artery or of the portal vein.
  • Stage IV:
    • Stage IVA: Cancer has spread to one or more of the following:
      • main part of the portal vein and/or common hepatic artery
      • branches of the portal vein and/or common hepatic artery on both sides
      • right hepatic duct and the left branch of the hepatic artery or of the portal vein
      • left hepatic duct and the right branch of the hepatic artery or of the portal vein.
      • Cancer may have spread to nearby lymph nodes.
    • Stage IVB: Cancer has spread to lymph nodes in more distant parts of the abdomen, or to organs in other parts of the body.

Stages of Distal extrahepatic Bile Duct Cancer

  • Stage 0: Abnormal cells are found in the innermost layer of tissue lining the distalextrahepatic Bile Duct.
  • Stage I:
    • Stage IA: Cancer cell is found in the distal extrahepatic Bile Duct wall only.
    • Stage IB: Cancer cells have spread through the wall of the distalextrahepatic Bile Duct but has not spread to nearby organs.
  • Stage II:
    • Stage IIA: Cancer has spread from the distal extrahepatic Bile Duct to the gallbladder, pancreas, duodenum, or other nearby organs.
    • Stage IIB: Cancer has spread from the distal extrahepatic Bile Duct to nearby lymph nodes. Cancer may have spread through the wall of the duct or to nearby organs.
  • Stage III: Cancer has spread to the large vessels that carry blood to the organs in the abdomen. Cancer may have spread to nearby lymph nodes.
  • Stage IV: Cancer has spread to organs in distant parts of the body.

Survival rates of Bile Duct Cancer?

Stage 5 year Survival Rate
Localized (Stage I) 15%
Regional Spread (Stage II & III) 6%
Distant Spread (Stage IV) 2%
Stage 5 year Survival Rate
Localized (Stage I) 30%
Regional Spread (Stage II & III) 24%
Distant Spread (Stage IV) 2%

Can Bile Duct Cancer be detected early?

Bile Ducts are located deep inside the body, so early tumors can’t be felt during routine physical exams. There are no specific tests that aids in early detection of Bile Duct Cancer. Furthermore, Bile Duct Cancer does not show any early stage symptoms. Hence, most Bile Duct Cancers are found only after the cancer has grown enough to cause signs or symptoms leaving only a small number of Bile Duct Cancers cases that have been detected early.

However, if there is any reason to suspect Bile Duct Cancer, complete medical history is checked for risk factors and symptoms.

Several tests may be needed to help diagnose Bile Duct Cancer. Most common tests are:

  • History and physical exam: Physical exam is conducted focusing mostly on the abdomen to check for any lumps, tenderness, or buildup of fluid. The skin and the white part of the eyes are also checked for jaundice.
  • Liver function tests: Blood sample is checked to measure the amounts of bilirubin and alkaline phosphatase released into the blood by the liver. A higher than normal amount of these substances can be a sign of liver disease that may be caused by Bile Duct Cancer.
  • Laboratory tests: Several tests may be done to check samples of tissue, blood, urine, or other substances in the body.
  • Blood test: is carried out to check level of bilirubin in the blood, as high level of bilirubin may indicate Bile Duct issues. Tests for albumin, liver enzymes (alkaline phosphatase, AST, ALT, GGT), in the blood are also taken into account. These tests are called liver function tests. High level of these substances might point to blockage of the Bile Duct, but they can’t ascertain the reason as Cancer.
  • Biopsy : where a small sample of tissue is removed so it can be looked at under a microscope for signs of Cancer
  • Scans : ultrasound scan, computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan
  • Ultrasound : High-energy sound waves are bounced off internal tissues or organs. The echoes form a picture of body tissues called a sonogram.
    • Abdominal ultrasound: This is helpful for cases with symptoms like jaundice or abdominal pain.
    • Endoscopic or laparoscopic ultrasound: An ultrasound transducer is placed near the Bile Duct, to get detailed images. The transducer is either passed through the mouth, and into the small intestine near the Bile Ducts (endoscopic ultrasound) or through a small surgical cut (laparoscopic ultrasound).
  • Computed tomography (CT) scan: A series of detailed pictures of areas inside the body are taken from different angles. The pictures are studied in a computer linked to an x-ray machine. CT scans can have several uses:
    • Highlights the area of tumor.
    • They can help stage the cancer.
    • CT angiography can be used to look at the blood vessels around the Bile Ducts . This can help determine if surgery is a treatment option.
    • CT scans can also be used to guide a biopsy needle into a suspected tumor or metastasis.
  • Magnetic resonance imaging (MRI) scan: MRI scans provide detailed images of soft tissues in the body using radio waves and strong magnets. A contrast material called gadolinium may be injected into a vein before the scan to better see details. Special types of MRI scans may also be used in people who may have Bile Duct Cancer:

    1. MR cholangiopancreatography (MRCP)
    2. MR angiography (MRA)
    • Cholangiography: A cholangiogram is an imaging test that looks at the Bile Ducts to see if they are blocked, narrowed, or dilated (widened). It can also be used to help plan surgery.
    • Magnetic resonance cholangiopancreatography (MRCP): This is a non-invasive way to image the Bile Ducts .
    • Endoscopic retrograde cholangiopancreatography (ERCP): In this procedure, an endoscope is passed down the throat, through the esophagus. A small catheter is passed into the common Bile Duct. A contrast dye is injected through the tube to help outline the Bile Ducts as x-rays are taken. The images can show narrowing or blockage of these ducts.
    • Percutaneous transhepatic cholangiography (PTC): In this procedure, a thin, hollow needle is placed through the skin of the belly into a Bile Duct within the liver. A contrast dye is then injected through the needle, and x-rays are taken as it passes through the Bile Ducts . Because it is more invasive, PTC is not usually used unless ERCP has already been tried or can’t be done for some reason.
    • Angiography: Angiography is an x-ray procedure for looking at blood vessels. For this test, a small amount of contrast dye is injected into an artery to outline blood vessels before x-ray images are taken. The images show if blood flow in an area is blocked or affected by a tumor, and any abnormal blood vessels in the area.

What are the Treatments available?

Treatment for Bile Duct Cancer depends upon where the cancer is located and whether it is possible for it to be completely removed by surgery. Unfortunately, those afflicted with this cancer tend to be older and may be unable to tolerate and recover from a major operation.

  • Surgery
    • Removal of the Bile Duct: A surgical procedure to remove part of the Bile Duct if the tumor is small. Lymph nodes are removed and tissue from the lymph nodes is viewed under a microscope .
    • Partial hepatectomy: The liver where cancer is found is removed.
    • Whipple procedure: The head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the Bile Duct are removed. Enough of the pancreas is left to make digestive juices and insulin.
  • Radiation therapy
    Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
    • External radiation therapy
    • Internal radiation therapy
  • Chemotherapy
    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by retarding their growth.
  • Photodynamic therapy
    A light-sensitive chemical is injected into a vein and accumulates in the fast-growing cancer cells. Photodynamic therapy can help relieve the signs and symptoms.
  • Biliary drainage
    It is a procedure to restore the flow of bile. It can involve bypass surgery to reroute the bile around the cancer or stents to hold open a Bile Duct being collapsed by cancer. Biliary drainage helps relieve signs and symptoms of cholangiocarcinoma.
  • Liver transplant
    In a liver transplant, the entire liver is removed and replaced with a healthy donated liver. A liver transplant is helpful mostly for perihilar Bile Duct Cancer.

Is there curative treatment for Bile Duct Cancer?

Bile Duct Cancer is mostly detected at a later stage when the cancer cell spreads and interrupts the normal functionality of the organs. Thus, making it very difficult to control and cure the cancer cells.

However, today there are several treatment options that can help control the symptoms for months or possibly years.

How frequently should one visit doctor for early diagnosis?

If there is any reason to suspect the occurrence of Bile Duct Cancer, consulting the doctor to get clarity is important. Also, if one is prone to the mentioned risk factors then regular blood tests and lab tests can aid in early detection of the disease thereby facilitating curative treatment.

How can I as a patient know it early?

Being aware of the symptoms, and any health issue that might indicate the presence of the disease needs to be examined thoroughly. Also, a few lab tests and regular tests can also sometime unveil the presence of the hideous disease.

Bladder Cancer

What is Bladder Cancer?

An abnormal growth of cells that starts invading the normal cells around it is called Cancer. When these abnormal tumor cells are present in the bladders, they lead to bladder cancer. These are malignant tumours. Cancer cells can also cause benign tumors sometimes grow large enough to cause problems, but they do not grow into nearby tissues or spread to distant parts of the body. The patient can usually be cured with surgery.

Anatomy of Bladder

Bladder Cancer Anatomy

The above image is used for educational purpose only.

What are the general symptoms of Bladder Cancer?

General symptoms of bladder cancer include:

  • Blood in the urine
  • Changes in bladder habits or symptoms of irritation
  • Bladder cancer can sometimes cause changes in urination, such as:
  • Having to urinate more often than usual
  • Pain or burning during urination
  • Feeling as if you need to go right away, even when the bladder is not full

Symptoms of advanced bladder canc

  • Being unable to urinate
  • Lower back pain on one side
  • Loss of appetite and weight loss
  • Swelling in the feet
  • Bone pain

These signs and symptoms of bladder cancer can also be caused by other conditions, including other bladder problems. However, it's important to get it checked so that the cause can be treated

What are the general causes of Bladder cancer?

Some of the causes and risk-factors for bladder Cancer include:

 

  • Smoking – Smokers are three times more likely to get bladder cancer than non-smokers.
  • Race and ethnicity - Whites are about twice as likely to develop bladder cancer as African Americans.
  • A ge  - The risk of bladder cancer increases with age.
  • Gender Bladder cancer is much more common in men than in women.
  • Chronic bladder irritation and infections
  • Personal history of bladder or other urothelial cancer
  • Bladder birth defects
  • Genetics and family history
  • Chemotherapy and radiation therapy
  • Arsenic in drinking water
  • Low Fluid Consumption

Can Bladder Cancer be prevented?

Most bladder cancers can be prevented by decreasing a person’s exposure to the risk factors listed under the “Causes” section.

What are the stages of bladder cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor  has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In bladder cancer, the stage depends on whether it is confined to bladders (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of bladder cancer?

Needless to say, if the bladder cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Of course, many people live much longer than 5 years (and many are cured).

The numbers below are based on thousands of people diagnosed with bladder cancer from 1988 to 2001. These numbers come from the National Cancer Institute's SEER database.

Stage Relative 5-year survival rate
0 98%
I 88%
II 63%
III 46%
IV 15%

Can bladder Cancer be detected early?

Your medical history and a physical exam to check for risk factors can help determine, to some extent, whether you have or are prone to bladder cancer.

If symptoms and/or the results of the physical exam suggest you might have bladder cancer, other tests will probably be done.

Screening

Screening tests or exams are used to look for a disease in people who have no symptoms (and who have not had that disease before).

Tests that might be used to screen for bladder cancer

 

  • Urinalysis
  • Urine cytology
  • Urine tests for tumor markers

What are the Treatments available?

The main types of treatment for bladder cancer are:

  • Surgery
  • Intravesical therapy
  • Chemotherapy
  • Radiation therapy

Surgery, alone or with other treatments, is used in nearly all cases.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor. You can also get your genetic make-up checked to see if you are prone to bladder cancer or not.

Bone Cancer

What is Bone Cancer?

Bone is a rigid organ that constitutes part of the vertebrate skeleton. It consists majorly of collagen and calcium phosphate. Collagen is a protein that provides a soft framework and calcium phosphate is a mineral that provides strengths and hardens the framework. This combination of collagen and calcium makes bone strong and flexible enough to withstand stress. An adult human body consists of 260 bones each serving a unique purpose.

Bones are composed of two types of tissue:

  • A strong, dense and hard outer layer, called cortical bone.
  • A spongy inner layer called trabecular bone.

Functions:

Bone serves multiple purposes in the human body. A few major functions are cited below:

  • It provides structural support for the body.
  • Bones protect internal organs from damage
  • Bone marrow makes and stores blood cells.
  • It also acts as a storage area for minerals.
  • Bones play a key role in body movement.

Bone Cancer

Bone Cancer begins as an error in a cell's DNA. The error directs the cell to grow and divide in an uncontrolled way. These cells go on living, rather than dying at a set time. The accumulating mutated cells form a mass (tumor) that can invade nearby structures or spread to other areas of the body. Bone cancer is classified into primary and secondary Bone Cancer.

Primary Bone Cancer originates in the bone cells and secondary Bone Cancer migrates to the bone cells. Primary Bone Cancer is far less common than Cancer that spreads to the bones.

Types of Bone Cancer

Bone Cancer is categorized into several subtypes depending on the area of their origin. Each of the subtypes is unique and need different treatment. Some of the most common types of Bone Cancer are as follows:

  • Osteosarcoma : It is the most common type of Bone Cancer accounting for 22 % of primary Bone Cancer in adults and 56% in children. It arises in the osteoid tissue of the bone. This tumor occurs mostly in the knee and upper arm areas of the body.
  • Chondrosarcoma : It is the second most common Bone Cancer , accounting for 35% of Bone Cancer occurrences. It occurs in the cartilaginous tissue. People older than 40 years are at a higher risk of developing this cancer. Chondrosarcoma is most commonly found in the bones of the hips and pelvis. Since it is largely resistant to chemotherapy and radiation treating planning the prognosis often poses a challenge.
  • The Ewing Sarcoma Family of Tumors (ESFTs): It is an aggressive and rare Bone Cancer that accounts for 8% of all Bone Cancer s in adults and 34% in children. ESFTs occur most commonly along the backbone and pelvis and in the legs and arms.
  • Pleomorphic sarcoma: Pleomorphic sarcomas are cancers of soft tissues. It is also a rare type of Bone Cancer and accounts for only 5% of cases.
  • Fibrosarcoma: It is an uncommon type of Bone Cancer and mostly arises behind the knee in adults.
  • Chordoma: Chordoma is a very rare cancer that poses a higher risk to people over 30 years of age. The lower or upper ends of the spinal column are the area where it is often located.
  • Spindle cell sarcoma: Spindle cell sarcoma is a rare type of Bone Cancer and tends to occur in adults over the age of 40.

Occurrence rate

There is no statistical report revealing the population-based incidence of Bone Cancer s in India. Bone sarcomas are rare tumours, approximating 0.2% of all cancers but malignant Bone Cancer cause significant morbidity and mortality. However, due to the advancement in surgical and medical oncology there have been some improvements in the survival of patients over the past few decades. Among the various types of bone sarcoma, Ewing sarcoma is the most common in India. The other common types being osteosarcoma (OGS), chondrosarcoma and synovial sarcoma.

 

Anatomy of Bone Cancer

Most common locations of Bone Cancer

What are the general symptoms of Bone Cancer?

People with Bone Cancer may experience some symptoms at a later stage when the cancer cells have spread to different organs of the body. The symptoms of Bone Cancer vary from one person to person depending on the location and size of the Bone Cancer and the previous health record of the patient. Generally, there is a gradual increase in the severity of the symptoms with time. Also, many of these symptoms might indicate some other health issue rather than Bone Cancer . So, it is recommended to consult a doctor, in case of spotting these symptoms, before reaching any conclusion.

When a bone tumour grows, it presses on healthy bone tissue and can destroy it, which causes the following symptoms:

  • Sustaining pain – Pain is the most common symptom of Bone Cancer . The pain starts off as occasional and then becomes severe and constant. This pain might get worsened by exercise or the pain hits back at night when the muscles are relaxed. In children, this symptom is often mistaken for a sprain. If a child or teenager has bone pain that persists during the night then it′s always best to have it checked out by a doctor.
  • Swelling - The swelling may not be felt until the tumour is quite large. It becomes more difficult to spot if the affected bone is deep within the body tissues.
  • Reduced movement - If the cancer is near a joint, then the patient might face difficulty in movement.
  • Broken bone – Cancer cells invade the healthy cells of the bone and make them fragile, which results in a fracture called pathological fracture.
  • General symptoms - These may include tiredness, a high temperature or sweats and weight loss.

What are the general causes of Bone Cancer?

The exact cause of Bone Cancer is yet not known. Over the course of time, some factors that might increase the risk of Bone Cancer are unveiled. Some risk factors known till date are discussed below:

  • Radiotherapy treatment
    Exposure to high doses of radiation may cause cancerous changes in the bone cells.
  • Bone conditions
    Certain conditions of the bone may increase the chances of developing Bone Cancer .
    • Paget’s disease of the bone sometimes increases the risk of Bone Cancer especially in older people over 50-60 years of age. Paget disease makes the bone heavy, thick, and brittle. They are weaker than normal bones and more likely to fracture. Bone Cancer develops in about 1% of those with Paget disease, usually when many bones are affected.
    • Ollier's disease is a rare condition of the bones that cause tumors to grow which can increase the risk of Bone Cancer .
  • Genetic conditions
    • A rare genetic condition called hereditary cancer predisposition, also known as Li-Fraumeni syndrome increases the risk of developing Bone Cancer to some extent. Li-Fraumeni creates a faulty version of a gene that usually helps stop the growth of tumours in the body. Sometimes, people with Li- Fraumeni develop multiple tumours often in their childhood or during adolescence.
    • Multiple exostose syndrome is an inherited condition that causes many bumps on a person’s bones. These bumps are made mostly of cartilage. They can be painful and deform and/or fracture bones. This disorder is caused by a mutation in any one of the 3 genes EXT1, EXT2, or EXT3. Patients with this condition have an increased risk of chondrosarcoma.
  • Other conditions
    • Retinoblastoma is a rare type of eye cancer which can sometimes lead to Bone Cancer , as the same inherited faulty gene can be responsible for both conditions. Also, if radiation therapy is used to treat the retinoblastoma, the risk of osteosarcoma in the bones around the eye is even higher.
    • Another syndrome that induces Bone Cancer is the Rothmund-Thomson syndrome
    • Babies born with an umbilical hernia are three times more likely to develop Ewing sarcoma.

Can Bone Cancer be prevented?

Most of the causes of Bone Cancer are hereditary or genetic that is beyond our control. However, leading a healthy life and taking certain precautions might aid in avoiding this deadly disease. Here are a few tips that are easy to follow and offer great resistance to the disease:

  • Being aware of the genes and locating if anyone in their bloodline has been diagnosed with the problem in the past.
  • Leading a healthy lifestyle and avoiding harmful habits like smoking, alcohol or stress helps in avoiding Cancer.
  • Diet and nutrition play a pivotal role in preventing any cancer. Keeping a track of caloric intake and sticking to a low-fat diet, including fruits and vegetables and reducing the intake of saturated fat and red meat helps in avoiding the disease.
  • Physical exercise and yoga are effective in maintaining a healthy body and controlling obesity. A healthy and fit body helps in preventing Cancer.
  • It is crucial for cancer to be diagnosed before metastasis. Consulting an expert for screening and detection of the condition before it spreads is very necessary.

Some herbal and organic tips can also be followed to prevent Bone Cancer . The use of turmeric and ginseng in preparing food helps in avoiding any form of cancer. Turmeric has a therapeutic compound called curcumin which possesses the properties to fight cancer and improve the immune system of the body. A clinical trial of curcumin proved that it could stop the precancerous changes becoming cancer. Ginseng is the herb which hinders the formation of cancer cells, while certain green tea extracts are also effective in hindering the growth of cancer tissue. Clinical research on the above topic is still in progress and an appropriate conclusion is yet to be reached.

What are the stages of Bone Cancer?

Bone Cancer is staged into 4 stages, based on the severity and spread of the Cancer cells. The treatment options for Bone Cancer are planned based on the stage of the Cancer and overall health of the patient.

  • Stage I: If the Cancer is limited to the bone and hasn′t spread to other areas of the body then it is termed as stage I. Cancer at this stage is considered low grade and not aggressive. It is further classified into two subgroups:
    • Stage IA: The tumor is low grade and is smaller than 8 cm. It has not spread to any lymph nodes or to other parts of the body and is marked as T1, N0, M0, G1/G2.
    • Stage IB: The tumor is low grade but is larger than 8 cm. It has not spread to any lymph nodes or to other parts of the body. It is marked as T2, N0, M0, G1/G2.
  • Stage II: If the cancer is limited to the bone and hasn′t spread to other areas of the body then it is characterized as stage II. In this stage, the cancer has turned high grade and aggressive. It is further categorized into:
    • Stage IIA: The tumour is of high grade and its size varies from 2 to 8 cm. It has not spread to any lymph nodes or to other parts of the body. It is marked as T1, N0, M0, G3/G4.
    • Stage IIB: The tumour is of high grade and is larger than 8 cm. It has not spread to any lymph nodes or to other parts of the body. The tumour is described as T2, N0, M0, G3/G4.
  • Stage III: At this stage, Bone Cancer has spread to two or more places on the same bone. The cancer is of high grade and is usually very aggressive. There are multiple high-grade tumours in the primary bone site, but they have not spread to any lymph nodes or to other parts of the body. It is described as T3, N0, M0, G3/G4.
  • Stage IV: This stage indicates that tumor may be of any size or grade and has spread beyond the bone to other areas of the body, such as the brain, liver or lungs.
    • Stage IVA: The cancer cells have spread to the lung(s) (any G, any T, N0, and M1a).
    • Stage IVB: The tumor has spread to the lymph nodes (any G, any T, N1, and any M), or to another organ besides the lung (any G, any T, any N, and M1b).

Survival rates of Bone Cancer?

The tremendous plunge in the development of science and technology has aided better treatment facility which resulted in more successful cases of Bone Cancer recovery in recent years. Survival rates are basically an indicator that helps in analyzing the expected life span of the patients based on previous records of patients with the same condition. However, these rates do not claim the same life expectancy for each individual.

Can Bone Cancer be detected early?

Yes, today there are a number of ways that help in detecting Bone Cancer at a very early stage. Increased awareness among the people about this disease has helped in identifying the hideous disease at early stages. Some tests and procedures for Bone Cancer diagnosis are discussed below:

  • Bone scan: A liquid with radioactive material is injected into a vein which gets accumulated in the abnormal areas of the bone. The cancer cells can then be spotted by using a scanner.
  • Computerized tomography (CT): It is used to generate a clear 3-D image of the inside of a bone. It is a painless procedure and helps to identify if the cancer cells have metastasized and to which locations.
  • Magnetic resonance imaging (MRI): The device uses a magnetic field and radio waves to create detailed images of the specific bone or part of a bone.
  • Positron emission tomography (PET): In this procedure, a small amount of radioactive glucose is injected into a vein and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. As cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.
  • X-rays: An X - ray scan can detect damages caused by the cancer cells. It also gives information about the location, size and shape of the tumour. An X-ray also helps in detecting any new cells that have started to form around the tumour.
  • Blood tests: Certain blood tests may also be recommended by the doctor to determine the level of an enzyme called alkaline phosphatase. The presence of cancerous cells may cause the raised level of this enzyme. But this test alone cannot certify the presence of Bone Cancer as there are multiple scenarios where this enzyme is found at a high level.
  • Bone biopsy: A sample of bone tissue is extracted and examined for cancer cells. This is the most reliable way to diagnose Bone Cancer . A core needle biopsy involves inserting a long, thin needle into the bone and removing a sample, while an open biopsy involves making an incision in the target bone area and surgically removing a sample of tissue.

What are the Treatments available?

Treatment options for Bone Cancer depend on several factors, including the type, size, location, and stage of the cancer, as well as the person’s age and general health. Some of the most common and effective treatment options for Bone Cancer are given below:

  • Surgery is the usual treatment for Bone Cancer . The entire tumor along with negative margins is removed through surgery.
    • Limb-sparing surgery, have made it possible for many people to avoid amputation.
    • Even when the Bone Cancer has metastasized and spread to the lungs then also the patient may be cured using surgery. An operation to remove the part of the lung that′s affected is used to cure metastatic cancer. This operation is called a thoracotomy.
  • Neoadjuvant Chemotherapy: In this procedure, medicinal aid is used to shrink the size of tumour before surgery. Due to its effective results and good response, neoadjuvant chemotherapy is now included as a routine procedure to treat cancer. Research revealed that neoadjuvant chemotherapy can significantly improve the survival rate of the patient and so most often the therapy consists of neoadjuvant chemotherapy followed by wide surgical resection and subsequent adjuvant chemotherapy.
  • Chemotherapy: In this procedure, anticancer drugs are used to kill or inhibit the growth of cancer cells. Patients with Bone Cancer usually receive a combination of anticancer drugs. It is an important part of the treatment for most osteosarcomas, spindle cell sarcomas and Ewing’s sarcomas.
    Common drugs for osteosarcoma include:
    • Cisplatin (Platinol)
    • Doxorubicin (Adriamycin)
    • Ifosfamide (Ifex)
    • Methotrexate
    Common drugs for Ewing sarcoma include:
    • Vincristine (Oncovin, Vincasar)
    • Doxorubicin (Adriamycin)
    • Cyclophosphamide (Cytoxan, Neosar)
    • Ifosfamide (Ifex)
    • Etoposide (Toposar, VePesid)
    • Dactinomycin (Cosmegen)
  • Radiation therapy: In this procedure, high-energy x-rays are used to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, in which radiation is given from a machine outside the body. If radiation is given using implants, then it is called internal radiation therapy or brachytherapy. For Bone Cancer , radiation therapy is most often used if the tumour cannot be removed by surgery. Radiation therapy may also be done before surgery to shrink the tumour, or it may be done after surgery to destroy any remaining cancer cells as per doctor’s recommendation. Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements.
  • Cryosurgery is the use of liquid nitrogen to freeze and kill cancer cells. This technique can sometimes be used to destroy the tumour.

Is there curative treatment for Bone Cancer ?

Yes, Bone Cancer is curable through surgery when detected at an early stage. Even at a later stage, surgery, chemotherapy, radiation therapy and several modern treatments help in curing the disease.

How frequently should one visit doctor for early diagnosis?

We would suggest visiting the doctor if there is persistent, severe or worsening bone pain, or if you experience any of the symptoms mentioned above. Also, if you have a high risk of developing Bone Cancer then keeping up a regular check on the health factors, helps in early diagnosis. While it's highly unlikely that the symptoms are caused by cancer, it's best to be sure by getting a proper diagnosis.

How can I as a patient know it early?

Being aware of the health updates and knowing about your family health history helps in identifying the risk factors that might lead to the development of Bone Cancer .

Brain Cancer (Adult)

What is Brain Cancer? (Adult)

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start at the brain and/or spinal cord, they cause brain cancer. Both benign and malignant tumors cause signs and symptoms and need treatment. Benign brain and spinal cord tumors grow and press on nearby areas of the brain but rarely spread into other parts of the brain. Malignant brain and spinal cord tumors are likely to grow quickly and spread into other parts of the brain.

Anatomy of Brain

 

Copyright © : The above image is copyright of respective author and being used for educational purpose only.

What are the general symptoms of Brain Cancer?

The signs and symptoms of brain and spinal cord tumors depend on a number of factors:

  • Location of tumour
  • size,
  • rate of growth
  • age of the patient

Some symptoms may appear gradually, others suddenly (like seizures).

General symptoms

Tumors in any part of the brain may cause the pressure inside the skull (known as intracranial pressure) to rise. This can be caused by growth of the tumor itself, swelling in the brain, or blockage of the flow of cerebrospinal fluid (CSF). Increased pressure can lead to general symptoms such as:

  • Headache
  • Nausea
  • Vomiting
  • Blurred vision
  • Balance problems
  • Personality or behavior changes
  • Seizures
  • Drowsiness or even coma

Symptoms of tumors in different parts of the central nervous system

  • Tumours in Cerebrum : cause weakness or numbness of part of the body, often on just one side.
  • Tumors in or near the parts of the cerebrum : cause problems with speech or even understanding words.
  • Tumors in the front part of the cerebrum: affect thinking, personality, and language.
  • Tumors in an area of the brain called the basal ganglia: cause abnormal movements and an abnormal positioning of the body.
  • Tumor in the cerebellum: cause trouble with walking or other everyday functions, even eating.
  • Tumors in the back part of the cerebrum: cause vision problems.
  • Tumors in or near other cranial nerves: may cause loss of hearing, balance problems, weakness of some facial muscles, or trouble swallowing.
  • Spinal cord tumors: numbness, weakness, or lack of coordination in the arms and/or legs, as well as bladder or bowel problems.

What are the general causes of Brain cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

Radiation exposure : The best known environmental risk factor for brain tumors. This comes most often from radiation therapy to treat some other condition. For example, before the risks of radiation were known, children with ringworm of the scalp (a fungal infection) were sometimes treated with low-dose radiation therapy, which was later found to increase their risk of brain tumors as they got older.

Family history : Certain genetic disorders or illnesses may increase the risk of developing brain and spinal cord cancer. These include:

  • Neurofibromatosis type 1 (NF1)
  • Neurofibromatosis type 2 (NF2)
  • Tuberous sclerosis
  • Von Hippel-Lindau disease
  • Li-Fraumeni syndrome
  • Other syndromes - Some families may have genetic disorders that are not well recognized or that may even be unique to a particular family.

Immune system disorders : People with impaired immune systems have an increased risk of developing lymphomas of the brain or spinal cord.

Factors with uncertain, controversial, or unproven effects on brain tumor risk: Cell phone use

Can Brain Cancer be prevented?

Brain Cancer may be prevented to an extent by reducing the exposure to risk factors, outlined in the “Causes” section. However, the risk of many cancers in adults can be reduced with certain lifestyle changes (such as staying at a healthy weight or quitting smoking). But other than radiation exposure, there are no known lifestyle-related causes of brain and spinal cord tumors, so at this time there is no known way to protect against most of these tumors.

What are the stages of Brain cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In Brain cancer, the stage depends on whether it is confined to Brain and spinal cord (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Brain cancer?

Needless to say, if the brain cancer is detected while it is still in Stage I and is easily accessible, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Brain Cancer be detected early?

At this time there are no widely recommended tests to screen for brain and spinal cord tumors. However, as a precaution you may go to the doctor and check whether you have any of the inherited syndromes that increase the risk of developing the brain cancer. Presence of any of the signs and symptoms should also alert you. It might be nothing, but why risk it? Just get a screening.

What are the Treatments available?

Since it is a very difficult cancer to treat, there is usually a team in place, led by a neurosurgeon. Other doctors on the team may include:

  • Neurologist: a doctor who diagnoses brain and nervous system diseases and treats them with medicines
  • Radiation oncologist: a doctor who uses radiation to treat cancer
  • Medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancers
  • Endocrinologist: a doctor who treats diseases in glands that secrete hormones

Several types of treatment can be used to treat brain and spinal cord tumors, including:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Targeted therapy
  • Other types of drugs

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should probably visit a doctor. 

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Brain Cancer (Child)

What is Brain and Spinal Cord Cancer/CNS Cancer?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start in thebrain or spinal cord, they cause brain cancer. However, not all cancer cells are malignant. Some are benign. That is, they may grow in size but do not spread and invade other cells.Brain tumors in children are more likely to start in the lower parts of the brain, such as the cerebellum and brain stem, than they are in adults. But they can start in the upper parts of the brain as well.

Anatomy of Brain

 

Copyright © : The above image is copyright of respective author and being used for educational purpose only.

What are the general symptoms of Brain Cancer?

Increased pressure in the brain due to both, benign and/or malignant tumours can lead to general symptoms such as:

  • Headache
  • Nausea
  • Vomiting
  • Crossed eyes or blurred vision
  • Balance problems
  • Behavior changes
  • Seizures
  • Drowsiness or even coma

What are the general causes of Brain cancer?

Clear causes for Brain and Spinal Cord tumours are still debatable. However, certain risk factors have been recognized.

Excessive Radiation exposure

Inherited and genetic conditions: People with inherited tumor syndromes often have many tumors that start when they are young. Some of the more well-known syndromes include:

  • Neurofibromatosis type 1 (von Recklinghausen disease)
  • Neurofibromatosis type 2
  • Tuberous sclerosis
  • Von Hippel-Lindau disease
  • Li-Fraumeni syndrome
  • Gorlin syndrome (basal cell nevus syndrome)
  • Turcot syndrome
  • Cowden syndrome
  • Hereditary retinoblastoma
  • Rubinstein-Taybi syndrome
  • Some families may have genetic disorders that are not well recognized or that could even be unique to a particular family.

Can Brain Cancer be prevented?

“Other than exposure to radiation, there are no known lifestyle-related or environmental causes of brain and spinal cord tumors in children, so at this time there is no way to protect against most of these cancers.” (cancer.org)

What are the stages of Brain cancer?

Most tumors in the brain or spinal cord do not usually spread. Hence, they are not formally staged. Some of the most important factors that determine your child’s prognosis include:

  • The type of tumor
  • The grade of the tumor
  • The location and size of the tumor
  • How much of the tumor can be removed by surgery
  • Your child’s age
  • Your child’s functional level
  • Whether or not the tumor has spread through the cerebrospinal fluid (CSF) to other parts of the brain or spinal cord
  • Whether or not tumor cells have spread beyond the central nervous system

Survival rates of Brain cancer?

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

Type of Tumor 5-Year Survival Rate
Pilocytic astrocytoma About 95%
Fibrillary (diffuse) astrocytoma About 80% to 85%
Anaplastic astrocytoma About 30%
Glioblastoma About 20%
Oligodendroglioma About 90% to 95%
Ependymoma/anaplastic ependymoma About 75%
PNETs (includes medulloblastoma and pineoblastoma) About 60% to 65%

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Brain Cancer be detected early?

At this time there are no widely recommended screening tests for most children to look for brain or spinal cord tumors before they start to cause symptoms. These tumoursare usually detected as a result of signs or symptoms the child is having. However, through genetic tests, one may find out whether one is at an increased risk of developing Brain Cancer. If yes, the doctor might suggest other tests to detect the Cancer early.

What are the Treatments available?

Based on the type and stage of the cancer and other factors, primary treatment options include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Targeted therapy
  • Other drug treatments

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs. Also, it is a good idea to get a second opinion from a doctor who has dealt with the kind of cancer your child has.

How frequently should one visit doctor for early diagnosis?

If your child has any of the symptoms, please do visit the doctor. A genetic test would also help.

 

How can I as a patient know it early?

If you feel your child has any of the symptoms mentioned in the Symptoms section, you should probably take your child to a doctor.
 
All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Breast Cancer

What is Breast Cancer?

The female breast is essentially made up of milk-producing glands called as lobules and tiny tubes called ducts which carry the secreted milk from lobules to the nipple. The rest of the tissue is designated as Stroma the supportive structure of an organ consisting of fatty and connective tissue which surrounds the lobules, ducts and the blood vessels and lymphatic vessels.

Functions:

  • Women's breasts are made of specialized tissue that produces milk (glandular tissue).
  • Breasts milk provides complete nutrition to an infant.
  • Breast milk contains carbohydrate (lactose), fats and proteins as well as micronutrients.
  • Breast secretions also ensure that the newborn has a significant amount of immunological protection in the form of maternal antibodies, chemical mediators, vitamins, and enzymes.

Breast Cancer

Cancer is caused due to uncontrollable growth of abnormal cells that start invading the normal cells around them. When these abnormal tumor cells are present in the breast, they lead to breast cancer. Majority of breast cancers have ductal or lobular origin and only a small number of breast cancers originate in other tissues. In Breast Cancer, apart from the primary tumor, the involvement of Lymph Nodes assumes great importance with respect to the spread of cancer to different tissues (metastases).

Though it is a disease that affects primarily women, men can get it, too. But don’t worry! Regular screenings and mammograms (an x-ray exam of the breast that is used to detect and evaluate breast changes) can help in early detection and prevention of the cancer’s spread through timely or early treatment.

Types of Breast Cancer

  • Ductal carcinoma in situ
    It is a non–invasive breast cancer. Cancer cells can be found in the lining of the breast milk duct. Ductal carcinoma in situ is very early cancer that is highly treatable, but if it’s left untreated or undetected, it can spread to the surrounding breast tissue.
  • Invasive ductal carcinoma
    Also referred as infiltrative ductal carcinoma, it is the most common type of breast cancer. It starts in a milk duct of the breast, breaks through the wall of the duct, and grows into the fatty tissue of the breast.
  • Invasive lobular carcinoma
    It is the second most common type of Breast Cancer. It starts in the milk-producing glands (lobules) and cancer cells in the lobules have spread into the surrounding breast tissue.
  • Inflammatory breast cancer
    It is a rare type of inflammatory Breast Cancer, aggressive and fast growing in which cancer cells infiltrate the skin and lymph vessels of the breast. It often produces no distinct tumor or lump that can be felt. But when the lymph vessels become blocked by the breast cancer cells, symptoms begin to appear.
  • Metastatic Breast Cancer
    Metastatic breast cancer is also classified as Stage 4 breast cancer. The cancer has spread to other parts of the body. This usually includes the lungs, liver, bones or brain.
  • Paget’s disease of the breast
    An uncommon type of Breast Cancer condition affecting the skin of the nipple and often the areola, which is the darker circle of skin around the nipple. Most people with Paget disease evident on the nipple also have one or more tumors inside the same breast.
  • Tubular
    It accounts for almost 2% of all Breast Cancer diagnosis. Tubular carcinoma cells have a distinctive tubular structure when viewed under a microscope. It is usually found on a mammogram and appears as a collection of cells that can feel like a spongy area of breast tissue. Typically, this type of breast cancer is found in women aged 50 and above and usually responds well to hormone therapy.
  • Mucinous Carcinoma
    Mucinous carcinoma represents approximately 1% to 2% of all breast cancers. The main differentiating features are mucus production and cells that are poorly defined. It also has a favorable prognosis in most cases.

Occurrence rate

In India, we are now witnessing more and more numbers of patients being diagnosed with breast cancer to be in the younger age groups (in their thirties and forties). Breast cancer is now the most common cancer in most cities in India, and 2nd most common in the rural areas.

Anatomy of Breast Cancer

What are the general symptoms of Breast Cancer?

Signs and Symptoms of Breast Cancer

  • Lump in the breast
    The most common and usually the first sign of Breast Cancer is the ‘Lump’ in the breast. Usually, the lady herself finds it out first.
    • The lump related to Breast Cancer may be tender but usually without pain.
    • The lump may sometimes feel hard and irregular in shape. It may appear distinctly different from the rest of the breast tissue.
    • Peculiarly, the lump does not disappear or change in size with the menstrual cycle.
    • Cancer related lump is firmly attached to the skin or the chest wall and does not move.
  • Lump in the Armpit
    • A lump in the armpit may be spotted because of the axillary lymph node involvement.
    • Axillary lump occurs mostly because of the spread of cancer.
    • The lump may be hard, tender, or painless.
  • Skin Changes
    • Dimpled Skin: It means hollowness or formation like a pit or depression in the breast.
    • Puckered Skin: It means with creases or crumpled.
    • A thickening and dimpling of the skin may occur.
  • Inflammatory Breast Cancer
    • Inflammatory Breast could be an indicator of breast cancer.
    • Persistent itching in the breast or the nipple, which is (often) not relieved by medications or medicated ointments or creams for local application.
  • Nipple Changes
    • Nipples are normally pointed outwards. However, nipples may also be pointed inwards (inverted). However, if normal nipples get inverted, it could be a cause of concern and the person should ideally see a doctor for consultation and medical opinion.
  • Discharge from Nipples
    • Although many noncancerous conditions may cause it, better to find out the reasons.
    • Discharge from a single nipple, especially if it occurs without squeezing it, and especially if containing blood may be a sign of Breast Cancer.
  • Paget’s Disease (a type of Breast Cancer):
    • Crusting, ulcers or scaling on the nipple may be a sign of some rare types of breast cancer, such as Paget disease of the nipple.

LATE SIGNS AND SYMPTOMS

  • Bone Pain
  • Nausea
  • Loss of Appetite
  • Weight Loss
  • Jaundice
  • Pleural Effusion: (buildup of fluid around the lungs)
  • Shortness of Breath
  • Cough
  • Headache
  • Double Vision
  • Muscle Weakness

It is important to note that pain can more often be a symptom of non-cancerous (benign) tumor. Yet, one should not be complacent but needs to be vigilant and get examined by a doctor to ascertain it.

While any or all these symptoms may not always end in breast cancer, it is advisable to consult a healthcare professional when any of these symptoms appear. Mammograms may help in detecting breast cancer before the appearance of a symptom. However, it must be stressed that mammograms are not always successful in discovering breast cancer. That does not mean you should not take one! Any prevention is better than cure. So, go out there, make that visit, consult your doctor and take a step closer to knowledge and, perhaps, relief!

What are the general causes of Breast cancer?

A person’s chances of getting breast cancer are calculated based on certain “risk factors”. Risk factor may refer to anything from age to habits to genetics. However, the presence of these risk factors doesn’t necessarily mean that one shall definitely be diagnosed with Cancer, but the probability of getting affected by Cancer increases many folds.

  • Gender: Women are 100 times more likely to get Breast Cancer than men.
  • Ageing: The chances of breast cancer increases with increasing age. Hence, going for mammogram tests in the 40’s is a smart move.
  • Early onset of menstruation (before age 12) and/or late onset of menopause (post-55).
  • Late or no pregnancy: Having children after the age of 30 can be a cause of breast cancer.
  • Genes: Breast Cancer is considered to be hereditary 5-10% of the time. If there is any occurrence of Breast Cancer in the family tree then cancer diagnostic tests can be done for early detection and action. Inherited mutations in certain genes, such as BRCA1 and BRCA2 increase the risk of breast and ovarian cancer.
  • If the Cancer is present in one breast, then the chances of developing cancer in the other breast are 3 times more likely.

Other risk factors include:

  • Dense breast tissue: Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get Breast Cancer.
  • Hormone Therapy: Taking hormones to replace missing estrogen and progesterone in menopause for more than five years raises the risk for Breast Cancer. The hormones that have been shown to increase risk are estrogen and progestin when taken together.
  • Contraceptives: Certain forms of oral contraceptive pills have been found to raise Breast Cancer risk.
  • Diethylstilbestrol: a drug given to women to lower chances of miscarriage in the mid-90s.
  • Intake of alcohol/tobacco is directly proportional to the increase in risk of getting breast cancer.
  • Obesity: Older women who are overweight or obese have a higher risk of getting Breast Cancer than those at a normal weight.

Lowering the risk of Breast Cancer

Breastfeeding may lower the risk of Cancer, according to research. Exercises seem to lower chances of developing Breast Cancer. According to a study in Women’s Health Initiative brisk-walking as little as 1.25 to 2.5 hours per week can reduce the risk by 18%! So grab those running shoes!

What are the stages of Breast Cancer?

Stage or Grade of Breast Cancer is largely determined by the findings such as

  • whether the tumor is local
  • spread to the nearby lymph nodes
  • spread to the distant organs.

TNM system is widely used to stage Breast Cancer:

  • T refers to tumor size.
  • N describes lymph node status.
  • M indicates whether the cancer has metastasized.

The stages of Breast Cancer are explained in details below:

  • Stage 0:
    Describes non-invasive Breast Cancers. There is no evidence of cancer cells out of the part of the breast, in which they started.
  • Stage I:
    Describes invasive Breast Cancer in which cancer cells are invading surrounding breast tissues.
    • Stage IA:
      • the tumor measures up to 2 centimeters
      • the cancer has not spread outside the breast and no lymph nodes are involved
    • Stage IB:
      • Small groups of cancer cells ranging from 0.2 millimeters - 2 millimeters are found in the lymph nodes.
      • There is a tumor in the breast that is no larger than 2 centimeters, and there are small groups of cancer cells ranging from 0.2 millimeter to 2 millimeters in the lymph nodes.
  • Stage II:
    • Stage IIA:
      • No tumor can be found in the breast, but cancer (larger than 2 millimeters) is found in 1 to 3 axillary lymph nodes or in the lymph nodes near the breast bone.
      • The tumor measures 2 centimeters or smaller and has spread to the axillary lymph nodes.
      • The tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.
    • Stage IIB:
      • The tumor ranges from 2 cm to5 cm and small groups of Breast Cancer cells ranging from 0.2 mm to 2 mm are found in the lymph nodes.
      • The tumor ranges from 2 cm to 5 cm, it has spread to 1 to 3 axillary lymph nodes or to lymph nodes near the breastbone
      • The tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes
  • Stage III:
    • Stage IIIA:
      • Tumor of any size could be spotted in the breast or sometimes there might not be a tumor at all. Cancer is found in 4 to 9 axillary lymph nodes or in the lymph nodes near the breastbone.
      • The tumor is larger than 5 cm and small groups of Breast Cancer cells ranging from 0.2 mm to 2 mm are found in the lymph nodes.
      • The tumor is larger than 5 centimeters; cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone.
    • Stage IIIB:
      • The tumor may be any size and has spread to the chest wall and/or skin of the breast.
      • May have spread to up to 9 axillary lymph nodes OR
      • May have spread to lymph nodes near the breastbone
    • Stage IIIC:
      • There may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have spread to the chest wall and/or the skin of the breast AND
      • The cancer has spread to 10 or more axillary lymph nodes OR
      • The cancer has spread to lymph nodes above or below the collarbone OR
      • The cancer has spread to axillary lymph nodes or to lymph nodes near the breastbone
  • Stage IV:
    Stage IV describes invasive Breast Cancer that has spread beyond the breast and nearby lymph nodes to other organs of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain.

Survival rates for Breast Cancer?

Survival rates indicate an average outcome of large number of people who had the disease, but they cannot precisely predict the expectancy of any particular case. The survival rate of Breast Cancer when detected at an early stage is quite high and if the detection is delayed till the last stage then the chances of survival drop significantly. Since, the symptoms of Breast Cancer are quite evident being aware of the condition aids in early detection.

Can Breast Cancer be detected early?

Breast Cancer is sometimes found after symptoms appear, but many women with Breast Cancer have no symptoms. This is why regular Breast Cancer screening is so important.

  • Physical exam and history: The body is thoroughly examined to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Clinical breast exam (CBE): The breast is closely observed by a doctor or health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
  • Mammograms: A mammogram is an x-ray of the breast that looks for changes that may be signs of Breast Cancer. Mammograms are the best Breast Cancer screening tests and all women are recommended to get it done to ensure complete safety. Women with any of the risk factors are recommended to go for a mammogram once every year.
  • Breast Ultrasound: Breast ultrasound uses sound waves to make a computer picture of the inside of the breast. A gel is put on the skin of the breast and an instrument called a transducer is moved across the skin to show the underlying tissue structure.
  • Breast MRI Scans: The MRI machine is called an MRI with dedicated breast coils. MRI uses strong magnets instead of radiation to make very detailed, cross-sectional pictures of the body.
  • Biopsy: Biopsy is the removal of a small amount of tissue for examination under a microscope. There are different kinds of breast biopsies. Some of them are mentioned below:
    • Fine needle aspiration biopsy: In this procedure, a very thin, hollow needle attached to a syringe is used to withdraw a small amount of tissue from a suspicious area.
    • Core needle biopsy: In this procedure, a larger needle is used to sample breast changes
    • Surgical (open) biopsy: In rare cases, surgery is needed to remove all or part of the lump for testing. This is called a surgical biopsy or an open biopsy. Most often, the surgeon removes the entire mass or abnormal area as well as a surrounding margin of normal- breast tissue.

      There are 2 types of surgical biopsies:
      • Incisional biopsy The removal of part of a lump or a sample of tissue.
      • Excisional biopsy The removal of an entire lump of tissue.
  • Lymph node biopsy: If the lymph nodes under the arm are enlarged, a doctor may need to check them for cancer spread. Most often, an enlarged lymph node is biopsied at the same time as the breast tumor.

Earlier the detection the better is the outcome of therapy (prognosis).About 70% of the patients are offered Breast Conservation Surgery and approximately 5% overall also undergo breast reconstruction.

About 35% of those cases are Locally Advanced cancers requiring Multi-Modality Treatment.

What are the Treatments available?

Right Diagnosis is the first step towards getting Right Treatment as various treatment options exist, which vary depending upon the spread of the disease, whether to nearby region or to distant organs (metastases) and the stage of the disease. Tata Memorial Hospital (TMH) from Mumbai is one of the leading cancer treatment centers in the world and amongst the oldest in India.

The Breast (Cancer) Unit of the Tata Memorial Hospital diagnoses about 4400 new Breast Cancer cases per year, 60% of which are operable ones. The unit performs on an average 45 Breast Cancer surgeries per week.

Treatments available are dependent on the stages of cancer. Primary treatments available are as follows:

  • Surgery to remove the breast. It is the most effective treatment when the spread of cancer is limited to the cells of the breast.
    • Breast-conserving: Surgery is an operation to remove the cancer and some normal tissue around it, but not the breast itself.
    • Total mastectomy: Surgery to remove the whole breast that has cancer. This procedure is also called a simple mastectomy
    • Modified radical mastectomy: Surgery to remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.
  • Radiation therapy: Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
    • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
    • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

    The way the radiation therapy is given depends on the type and stage of the cancer being treated.
  • Chemotherapy: Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
  • Hormone therapy: It is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing.
    • Hormone therapy with tamoxifen is often given to patients with early localized Breast Cancer.
    • Hormone therapy with a luteinizing hormone-releasing hormone (LHRH) agonist is given to some premenopausal women who have just been diagnosed with hormone receptor positive Breast Cancer.
    • Hormone therapy with an aromatase inhibitor is given to some postmenopausal women who have hormone receptor positive Breast Cancer.
    • Other types of hormone therapy include megestrol acetate or anti-estrogen therapy such as fulvestrant.
  • Targeted therapy: It is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibodies, tyrosine kinase inhibitors, cyclin-dependent kinase inhibitors, mammalian target of rapamycin (mTOR) inhibitors, and PARP inhibitors are types of targeted therapies used in the treatment of Breast Cancer.

Is there curative treatment for Breast Cancer?

Diagnosing Breast Cancer early is the key to optimum treatment and a better prognosis, i.e. outcome of therapy Breast Cancer is highly treatable when detected at an early stage. However, the recurrence rate of Breast Cancer is also high, so proper care needs to be taken even after complete treatment and regular inspections and examinations needs to be done at least once a year to avoid the turmoil again.

How frequently should one visit a doctor for an early diagnosis?

In case of experiencing any of the mentioned symptoms or having a prior or familial history of Breast Cancer, a physical examination by a specialist is recommended once in a year.

How can I as a patient know it early?

Diagnostic methods include a screening mammogram and clinical breast examination. Sometimes, Breast Cancer can even be diagnosed with a simple self-examination, when lumps on or near the breasts are felt. However, not every change in the breast is a sign of Breast Cancer. It is advisable to visit the doctor nonetheless as more information is needed for an accurate diagnosis.

Breast Self Examination (BSE) One can use this method at home to check for lumps once a month.

(Adapted from the American Cancer Society by Health Gate Editorial Staff)

For a menstruating woman, the best time to do BSE is 2 or 3 days after the period ends. These are the days when the breasts are least likely to be tender or swollen. For woman who have undergone menopause, any day of the month is suitable to do a BSE. For those taking hormones, consulting the doctor about BSE would be helpful.

Here are 5 efficient self examination tests that can be done at home:

Step 1

Stand in front of a mirror that is large enough for you to see your breasts clearly. Check each breast for anything unusual. Look for a discharge from the nipples and check the skin for

  • puckering,
  • dimpling, or
  • scaliness.

Steps 2 and 3

Check for changes in the shape or contour of your breasts. As you do these steps, you should feel your chest muscles tighten.

Step 2 - watching closely in the mirror, clasp your hands behind your head and press your hands forward.

Step 3 - press your hands firmly on your hips and bend slightly toward the mirror as you pull your shoulder and elbows forward.

Step 4 - gently squeeze each nipple and look for a discharge.

Step 5 - raise one arm. Use the pads of the fingers of your other hand to check the breast and the surrounding area—firmly, carefully, and thoroughly. Some women like to use lotion or powder to help their fingers glide easily over the skin. Feel for any unusual lump or mass under the skin.

Feel the tissue by pressing your fingers in small, overlapping areas about the size of a dime. To be sure you cover your whole breast, take your time and follow a definite pattern: lines, circles, or wedges.

Pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone and all the way over to your shoulder.

Here are some tips on patterns that you can use:

  • Lines:
    • Start in the underarm area and move your fingers downward little by little until they are below the breast.
    • Then move your fingers slightly toward the middle and slowly move back up.
    • Go up and down until you cover the whole area.
  • Circles:
    • Beginning at the outer edge of your breasts, move your fingers slowly around the whole breast in a circle.
    • Move around the breast in smaller and smaller circles, gradually working toward the nipple.
    • Don't forget to check the underarm and upper chest areas, too.
  • Wedges:
    • Starting at the outer edge of the breast, move your fingers toward the nipple and back to the edge.
    • Check your whole breast, covering one small wedge-shaped section at a time.
    • Be sure to check the underarm area and the upper chest.

Step 6 - repeat step 5 while you are lying down. Lie flat on your back, with one arm over your head and a pillow or folded towel under the shoulder.

Step 7 - you may want to repeat step 5 in the shower. Your fingers will glide easily over soapy skin, so you can concentrate on feeling for changes underneath.

It is recommended that all women over the age of 20 examine their breasts once a month. One must not forget that delaying the diagnosis of Breast Cancer would not change the diagnosis, it can only worsen the outcome.

Cancer in Children

What is the difference between adult cancers and cancers in children?

Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors. Also, children’s bodies tend to handle chemotherapy better than those of adults. Hence, they respond better to chemo treatment. However, cancer treatments such as chemo and radiation therapy can cause long-term side effects, so children who have had cancer need careful follow-up for the rest of their lives.

What are the most common cancers seen in children?

  • Leukaemia
  • Brain and other central nervous system tumors
  • Neuroblastoma
  • Wilms tumor
  • Lymphoma (including both Hodgkin and >non-Hodgkin)
  • Rhabdo-myo-sarcoma
  • Retinoblastoma
  • Bone cancer (including >osteosarcoma and >Ewing sarcoma)

What are the causes of cancers in children?

Lifestyle factors are not considered to play much of a part in childhood cancers but environmental factors, such as radiation exposure, have been linked with some types. Parental exposures (such as smoking) might increase a child’s risk of certain cancers, but there is still much research going on to find conclusive results. So far, most childhood cancers have not been shown to have outside causes.

Changes in the DNA, inherited or developed, increase the risk of cancer in children.

Can childhood cancers be prevented?

Since childhood cancers are usually not lifestyle and environment-related, change in habit or location will probably not make a difference. However, if it is due to a mutated gene, preventive surgery may be sought. However, this is very rare.

Possible signs and symptoms of cancer in children

Each type of cancer has its own symptoms. However, some common symptoms are as follows.

  • An unusual lump or swelling
  • Unexplained paleness and loss of energy
  • Easy bruising
  • An ongoing pain in one area of the body
  • Limping
  • Unexplained fever or illness that doesn't go away
  • Frequent headaches, often with vomiting
  • Sudden eye or vision changes
  • Sudden unexplained weight loss

How are childhood cancers treated?

Treatment options depend on the type and stage of cancer. Treatment options might include surgery, radiation therapy, chemotherapy, and/or other types of treatment. In many cases, more than one of these treatments is used.

CervicalCancer

What is Cervical Cancer

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. Cervical cancers do not suddenly change into cancer. The normal cells of the cervix first gradually develop pre-cancerous changes that turn into cancer. These changes can be detected by the Pap test and treated to prevent cancer from developing.

Anatomy of Cervical

cervical-cancer

What are the general symptoms of Cervical Cancer?

Cervical cancer, at its early stage, usually causes no symptoms. But more advanced cervical cancers can sometimes cause symptoms, such as:

  • Vaginal bleeding (including bleeding after sexual intercourse).
  • Unusual vaginal discharge
  • Pelvic pain.
  • Pain during sexual intercourse.

What are the general causes of Cervical cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

Major risk factor: Human papillomavirus (HPV) infection

Other risk factors for Cervical Cancer include:

  • Giving birth to many children.
  • Having many sexual partners.
  • Having first sexual intercourse at a young age.
  • Smoking cigarettes.
  • Using oral contraceptives ("the Pill").

Can Cervical Cancer be prevented?

Cervical Cancer may be prevented to an extent by reducing the exposure to risk factors, outlined in the “Causes” section.

What are the stages of Cervical cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor  has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In Cervical cancer, the stage depends on whether it is confined to Cervicals (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Cervical cancer?

Needless to say, if the cervical cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Cervical Cancer be detected early?

Cervical Cancer does not usually show signs and symptoms in the early stage. Hence, regular check-ups are recommended for detection. The earlier it is found, the easier it is to treat.

  • Diagnostic tests include:
  • Physical exam and history
  • Pap test
  • Pelvic exam
  • HPV test
  • Endocervical curettage
  • Colposcopy
  • Biopsy

What are the Treatments available?

Treatment options depend on the following:

  • The stage of the cancer.
  • The type of cervical cancer.
  • The patient's desire to have children.
  • The patient’s age.

Fo-ur types of standard treatment are used:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Targeted therapy

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor.

All matter is for informational purposes only and has been collated from www.cancer.gov and  www.cancer.org . Zuvius Lifesciences does not claim authorship of the above.

Colon Cancer

What is Colon Cancer?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start in the colon, they cause colon cancer.

Anatomy of Colon Cancer

colon-cancer

What are the general symptoms of Colon Cancer?

  • A change in bowel habits.
  • Blood (either bright red or very dark) in the stool.
  • Diarrhoea, constipation, or feeling that the bowel does not empty all the way.
  • Stools that are narrower than usual.
  • Frequent gas pains, bloating, fullness, or cramps.
  • Weight loss for no known reason.
  • Feeling very tired.
  • Vomiting.

What are the general causes of Colon cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • A family history of cancer of the colon or rectum.
  • Certain hereditary conditions
  • A history of ulcerative colitis ( ulcers in the lining of the large intestine) or Crohn disease.
  • A personal history of cancer of the colon, rectum, ovary, endometrium, or breast.
  • A personal history of (small areas of bulging tissue) in the colon or rectum.

Can Colon Cancer be prevented?

It can be prevented to a certain extent by avoiding the risk factors.

What are the stages of Colon cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In Colon cancer, the stage depends on whether it is confined to the origin of the cancer (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Colon cancer?

Needless to say, if the endometrial colon cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

 

Medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Colon Cancer be detected early?

Apart from the signs and symptoms, certain tests can help diagnose the cancer early. These include:

  • Physical exam and history
  • Colonoscopy
  • Digital rectal exam
  • Fecal occult blood test
  • Barium enema
  • Sigmoidoscopy
  • Virtual colonoscopy
  • Biopsy

What are the Treatments available?

Based on the type and stage of the cancer and other factors, primary treatment options include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Targetted therapy

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should probably visit a doctor. You can also get your genetic make-up tested to see if you are prone to colon cancer.

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Eye Cancer

What is Eye Cancer?

An abnormal growth of cells that starts invading the normal cells around it is called Cancer. When these abnormal tumor cells are present in the eyes, they lead to eye cancer. These are malignant tumours. Cancer cells can also cause benign tumors sometimes grow large enough to cause problems, but they do not grow into nearby tissues or spread to distant parts of the body.

What are the general symptoms of Eye Cancer?

Symptoms for eye cancer may not appear until it’s too late. However, some of the common signs and symptoms are as follows:

  • Blurry vision or sudden loss of vision
  • Floaters (spots or squiggles drifting in the field of vision) or flashes of light
  • Losing part of your field of sight
  • A growing dark spot on the colored part of the eye (iris)
  • Change in the size or shape of the pupil
  • Change in position of the eyeball within its socket
  • Bulging of the eye
  • Change in the way the eye moves within the socket

Pain is rare unless the tumor has grown extensively outside the eye.
However, some of these may be caused due to less serious ailments as well. Do go to the doctor if you have any of the symptoms.

What are the general causes of Eye Cancer?

Some of the causes and risk-factors for eye cancer include:

Eye melanoma
  • Race/ethnicity : More common in caucasians
  • Eye color: Melanoma more like in light-coloured eyes
  • Certain inherited conditions : People with dysplastic nevus syndrome
Eye lymphoma
  • Weakened immune system.

Can Eye Cancer be prevented?

Most eye cancers can be prevented by decreasing a person’s exposure to the risk factors listed under the “Causes” section.

What are the stages of eye cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor  has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In eye cancer, the stage depends on whether it is confined to eyes (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of eye cancer?

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

Can eye Cancer be detected early?

Given the rarity of the cancer, there are no routine tests to detect it early. However, those with a weakened immune system and/or dysplastic nevus syndrome should go for regular checkups.

What are the Treatments available?

There are different treatments for different stages.

  • Surgery
  • Radiation therapy
  • Laser therapy
  • Chemotherapy
  • Targeted therapy

A combination of these treatments may also be used at times.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor.

Endometrial Cancer

What is Endometrial Cancer?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start at the endometrium (inner lining of uterus), they cause endometrial cancer.

Anatomy of Endometrium

endomentrial

What are the general symptoms of Endometrial Cancer?

  • Unusual vaginal bleeding, spotting, or other discharge
  • Pelvic pain and/or mass and weight loss

What are the general causes of Endometrial cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

 

Factors that influence the risk of endometrial cancer include:

  • Things that affect hormone levels, like taking estrogen after menopause, birth control pills, or tamoxifen; the number of menstrual cycles (over a lifetime), pregnancy, obesity, certain ovarian tumors, and polycystic ovarian syndrome
  • Use of an intrauterine device
  • Age
  • Diet and exercise
  • Diabetes
  • Family history (having close relatives with endometrial or colorectal cancer)
  • Having been diagnosed with breast or ovarian cancer in the past
  • Having been diagnosed with endometrial hyperplasia in the past
  • Treatment with radiation therapy to the pelvis to treat another cancer

Can Endometrial Cancer be prevented?

Endometrial cancer be prevented to a certain extent by avoiding the risk factors.

 

What are the stages of Endometrial cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In Endometrial cancer, the stage depends on whether it is confined to the origin of the cancer (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

 

Survival rates of Endometrial cancer?

Needless to say, if the endometrial cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

 

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Endometrial Cancer be detected early?

Noticing any signs and symptoms of endometrial cancer, and reporting them right away to your doctor allows early diagnosis.

What are the Treatments available?

Based on the type and stage of the cancer and other factors, primary treatment options for women include:

  • Surgery
  • Radiation therapy
  • Hormonal therapy
  • Chemotherapy

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should probably visit a doctor.
 

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Kidney Cancer

What is Kidney Cancer?

An abnormal growth of cells that starts invading the normal cells around it is called Cancer. When these abnormal tumor cells are present in the kidneys, they lead to kidney cancer. These are malignant tumours. Cancer cells can also cause benign tumors sometimes grow large enough to cause problems, but they do not grow into nearby tissues or spread to distant parts of the body.

 

What are the general symptoms of Kidney Cancer?

Symptoms for kidney cancer may not appear until it’s too late. However, some of the common signs and symptoms are as follows:

  • Blood in the urine (hematuria)
  • Low back pain on one side (not caused by injury)
  • A mass (lump) on the side or lower back
  • Fatigue (tiredness)
  • Loss of appetite
  • Weight loss not caused by dieting
  • Fever that is not caused by an infection and that doesn’t go away
  • Anaemia (low red blood cell counts)

However, some of these may be caused due to less serious ailments as well. Do go to the doctor if you have any of the symptoms.

What are the general causes of Kidney cancer?

Some of the causes and risk-factors for kidney cancer include:

    • Smoking
    • Obesity
    • Advanced kidney disease poses a higher risk
    • Gender: twice as common in men
    • Genetic and hereditary risk factors: People who have the conditions listed here have a much higher risk for getting kidney cancer, although they account for only a small portion of cases overall.

a)  von Hippel-Lindau disease

b)  Hereditary papillary renal cell carcinoma

c)  Hereditary leiomyoma-renal cell carcinoma

d)  Birt-Hogg-Dube (BHD) syndrome

e)  Familial renal cancer

f)  Hereditary renal oncocytoma

Can Kidney Cancer be prevented?

Most kidney cancers can be prevented by decreasing a person’s exposure to the risk factors listed under the “Causes” section.

What are the stages of kidney cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In kidney cancer, the stage depends on whether it is confined to kidneys (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Kidney Cancer?

Survival rates indicate an average outcome of a large number of people who had the disease, but they cannot precisely predict the expectancy of any particular case. The survival rate of Kidney Cancer when detected at an early stage is quite high. People with Kidney Cancer tend to be older and may have other serious health conditions. Therefore, the percentage of people surviving the Cancer itself is likely to be higher.

Stage 5 year Survival Rate
I 81%
II 74%
III 53%
IV 8%

Can kidney Cancer be detected early?

Most kidney cancers can be found early.

 

What are the Treatments available?

There are different treatments for different stages.

  • Surgery
  • Ablation and other local therapies
  • Active surveillance
  • Radiation therapy
  • Targeted therapy
  • Immunotherapy(biologic therapy)
  • Chemotherapy

A combination of these treatments may also be used at times.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor.

Liver Cancer

What is Liver Cancer?

An abnormal growth of cells that starts invading the normal cells around it is called Cancer. When these abnormal tumor cells are present in the livers, they lead to liver cancer. These are malignant tumours. Cancer cells can also cause benign tumors sometimes grow large enough to cause problems, but they do not grow into nearby tissues or spread to distant parts of the body. The patient can usually be cured with surgery.

Anatomy of Liver

liver cancer

Copyright © Terese Winslow, U.S. Govt, The above image is used for educational purpose only.

What are the general symptoms of Liver Cancer?

Though the symptoms for Liver Cancer usually don’t appear before a later stage, sometimes they may show up earlier. This would help in early diagnosis, when treatment is most likely to be helpful.

SYMPTOMS

  • Unintentional weight loss
  • Loss of appetite
  • Feeling very full after a small meal
  • Nausea or vomiting
  • An enlarged liver
  • An enlarged spleen
  • Pain in the abdomen or near the right shoulder blade
  • Swelling or fluid build-up in the abdomen
  • Itching
  • Yellowing of the skin and eyes (jaundice)

OTHER SYMPTOMS

  • Fever
  • Enlarged veins on the stomach that can be seen through the skin
  • Abnormal bruising or bleeding.

These signs and symptoms of liver cancer can also be caused by other conditions, including other liver problems. However, it's important to get it checked so that the cause can be treated!

What are the general causes of Liver cancer?

Some of the causes and risk-factors for liver Cancer include:

  • Gender: Hepato-cellular carcinoma is much more common in males than in females.
  • Race/ethnicity
  • Chronic viral hepatitis : The most common risk factor for liver cancer is chronic (long-term) infection with hepatitis B virus (HBV) or hepatitis C virus (HCV).
  • Cirrhosis: Cirrhosis is a disease in which liver cells become damaged and are replaced by scar tissue.
  • Heavy alcohol use
  • Obesity
  • Type 2 diabetes
  • Inherited metabolic diseases
  • Aflatoxins
  • Anabolic steroids
  • Arsenic in water
  • Infection with parasites
  • Tobacco use

Can Liver Cancer be prevented?

Most liver cancers can be prevented by decreasing a person’s exposure to the risk factors listed under the “Causes” section.

  • Avoiding and treating hepatitis infections – Having sex with someone who already has it, having multiple sex partners, visiting a country where Hepatitis is common, being born to a mother who has HBV can make you prone to the Hepatitis virus and hence, Liver Cancer.
  • Limiting alcohol and tobacco use
  • Getting to and staying at a healthy weight
  • Limiting exposure to cancer-causing chemicals- Such as aflatoxins, arsenic and so on.

Also,  inherited diseases can cause cirrhosis of the liver, increasing a person’s risk for liver cancer. It’s always best to see if you have a natural risk factor for liver cancer in your genes.

What are the stages of liver cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In liver cancer, the stage depends on whether it is confined to livers (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

 

Survival rates of Liver Cancer?

Needless to say, if the liver cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

“For all stages combined, the relative 5-year survival rate from liver cancer is about 15%. Part of the reason for this low survival rate is that most patients with liver cancer also have other liver problems such as cirrhosis, which itself can be fatal.

In general, survival rates are higher for people who can have surgery to remove their cancer, regardless of the stage.” – cancer.org

Can liver Cancer be detected early?

Your medical history and a physical exam to check for risk factors can help determine, to some extent, whether you have or are prone to liver cancer.

If symptoms and/or the results of the physical exam suggest you might have liver cancer, other tests will probably be done.

IMAGING TESTS

These include:

  • Ultrasound
  • CT Scan
  • Magnetic resonance imaging (MRI)
  • Angiography
  • Bone scan

OTHER TESTS AND PROCEDURES

If the medical professional believes that you have cancer but the Imaging tests have proved to be inconclusive, he or she may suggest other tests as well:

  • Laparoscopy
  • Biopsy

LAB TESTS

These may be done to detect cancer, review your health during and post-treatment and so on.

  • Alpha-fetoprotein blood (AFP) test -Levels in the blood of adults can signify liver disease, liver cancer, or other cancers.
  • Other blood tests
  • Liver function tests (LFTs)
  • Blood clotting tests
  • Tests for viral hepatitis
  • Kidney function tests
  • Complete blood count (CBC)
  • Blood chemistry tests and other tests

What are the Treatments available?

Liver cancers may be categorized as: potentially resectable or transplantable, unresectable, inoperable with only local disease, and advanced. There are different treatments for different stages.

POTENTIALLY RESECTABLE OR TRANSPLANTABLE LIVER CANCER

Potentially resectable: If a cancer is at an early stage (stage I and some stage II) and the rest of the liver is healthy, Surgery would be good option.
Potentially transplantable: Doctors resort to liver transplants if the cancer is at an early stage but the rest of the liver is not healthy, or if the tumour is embedded deep in the liver.

UNRESECTABLE LIVER CANCER

These haven’t extended to lymph nodes or distant sites. However, they can’t be removed safely by surgery because

  • The tumor is too large
  • The tumor is in a part of the liver that makes it hard to remove
  • There are several tumors or the cancer has spread throughout the liver

Treatment options include

  • Ablation,
  • Embolization
  • Targeted therapy
  • Chemotherapy
  • Radiation therapy

Sometimes, the treatment may shrink the tumor enough so that surgery is possible again.
These treatments won’t cure the cancer, but they can reduce symptoms and may even help you live longer.

INOPERABLE WITH ONLY LOCAL DISEASE

Sometimes, the patient isn’t healthy enough to be operated on. In such cases there are other treatments available:

  • Ablation,
  • Embolization
  • Targeted therapy
  • Chemotherapy
  • Radiation therapy

ADVANCED (METASTATIC) LIVER CANCERS

These cannot be treated with surgery due to the extent to which they have spread.
Clinical trials of targeted therapies, chemotherapy , radiation therapy, and other new treatments may help.

Recurrent liver cancer

Cancer that comes back after treatment is called recurrent. These can be small, localized ones or widespread. Treatment will depend on the state and stage of the recurring cancer.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor. You can also get your genetic make-up checked to see if you are prone to liver cancer or not.

Lung Cancer

What is Lung Cancer?

An abnormal growth of cells that starts invading the normal cells around it is called Cancer. When these abnormal tumor cells are present in the lungs, they lead to lung cancer. There are three main types of lung cancer.

Non-Small Cell Lung Cancer :

  • Most common type of lung cancer. About 85% of lung cancers are non-small cell lung cancers.
  • Subtypes: Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma

Small Cell Lung Cancer (Oat Cell Cancer)

  • About 10%-15% of lung cancers are small cell lung cancers.
  • Tends to spread quickly.

Lung Carcinoid Tumor (Lung Neuroendocrine Tumors)

  • Fewer than 5% of lung cancers are lung carcinoid tumors.
  • Grow slowly and rarely spread.

Each type has different treatment options treatment options. Hence, if you aren’t sure which type you have, ask your doctor so you can get the right information

Anatomy of Lung

lung cancer

What are the general causes of Lung cancer?

Most lung cancers do not cause any symptoms until they have spread too far to be cured, but sometimes, we do get symptoms at an early stage.

The most common symptoms include:

  • Weight loss
  • Loss of appetite
  • Coughing up blood or rust-colored sputum (spit or phlegm)
  • Shortness of breath
  • Recurring and persistent cough that may or may not get worse
  • Chest pain that worsens with deep breathing, coughing, or laughing
  • Hoarseness
  • Feeling tired or weak
  • Infections such as bronchitis and pneumonia that don’t go away or keep coming back
  • New onset of wheezing

If lung cancer spreads to distant organs, it may cause:

  • Bone pain
  • Nervous system changes
  • Yellowing of the skin and eyes (jaundice), from cancer spread to the liver
  • Lumps near the surface of the body, due to cancer spreading to the skin or to lymph nodes

These symptoms are more likely to be caused by conditions other than lung cancer. Still, it’s important to see your doctor right away so the cause can be found and treated, if needed.

Can Lung Cancer be prevented?

Avoiding risk factors and increasing protective factors may lower risk but it does not mean that you will not get cancer.
Different ways to prevent cancer include:

  • Changing lifestyle or eating habits.
  • Avoiding things known to cause cancer.
  • Treating a precancerous condition.

What are the stages of lung cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor  has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In lung cancer, the stage depends on whether it is confined to lungs (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of lung cancer?

Needless to say, if the lung cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can lung Cancer be detected early?

Lung Cancer can be detected early via screening. Screening is done at the diagnostic stage to check for hidden symptoms.
This stage includes:

  • Physical exam and history
  • Lab test
  • Bronchoscopy
  • Chest X-ray
  • CT Scan
  • Biopsy
  • Sputum cytology

However they have certain risks:

  • False-negative test results can occur.
  • False-positive test results can occur.
  • Chest x-rays and low-dose spiral CT scans expose the chest to radiation.

But it’s best to know for sure! Talk to your doctor about your risk for lung cancer and your need for screening tests. Better sure than wary!

What are the Treatments available?

For most small cell and non-small cell lung cancer patients, current treatments do not completely cure the cancer. However, it may be kept in check through:

  • Surgery
  • Chemotherapy
  • Avoidance of risk factors
  • Healthy habits

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor. You can also get your genetic make-up checked to see if you are prone to lung cancer or not.

Lung carcinoid tumour

What is Lung carcinoid tumour?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs.A Lung carcinoid tumour is a type of Lung Cancer, i.e. the abnormal cells start in the lung. However, it grows much slower than other lung cancers.

Anatomy of Lung

Lung Carcinoid Cancer

What are the general symptoms of Lung carcinoid tumour?

  • Central carcinoids
    • Cough, which can sometimes be bloody
    • Wheezing
    • Shortness of breath
    • Chest pain, especially when taking deep breaths
  • Peripheral carcinoids
    • Rarely cause any symptoms
    • If there are too many, it may lead to breathing trouble.
  • Carcinoid syndrome:
    • Facial flushing (redness and warm feeling)
    • Diarrhea
    • Wheezing
    • Fast heartbeat.
  • Cushing syndrome:
    • Weight gain
    • Easy bruising
    • Weakness
    • Drowsiness
    • High blood sugar (or even diabetes)
    • High blood pressure
    • Increased body and facial hair

What are the general causes of Lung carcinoid tumour cancer?

Every type of cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • Gender - women more prone than men
  • Age - found in people around 60 years of age.
  • Multiple endocrine neoplasia type 1
  • Tobacco smoke

Can Lung carcinoid tumour be prevented?

Lung carcinoid tumour can be prevented to a certain extent by avoiding the risk factors.

What are the stages of Lung carcinoid tumour?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In lung carcinoid tumour, the stage depends on whether it is confined to the origin of the cancer (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Lung carcinoid tumour?

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal. For all cases of lung carcinoid tumour cancer combined.  However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Lung carcinoid tumour be detected early?

Noticing any signs and symptoms of lung carcinoid tumour, and reporting them right away to your doctor allows early diagnosis. Since carcinoid tumours grow slowly, it is relatively easier to diagnose them at an early stage.

What are the Treatments available?

Based on the type and stage of the tumour and other factors, primary treatment options include:

  • Surgery
  • Chemotherapy
  • Other drug treatments
  • Radiation therapy

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should probably visit a doctor.

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Lymphoma of the skin

What is Lymphoma of the skin?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs.Lymphoma is a cancer that starts in cells called lymphocytes, which are part of the body’s immune system. When lymphoma occurs in the skin, it is known as Lymphoma of the skin.
There are two types:

 

  • Hodgkin lymphoma (also known as Hodgkin’s lymphoma, Hodgkin disease, or Hodgkin’s disease)
  • Non-Hodgkin lymphoma, which includes all other lymphomas, including all skin lymphomas

What are the general symptoms of Lymphoma of the skin?

Lymphomas of the skin are usually visible. They can appear as:

 

  • Small, pimple-like lesions (papules)
  • Flat lesions (patches)
  • Thick, raised or lowered lesions (plaques)
  • Larger lumps or bumps under the skin (nodules or tumors)

In addition, general symptoms include:

 

  • Unexplained weight loss
  • Fever
  • Profuse sweating (enough to soak clothing), particularly at night
  • Severe itchiness

What are the general causes of Lymphoma of the skin?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

 

Risk factors:

 

  • Age – While it usually appears in people in the age range of 50-60 or older, certain types of lymphoma can occur in younger people, including children.
  • Gender – More common in men.
  • Weakened immune system
  • Infections

Can Lymphoma of the skin be prevented?

Lymphoma of the skin be prevented to a certain extent by avoiding the risk factors.

What are the stages of Lymphoma of the skin?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In Lymphoma of the skin, the stage depends on whether it is confined to the origin of the cancer (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Lymphoma of the skin?

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

 

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Lymphoma of the skin be detected early?

Since lymphoma of the skin affects well, the skin, the changes are easily noticeable. However, most of the times it takes time to be diagnosed because the signs and symptoms are similar to other skin problems and infections.

What are the Treatments available?

Based on the type and stage of the cancer and other factors, primary treatment optionsinclude:

  • Treatments directed only at the skin
  • Treatments that can affect the whole body (systemic treatments)

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should probably visit a doctor.

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Melanoma Skin Cancer

What is Melanoma Skin Cancer?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start at the skin, they cause skin cancer. Melanoma is a cancer that begins in the melanocytes. Other names for this cancer include malignant melanoma and cutaneous melanoma.

What are the general symptoms of Melanoma Skin Cancer?

New spots on the skin that change shape, size or colour or look different from your other spots, are the most prominent warning signs. The ABCDE rule is another guide to the usual signs of melanoma.

  • A is for Asymmetry: One half of a mole or birthmark does not match the other.
  • B is for Border:The edges are irregular, ragged, notched, or blurred.
  • C is for Color:The color is not the same all over.
  • D is for Diameter:The spot is larger than 6 millimeters across (about ¼ inch – the size of a pencil eraser), although melanomas can sometimes be smaller than this.
  • E is for Evolving: The mole is changing in size, shape, or color.

Other warning signs are:

  • A sore that does not heal
  • Spread of pigment from the border of a spot into surrounding skin
  • Redness or a new swelling beyond the border
  • Change in sensation – itchiness, tenderness, or pain
  • Change in the surface of a mole – scaliness, oozing, bleeding, or the appearance of a bump or nodule

What are the general causes of Melanoma Skin cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • Ultraviolet (UV) light exposure - Thought to be the major risk factor for most skin cancers. Sunlight is the main source of UV rays. Tanning beds are another source of UV rays.
  • Having light-colored skin increases chances of developing Skin Cancer
  • Older age - The risk of getting Melanoma cell skin cancers rises as people get older.
  • Male gender
  • Multiple or unusual moles
  • Previous skin cancer
  • Xeroderma pigmentosum (XP) - This very rare inherited condition reduces the ability of skin cells to repair DNA damage caused by sun exposure.
  • Weakened immune system

Can Melanoma Skin Cancer be prevented?

The best ways to lower your risk of skin cancer are to avoid the risk factors.

 

What are the stages of Melanoma Skin cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In Skin cancer, the stage depends on whether it is confined to Skin (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Melanoma Skin cancer?

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

 

Can Melanoma Skin Cancer be detected early?

Melanoma Skin Cancer can be detected early with screening or even, simply with a self-exam where you take note of the changes on your skin.

What are the Treatments available?

Based on the type and stage of the cancer and other factors, treatment options may include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Targeted therapy
  • Immunotherapy

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

 

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should probably visit a doctor.

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Non-small cell lung Cancer

What is Non-small cell lung Cancer?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start at the lung, they cause lung cancer. Of these, About 85% to 90% of lung cancers are non-small cell lung cancer (NSCLC). There are 3 main subtypes of NSCLC:

  • Squamous cell carcinoma
  • Adenocarcinoma
  • Large cell carcinoma

What are the general symptoms of Non-small cell lung Cancer?

Most common symptoms of lung cancer are:

  • Persistent cough that may worsen
  • Chest pain
  • Hoarseness
  • Weight loss
  • Loss of appetite
  • Coughing up blood or rust-colored sputum (spit or phlegm)
  • Shortness of breath
  • Feeling tired or weak
  • Infections such as bronchitis and pneumonia that don’t go away or keep coming back
  • New onset of wheezing

When lung cancer spreads to distant organs, it may cause:

  • Bone pain (like pain in the back or hips)
  • Neurologic changes
  • Yellowing of the skin and eyes (jaundice)
  •  Lumps near the surface of the body

What are the general causes of Non-small cell lung cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • Tobacco smoke
  • Radon
  • Asbestos
  • Air pollution
  • Radiation therapy to the lungs
  • Arsenic in drinking water
  • Personal or family history of lung cancer

Can Non-small cell lung Cancer be prevented?

It can be prevented to a certain extent by avoiding the risk factors.

What are the stages of Non-small cell lung cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In Non-small cell lung cancer, the stage depends on whether it is confined to the origin of the cancer (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Non-small cell lung cancer? – Please advise (This is the same as breast cancer)

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

 

Medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Non-small cell lung Cancer be detected early?

The best bet is to pay attention to the signs and symptom s as there are currently no routine tests for non-small cell lung cancer detection.

“Usually symptoms of lung cancer do not appear until the disease is already in an advanced, non-curable stage. Even when symptoms of lung cancer do appear, many people may mistake them for other problems” – www.cancer.org

What are the Treatments available?

Based on the type and stage of the cancer and other factors, primary treatment options include:

  • Surgery
  • Radiofrequency ablation (RFA)
  • Radiation therapy
  • Chemotherapy
  • Targeted therapies
  • Immunotherapy

Palliative procedures can also be used to help with symptoms.

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor.

 

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Oesophagus Cancer

What is Oesophagus Cancer?

Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs. When such cells start in the oesophagus, they cause oesophagus cancer.

Anatomy of Oesophagus

oesophagus Cancer

What are the general symptoms of Oesophagus Cancer?

Most common symptoms are:

  • Pain/difficulty when swallowing
  • Weight loss
  • Pain behind the breastbone
  • Hoarseness and cough
  • Indigestion and heartburn

What are the general causes of Oesophagus cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • Tobacco use
  • Heavy alcohol use
  • Barrett esophagus
  •  Older age
  • Being male

Can Oesophagus Cancer be prevented?

It can be prevented to a certain extent by avoiding the risk factors.

 

What are the stages of Oesophagus cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

 

In Oesophagus cancer, the stage depends on whether it is confined to the origin of the cancer (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

 

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

 

Survival rates of Oesophagus cancer? – Please advise (This is the same as breast cancer)

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

 

Medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Oesophagus Cancer be detected early?

The best bet is to pay attention to the signs and symptoms. Some tests may help detect the cancer at an early stage. These include:

  • Physical exam and history
  • Chest x-ray
  • Barium swallow
  • Oesophagoscopy
  • Biopsy

What are the Treatments available?

Based on the type and stage of the cancer and other factors, primary treatment options include:

    • Surgery
    • Radiation therapy
    • Chemotherapy
    • Targetted therapy
    • Endoscopic treatments

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor.
 

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Oral Cancer

What is Oral Cancer?

The uncontrolled growth of mutated cells in the oral region is called Oral Cancer. The term Oral Cancer includes cancers of the mouth and the pharynx. It encompasses the lips, the inside lining of the lips and cheeks, the teeth, the gums, most of the tongue, the bottom of the mouth, and the bony roof of the mouth, or hard palate.

  • Squamous cell carcinoma: The throat and mouth are lined with flat and scale-like squamous cells. Cancer in this region is called squamous cell carcinoma and it accounts for more than 90 percent of the Oral Cancers.
  • Verrucous carcinoma: About 5 percent of all oral cavity tumors are verrucous carcinoma, which is a type of very slow-growing cancer made up of squamous cells.
  • Minor salivary gland carcinomas: This includes several kinds of Oral Cancer that can develop on the minor salivary glands, found throughout the lining of the mouth and throat. It includes:
    • Adenoid cystic carcinoma,
    • Mucoepidermoid carcinoma,
    • Polymorphous low-grade adenocarcinoma.

Lymphomas: Oral Cancers that develop in lymph tissue are known as lymphomas. The tonsils and base of the tongue both contain lymphoid tissue.

Anatomy of Mouth

Oral Cancer

What are the general symptoms of Oral Cancer?

The symptoms of oral cancer may include:

  • A persistent red or white patch on the gums, tongue, tonsil, or lining of the mouth.
  • Constant pain in the mouth.
  • Having a sore throat or mouth sore for a long time.
  • Difficulty in swallowing or chewing.
  • A lump or thickening in the cheek or neck.
  • Numbness in the mouth.
  • Unexplained bleeding.
  • Frequent pain in the ear (rare).
  • Persistent bad breath.
  • Weight loss.
  • Difficulty moving the jaw or tongue.
  • Irregular Voice changes.

What are the general causes of Oral Cancer?

Oral Cancer may at times develop in patients without any prominent causative. But the following risk factors increase the probability of occurrence of the disease.

  • Smoking – 60 % of the cases of Oral Cancer are caused by smoking. Smoking highly increases the risk of developing mouth and oropharyngeal cancer.
  • Alcohol – Drinking alcohol increases risk of mouth and oropharyngeal cancer, especially when combined with smoking. 30 % of Oral Cancers are caused by drinking alcohol.
  • Human papillomavirus (HPV) – It is a sexually transmitted disease. HPV 16 and HPV 18 highly increase the risk of Oral Cancer.
  • Chewing tobacco or betel quid – Chewing tobacco or betel quid (gutkha) is known to cause mouth and oropharyngeal cancer.
  •  Diet – Lack of vitamins and minerals, such as iron or folic acid, in the diet may result in the development of Oral Cancer.
  • Family history – Geneticconditions and earlier instances of the disease in the family increases the risk.
  • Gender – Men are twice as likely to develop Oral Cancer as women.
  • Ultraviolet light: Excessive sun exposure increases the risk of lips cancer.
  • Age – Oral cancers are more common among people above 50 years.
  • Immune system– Immune systems weakened by certain medications can easily be attacked.

Can Oral Cancer be prevented?

Not all cases of Oral cavity and oropharyngeal Cancer can be prevented, but the risk of developing these Cancers can be greatly reduced by avoiding certain risk factors.

  • Avoid the use tobacco in any form.
  • Limit the use of alcohol.
  • Stay out of the sun.
  • Eat lots of fruits and vegetables and maintain a healthy diet.
  • Avoid HPV infection.
  • Treat pre-cancerous growths.

What are the stages of Oral Cancer?

The most common system used for staging Oral Cancer is TNM staging.

  • Tumor (T) describes the size of the original tumor.
  • Node (N) indicates whether the cancer is present in the lymph nodes.
  • Metastasis (M) refers to whether cancer has spread to other parts of the body.

A number (0-4) or the letter X is assigned to each factor. A higher number indicates increasing severity. The letter X means the information could not be assessed. Once the T, N and M scores have been assigned, an overall stage is assigned. The stages range from 0 to 4:

  • Stage 0: The tumor has not invaded tissue beyond you the origin and is not more than 2cm long.
  • Stage 1: The tumor is less than 4 cm.
  • Stage 2: The tumor is slightly larger than 4 cm, but still limited to the area of origin.
  • Stage 3: The tumor has grown and spread to nearby tissues and organs.
  • Stage 4: The tumor has spread to your lymph nodes or distant organs.

Survival rates of Oral Cancer?

The survival rate and diagnosis usually go hand in hand. If the symptoms and stage of throat cancer are discovered earlier, the individual will have a greater chance of survival. The 5-year relative survival rates for Oral Cancers are:

  • 83% for cancer that has not spread
  • 62% for cancer that has spread to nearby lymph nodes
  • 38% for cancer that has spread to distant parts of the body

Can Oral Cancer be detected early?

With the development of science and technology, today there are several tests that aid in the diagnosis of Oral Cancer. These tests include:

  • Physical exam: The lips and mouth areas are examined to look for abnormalities — areas of irritation, such as sores and white patches.
  • X-rays of the mouth and throat, including CAT (computed tomography) scans
  • PET scans (positron emission tomography) - It uses radioactive materials to identify excessive activity in an organ.
  • Biopsy: A small sample of tissue is removed from a tumor to diagnose cancer. Oral Cancer usually requires a biopsy. There are different methods to obtain a biopsy:
    • Fine Need Aspiration (FNA) biopsy. A thin needle is inserted into the tumor mass and a sample is aspirated (drawn out by suction) into a syringe.
    • Incisional biopsy. A sample is removed with a scalpel (surgical knife).
    • Punch biopsy. A small circular blade removes a round area of tissue.
  • Image Testing: A variety of imaging tests may help determine whether cancer has spread beyond your mouth. Imaging tests may include X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, among others.

What are the Treatments available?

Today there are several treatments that can cure Oral Cancer and increase the life expectancy of the patients. Some of the common treatments are surgery, radiation therapy.

Surgery

Tumor resection involves an operation to remove the entire tumor. Minimally invasive surgical techniques are used to treat the cancer. Neck dissection removes any cancer cells that may have spread to the lymph nodes. Once the surgery is done, a surgery to reconstruct the mouth might be conducted.

Radiation Therapy

Radiation therapy stops cancer cells from dividing and slows the growth of the tumor. Radiotherapy also destroys cancer cells and can shrink or eliminate tumors. Radiation therapy involves 5-6 weeks of daily treatments.

Chemotherapy

Chemotherapy uses anticancer drugs to destroy cancer cells throughout the body. It may be an option if the cancer has spread to nearby lymph nodes. Chemotherapy is prescribed for different reasons:

  • Chemoradiation – A combination of chemotherapy and radiotherapy as an alternative to surgery.
  • After surgery to decrease the risk of the cancer returning
  • Palliative treatment - To slow the growth of a tumor and control symptoms when the cancer cannot be cured.

Targeted drug therapy

Targeted drug therapy targets cancerous cells to interfere with cell growth on a molecular level. Cetuximab is one targeted therapy approved for treating head and neck cancers in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of cancer cells. Targeted drugs can be used in combination with chemotherapy or radiation therapy.   

How frequently should one visit doctor for early diagnosis?

Visiting a doctor for regular mouth check up is recommended. If you spot any of the symptoms or have high risks of the disease then periodic diagnosis aids in detecting the cancer at early stage.

How can I as a patient know it early?

Being aware of the causatives and symptoms helps in identifying the signs of the disease.

Ovarian Cancer

What is Ovarian Cancer?

Ovary

The ovary is a ductless reproductive gland about the shape and size of an almond in which the female reproductive cells are produced. Females have a pair of ovaries, held by a membrane beside the uterus on each side of the lower abdomen. The ovaries are located on opposite sides of the uterus in the pelvic cavity and are attached to the uterus by the ovarian ligament

Functions:

The ovaries play two central roles in the female reproductive system by acting as both glands and gonads.

  • Acting as glands, the ovaries produce several female sex hormones including estrogens and progesterone.
  • Estrogen controls the development of the mammary glands and uterus during puberty and stimulates the development of the uterine lining during the menstrual cycle.
  • Progesterone acts on the uterus during pregnancy to allow the embryo to implant and develop in the womb.
  • The ovary is needed in reproduction since it is responsible for producing the female reproductive cells, or ova.

Cancer

Our body is made up of zillions of cells, and there is a continuous process where the cells of our body gets worn out after certain duration and gets replaced by new cells.

Cells in our body divide by a process called mitosis, where they replicate their DNA and divide into two halves. However, normal cells don’t divide infinitely, they stop dividing generally after 50 or 60 generations and commit apoptosis. This process is called senescence. Cancer cells don’t obey senescence, they are immortal and they keep dividing over and over again, giving rise to a tumor.

The National Cancer Institute defines cancer as “ a term used for diseases in which abnormal cells divide without control and invade nearby tissues”. Cancer is a collective term used for a number of diseases. There are multiple different types of cancer that show up in different parts of the body and every type of cancer works difffernetly, caused by different factors and demands unique prognosis.

Ovarian Cancer

Ovarian cancer refers to any cancerous growth that occurs in the ovary.

Types of Ovarian Cancer

There are many different types of ovarian tumors classified by the types of cells and tissue they originate from.

Epithelial ovarian cancers (EOC)

It is the most common type of ovarian cancer accounting to 90% of occurrences. Epithelial ovarian cancer means the cancer started in the surface layer covering the ovary. Epithelial cell tumors usually occur in women older than 50 years. These are sometimes referred to as carcinomas.

The four most common cell types of epithelial ovarian cancer are serous, mucinous, clear cell, and endometrioid. These cancers arise due to DNA changes in cells. The serous cell type is the most common variety.

Stromal tumors

The stroma is the supportive tissue of the ovary. They account for 5 – 8 % of ovary cancer. Stromal cell tumors are rare and may occur in women of any age, although certain tumors, such as androblastomas, may be more common in adolescence. These cancers come from various types of cells within the ovary. Stromal ovarian cancers include granulosa-stromal tumors and Sertoli-Leydig cell tumors.

Germ cell tumors

Germ cell tumors arise from the reproductive cells of the ovary and they accounts for 3 - 5 % of ovarian cancer. These tumors are uncommon and are seen most commonly in teens or young women. This type of tumor includes different categories: dysgerminomas, yolk sac tumors, embryonal carcinomas, polyembryomas, non-gestational choriocarcinomas, immature teratomas, and mixed germ cell tumors.

Ovarian Cancer Occurrence Rate in India

Ovarian cancer is among top three killers among adults in both rural and urban India. Though cancer incidence rates in India is lower as compared to western countries, but the rates are changing rapidly over recent decades. During the year 2002, it ranked third in frequency (4.1%) among all cancers in women.

In India, during the period 2004-2005, proportion of ovarian cancer varied from 1.7% to 8.7% of all female cancers in various urban and rural populations.

Anatomy of Ovarian Cancer

Ovarian Cancer

What are the general symptoms of Ovarian Cancer?

Ovarian cancer may not produce symptoms, particularly in the early stages. Some of the symptoms are mentioned below. However, they can be very subtle and vague, as well as very common.

  • fatigue
  • clothes suddenly not fitting
  • leg swelling
  • changes in bowel habits
  • changes in bladder habits
  • shortness of breath
  • Persistent pelvic or abdominal pain
  • Difficulty eating or feeling full quickly
  • Increased abdominal size/persistent bloating

These symptoms, of course, occur with many different conditions and are not specific to cancer. Consulting the doctor and discussing the symptoms is important, especially if they occur frequently and persist for more than a few weeks.

What are the general causes of Ovarian cancer?

The risk of developing Ovarian Cancer in the course of their lifetime for the general population of women is 2 %. However, some women have an increased risk of developing Ovarian Cancer. All women should be aware of the risk factors and of the symptoms of Ovarian Cancer.

"When you know the risk, you're empowered to make choices to reduce that risk. It’s not about scaring people; it’s about giving them the chance to be realistic."

There are a number of possible causes of Ovarian Cancer but these are not yet fully understood. The most important risk factors are age and a family history of ovarian or breast Cancer.

Age

The risk of developing Ovarian Cancer increases with increasing age. Women over the age of 50 have a higher risk, and most cases of Ovarian Cancer occur in women who have already gone through the menopause. Although it is not common for younger women to get Ovarian Cancer, there are instances of Ovarian Cancer in pre-menopausal women. This is especially important if women have a family history of ovarian or breast Cancer.

Family history

About 85 % of Ovarian Cancer cases are 'sporadic'. This means they are one-offs, not inherited and close female relatives face no significant increase in their risk of developing the disease themselves.

The remaining 15 – 20 % of cases are believed to be caused by an inherited faulty gene, which is often the BRCA1 or BRCA2 gene.

Other Ovarian Cancer risk factors

The risk of Ovarian Cancer may also be linked to various activities, foods or physical traits, though these theories have no evident proofs to be backed by. Some such factors are cited below:

Being overweight:

There is a slight increased risk of developing Ovarian Cancer for an obese person.

Use of Hormone Replacement Therapy (HRT):

Taking HRT increases a woman’s risk of developing Ovarian Cancer by 40 % compared to a woman who has never taken HRT. The lifetime risk of developing Ovarian Cancer is 2 %.

Endometriosis:

There is evidence to suggest that women with endometriosis have an increased risk of developing Ovarian Cancer.

Smoking:

Smoking can increase the risk of certain types of Ovarian Cancer. 3% of Ovarian Cancer seems to be linked to exposure to tobacco smoke.

Diabetes:

Research has shown that diabetics have an increased risk of up to 25 % compared with non-diabetics of developing Ovarian Cancer. Additionally the risk may be slightly higher in diabetics who use insulin as opposed to diet or tablet controlled diabetics.

Childbearing status:

Women who have delivered at least one child, especially before age 30, are at a lower risk for developing the disease. The more children a woman has, the more her Ovarian Cancer risk declines. Women who breastfeed further reduce their risk.

Breast, colorectal or endometrial Cancer:

Women who’ve been diagnosed with one of these Cancers have a higher risk of developing Ovarian Cancer.

Can Ovarian Cancer be prevented?

Some of the risk factors that might lead to ovarian cancer can be controlled by taking preventive measures. Some of the precautions are mentioned below:

Pregnancy and breastfeeding:

These combine to reduce the chance of developing ovarian cancer but they do not guarantee that one will not develop ovarian cancer. It is recognised that an increased number of ovulatory cycles raises the risk of ovarian cancer and conversely a decreased number of cycles reduces the risk.

Hysterectomy and/or having tubes tied:

Some women opt to have their fallopian tubes tied because they do not want any more children – this is called sterilisation. It is known to reduce ovarian cancer risk. Previously it was also thought that women who had had a hysterectomy (surgical removal of the womb) had a lower risk of developing ovarian cancer – however the benefits of this are now unclear and depend on factors such as the age at which surgery is done. Having a hysterectomy is known to reduce the risk of ovarian cancer.

Contraceptive Pills:

If a woman takes birth control pills for more than 10 years, then her risk of ovarian cancer drops significantly. Tubal ligation has long been known to decrease the risk of ovarian cancer.

What are the stages of Ovarian cancer?

Ovarian cancer can be staged using TNM system.

T - The size of the tumor.

N - The spread to the lymph glands/lymph nodes (N).

M - The tumor has spread anywhere else in the body.

Stage I (T1-N0-M0): The tumor is limited to the ovaries or fallopian tubes.

  • Stage IA (T1a-N0-M0): Only one ovary or fallopian tube is affected by the tumor. No cancer is detected on the surface of the ovary or fallopian tube and there are no malignant cells detected in fluid taken from the abdomen.
  • Stage IB (T1b-N0-M0): Both ovaries (or fallopian tubes) are affected by the tumor. No cancer is detected in either the surface of the ovaries or fallopian tube, or in the fluid from the abdomen.
  • Stage IC: The tumor is limited to one or both ovaries or fallopian tubes, with any of the following:
  • Stage IC1: (T1C1-N0-M0):The ovary capsule is ruptured as a result of the surgery.
  • Stage IC2: (T1C2-N0-M0): The ovary capsule ruptured before surgery, or there is a detectable tumour on the ovary or fallopian tube surface.
  • Stage IC3: (T1C3-N0-M0): Cancerous cells are detected in the fluid taken from the abdomen.

Stage II (T2-N0-M0): The tumor is in one or both ovaries, or fallopian tubes, and has extended into the pelvis or the peritoneum (thin flexible sheet of transparent tissue that covers the organs inside your abdomen).

  • Stage IIA (T2a-N0-M0): The cancer is also affecting the uterus and/or fallopian tubes
  • Stage IIB (T2b-N0-M0): The cancer is affecting other organs in your pelvis

Stage III (T1/T2-N1-M0): The tumor is in one or both ovaries, or fallopian tubes, or the peritoneum, and has also extended to the lining of the pelvis and abdomen and/or nearby lymph nodes.

  • Stage IIIA1 (T1/2-N1-M0): Very tiny cancer cells are detected in the lymph nodes in the lining of the abdomen. (Stage IIIA1(i) the tumour is up to 10 mm in dimension, and Stage IIIA1(ii) the tumour is more than 10 mm in greatest dimension).
  • Stage IIIA2 (T3a2-N0/N1-M0): Very tiny cancer cells are detected above the pelvis, with or without the tumour detectable in the lymph nodes in the lining of the abdomen.
  • Stage IIIB (T3b-N0/N1-M0): Small tumours (less than 2cm in diameter) are detectable beyond the pelvis, and the lymph nodes may or may not contain cancerous cells.
  • Stage IIIC (T3c-N0/N1-M0): Small tumours (more than 2cm in diameter) are detected beyond the pelvis, including into the non-functional part of the liver and spleen and/or there is cancer.

Stage IV

Stage IV – A and B (any T–any N–M1): The cancer cells have spread to another organ such as the liver, the brain or the lungs.

Survival rates of Ovarian cancer?

Survival depends on many different factors. It depends on your individual condition, type of cancer subtype, treatment and level of fitness.

Epithelial Ovarian Cancer is the most deadly of the gynecologic cancers. Approximately 80% of patients will eventually die of the disease. However, survival in the short term is quite good. With the addition of IP chemotherapy, the survival of ovarian cancer has been significantly extended. According to recent studies, if a patient undergoes optimal debulking, followed by IP chemotherapy, then they have a greater than 50% chance to still be alive in six years. This is quite good compared to other advanced stage cancers. Even in the recurrent setting, epithelial Ovarian Cancer is often very sensitive to chemotherapy. The disease can often go in to complete remission (no detectable disease) many times. However, once it recurs, it is not curable and will continue to come back.

Germ cell and stromal tumors have a much better prognosis. They are often cured because they are more often detected at early stages

Stage Survival Rate
StageI 90%
StageIA 94%
StageIB 92%
StageIC 85%
StageII 70%
StageIIA 78%
StageIIB 73%
StageIII 39%
StageIIIA 59%
StageIIIB 52%
StageIIIC 39%
StageIV 17%

The survival rate is higher than 90 percent when the cancer is found early and treated right away. Doctors diagnose 15 percent of Ovarian Cancers at the earliest stages. Scientists are currently researching more improved and reliable ways to detect ovarian cancer early.

Can Ovarian Cancer be detected early?

It’s much easier to treat ovarian cancer when diagnosed at an early stage. However, it’s not easy to detect. Ovaries are situated deep within the abdominal cavity, so it is unlikely to feel a tumor. There’s no routine diagnostic screening available for Ovarian Cancer. That’s why it’s so important to report unusual or persistent symptoms to your doctor.

If a woman has Ovarian Cancer symptoms, a strong family history, or a genetic predisposition such as a BRCA mutation, following tests are suggested:

  • Blood Test - Though blood test is not the best test for diagnosing Ovarian Cancer, but it is helpful if a woman has symptoms of Ovarian Cancer or has already been diagnosed with ovarian cancer.
  • Transvaginal Ultrasound - A transvaginal ultrasound is a test used to examine a woman’s reproductive organs and bladder.
  • Pelvic Exam - A pelvic exam should be a part of a woman’s regular female health exam. A pelvic examination may reveal an Ovarian or abdominal mass. Ovarian cancer is rarely detected in a pelvic exam and usually it is detected if it is in an advanced stage.

Often vague symptoms eventually lead to a clinical diagnosis, or one based on suspicion generated by exams, laboratory tests, and imaging. However, an accurate diagnosis requires some of the tumor to be removed, either by biopsy (less often), or preferably, surgery to verify the diagnosis.

Various types of imaging studies can be used to diagnose this disease and lead to tissue sampling. Ultrasound and CT scans are the most commonly done studies. These often can give images that show masses in the abdomen and pelvis, fluid in the abdominal cavity (ascites), obstructions of the bowels or kidneys, or disease in the chest or liver. PET scans can be used, but often are not necessary if a CT scan is able to be performed.

What are the Treatments available?

The treatment depends on how far the cancer has spread. A team of doctors will determine a treatment plan depending on your situation. It will most likely include two or more of the following:

  • chemotherapy
  • radiation
  • surgery to stage the cancer and remove the tumor
  • targeted therapy
  • hormone therapy

Surgery

Surgery is the main treatment for Ovarian Cancer. The goal of surgery is to remove the tumor, but a hysterectomy, or complete removal of the uterus is often necessary. It is often recommend removing both ovaries and fallopian tubes, nearby lymph nodes, and other pelvic tissue. Identifying all tumor locations is difficult.

Chemotherapy

Chemotherapy is typically given after surgery for all stages of Ovarian Cancer. Chemotherapy drugs are usually given intravenously, or administered directly into the abdominal cavity (intraperitoneal chemotherapy).

Targeted Therapies

New therapies for Ovarian Cancer may be directed at blocking tumor growth by interfering with the formation of blood vessels to supply the tumor. The process of blood vessel formation is known as angiogenesis. The drug Avastin works by blocking angiogenesis, causing tumors to shrink or stop growing.

How frequently should one visit doctor for early diagnosis?

Having a symptoms associated with Ovarian Cancer may not necessarily indicate the presence of the disease. However, expert advice to rule out the possibility is prudent, making curative treatment possible. So, regular self examination and a physical examination at least once a year is recommended to facilitate early diagnosis of the disease.

How can I as a patient know it early?

Being aware of the symptoms, and any health issue that might indicate the presence of the disease needs to be examined thoroughly. Also, a few lab tests and regular tests can also sometime unveil the presence of the hideous disease.

Pancreatic Cancer

What is Pancreatic Cancer?

Pancreas

Pancreas is a long, flat, pear shaped glandular organ that lies in the abdomen. The pancreas consists of exocrine and endocrine glands which secrete pancreatic juices, hormones, and insulin.

  • Endocrine gland is responsible for the secretion of the hormones insulin and glucagon that controls our blood sugar level.
  • Exocrine gland secret pancreatic juices that are released into the intestine by pancreatic ducts in order to help digest fat, proteins, and carbohydrates.

Functions

  • It serves as two glands in one: a digestive exocrine gland and a hormone-producing endocrine gland.
  • The pancreas secretes enzymes to break down the proteins, lipids, carbohydrates, and nucleic acids in food.
  • The pancreas secretes the hormones insulin and glucagon to control blood sugar levels.

Pancreatic Cancer:

Cancer is a class of disease characterized by mutated cell growth in an uncontrolled way. Pancreatic cancer occurs when this uncontrolled cell growth begins in any part of the pancreas. Rather than developing into normal, healthy pancreas tissue, these abnormal cells continue dividing and form lumps or masses of tissue called tumours. Tumours then interfere with the main functions of the pancreas.

If a tumour stays in one spot and demonstrates limited growth, then it is considered to be benign. The tumor which sheds cells that migrate to different parts of the body is called a malignant tumor.

When a tumour successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a more serious condition that is very difficult to treat.

Types of Pancreatic Cancer:

Pancreatic Cancer is classified into two types, based on the part of pancreas that is affected -

  • Exocrine tumors: Most tumours affecting the exocrine gland are called adenocarcinomas. This type of cancer forms in the pancreas ducts and treatment for these tumours is based on stage of growth. About 95 % of Pancreatic Cancers begin in the exocrine cells of the pancreas.
    Other less common types of exocrine tumors are :
    • Adenosquamous carcinoma
    • Squamous cell carcinoma
    • Giant cell carcinoma
    • Acinar cell carcinoma
    • Small cell carcinoma
  • Endocrine tumors : These tumors are less common and are most often benign. Though rare, cancer stemming from a pancreatic endocrine tumor (PET) affects the hormone-producing cells. These tumors are also called islet cell tumours or neurendocrine tumours.
    Endocrine Pancreatic Cancers are uncommon, and are named according to the type of hormone produced:
    • Insulinomas
    • Glucagonomas
    • Somatostatinomas
    • Gastrinomas
    • VIPomas
    • Non-secreting islet tumors.

Occurrence Rate of Pancreatic Cancer

Pancreatic Cancer is more common in western countries as compared to developing countries like India. However, data from recent studies and surveys have revealed that there is an alarming rise in Pancreatic Cancer cases.

The one year survival rate for this rare and aggressive form of cancer is about 20% and 5 year survival rate declines to 7%. Though the 5 year survival rate is low, it can rise upto 20% – 35%, if the tumor is detected at early stage (before metasizing) and is removed completely.

Anatomy of Pancreas

pancreas cancer

Copyright © Terese Winslow, U.S. Govt, The above image is used for educational purpose only.

What are the general symptoms of Pancreatic Cancer?

Pancreatic Cancer is aggressive with few symptoms until the cancer is advanced. In the early stages, the cancer doesn’t usually show any signs or symptoms. By the time the symptoms are visible, the cancer has already spread beyond the pancreas.

  • Jaundice and related symptoms
    • Dark urine
    • Light-coloured stools
    • Itchy skin
  • Abdominal or back pain
  • Loss of appetite, nausea, and vomiting
  • Digestive problems
    • Pale, greasy stools
    • Nausea and vomiting
  • Gallbladder enlargement
  • Blood clots
  • Fatty tissue abnormalities
  • Diabetes

These symptoms of Pancreatic Cancer have numerous other causes, making it difficult to diagnose the disease before it is in an advanced stage.

What are the general causes of Pancreatic cancer?

Cancer is the result of cells that grows uncontrollably and do not die naturally. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, it results into cancer.

Pancreatic Cancer cells do not experience programmatic death, but instead continue to grow and divide. Although scientists do not know exactly what causes these cells to behave this way, they have identified several potential risk factors. Some of the causes are discussed below:

DNA Cells

DNA cells may sometime experience uncontrolled growth due to mutations in the DNA, and damage the genes involved in cell division. Four key types of genes are responsible for the cell division process:

  • Oncogenes tell cells when to divide,
  • Tumour suppressor genes tell cells when not to divide,
  • Suicide genes control apoptosis and tell cells to kill themselves if something goes wrong,
  • DNA-repair genes instruct cells to repair damaged DNA.

Cancer occurs when a cell's gene mutations results in permanent DNA damage. DNA mutations that lead to Pancreatic Cancer are mostly a resultant of factors that affected DNA after birth rather than a merely inheritance from parents.

Genes - the family type

Pancreatic Cancer can be the result of a genetic predisposition inherited from family members. About 10% of Pancreatic Cancers are caused by inherited gene mutations. Genetic syndromes that are associated with Pancreatic Cancer include hereditary breast and ovarian cancer syndrome, melanoma, pancreatitis, and non-polyposis colorectal cancer (Lynch syndrome).

Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Certain pesticides, dyes, and chemicals used in metal refining are thought to be carcinogenic, increasing the risk of developing Pancreatic Cancer.

When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. These free radicals damage cells, affecting their ability to function normally, and the result can be cancerous growths.

Other lifestyle factors that might lead to Pancreatic Cancer are:

Tobacco use: The risk of getting Pancreatic Cancer increases with the use of tobacco. It is twice as high among smokers compared to those who have never smoked. The good thing is that it is a controllable factor and one can choose to avoid it.

Overweight and obesity: Obese people are about 20% more likely to develop Pancreatic Cancer. Extra weight around the waistline may be a risk factor. People who exercise regularly have about half the risk of Pancreatic Cancer as sedentary people do.

Workplace exposure to certain chemicals : Heavy exposure at work to certain pesticides, dyes, and chemicals used in metal refining may increase the risk of developing Pancreatic Cancer.

Age : Most of the patients reported for Pancreatic Cancer are above 45 years of age.

Gender : Men are about 30% more likely to develop Pancreatic Cancer than women.

Diabetes : Pancreatic Cancer is more common in people who have diabetes. In some people, though, the cancer seems to have caused the diabetes. This can happen when cancer spreads through the pancreas and damages enough of the insulin-making cells to cause diabetes.

Chronic pancreatitis : This condition is linked with an increased risk of Pancreatic Cancer, but most people with pancreatitis never develop Pancreatic Cancer.

Stomach problems : Infection of the stomach with the ulcer-causing bacteria Helicobacter pylori (H. pylori) may increase the risk of getting Pancreatic Cancer.

Can Pancreatic Cancer be prevented?

The best way to lower the risk of Pancreatic Cancer is to avoid risk factors and get an early diagnosis, with regard to natural factors. Some of the lifestyle changes mentioned below do offer some shielding to the disease:

  • Exercising and maintaining healthy weight.
  • Staying away from tobacco, smoking and alcohol.
  • Controlling diabetes.
  • Ensuring workplace safety.

What are the stages of Pancreatic Cancer?

The “stage of cancer” is a term used to describe the spread and extent of the Cancer cells. During diagnosis, a stage is assigned to the cancer to facilitate planning and proper treatment of the disease. The stages of Pancreatic Cancer are categorized as follows:

Stage 0 (Tis, N0, M0):

Pancreatic Cancer is limited to a single layer of cells in the pancreas. The Pancreatic Cancer is not visible on imaging tests.

Stage I(T1/T2, N0, M0)

Pancreatic Cancer is limited to the pancreas, but has grown to less than 2 centimeters across (stage IA) or greater than 2 centimeters (stage IB). It has not spread to lymph nodes or other parts of the body.

Stage II (T1, T2, or T3; N0/N1; M0)

A tumor of any size may have extended beyond the pancreas, but the tumor has not spread to nearby arteries or veins. It has not spread to any lymph nodes or other parts of the body.

 

Stage III (T4, N1, M0): 

A tumor has spread to nearby arteries, veins, and/or lymph nodes but has not spread to other parts of the body.

Stage IV (any T, any N, M1):

Any tumor that has spread to other parts of the body.

Survival rates of Pancreatic Cancer? – Please advise (This is the same as breast cancer)

Survival rate is a calculation of the probability of surviving the disease based on the earlier track records of a number of patients having the same disease at the same stage. Since, the prognosis and treatment of each individual may vary based on a number of other factors like health history, immunity, family history etc., so predicting the outcome of any particular case to precision is not possible.

Exocrine Pancreatic Cancer

Stage 5 year Survival Rate
Stage IA 14%
Stage IB 12%
StageIIA 7%
Stage IIB 5%
Stage III 3%
Stage IV 1%

Neuroendocrine Pancreatic Tumors

Stage 5 year Survival Rate
Stage I 61%
Stage II 52%
Stage III 41%
Stage IV 16%

Can Pancreatic Cancer be detected early?

Pancreatic Cancer is hard to find early. The pancreas is located deep inside the body, so early tumors can’t be seen or felt during routine physical exams. People usually have no symptoms until the cancer has already spread to other organs. Screening tests are used to look for a disease in people with no evident symptoms.

Tests for Pancreatic Cancer

If a person has spotted any of the signs and symptoms that might be caused by Pancreatic Cancer, certain exams and tests needs to be done at the earliest.

Medical history and physical exam

The signs of Pancreatic Cancer along with other health problems are examined. The examination mostly focuses on the belly. Pancreatic Cancers can sometimes cause the liver or gallbladder to swell. Skin and the whites of the eyes will also be checked for jaundice (yellowing).

Imaging tests

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the pancreas. Imaging tests might be done for a number of reasons both before and after a diagnosis of Pancreatic Cancer, including:

  • To look for suspicious areas that might be cancer
  • To learn if and how far cancer has spread
  • To help determine if treatment is working
  • To look for signs of cancer coming back after treatment.

Computed tomography (CT) scan

The CT scan makes detailed cross-sectional images of the body. CT scans are often used to diagnose Pancreatic Cancer because they can show the pancreas clearly. They can also help show if cancer has spread to organs near the pancreas, as well as to lymph nodes and distant organs. A CT scan can help determine if surgery might be a good treatment option.

Magnetic resonance imaging (MRI)

MRI is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Ultrasound

Ultrasound tests use sound waves to create images of the pancreas.

  • Abdominal ultrasound: A wand-shaped probe called ultrasound transducer is moved over the skin of the abdomen. It gives off sound waves and detects the echoes as they bounce off organs. The transducer receives the echoes and sends them to a computer, which uses the echoes to make pictures called sonograms.
  • Endoscopic ultrasound (EUS): In this procedure, an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves off internal tissues or organs and make echoes to produce the sonogram. This procedure is also called endosonography.

Endoscopic retrograde cholangiopancreatography (ERCP): An endoscope is passed down the throat, through the esophagus and stomach, and into the first part of the small intestine.

A small amount of dye is then injected into the common bile duct, and x-rays are taken. This dye outlines the bile and pancreatic ducts. The x-rays can show narrowing or blockage in these ducts that might be due to Pancreatic Cancer. Sometimes, a small brush is put through the tube to remove cells for a biopsy.

Percutaneous transhepatic cholangiography (PTC): In this procedure, a thin, hollow needle is put through the skin of the belly and into a bile duct within the liver. A contrast dye is then injected through the needle, and x-rays are taken as it passes through the bile and pancreatic ducts. As with ERCP, this approach can also be used to take fluid or tissue samples. Because it is more invasive, PTC is not usually used unless ERCP has already been tried or can’t be done for some reason.

Somatostatin receptor scintigraphy (SRS)/OctreoScan

It can be very helpful in finding pancreatic neuroendocrine tumors (NETs). A hormone-like substance called octreotide that is bound to a radioactive substance is injected into a vein. Octreotide travels through the blood and attaches to the tumor cells of many types of NETs. A special camera is then used to trace the radioactivity in the body.

Positron emission tomography (PET) scan

For a PET scan, a slightly radioactive form of sugar is injected. A special camera is then used to create a picture of areas of radioactivity in the body.

This test is sometimes used to look for spread from exocrine Pancreatic Cancers, but because NETs grow slowly, they do not show up well on PET scans.

Angiography

This is an x-ray test that looks at blood vessels. A small amount of contrast dye is injected into an artery to outline the blood vessels, and then x-rays are taken.

An angiogram can show if blood flow in a particular area is blocked or compressed by a tumor. It can also show abnormal blood vessels in the area. This test can be useful in finding out if a Pancreatic Cancer has grown through the walls of certain blood vessels. Mainly, it helps surgeons decide if the cancer can be removed completely without damaging vital blood vessels, and it can also help them plan the operation.

Blood tests for

A procedure in which a blood sample is checked to measure the amounts of certain substances, such as bilirubin, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.

Liver function tests: Jaundice (yellowing of the skin and eyes) is often one of the first signs of Pancreatic Cancer, but it can have many causes other than cancer.

Tumor markers: In this procedure a sample of blood, urine , or tissue is checked to measure the amounts of certain substances, such as CA 19-9, and carcinoembryonic antigen (CEA). Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers.

Biopsy

A small sample of tumor is removed and observed closely under the microscope. This procedure is called a biopsy. Biopsies can be done in different ways.

  • Percutaneous biopsy: A thin, hollow needle is inserted through the skin over the abdomen and into the pancreas to remove a small piece of a tumor. This is known as a fine needle aspiration (FNA).
  • Endoscopic biopsy: An endoscope is passed down the throat and into the small intestine near the pancreas. At this point, either endoscopic ultrasound (EUS) is used to pass a needle into the tumor or endoscopic retrograde cholangio pancreatography (ERCP) to remove cells from the bile or pancreatic ducts.
  • Surgical biopsy: Surgical biopsies are useful to find if cancer has spread beyond the pancreas and to other organs in the abdomen. The most common way to do a surgical biopsy is to use laparoscopy.

What are the Treatments available?

Once the cancer is diagnosed and its stage is determined then the treatment is planned based on the type of tumor and patients’ overall health condition. The treatment plan may indulge multiple phases involving more than one type of treatment.

Before rooting for a specific treatment plan, the doctor conducts multiple tests of the genes, tumor and other factors. Based on the results of these tests the most acute treatment strategy is formulated. Some of the advanced treatment options are discussed below:

  • Surgery
    Surgery is the most preffered treatment when the tumor is restricted to the pancreas only and has not spread beyond it. Surgery includes removing all or part of the tumour depending on its location, size and extent of spread. It is highly efficient for treating cancers of early stages. However, the later stages of Pancreatic Cancer is difficult to treat and may involve more complex treatment plan
  • Neoadjuvant therapy
    Neoadjuvant treatments are the preliminary treatment that aids in shrinking the tumor before proceeding for surgerical treatments. Some of the most commonly used neoadjuvant therapies are chemotherapy, radiation therapy and hormone therapy.
  • Adjuvant therapy
    Adjuvant therapy refers to the after surgery treatments that helps to decrease the risk of recurring cancer incidences. Adjuvant therapy may begin within 8 weeks after surgery, based on the recovery rate and the overall health condition of the patient. Adjuvent therapy may include chemotherapy, radiation therapy, targeted therapy and palliative treatment.

Is there a curative treatment for Pancreatic Cancer?

Pancreatic Cancer is a very rare and aggressive type of Cancer. It grows very fast and does not show any sign and symptom at the earlier stages and hence finding a cure for the same becomes a bit difficult. There are several options for treatment but the outcome of the treatment may not be favourable.

How frequently should one visit doctor for early diagnosis?

If you encounter any of the symptoms then consulting a doctor is the smartest move though the symptom might not necessarily indicate the presence of the fatal disease. Also having any prior history or familial history of the disease calls for a regular examination alteast once a year. If one is suffering from diabetes or jaundice it is better to test for Pancreatic Cancer to be on the safer side.

How can I as a patient know it early?

Considering the location of the pancreas and the nature of Pancreatic Cancer it is very difficult to detect it at an early stage. However, being alert and going for regular examinations can definitely help one in diagnosing the disease.

Penile Cancer

What is Penile Cancer?

Penile cancer develops in or on the penis. Cancer is the growth of abnormal cells that take over neighbouring cells and tissues and, at later stages, also spread to organs.

What are the general symptoms of Penile Cancer?

  • Skin changes
    • An area of skin becoming thicker and/or changing color
    • A lump on the penis
    • An ulcer (sore) that might bleed
    • A reddish, velvety rash
    • Small, crusty bumps
    • Flat, bluish-brown growths
    • Smelly discharge (fluid) under the foreskin
  • Swelling
  • Lumps under the skin in the groin area

What are the general causes of Penile cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • Smoking
  • UV light treatment of psoriasis
  • Age: The older you are, the more prone you are.
  • AIDS
  • Not being circumcised
  • HPV infection

Can Penile Cancer be prevented?

Penile cancer can be prevented to a great degree by avoiding the risk factors. Genital hygiene, restraint from smoking and avoidance of HPV infection help a great degree.

What are the stages of Penile cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In Penile cancer, the stage depends on whether it is confined to the penis (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

Survival rates of Penile cancer?

Needless to say, if the cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

However, medicine is evolving everyday to meet these challenges and to keep you happy, healthy and alive!

Can Penile Cancer be detected early?

Most penile cancers can be detected early since they usually start by affecting the skin.

What are the Treatments available?

Based on the type and stage of the cancer and other factors, treatment options may include:

  • Surgery
  • Radiation therapy
  • Local therapy
  • Chemotherapy

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor.

All matter is for informational purposes only and has been collated from www.cancer.gov and www.cancer.org. Zuvius Lifesciences does not claim authorship of the above.

Sinus Cancer

What is Nasal Cavity and Paranasal Sinus Cancer?

The nasal cavity is the space just behind the nose through which air passes to the throat. The Paranasal Sinuses are air-filled areas that surround the nasal cavity. There are several Paranasal Sinuses named after the bones that surround them:

  • Frontal Sinuses are in the lower forehead above the nose.
  • Maxillary Sinuses are in the cheekbones on either side of the nose.
  • Ethmoid Sinuses  are beside the upper nose, between the eyes.
  • Sphenoid Sinuses are behind the nose, in the center of the skull.

Nasal cavity and paranasal Sinus Cancer begins when healthy cells in the nasal area grows out of control, forming a mass called a tumor. A tumor can be malignant or benign. A malignant tumor is cancerous, which means it can grow and spread to other parts of the body. Sinus Cancer is categorized into different types depending on the different kind of cells they originate in. The categorization is important as it determines the rate of spread of the disease and the prognosis needed.

The types of Sinus Cancer include:

  • Squamous cell carcinoma: This is the most common type of nasal cavity and paranasal Sinus Cancer. Squamous cells are flat cells that make up the thin surface layer of the structures of the head and neck.
  • Adenocarcinoma. This is the second most common type of nasal cavity and paranasal Sinus Cancer. It begins in gland cells.
  • Melanoma. Melanoma develops from cells called melanocytes that give the skin its color. It is usually an invasive, fast-growing cancer. However, it only accounts for about 1% of tumors found in this area of the body.
  • Inverting papilloma. These are benign, wart-like growths that may develop into squamous cell carcinoma. Approximately 10% to 15% of these will develop into cancer.
  • Esthesioneuroblastoma. This type of cancer is related to the nerves that control the sense of smell. It occurs on the roof of the nasal cavity and involves a structure called the cribriform plate. The cribriform plate is a bone located deep in the skull between the eyes and the sinuses.
  • Midline granuloma. A group of several unrelated conditions that cause the breakdown of the healthy tissue of the nose, sinuses, and nearby tissues. Some cases are due to immune system problems, and many others are actually a type of lymphoma (see below).
  • Lymphoma. Lymphoma is a cancer of the lymphatic system. The lymphatic system carries lymph, a colorless fluid containing lymphocytes. Lymphoma may develop within the lymph tissue found in the lining of the nasal cavity and Paranasal Sinuses, called the mucosa.
  • Sarcoma. Sarcoma is a type of cancer that begins in muscle, connective tissue, or bone.

Occurrence Rates:

  • 30 to 40% will have it in their maxillary sinuses.
  • 40 to 50% will develop it in their nasal cavity.
  • 10 to 15% will have the cancer in their ethmoid sinuses.

Anatomy of Sinus Cancer

Sinus Cancer

What are the general symptoms of Sinus Cancer?

Possible symptoms of Sinus Cancer include:

  • A lump or sore inside the nose that does not heal.
  • A lump on the face or roof of the mouth.
  • Numbness or tingling in the face.
  • Swelling or other trouble with the eyes, such as double vision or the eyes pointing in different directions.
  • Pain or pressure in the ear.
  • Nasal obstruction or persistent nasal congestion and stuffiness, which is often called sinus congestion 
  • Chronic sinus infections that do not respond to antibiotic treatment.
  • Frequent headaches or pain in the sinus region.
  • Pain or swelling in the face, eyes, or ears.
  • Persistent tearing of the eyes.
  • Bulging of one of the eyes or vision loss.
  • Decreased sense of smell.
  • Pain or numbness in the teeth.
  • Loosening of teeth.
  • A lump on the face, nose, or inside the mouth.
  • Frequent nosebleeds.
  • Difficulty opening the mouth.
  • A lump or sore inside the nose or neck that does not heal.
  • Fatigue.

What are the general causes of Sinus cancer?

Sinus Cancer is associated to a number of artificial causatives that can be controlled to avoid the disease. However, many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

There are 2 risk factors that greatly increase the risk of Nasal Cavity and Paranasal Sinus Cancer:

  • Tobacco use Use of tobacco is the single largest risk factor for head and neck cancer. Tobacco products include cigarettes, cigars, pipes, chewing tobacco, and snuff. Eighty-five percent (85%) of Sinus Cancer is linked to tobacco use. 
  • Alcohol Frequent and heavy consumption of alcohol is a high risk factor for Sinus Cancer. Using alcohol and tobacco together increases this risk even more.

Other factors can raise a person’s risk of developing Nasal Cavity or Paranasal sinus cancer.

  • Gender Nasal Cavity and Paranasal Sinus Cancer occurs twice as often in men as in women.
  • Age Nasal Cavity and Paranasal Sinus Cancer are most commonly found in people between the ages of 45 and 85. However, the development of this cancer is also found among younger people now a days.
  • Human papillomavirus (HPV) Infection with this virus is a risk factor for Nasal Cavity and Paranasal Sinus Cancer.
  • Specific inhalants Breathing in certain substances, most commonly found work environments, may increase the risk of developing Nasal Cavity or Paranasal Sinus Cancer. These substances include:
    • Dust from the wood, textiles, or leather industries
    • Flour dust
    • Nickel dust
    • Chromium dust
    • Mustard gas
    • Asbestos
    • Rubbing alcohol, also called isopropyl alcohol, fumes
    • Radium fumes
    • Glue fumes
    • Formaldehyde fumes
    • Solvent fumes used in furniture and shoe production
  • Exposure to air pollution Being exposed to air pollution may increase a person’s risk of developing Nasal Cavity and Paranasal Sinus Cancer.
  • Marijuana use Recent research suggests that people who have used marijuana may be at higher risk for head and neck cancer.

Can Sinus Cancer be prevented?

Though some of the causatives of sinus cancer are beyond our control but most of them are controllable.

  • The two major known causes of sinus cancer are usage of tobacco and alcohol. So, by lowering and controlling their consumption one can definitely be prevented.
  • Using marijuana also increases the risk, so saying no to marijuana drops the risk.
  • Ensuring safe sex reduces the risk of HPV.
  • Ensuring safe work and home environment free of air pollutants.

What are the stages of Sinus Cancer?

Sinus Cancer can be staged using the TNM staging system:

  • refers to the spread of cancer cells to tissues next to the testicle.
  • N describes the spread of cancer cells to regional lymph nodes.
  • M indicates whether the cancer has metastasized.

The results are combined to determine the stage of cancer for each person. There are 5 stages for nasal cavity and paranasal Sinus Cancer: stage 0 (zero) and stages I through IV (1 through 4).

Tumor

  • TX: Primary tumor cannot be evaluated.
  • T0: No evidence of a tumor could be found.
  • Tis: This is a very-early-stage cancer, cancer cells are found only in 1 layer of tissue. It is also called carcinoma in situ.

Primary tumor (T) in the maxillary sinus

  • T1: The spread of tumor is limited to the inside of the sinus.
  • T2: The tumor has spread to the bone surrounding the sinuses.
  • T3: The tumor invades the surrounding bone, the skin of the cheek, or the other sinuses.
  • T4a: The tumor has invaded the bone surrounding the eye, the skin of the cheek, or the throat.
  • T4b: The tumor might invade: the back of the eye, the brain area, or the bones of the skull.

Primary tumor (T) in the nasal cavity and ethmoid sinus

  • T1: The tumor is limited to the inside of the sinus and has no involvement with the bone.
  • T2: The tumor extends into the nasal cavity.
  • T3: The tumor extends into the maxillary sinus or to the bone surrounding the eye.
  • T4a: The tumor has spread throughout the facial bones or into the base of the skull.
  • T4b: The tumor invades any of the following: the back of the eye, the brain area, or the back of the head.

Node (N)

  • NX: The regional lymph nodes cannot be evaluated.
  • N0: There is no evidence of cancer in the regional lymph nodes.
  • N1: The cancer has grown up to 3 cm and has spread to a single lymph node on the same side as the primary tumor.
  • N2a: The cancer sizes from 3 cm to 6 cm and has spread to a single lymph node on the same side as the primary tumor.
  • N2b: The cancer has spread to more than 1 lymph node on the same side as the primary tumor, but none measures larger than 6 cm.
  • N2c: The cancer has spread to more than 1 lymph node on either side of the body, but none measures larger than 6 cm.
  • N3: The cancer is found in at least 1 nearby lymph node and is larger than 6 cm.

Metastasis (M)

  • MX: Distant metastasis cannot be evaluated.
  • M0: The cancer has not spread to other parts of the body.
  • M1: The cancer has spread to another part(s) of the body.

Grade (G)
It describes how much cancer cells look like healthy cells when viewed under a microscope.

  • GX: The grade cannot be evaluated.
  • G1: The cells look more like healthy tissue and are well differentiated.
  • G2: The cells are only moderately differentiated.
  • G3: The cells don’t resemble healthy tissue and are poorly differentiated.

Stage I: This is a noninvasive cancer (T1) with no spread to lymph nodes (N0) and no distant metastasis (M0).

 Sinus Cancer Stage I

@ 2005 American Society of Clinical Oncology

Stage II: This is an invasive cancer (T2) that has not spread to lymph nodes (N0) or to distant parts of the body (M0).

 Sinus Cancer Stage II

@ 2005 American Society of Clinical Oncology

Stage III: This includes invasive cancer (T3) with no spread to regional lymph nodes (N0) and no metastasis (M0), as well as invasive cancer (T1, T2, T3) that has spread to regional lymph nodes (N1) but shows no sign of metastasis (M0).

 Sinus Cancer Stage III

@ 2005 American Society of Clinical Oncology

Stage IVA: This is an invasive cancer (T4a) that either has no lymph node involvement (N0) or has spread to only 1 same-sided lymph node (N1) but with no metastasis (M0). It is also used for any cancer (any T) with more significant nodal involvement (N2) but with no metastasis (M0).

 Sinus Cancer Stage IVA

@ 2005 American Society of Clinical Oncology

Stage IVB: This is an invasive cancer (any T) that has spread to lymph nodes (any N) but has no metastasis (M0). It is also used for any cancer (any T) that is found in lymph nodes and is larger than 6 cm (N3) but has no metastasis (M0).

 Sinus Cancer Stage IVB

@ 2005 American Society of Clinical Oncology

Stage IVC: This refers to any tumor (any T, any N) when there is evidence of distant spread (M1).

 Sinus Cancer Stage IVC

@ 2005 American Society of Clinical Oncology

Survival rates of Sinus Cancer?

The survival rate and diagnosis usually go hand in hand. If the symptoms and stage of Sinus Cancer are discovered earlier, the individual will have a greater chance of survival. Here is an analysis of 5 year survival rate of different types of Sinus Cancer based on earlier history. However, these rates might go up and down when calculated for a particular area.

Stages 5-year relative survival rate
I 63%
II 61%
III 50%
IV 35%

Can Sinus Cancer be detected early?

Small cancers of the nasal cavity and paranasal sinuses usually do not cause any specific symptoms. Many of these cancers are not found until they have grown large enough to block the nasal airway or sinuses, or until they have spread to nearby tissues or even to distant areas of the body.

Here are a few diagnostic tests that might be recommended to detect the presence of this disease.

  • Screening : Screening refers to tests and exams used to detect cancer, in people who do not have any symptoms. Screening can find some types of cancer early, when treatment is most likely to be effective.
  • Physical examination: During a physical examination, any lump on the neck, lips, gums, and cheeks is checked. The doctor further inspects the nose, mouth, throat, and tongue for abnormalities, often using a light and/or mirror for a clearer view.
  • Biopsy: A biopsy is the removal of a small amount of tissue for examination under a microscope.
    • Fine-needle aspiration (FNA) biopsy  : The removal of tissue or fluid using a thin needle.
    • Incisional biopsy  : The removal of part of an area of tissue that doesn’t look normal.
    • Excisional biopsy  : The removal of an entire area of tissue that doesn’t look normal.
  • Endoscopy: An endoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope.
  • Nasoscopy : It is a procedure to look inside the body for abnormal areas. A thin, tube-like instrument with a light and a lens for viewing is inserted into the nose.
  • X-ray: An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation
  • Computed tomography (CT or CAT) scan: A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles.
  • Laryngoscopy: It is a procedure to look at the larynx for abnormal areas. A mirror or a laryngoscope is inserted through the mouth to see the larynx.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields, to produce detailed images of the body, especially images of soft tissue, such as the eye in its socket and the part of the brain near the sinuses.

What are the Treatments available?

Depending on the type of Cancer and how far it has spread, different treatments are employed to cure or retard the growth and spread of the disease. Here are a few treatment options usually opted by doctors or oncologists.

Here are a few diagnostic tests that might be recommended to detect the presence of this disease.

  • Surgery: Surgery is used to remove a tumor in the paranasal sinus or nasal cavity. During the operation, the tumor and some surrounding healthy tissue, called margin are removed.

    Common types of surgery for nasal cavity and paranasal sinus cancer include:

    • Excision: An operation to remove the cancerous tumor and some of the healthy tissue around it is conducted.
    • Maxillectomy:This is a surgery that removes part or all of the hard palate, the bony roof of the mouth. Artificial devices called prostheses or, flaps of soft tissue with and without bone can be placed to fill gaps.
    • Endoscopic sinus surgery: This is less destructive to healthy tissue than traditional operations. Occasionally, it can be used for benign tumors. The surgeon makes a small incision to remove the tumor using a thin, telescope-like tube inserted into the nasal cavity or sinus.
    • Neck dissection: This is the surgical removal of lymph nodes in the neck area.
    • Reconstructive surgery: It may be recommended when surgery requires removing large or specific areas of tissue.
  • Radiation therapy: It is the use of high-energy x-rays or other particles to destroy cancer cells. Radiation therapy is most often used in combination with surgery.
    • External-beam radiation therapy:  External-beam radiation therapy is the most common type of radiation given from a machine outside the body. Specific types of external radiation therapy include:
      • Intensity-modulated radiation therapy (IMRT)
      • Proton therapy.
    • Internal radiation therapy: Radiation treatment given using implants, it is called internal radiation therapy or brachytherapy. Internal radiation therapy involves tiny pellets or rods containing radioactive materials that are surgically implanted in or near the tumor. The implant is left in place for several days while the person stays in the hospital.
  • Chemotherapy: Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).
  • Palliative care: It is a treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families.

Is there curative treatment for Sinus Cancer?

Early stage of the Sinus Cancer is small, localized, and highly curable when treated with surgery and/or radiation therapy or chemotherapy. Advancement in science and technology is facilitating modern methods of highly successful treatment.

How frequently should one visit doctor for early diagnosis?

Spotting any of the symptoms of nasal cancer or having a doubt in your mind calls for a visit to the doctor. Also, a familial history or personal history of the disease commands a regular examination at least once a year or as per the doctor’s advice.

How can I as a patient know it early?

Consulting a doctor or oncologist in case of any indication felt or experienced that might suggest the presence of the disease. Ignoring even a small indication might result in devastation. In early stages sinus cancer is highly curable but it gets complicated with passing time.

Skin Cancer

What is Skin Cancer?

Skin is a protective layer that covers our whole body. It shields us against heat, sunlight, injury, and infection.

The uncontrolled growth of mutated cells in the skin is called skin cancer. It occurs when unrepaired DNA damage skin cells triggers mutations, or genetic defects, that lead the skin cells to multiply rapidly and form malignant tumors. These cancer cells can potentially invade the neighbouring cells and tissues and at the later stages can also spread to distant organs. Skin cancer is the most common type of cancer.

Types:

  • Melanoma: It is a rare and aggressive type of skin cancer. If it isn’t diagnosed early, it is likely to invade nearby tissues and spread to other parts of the body. It accounts for only 2% of skin cancer but causes most deaths from skin cancer
  • Nonmelanoma: Squamous cell and basal cell skin cancers are called nonmelanoma skin cancers. These are often found in areas exposed to sun, but may occur elsewhere. They usually respond to treatment and rarely spread to other parts of the body.

Less common types of skin cancer

    • Merkel cell carcinoma
    • Kaposi sarcoma
    • Cutaneous (skin) lymphoma
    • Skin adnexal tumors (tumors that start in hair follicles or skin glands)
    • Various types of sarcomas

Skin Cancer Occurrence Rate in India

The exact incidence of skin cancer in India is not known. However, skin cancers constitute about 1-2% of all diagnosed cancers. The incidence of skin cancer in India is quite low when compared to western countries. Most of the cases being reported in India are squamous cell carcinoma and basal cell carcinoma while the occurrence of non melanoma skin cancer is quite low among Asians.

Anatomy of Skin

Skin Cancer

Copyright © M Hssurgery.com, The above image is used for educational purpose only.

What are the general symptoms of Skin Cancer?

Different types of skin cancer shows different signs. Below mentioned are some of the symptoms that might indicate the presence of the disease but they do not necessarily ascertain the disease. However, if any of the symptoms is spotted then consulting a doctor is highly recommended.

Basal cell carcinoma:

  • A pearly or waxy bump
  • A flat, flesh-colored or brown scar-like lesion.

Squamous cell carcinoma:

  • A firm, red nodule.
  • A flat lesion with a scaly, crusted surface.

Melanoma signs and symptoms:

  • A large brownish spot with darker speckles
  • A mole that changes in color, size or feel or that bleeds
  • A small lesion with an irregular border and portions that appear red, white, blue or blue-black
  • Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus

Other Symptoms:

  • Red or purple patches on the skin or mucous membranes.
  • Firm, shiny nodules that occur on or just beneath the skin and in hair follicles.
  • Hard, painless nodules

What are the general causes of Skin cancer?

Skin cancer is associated to a number of causatives. However, many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.

  • Ultraviolet (UV) light exposure – One of the major risk factor for most skin cancers is high exposure to the sun. Tanning beds, lamps are another source of UV rays.
  • Having fair skin – Less pigment (melanin) in your skin provides less protection from damaging UV radiation.
  • Older age – The risk of getting basal and squamous cell skin cancers rises as people get older due to accumulated exposure to UV radiation. However, skin cancers are increasingly being found in younger individuals.
  • Male gender – Men are about twice as likely as women to have basal cell cancers
  • Exposure to chemicals – Certain chemicals, including Arsenic, coal tar, paraffin, and certain types of oil may also have an increased risk of skin cancer.
  • Increased Radiation exposure – Treatment with radiation can increase the risk for developing skin cancers in the exposed area.
  • Multiple or unusual moles – People who have many moles or abnormal moles called dysplastic nevi are at increased risk of skin cancer.
  • Severe sunburns in the past – Having had one or more blistering sunburns as a child or teenager increases your risk of developing skin cancer as an adult
  • Long-term or severe skin inflammation or injury – Skin damaged by some severe inflammatory skin diseases is more likely to develop skin cancers, although this risk is generally small.
  • Xeroderma pigmentosum (XP) – This very rare inherited condition reduces the ability of skin cells to repair DNA damage caused by sun exposure.
  • Basal cell nevus syndrome (also known as nevoid basal cell carcinoma syndrome or Gorlin syndrome) – In this rare congenital (present at birth) condition, people develop many basal cell cancers over their lifetime.
  • Weakened immune system – People with weakened immune systems have a greater risk of developing skin cancer. This includes people living with HIV/AIDS and those taking immunosuppressant drugs after an organ transplant.
  • Human papilloma virus (HPV) infection – Infection with certain types of HPV, particularly those that affect the anal or genital area, may increase your skin cancer risks.
  • Smoking – People who smoke are more likely to develop squamous cell skin cancer.
  • History of skin cancer

Can Skin Cancer be prevented?

The best ways to lower your risk of skin cancer are to avoid long exposure to intense sunlight and practice sun safety, with glares, hats, t-shirts and umbrellas. Wearing a good quality sun screen throughout the year also provides safety. Tanning beds and lamps should be avoided completely.

Regular, thorough skin examinations are also important, especially if there are a large number of moles or other risk factors. While this will not prevent skin cancer from developing, it may help to catch it early, when it can be treated more easily.

What are the stages of Skin cancer?

Non-melanoma skin cancers rarely spread and may not be staged. The chance that squamous cell carcinomas will spread is slightly higher and may be staged using the TNM System.

  • T refers to the spread of cancer cells to tissues next to the testicle.
  • N describes the spread of cancer cells to regional lymph nodes.
  • M indicates whether the cancer has metastasized.

Like all other cancers skin cancer is also staged into levels depending on the spread, size and severity of the disease.

  • Stage 0: The cancer cells are confined to the epidermis
  • Stage I: The cancer cells have grown deeper into the skin, but have not spread to the lymph nodes or other parts of the body.
  • Stage II: Cancer cells have grown deeper into the skin, or have more high-risk features, but have not spread to the lymph nodes or beyond.
  • Stage III: The cancer cells have spread to nearby lymph nodes, but not to distant organs.
  • Stage IV: The cancer cells have spread beyond the skin and regional lymph nodes to distant organs such as the liver, lungs or brain or distant lymph nodes and areas of the skin.

Survival rates of Skin cancer?

Needless to say, if the skin cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

Melanoma Staging Survival Rate:

Stages 5 year Survival Rate
Stage I A 97%
Stage I B 92%
Stage IIA 81%
Stage IIB 70%
Stage IIC 53%
Stage IIIA 78%
Stage IIIB 59%
Stage IIIC 40%
Stage IV 15%

Can Skin Cancer be detected early?

Being aware of the signs and symptoms definitely aids in its early detection. Some other methods of diagnosis are discussed below:

  • Physical Examination : Skin Cancer can be detected early with screening or even, simply with a self-exam where you take note of the changes on your skin.
  • Skin biopsy : Removal of the suspicious-looking skin for lab testing.

What are the Treatments available?

Based on the type and stage of the cancer and other factors, treatment options may include:

  • Surgery
  • Other forms of local therapy
  • Radiation therapy
  • Systemic chemotherapy
  • Targeted therapy
  • Immunotherapy
  • Chemotherapy

Treatment is based on the type of tumor and other factors, and often more than one type of treatment is used. Discuss all of your treatment options as well as their possible side effects with your treatment team to help make the decision that best fits your needs.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor. Also, a familial history or personal history of the disease commands a regular examination at least once a year for the disease.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section, you should definitely visit a doctor. Ignoring even a small indication might result in devastation. In early stages Skin cancer is highly curable but it gets complicated with passing time.

Stomach Cancer

What is Stomach (Gastric) Cancer?

Stomach

Stomach is a hollow muscular sac like organ that plays a major role in the digestion of food. It is located in the left upper part of the abdomen just below the ribs. Stomach receives and holds the food and starts to digest it by secreting gastric juice. The food and gastric juice are mixed and then emptied into the first part of the small intestine called the duodenum.

Stomach Cancer

Stomach cancer, also called gastric cancer, is a disease in which malignant cells form in the lining of the stomach. Stomach cancer generally develops slowly and do not show any prominent sign or symptom.

Types of Stomach Cancer

  • Adenocarcinomas: These Cancers develop from the cells that form the innermost lining of the stomach (known as the mucosa). They account for 90 – 95 % of Stomach Cancers.
  • Lymphoma: These are Cancers of the immune system tissue that are sometimes found in the wall of the Stomach. They account for 4% of Stomach Cancer occurrences.
  • Gastrointestinal stromal tumor (GIST) : These are rare tumors that start in very early forms of cells in the wall of the stomach called interstitial cells of Cajal.
  • Carcinoid tumor: These are tumors that start in hormone-making cells of the Stomach. Most of these tumors do not spread to other organs. About 3% of Stomach Cancers are carcinoid tumors.
  • Other Cancers: Cancer such as squamous cell carcinoma, small cell carcinoma, and leiomyosarcoma, can also start in the stomach, but these Cancers are very rare.

Stomach Cancer Occurrence Rate in India

A recent study conducted by Tata Memorial Centre (TMC) on cancer mortality in India has revealed that Stomach Cancer is the second biggest killer in India. An approximation of 22,200 men and 27,500 women die of Gastric Cancer every year in India. Experts revealed that this high rate of Stomach Cancer is contributed by unhealthy diet and lifestyle.

In many places in India the diet is low in fibre content. Spicy food and lots of non-vegetarian food can cause the chronic inflammation of the stomach lining, which if left untreated can turn cancerous.

Anatomy of Stomach (Gastric)

Stomach Cancer

What are the general symptoms of Stomach (Gastric) Cancer?

Most Stomach (Gastric)  cancers do not cause any symptoms until they have spread too far to be cured, but sometimes, we do get symptoms at an early stage.
Early stages:

  • Indigestion and stomach discomfort.
  • A bloated feeling after eating.
  • Mild nausea.
  • Loss of appetite.
  • Heartburn.
  • Fatigue

Advanced stages:

  • Blood in the stool that might or might not be visible to naked eyes.
  • Vomiting.
  • Weight loss for no known reason.
  • Stomach pain.
  • Jaundice
  • Ascites (build-up of fluid in the abdomen).
  • Trouble swallowing.

These symptoms are more likely to be caused by conditions other than Stomach (Gastric)  cancer. Still, it’s important to see your doctor right away so the cause can be found and treated, if needed.

What are the general causes of Stomach (Gastric) cancer?

The definite causatives of Stomach Cancer are yet under study. However, there is a strong correlation between a diet high in smoked and salted foods and Stomach Cancer.

Throughout these years of analysis and diagnosis of the disease certain risk factors have been identified that highly increases the probability of the occurrence of the disease. Some of them are discussed below:

  • Gender: Stomach Cancer is more common in men than in women.
  • Age: The risk of Stomach Cancer increases with increasing age. Most people diagnosed with Stomach Cancer are between their late 60s and 80s.
  • Helicobacter pylori (H. pylori) infection: It is a major cause of Stomach Cancer, especially cancers in the lower (distal) part of the stomach. Every one in three Stomach Cancer cases can be attributed to H pylori infection.
  • Stomach lymphoma: People who have had a certain type of lymphoma of the stomach known as mucosa-associated lymphoid tissue (MALT) lymphoma have an increased risk of getting adenocarcinoma of the stomach.
  • Diet: An increased risk of Stomach Cancer is seen in people with diets that have large amounts of smoked foods, salted fish and meat, and pickled vegetables. On the other hand, eating lots of fresh fruits and vegetables appears to lower the risk of Stomach Cancer.
  • Tobacco use: Tobacco usage is the major cancer causative. The rate of Stomach Cancer is almost doubled in smokers.
  • Previous stomach surgery: Stomach Cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases such as ulcers.
  • Hypertrophic Gastropathy: Excess growth of the stomach lining causes large folds in the lining and leads to low levels of stomach acid. This is a rare condition that accounts to Stomach Cancer.
  • Familial adenomatous polyposis (FAP): People with this syndrome are at greatly increased risk of getting colorectal cancer and have a slightly increased risk of getting Stomach Cancer.
  • Pernicious anemia: Certain cells in the stomach lining normally make a substance called intrinsic factor (IF) that we need to absorb vitamin B12 from foods. People without enough IF may end up with a vitamin B12 deficiency, which affects the body’s ability to make new red blood cells and can cause other problems as well. This condition is called pernicious anemia. Along with anemia (too few red blood cells), people with this disease have an increased risk of Stomach Cancer.

If you have any of the above symptoms, please get yourself checked. It may be noting, but it’s best to be sure!

Can Stomach (Gastric) Cancer be prevented?

Stomach Cancer can be prevented to an extent by avoiding the risk factors. One can lower the risk of developing Stomach Cancer by

  • Maintaining a healthy weight.
  • Eating a balanced, low-fat diet.
  • Dietary supplements
  • Quitting smoking.
  • Exercising regularly.
  • Treating Helicobacter pylori infection
  • Taking medicines to treat a precancerous condition or to keep cancer from starting.

What are the stages of Stomach (Gastric) cancer?

The stages of adenocarcinoma Stomach Cancer include:

Stage I. At this stage, the tumor is limited to the layer of tissue that lines the inside of the stomach. Cancer cells may also have spread to a limited number of nearby lymph nodes.

Stage II. The cancer at this stage has spread deeper, growing into the muscle layer of the stomach wall. Cancer may also have spread to more of the lymph nodes.

Stage III. At this stage, the cancer may have grown through all the layers of the stomach and spread to nearby structures. Or it may be a smaller cancer that has spread more extensively to the lymph nodes.

Stage IV. This stage indicates that the cancer has spread to distant areas of the body.

Survival rates of Stomach (Gastric) cancer?

Relative survival statistics compare the survival of patients diagnosed with cancer with the survival of people in the general population who are the same age, race, and sex and who have not been diagnosed with cancer. Because survival statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient. No two patients are entirely alike, and treatment and responses to treatment can vary greatly.

Cancer stage at diagnosis highly determines treatment options and has a strong influence on the length of survival. The earlier Stomach Cancer is caught, the better chance a person has of surviving.

Can Stomach (Gastric) Cancer be detected early?

Since people with Stomach Cancer rarely show symptoms in the early stages, the disease is often not diagnosed until it’s more advanced.

However, with the advancement in science and technology a few tests and procedures aids in locating the disease at an early stage. Some of the tests are:

  • Physical Examination: The doctor checks the medical history of the patient and extracts the detailed information regarding the signs and symptoms.
  • Upper Endoscopy: A thin tube containing a tiny camera is passed down through the throat into the stomach. If any suspicious areas are found, a biopsy is performed.
  • Biopsy: It is the removal of a small amount of tissue for examination under a microscope.
  • Endoscopic ultrasound: An ultrasound uses sound waves to create a picture of the internal organs. The ultrasound image helps doctors determine the spread of cancer.
  • Imaging tests: Imaging tests used to look for Stomach Cancer include computerized tomography (CT) scans, positron emission tomography (PET) and X-ray exam.
  • Exploratory surgery: Exploratory surgery is usually done laparoscopically. This means the surgeon makes several small incisions in your abdomen and inserts a special camera that transmits images to a monitor in the operating room.

What are the Treatments available?

The main treatments for Stomach Cancer are:

  • Surgery
    • Removing early-stage tumors from the stomach lining
    • Removing a portion of the stomach (subtotal gastrectomy)
    • Removing the entire stomach (total gastrectomy)
    • Removing lymph nodes to look for cancer
    • Surgery to relieve signs and symptoms
  • Chemotherapy: Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy can be given before surgery to help shrink a tumor so that it can be more easily removed. Chemotherapy is also used after surgery to kill any cancer cells that might remain in the body.
  • Targeted therapy Targeted therapy uses drugs that attack specific abnormalities within cancer cells. Targeted drugs used to treat Stomach Cancer include:
    • Trastuzumab (Herceptin) for Stomach Cancer cells that produce too much HER2.
    • Ramucirumab (Cyramza) for advanced Stomach Cancer that hasn't responded to other treatments.
    • Imatinib (Gleevec) for a rare form of Stomach Cancer called gastrointestinal stromal tumor.
    • Sunitinib (Sutent) for gastrointestinal stromal tumors.
    • Regorafenib (Stivarga) for gastrointestinal stromal tumors.
  • Radiation therapy: Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. Radiation therapy can be used before surgery to shrink a stomach tumor so that it's more easily removed. Radiation therapy can also be used after surgery to kill any cancer cells that might remain around your stomach.
  • Immunotherapy : In this procedure, vaccines and medication are used to stimulate the immune system of the body. It boosts the body's natural defenses to fight against cancer. Substances made by the body or in a laboratory are used to improve or restore immune system function. Immunotherapy works in either of the following ways:
    • Stops or slows down the growth of cancer cells
    • Inhibit cancer from spreading to other parts of the body
    • Helps the immune system to destroy cancer cells

Is there curative treatment for Stomach (Gastric) Cancer?

This is dependent on te stage the Cancer has reached. However, the Cancer is usually in an advanced stage when it is diagnosed. In such cases, it can be treated, but rarely cured.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor. You can also get your genetic make-up checked to see if you are prone to Stomach (Gastric) cancer or not.

Throat Cancer

What is Throat Cancer?

Throat is a 5-inch-long tube that runs from nose to neck. Throat Cancer is a compilation that includes Cancer of the mouth, tonsils, nose, sinuses, salivary glands and neck lymph nodes. Larynx (Laryngeal Cancer) that is the voice box and pharynx (Pharyngeal Cancer) which is the hollow tube running from nose to windpipe, are the two most prone areas of Throat Cancer.

Anatomy of Throat

Throat Cancer

What are the General Symptoms of Throat Cancer?

While it is easy to observe the common signs and symptoms of throat Cancer, its early detection still gets delayed because of negligence. Being aware of these common signs and symptoms is sure to aid.

  • Difficulty swallowing due to sore Throat (dysphagia)
  • Change in voice
  • Unexplainable weight loss
  • Swelling of the eyes, jaw, throat or neck
  • Bleeding in the mouth or through the nose
  • Constant urge to clear your throat
  • Chronic cough (may cough up blood)
  • Wheezing
  • Ear pain
  • Hoarseness

What are the general causes of Throat Cancer?

Throat Cancer is associated with various causes which range from excessive smoking, tobacco use, to exposure to chemicals. Among all, smoking has been the most prevalent cause contributing to Throat Cancer symptoms.

A few common likely causative factors of throat Cancer are:

  • Maintaining a low diet in fruits and vegetables
  • Rampant use of cigarettes, pipes and cigars.
  • Excessive consumption of alcohol.
  • Human papillomavirus (HPV), a sexually transmitted virus.
  • Chronic acid reflux called GERD.
  • Contracting Epstein - Barr virus (EBV) virus is transmitted via saliva.

Can Throat Cancer be prevented?

Though there’s no definitive formula to prevent Throat Cancer, but it can be definitely be prevented to an extent. Here are some of the measures that might protect you from the dreadful disease.

  • Saying no to smoking.
  • Reducing alcohol intake.
  • Eating plenty of fruits, vegetables, and lean meats while avoiding fat and sodium intake and take steps to lose excess weight.
  • Engaging in physical activity at least 150 minutes a week.
  • Reducing risk of HPV. Limiting the number of sexual partners and practicing safe sex. Also, the HPV vaccine might offer you some protection.

What are the stages of Throat Cancer?

Throat Cancer is staged on three key components:

  • Tumor (T) describes the size of the original tumor.
  • Node (N) indicates whether the Cancer is present in the lymph nodes.
  • Metastasis (M) refers to whether Cancer has spread to other parts of the body.

A number (0-4) or the letter X is assigned to each factor. A higher number indicates increasing severity. The letter X means the information could not be assessed.

Once the T, N and M scores have been assigned, an overall stage is assigned. The stages range from 0 to 4:

  • Stage 0: The tumor has not invaded tissue beyond your throat.
  • Stage 1: The tumor is less than 7 cm and limited to your throat.
  • Stage 2: The tumor is slightly larger than 7 cm, but still limited to your throat.
  • Stage 3: The tumor has grown and spread to nearby tissues and organs.
  • Stage 4: The tumor has spread to your lymph nodes or distant organs.

Survival rates of Throat Cancer?

The survival rate and diagnosis usually go hand in hand. If the symptoms and stage of Throat Cancer are discovered earlier, the individual will have a greater chance of survival. Here is a analysis of 5 year survival rate of different types of Throat Cancer based on earlier history.

Stage Supraglottis Glottis Subglottis Hypopharynx
I 59% 90% 65% 59%
II 59% 74% 56% 39%
III 53% 56% 47% 36%
IV 34% 44% 32% 24%

Survival rates are based on previous outcomes of large numbers of people who had the disease, but they cannot predict what will happen in any person’s case. Many other factors can affect a person’s outlook, such as their general health and how well the Cancer responds to treatment.

Can Throat Cancer be detected early?

Being aware of the symptoms and keeping an eye on your health will definitely help you detect Cancer at early stage. Also, screening tests may help finding some types of Cancer early, when treatment is most likely to be effective. There are a series of diagnostic tests for you to identify and beat it.

Throat Cancer Diagnostic Tests

  • Direct (flexible) laryngoscopy: In this,a fiber-optic laryngoscope, a thin, flexible, lighted tube is inserted through the mouth or nose to look at the larynx and nearby areas.
  • Indirect laryngoscopy: Special small mirrors are used to view the larynx and nearby areas.
  • Panendoscopy: It is a procedure that combines laryngoscopy, esophagoscopy, and bronchoscopy.
  • Biopsy: Different methods are used to obtain tissue for a biopsy, depending on where the tumor is located.
    • Conventional incisional biopsy: The doctor surgically removes part or all of the tissue where Cancer is suspected.
    • Fine-needle-aspiration biopsy (FNA): This is used if there is a lump in neck that can be felt. A thin needle is inserted into the area, and then cells are withdrawn and examined under a microscope.
    • Endoscopy: An endoscope is inserted through the mouth, nose or an incision. The endoscope has a tool to remove tissue samples.
  • Imaging tests, which includes
    • CT or CAT (computed axial tomography) scans
    • PET (positron emission tomography) scans
    • MRI (magnetic resonance imaging) scans
    • Chest and dental X-rays
  • Barium swallow: Also called an upper GI (gastrointestinal) series, this set of X-rays of the esophagus and stomach may be used to look for Cancer.
  • Laryngeal videostroboscopy: This test lets the doctor look at the larynx and see how well you swallow.
  • Fiberoptic endoscopic examination of swallowing (FEES): A small, flexible endoscope is inserted through the nose, allowing the doctor to examine swallowing.

What are the Treatments available?

Depending on the type of Cancer and how far it has spread, treated with one or a combination of therapies.

  • Surgery:
    The types of surgical procedures depend on the location and stage of your cancer. Options may include:
    • Surgery for early-stage Throat Cancer.
    • Surgery to remove all or part of the voice box (laryngectomy).
    • Surgery to remove part of the throat (pharyngectomy).
    • Surgery to remove cancerous lymph nodes (neck dissection).
  • Chemotherapy:
    Chemotherapy may be used to shrink a tumor before surgery or kill lingering Cancer cells after surgery and/or radiation treatment. A combination of chemotherapy and radiation therapy may be used as a primary treatment for patients with larger tumors or those who cannot tolerate surgery.
  • Radiation Therapy:
    Radiation therapy uses high-energy beams from sources such as X-rays and protons to deliver radiation to the Cancer cells, causing them to die. For early-stage Throat Cancers, radiation therapy may be the only treatment necessary. For more advanced Throat Cancers, radiation therapy may be combined with chemotherapy or surgery. In very advanced Throat Cancers, radiation therapy may be used to reduce signs and symptoms and make you more comfortable.
  • Targeted Therapies:
    These innovative new drugs stop the growth of Cancer cells by interfering with certain proteins and receptors or blood vessels that supply the tumor with what it needs to grow. Targeted drugs treat Throat Cancer by taking advantage of specific defects in Cancer cells that fuel the cells' growth. These drugs can be used in combination with chemotherapy or radiation therapy.

Is there curative treatment for Throat Cancer?

Early stage of the Throat Cancer is small, localized, and highly curable when treated with surgery& or radiation therapy. It includes stage I, II, and some stage III Cancers.

How frequently should one visit doctor for early diagnosis?

Having some of the symptoms associated with Throat Cancer may not necessarily indicate the presence of the disease. However, expert advice to rule out the possibility is prudent, making curative treatment possible.

How can I as a patient know it early?

Being aware of the signs and symptoms will definitely help a patient to suspect the disease. And the going for a diagnosis or visiting a doctor will clear the air.

Thyroid Cancer

What is Thyroid Cancer

Thyroid

The Thyroid gland is about 2 inch long, butterfly shaped organ located on the front side of the throat. It is one of the largest endocrine glands.

Functions

The Thyroid gland synthesizes two vital hormones: triiodothyronine and thyroxine which are responsible for regulating body’s temperature, heartbeat, metabolism, growth, appetite, menstrual cycle etc.

Thyroid Cancer

Thyroid Cancer is a type of tumor located within the thyroid gland which may be in the benign or malignant state.  Four types of Thyroid Cancer could be differentiated till date – Papillary, Follicular, Medullary and Anaplastic Thyroid Cancer.

Types of Thyroid Cancer

  • Papillary CancerIt accounts for 80% of the thyroid cancer occurrences. It grows slowly and spreads gradually over different parts.  It can often be treated successfully and are rarely fatal.
  • Follicular Cancer: This cancer is mostly caused due to lack of Iodine in the diet.It accounts for 10% of the total thyroid cancer occurrences. They usually do not spread to the lymph nodes but they can spread to other parts of the body.  The prognosis of follicular cancer is good but the rates are lower than papillary cancer.
  • Medullary Cancer: It accounts for 4% of thyroid cancers. This type of thyroid cancer is more difficult to find and treat.  It can be further classified as:
    • Sporadic Medullary Thyroid Cancer:It accounts for about 8 out of 10 cases of Medullary Thyroid Cancer.  It occurs mostly in older adults. 
    • Familial Medullary Thyroid Cancer : It is an inherited condition accounting 20% to 25% occurances in each generation of a family.  These cancers often develop during childhood or early adulthood and spreads rapidly.
  • Anaplastic Thyroid Cancer: This is a rare form of thyroid cancer, amounting up to 2% of all thyroid cancers. This cancer is referred as undifferentiated. It often spreads quickly into the neck and to other parts of the body, and is difficult to treat.

Occurrences of Thyroid Cancer

A recent study on the topic, revealed that Thyroid Cancer is the most common type of endocrine- cancer amounting 3.8% of all cancer cases. Here is a depiction of the global occurrence of Thyroid Cancer.

Type Occurrence Rate
Papillary Cancer 80%
Follicular Cancer 15%
Medullary Cancer 3%
Anaplastic  cancer 2%

Thyroid Cancer is a common cancer type and its diagnosis tends to scare the patients, however most cases of Thyroid Cancers are highly treatable and can be cured with surgery and other advanced treatments.

Anatomy of Thyroid Cancer

Anatomy of thyroid gland

Thyroid Cancer

Anatomy of Thyroid Cancer

Thyroid Cancer

What are the General Symptoms of Thyroid Cancer?

The symptoms of thyroid cancer vary from person to person. Some people may not experience any symptom till the later stages until the physician diagnose the lump in the neck during routine health examination while some may experience prominent early symptoms. The most common symptoms of thyroid cancer are as

  • Lump in the neck
  • Hoarse voice
  • Pain in the neck or behind the ears
  • Swollen lymph nodes in the neck.
  • Difficulty in swallowing
  • Sore throat
  • Difficulty in breathing
  • Cough that lasts longer than 3 weeks

What are the general causes of Thyroid Cancer?

There are various causes which contribute towards the increased risk of developing Thyroid Cancer. Some of them are given below:

  • Exposure to radiation for a prolonged period probably during the childhood.
  • Individuals with certain health conditions like Cowden's syndrome, a rare autosomal disorder can easily fall a prey to Thyroid Cancer.
  • Abnormality or mutations in certain genes can result in the development of Thyroid Cancer.
  • Thyroid Cancers like other types of Cancers can develop in individuals who have a family history of Cancer.
  • Inadequate amount of iodine in the diet can also result in the development of Thyroid Cancer.

Can Thyroid Cancer be prevented?

Most cases of Thyroid Cancer cannot be prevented. However in some cases, certain preventive measures can reduce the risk of developing Thyroid Cancer to a great extent. Some of those measures are outlined below:

By avoiding exposure to radiation:

The cells of the Thyroid gland (and most other glands) are very sensitive to x-rays and other forms of radiation, and easily destroyed or mutated if exposed to it. If you are advised a CT scan by your healthcare professional for any underlying illness , consult with your physician for any other alternative measures like MRI etc since the amount of radiation emitted by CT SCAN is 50 times greater than that of the radiation emitted by MRI or X- rays.

Radiation exposure especially in children increases the risk of Thyroid Cancer. Imaging tests such as x-rays and CT scans also expose children to radiation, but at much lower doses. The exact measure of exposure that might raise the risk of Thyroid Cancer is yet not clear.

Avoid residing near a nuclear power plant:

The surroundings or neighbouring areas should be thoroughly scrutinized while selecting the place of residence. It is advised to select a place that is located at least 10 miles away from the resident area.

If an individual is residing in a place which is near to any nuclear power plant then extreme preventive measures should be taken in case of nuclear fallout. A suitable dosage of potassium iodide needs to be administered to those individuals who are residing in places of nuclear emergency.

Maintaining proper level of Iodine:

The Thyroid gland needs a steady supply of iodine to function properly and to synthesize its hormones.

Iodine deficiency causes the Thyroid gland to swell initially causing goiter, but chronic deficiency promotes nodules and highly increases the risk of Cancer. Iodine can be consumed through common salt or through fish / shellfish.

Blood tests for gene mutations:

If an individual have familial history of Thyroid Cancer, then it is highly recommended to opt for a blood test. A gene mutation can predominantly cause familial medullary Thyroid Cancer (MTC).

Regular Thyroid Screenings:

Most of the Thyroid Cancer cases can be found in the early stages. Oncologists recommend self examination of the neck area at least twice a year and a medical screening once a year.

Special precautions during child bearing age:

Gender or age cannot be prevented but we can be a bit more vigilant with self exams and screenings. Women are 3x more likely than men to develop Thyroid Cancer and about 65% of cases occur during childbearing years (20-45 years).

What are the stages of Thyroid Cancer?

Usually Thyroid Cancers are staged on the basis of TNM staging systems. Here are listed the number staging systems which doctor uses for Cancer staging.

T indicates the size of the main (primary) tumor and whether it has grown into nearby areas.

  • TX: Primary tumor cannot be accessed.
  • T0: No evidence of primary tumor.
  • T1: T1 stage is the earliest possible stage of Thyroid Cancer where the tumor is entirely within the Thyroid gland and the size of the tumor does not exceed 2cm.
    • T1a: The tumor is not over 1 cm and is limited to Thyroid gland.
    • T1b: The tumor size ranges from 1 cm to 2 cm and is limited to the Thyroid gland.
  • T2: In this stage the tumor is only inside the Thyroid gland but the size of the tumor is slightly larger than that of T1 stage. In T2 stage the tumor mass is within 4 cm.
  • T3: In this stage the size is larger than 4 cm and the Cancerous growth is seen spreading across the walls of the tissues surrounding the Thyroid gland.
  • T4: T4 stage ranges from moderately advanced stage to highly advanced stage.
    • T4a: The tumor can be of any size and it has grown excessively beyond the Thyroid gland into the nearby glands. It is called moderately advanced stage.
    • T4b: The tumor size is significantly larger and expanding the region beyond the Thyroid capsule to the surrounding vessels invading the adjacent soft tissues like pre vertebral fascia, larynx, esophagus etc. This is also called very advanced disease.

N: N denotes regional lymph nodes. Numerous lymph nodes are located in the region of head and neck. These can be further classified into N0 and N1.

  • N0: There are no lymph nodes involvement or the tumor is clinically or radio logically node negative.
  • N1: These denote that the Cancer has spread to the adjacent lymph nodes. It can be further referred to as clinically or radio logically node negative.
    • N1a: The Cancer has spread to lymph nodes around the Thyroid in the neck.
    • N1b: The Cancer has spread to other lymph nodes in the neck (called cervical) or to lymph nodes behind the throat or in the upper chest

M: Here M denotes distant metastasis which means that the Cancer has spread to the distant tissues and organs.

  • MX: Distant metastasis cannot be assessed.
  • M0: There is no distant metastasis.
  • M1: The Cancer has spread to other parts of the body, such as distant lymph nodes, internal organs, bones, etc

Survival rates of Thyroid Cancer?

It is difficult to estimate the exact survival rate of patient as the survival rates of patients suffering from Thyroid Cancer can vary from one individual to another. Here are outlined the survival analysis of 5 years study of patients who were victims of different branches of Thyroid Cancer.

Cancer stats at a glance

Papillary Thyroid Cancer

Based on patients diagnosed 1998 to 1999

Stage 5-Year Relative Survival Rate
I near 100%
II near 100%
III 93%
IV 51%

Follicular Thyroid Cancer

Based on patients diagnosed 1998 to 1999

Stage 5-Year Relative Survival Rate
I near 100%
II near 100%
III 71%
IV 50%

Medullary Thyroid Cancer*

Stage 5-Year Relative Survival Rate
I near 100%
II 90%
III 71%
IV 21%

Based on patients diagnosed between 1985 and 1991

Can Thyroid Cancer be detected early?

It comes to a relief, as most Thyroid Cancers can be detected early due to their prominent symptoms, like neck lumps or nodules. Early Thyroid Cancers are also sometimes diagnosed during ultrasound tests or blood tests. However, to be sure proper tests and diagnostics are essential also a few people may not experience the signs and symptoms at the early stages. Some of the investigation and diagnostic test which your doctor may advice to detect the TNM stages of Thyroid Cancer are as follows.

  • Physical examination of the tumor: The very first step in the detection of Thyroid Cancer is the physical examination of the affected area by your healthcare professional. In this process of examination, you will be asked questions related to your current condition, previous medical history, your present symptoms etc.
  • Biopsy: The FNAC biopsy is one of the most important tests to detect Cancer. This involves aspirating some of the tissues with fluid from the lymph node of the suspected tumor and observing the tissues under microscope. The whole process of biopsy is performed under local anesthesia to ease the pain and discomfort of the patient. In some insances where the FNA biopsies fail to detect the Cancerous growth than, other types of more invasive biopsies are performed. They include a ‘core’ biopsy or an open biopsy and in some rare cases, a lobectomy is performed which is the removal of the major portions of the effected Thyroid gland that is performed under general anaesthesia in operation theatre.
  • Imaging Tests: One or more imaging tests are usually advised by the physician to know about the benign or metastatic nature of the tumor, or to find any suspicious areas in the neck which might denote Cancer. These imaging test include
    • Ultrasound: This is an imaging test which creates images of the body parts by utilizing sound waves. This test is usually helpful in determining the physical state of the Thyroid nodule whether it is solid or a fluid filled mass.
    • Radio iodine scan: This test is mainly used in papillary or follicular Thyroid Cancer to determine if the Cancer has spread to other parts of the body. This scan is usually performed by injecting some amount of radioactive iodine. The areas affected by the Cancer readily absorb the radioactive solution which can be monitored under a special camera.
    • CT SCAN and MRI SCAN: Cross sectional images of the effected region can be generated by CT SCAN while detailed images of affected as well as adjacent soft tissues can be obtained from an MRI SCAN.
  • Blood Test: Blood tests are usually used to monitor if the Thyroid is functioning in a normal or abnormal manner. These tests may include TSH test (Thyroid stimulating hormone test), PTH test (paraThyroid hormone test), Thyroid hormone test etc. Some other blood tests are also advised which includes routine blood test, kidney function test and liver function test.

What are the Treatments available for Thyroid Cancer?

There are several treatment options which are alone or in combination implemented to treat Thyroid Cancer depending the severity of the disease. They include

  • Surgery:
    There are three types of standard surgical procedures which are used to remove the tumor surgically. They include lobectomy surgical procedure which removes the Thyroid Cancer induced lobe, Thyroidectomy which involves the partial or total removal of the whole Thyroid gland.
  • Radiation Therapy:
    Following surgery radiation therapy is implemented to prevent episodes of reoccurrence of Cancer cells. There are types of standard radiation therapy – the external as well as the internal radiation therapy. The former is the one in which a machine is used externally to kill the timorous growth while the latter implies the administration of radioactive substance internally which may be either incorporated in wires or needles. The radiation oncologist decides which therapy is required for a particular individual depending on the stage of the tumor.
  • Chemotherapy:
    Chemotherapy is administered either before or after surgical procedure to shrink the tumor size and to prevent it from spreading to nearby organs. Chemotherapy is given either through oral or intravenous route depending upon the severity of the disease.
  • Hormone Therapy:
    Hormonal therapy is usually given orally which stops the Cancer from growing by blocking the action of certain hormones required for the survival of tumor cells.
  • Targeted Therapies:
    These innovative new drugs stop the growth of Cancer cells by interfering with certain proteins and receptors or blood vessels that supply the tumor with what it needs to grow. Targeted drugs treat Throat Cancer by taking advantage of specific defects in Cancer cells that fuel the cells' growth. These drugs can be used in combination with chemotherapy or radiation therapy.

Is there any curative treatment for Thyroid Cancer?

If the Cancer is detected in its early stage then proper measures can be taken to reverse it, extending the survival of the patient. However, for later stage diagnosis the treatment involves only conservative measures where palliative medicine aids in relieving the symptoms associated with it.

How frequently should one visit doctor for early diagnosis?

It is recommended that you perform TSH test at least once in six months. However if you notice any kind of symptoms associated with Thyroid Cancer, it is recommended to consult with your healthcare professional at the earliest.

How can I as a patient know it early?

Keep yourself updated with the symptoms as well the risk factors associated with this disease so that once something fishy is going on within your organs, seek medical help at the earliest.

Uterine Cancer

What is Uterine Cancer

Uterus

Uterus is a hollow pear shaped pelvic organ located between the bladder and rectum. The uterus is also known as the womb, where the fetus development occurs. The uterus sits in an inverted position within the pelvic cavity of the torso. It is located along the body’s midline posterior to the urinary bladder and anterior to the rectum. The narrow inferior region of the uterus, known as the cervix, connects the uterus to the vagina below it and acts as a sphincter muscle to control the flow of material into and out of the uterus.

Functions

  • It is responsible for the development of the embryo and fetus during pregnancy.
  • It plays a vital role in continuity of life.

Uterine Cancer

The uncontrolled growth of mutated cells in the lining of uterus is called Uterine Cancer. It is also called as endometrial cancer. Uterine Cancer can start in different parts of the uterus.

Types of Uterine Cancer

The walls on the interior of the uterus have 2 layers of tissues - endometrium (inner lining) and myometrium (outer muscles). Based on the affected tissue, cancer is broadly categorized into two types:

  • Endometrial Cancer:This is the most common type of Uterine Cancer with 95 % of cases. Most Uterine Cancers start in the endometrium. This is called endometrial Cancer. Most Endometrial Cancers are adenocarcinoma (Cancers that begin in cells that make mucus and other fluids).
  • Uterine sarcomas Sarcoma accounts for about 2% to 4% of Uterine Cancers. Uterine sarcoma is an uncommon form of Uterine Cancer that forms in the muscle and tissue that support the uterus.

Anatomy of Uterine Cancer

Anatomy of uterus

Uterine Cancer

What are the General Symptoms of Uterine Cancer?

Uterine Cancer generally shows the following symptoms but these symptoms might vary or there may not be any prominent initial symptom at all.

  • Abnormal vaginal bleeding or discharge.
  • Pelvic pain
  • Constipation
  • Pain, pressure or cramps in the lower abdomen
  • Problems during pregnancy, including premature contractions and spontaneous abortion.

What are the general causes of Uterine Cancer?

There are multiple factors that lead to the development of Uterine Cancer; some of them are controllable while many are beyond one’s control. Here we have listed the major risk factors that lead to the development of uterus Cancer:

  • Hormonal Changes – Any imbalance or fluctuations in the levels of two main female hormones namely estrogens and progesterone is a high risk.
  • Prolonged menstruation – Early puberty or late menopause increases the risk of Endometrial Cancer. Women having more menstrual cycles in their lifetime have an increased endometrial Cancer risk. This includes starting periods before age 12 and going through menopause after age 50.
  • Infertility – Infertility is a major risk for Uterine Cancer. Irregular menstrual cycles and infertility also may be related to imbalances in estrogen and progesterone levels, and this hormone imbalance may increase the risk for Endometrial Cancer.
  • Age – Women in later ages tends to develop Uterine Cancer, especially the ones who have undergone menopause.
  • Obesity - Excess body fat alters the body's balance of hormones. Fat cells produce estrogen, so obese women are at an increased risk for Uterine.
  • Tamoxifen - It acts as an anti-estrogen in breast tissue, but increases estrogen level in the uterus.
  • An inherited colon Cancer syndrome - Hereditary non polyposis Colorectal Cancer (HNPCC) is a syndrome that increases the risk of colon Cancer and other Cancers, including endometrial Cancer. HNPCC occurs because of a gene mutation passed from parents to children.
  • Family History - Women with a family history of endometrial, colon or Ovarian Cancer may be at a higher risk of developing Endometrial Cancer.

Can Uterine Cancer be prevented?

Though most of the causatives of Uterine Cancer are natural and cannot be controlled yet a few precautionary measures might help to lower the risk. Some of them are

  • Maintaining healthy diet.
  • Exercising regularly and maintaining a fit body.
  • Maintaining balanced level of hormones.
  • Consulting a doctor for endometrial problems or HNPCC cases.

What are the stages of Uterine Cancer?

Staging of Uterine Cancer helps in proper diagnosis and planning for the treatment. It is staged in 4 levels ranging from stage I to IV, the severity increasing with each passed stage. The stages are discussed in details below:

  • Stage 0 (Tis, N0, M0):
    This stage is also known as carcinoma in-situ. Cancer cells are only found in the surface layer of cells of the endometrium, without growing into the layers of cells below. The Cancer has not spread to nearby lymph nodes or distant sites. This is a preCancerous stage and is not included in the FIGO staging system.
  • Stage I (T1, N0, M0)
    Cancer is found only in the uterus. The Cancer has not spread to lymph nodes or distant sites.
    • Stage IA: In this earliest form of stage I Cancer and it lies in the endometrium only. It has not spread to lymph nodes or distant sites.
    • Stage IB: Cancer has spread halfway or more into the myometrium but has not gone beyond the body of uterus.
  • Stage II (T2, N0, M0)
    Cancer is present in both the uterus and cervix. The Cancer has not spread outside of the uterus. The Cancer has not spread to lymph nodes or distant sites.
  • Stage III (T3, N0, M0)
    Cancer has spread beyond the uterus, but not beyond the pelvis
    • Stage IIIA:
      Cancer has spread to the outer layer of the uterus or to the fallopian tubes, ovaries, and ligaments of the uterus. The Cancer has not spread to lymph nodes or distant sites.
    • Stage IIIB:
      Cancer has spread to the vagina or to the tissues around the uterus. The Cancer has not spread to lymph nodes or distant sites.
    • Stage IIIC:
      Cancer has spread to lymph nodes in the pelvis and/or around the aorta.
  • Stage IV (T4, any N, M0) or (any T, any N, M1)
    Cancer has spread past the pelvic region and can affect the bladder, rectum and more distant parts of the body.
    • Stage IVA:
      The Cancer has spread to the inner lining of the rectum or urinary bladder. It may or may not have spread to nearby lymph nodes but has not spread to distant sites.
    • Stage IVB:
      The Cancer has spread to distant lymph nodes, the upper abdomen, the omentum, or to organs away from the uterus. The Cancer can be any size and it may or may not have spread to lymph nodes.

Survival rates of Uterine Cancer?

Stage Survival Rate
0 90%
IA 88%
IB 75%
II 69%
IIIA 58%
IIIB 50%
IIIC 47%
IVA 17%
IVB 15%

Can Uterine Cancer be detected early?

Some of the ways to detect Cancer at an early stage are:

  • Pelvic examination: During pelvic examination doctor carefully observes the outer portion of the vulva. This can be done by inserting fingers through the vaginal opening or by inserting a speculum that opens up the vagina and lets the doctor view the vagina and cervix.
  • Ultra sound: Transvaginal ultrasound is used to look at the thickness and texture of endometrium. This is done by inserting the transducer into the vaginal opening and creating a video image of the uterus.
  • Heteroscopy: A lens on a special lighted microscope, called heteroscope is inserted through the vagina which allows the doctor to examine the Cancer.
  • Biopsy: A sample of endometrial cell/ tissue is removed from uterine line and observed under microscope.
  • Dilatation and curettage: When enough information couldn’t be obtained by biopsy then dilatation and curettage is used. In this procedure, the cervix is widened (dilated) so that a curette (a spoon-shaped instrument with a sharp edge) can be inserted into the uterus to remove cells, tissues or growths from the endometrium.

What are the Treatments available for Uterine Cancer?

The options for treating endometrial Cancer depend on multiple characteristics of the Cancer, such as the stage, health and root cause etc.

  • Surgery:
    Depending on the spread of the malignant cells, surgery is conducted to remove the uterus, fallopian tubes and ovaries. A hysterectomy causes menopause and infertility.
  • Radiation Therapy:
    Radiation therapy uses powerful energy beams, such as X-rays and protons, to kill Cancer cells. It reduces the risk of Cancer recurrence after surgery, and helps to shrink a tumour before surgery (down-staging the tumour) and make it easier to remove.
    Radiation therapy includes
    • External Radiation
    • Internal radiation (brachytherapy)
  • Hormone Therapy:
    This involves taking medications that affect hormone levels in the body. Hormone therapy is used to:
    • Increase the amount of progesterone
    • Reduce the amount of estrogen
  • ChemoTterapy:
    Chemotherapy uses chemicals to kill Cancer cells.
  • Supportive (palliative) care:
    Palliative care is specialized medical care that focuses on providing relief while undergoing aggressive treatments like surgery, chemotherapy or radiation therapy.

Is there any curative treatment for Uterine Cancer?

Uterine Cancer, if detected at early stages is easy to cure. Endometrial Cancer can usually be cured while uterine sarcoma is harder to cure. Removing the uterus along with the surrounding affected organs generally aids in curing the Cancer. But at the later stages when the Cancer spreads to distant body parts then different treatments needs to be implemented.

How frequently should one visit doctor for early diagnosis?

If you encounter any of the symptoms then consulting a doctor is the smartest move though the symptom might not necessarily indicate the presence of the fatal disease.

How can I as a patient know it early?

Endometrial Cancer is often detected at an early stage as it frequently produces abnormal vaginal bleeding, which prompts the patient to see a doctor. But at times, early stages are missed due to negligence or no evident symptoms.

Retinoblastoma Cancer

What is Retinoblastoma Cancer?

Retinoblastoma Cancer

Retinoblastoma (Rb) is a rare form of cancer that rapidly develops from immature cells of the retina. It is a malignant Cancer of the eye, found exclusively in young children below 7 years of age. In 75% of cases, the tumor is found only in one eye, while the rest 25% cases report tumor in both eyes.

Retinoblastoma is usually confined to the eye but, if left untreated, is capable of metastasis or spreading to other parts of the body. The tumor is highly curable if its growth is restricted to the eyes only, the outlook declines with the increase in the spread of the Cancer cells.

Occurrence Rate of Retinoblastoma Cancer

Retinoblastoma is a rare disease and is indicated by a white dot on the retina and a squint. It accounts for almost 2% of all cancer occurrences in children below the age of 15. Globally, there are 11 cases per million children below 5 years of age, who have retinoblastoma. It may relieve the mind of many to know the rarity of this disease.

However, a recent survey by AIIMS revealed that the occurrence rate of Retinoblastoma among Indian children is rapidly increasing. Statistics suggest that almost 20,000 new cases of the disease are reported every year. 9-10 % of all Pediatric Cancer patients in India have Retinoblastoma. Though the incidences are increasing at an alarming rate, yet it can be cured when detected early. Median age at diagnosis was 2 years for boys and 1 year for girls with unilateral retinoblastoma; it is less than 12 months for bilateral disease.

For a country of 3120 crores, the number of cases reported might seem small when compared with breast cancer or other head and Neck cancer. Hence, opening with such information puts it in proper perspective.

Retina

The Retina is a thin layer of tissues at the back of the eyeball that contains cells sensitive to light. It is the light-detecting tissue of the eye.

Functions:

  • The retina receives the light focused by the lens.
  • It converts the light into neural signals and sends these signals to the brain for visual recognition.

How does Retinoblastoma Cancer develop?

A baby’s eyes start developing in the womb early in the first trimester of pregnancy. Retina i.e the light detecting part of the eye is formed by rapidly growing cells called Retinoblasts. These growing cells eventually mature to form the retina. In some rare scenario, the growth of retinoblast cells goes on abnormally forming a tumor in the eye.

These tumors may continue to grow, filling almost the entire vitreous humor (the jellylike substances the fills the eyeball). These tumors can also break off and spread to other parts of the eye, and eventually to other distant organs of the body.

Types of Retinoblastoma Cancer

  • Congenital (hereditary) Retinoblastoma:
    For about 33% of children with Retinoblastoma, the abnormality in the RB1 gene is present at birth and is in all the cells of the body, including all the cells of both retinas. This is known as a germline mutation.

    In most of these children, there is no family history of this Cancer. Only about 25% of the children born with this gene change inherit it from a parent. Children born with a mutation in the RB1 gene usually develop retinoblastoma in both eyes (known as Bilateral Retinoblastoma), and there are often several tumors within the eye (known as multifocal retinoblastoma).
  • Sporadic (non-hereditary) Retinoblastoma
    In about 66% of children with Retinoblastoma, the abnormality in the RB1 gene develops on its own in only a cell in one eye. The causes of this change are still under scrutinization. A child who has sporadic retinoblastoma develops only one tumor in one eye. This type of Retinoblastoma is often found at a later age than the hereditary form.

    Children with this type of Retinoblastoma do not have the same increased risk of other Cancers as children with congenital Retinoblastoma.

Anatomy of Retinoblastoma Cancer

Retinoblastoma Cancer

What are the general symptoms of Retinoblastoma Cancer?

  • Leukocoria (cat's eye reflex or white pupil). This may be first observed in photographs where the eye appears white rather than reflecting the reddish-orange light from the eye's retina.

  • Leukocoria Misaligned eyes (strabismus)

  • Blurred vision
  • Squint, eyes appear to be looking in different directions (lazy eye).
  • Redness or inflammation of eyes
  • Infection around the eye.
  • The eyeball is larger than normal.
  • The colored part of the eye and pupil look cloudy.

What are the general causes of Retinoblastoma Cancer?

A risk factor is anything that affects a person’s chance of getting a disease such as cancer. There are very few known risk factors for Retinoblastoma.

Age: Most children diagnosed with retinoblastoma are younger than 3 years old. In most cases, hereditary retinoblastomas are found during the first year of life, while non-inherited Retinoblastomas tend to be diagnosed in 1- and 2-year-olds. Retinoblastomas are rare in older children and in adults.

Heredity: 40% of Retinoblastoma patients have a genetic defect that leads to multiple tumors in one eye or both eyes. This is known as hereditary or germline retinoblastoma. These patients are typically diagnosed before 1 year of age. Patients with hereditary Retinoblastoma may pass this disease to their children.

Gender: It is more common in boys than girls.

Non Heredity: 60% of patients have a nonhereditary form of retinoblastoma. Each of these patients develops a tumor in only one eye. Nonhereditary patients are diagnosed on average around 2 years of age.

Can Retinoblastoma Cancer be prevented?

Since the causative and risk factors for Retinoblastoma are all natural and we have no control over them, so it becomes almost impossible to prevent the occurrence of Retinoblastoma Cancer. However, it brings a sigh of relief to know that the success rate of treatment is quite high when the cancer is diagnosed at its early stage. So the best prevention is through early detection.

General eye exam of the eyes of babies at birth and after 6 -12 months helps in detecting any serious congenital problems. Adults are advised to take their babies for a regular eye examination at least once a year or more often if one has any eye issues.

What are the stages of Retinoblastoma Cancer?

It is very important to stage Cancer for a planned diagnostic and treatment of the disease. Cancer is staged based on the size and location of the tumor(s). Although currently there are several staging systems available, the most convenient method is staging by the location of tumor.

  • Intraocular Retinoblastoma: Cancer is found in one or in both eyes, but does not extend beyond the eye.
  • Extraocular Retinoblastoma: Cancer has extended beyond the eye, usually through the optic nerve. It may be confined to the tissues around the eye, or it may have spread to other parts of the body.
  • Trilateral Retinoblastoma: In Bilateral Retinoblastoma, a related tumor develops in the pineal gland at the base of the brain. The presence of these tumors can result in other neurological symptoms and require neuroimaging of the brain for diagnosis.
  • Recurrent Retinoblastoma: Recurrent disease means that cancer has come back or progressed after it has been treated. It may recur in the eye or elsewhere in the body.

Another most common staging system for Retinoblastoma based on the size and spread of cancer is given below:

Stage 0: The tumor is in the eye only. The eye need not be removed and the tumor can be treated without surgery.

Stage I: The tumor is in the eye only. The eye needs to be removed and no cancer cells remain.

Stage II: The tumor is in the eye only. The eye needs to be removed, yet there are cancer cells left that can be seen only with a microscope.

Stage III:

  • In stage IIIa, cancer has spread from the eye to tissues around the eye socket.
  • In stage IIIb, cancer has spread from the eye to lymph nodes near the ear or in the neck.

Stage IV:

  • In stage IVa, cancer has spread to the blood but not to the brain or spinal cord. One or more tumors may have spread to other parts of the body such as the bone or liver.
  • In stage IVb, cancer has spread to the brain or spinal cord. It also may have spread to other parts of the body.

Survival rates of Retinoblastoma Cancer?

The survival rate depends on several factors, including whether the Cancer has spread from the eye to other parts of the body.

  • If the tumor is contained within the eye (one or both eyes), more than 95 percent of treated patients can be cured.
  • For children with retinoblastoma in both eyes, about 70 to 80 percent of the eyes can be saved.

Can Retinoblastoma Cancer be detected early?

Retinoblastoma Cancer might be indicated by several symptoms like pain, fatigue or a lump. In case any of these signs are visible it is recommended to visit a doctor and go for an examination.

  • Eye exam:
    • Ophthalmoscopy: The inside of the eye is carefully observed using a small magnifying lens and a light to check the retina and optic nerve.
    • Slit-lamp biomicroscopy: The retina, optic nerve, and other parts of the eye are checked thoroughly using a strong beam of light and a microscope.
    • Fluorescein angiography: In this procedure, blood vessels and the flow of blood inside the eye is observed. An orange fluorescent dye called fluorescein is injected. As the dye travels through blood vessels, a special camera takes pictures of the retina and choroid to find any blockage or leakage.
  • Blood test: A laboratory test in which a sample of blood or tissue is tested for a change in the RB1 gene.
  • Ultrasound exam of the eye: In this procedure, high-energy sound waves are bounced off the internal tissues of the eye to make echoes. Eyedrops are used to numb the eye and a small probe that sends and receives sound waves is placed gently on the surface of the eye. The echoes make a picture of the inside of the eye and the distance from the cornea to the retina is measured. The picture, called a sonogram, shows on the screen of the ultrasound monitor.
  • MRI (magnetic resonance imaging): In this procedure, a magnet, radio waves, and a computer are used to make a series of detailed pictures of the eye. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • CT scan (CAT scan): In this procedure, a series of detailed pictures of the eye are taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called

What are the Treatments available?

The treatment depends on the number, position and size of the tumors in the eye. The aim of treatment is first to get rid of the cancer and secondly to try to protect the eyesight. Some treatments may cause changes in the vision in the affected eye.

Different types of treatment are available for patients with retinoblastoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials.

Smaller tumours

Local Therapy: For smaller tumors, treatment is given to the eye itself. One of the following methods may be used:

  • Cryotherapy/Focal Therapy: It is the treatment with laser therapy or freezing treatments (cryotherapy) while under anesthesia. These focal therapies may continue even after chemotherapy is complete. Sometimes, the tumors in the eye are small enough to be treated with only focal therapy.
  • Laser Therapy: A laser is directed through the pupil and used to heat the tumour. A number of sessions of laser therapy are recommended at intervals of 3 to 4 weeks.
  • Plaque: A small radioactive disc is stitched over the tumor on the outside of the eye. The disc needs to stay in place for up to four days while the radiation destroys the cancer cells.
  • Thermotherapy: This process uses heat to destroy the cancer cells and may be combined with chemotherapy or radiotherapy, as heat can improve the effectiveness of these treatments. The heat is produced by a laser, which is directed at the tumor.

Larger tumours

  • Chemotherapy
    Anti-Cancer drugs are used to destroy Cancer cells. It may be given before the local treatments mentioned above, to help shrink the tumor and make treatment more successful. Chemotherapy can also be used if cancer has spread to other parts of the body, or if there’s a risk that it may spread. The chemotherapy drugs most commonly used to treat Retinoblastoma are carboplatin, etoposide and vincristine. Some of the most common chemotherapies used are:
    • Systemic chemotherapy
    • Regional chemotherapy
    • Ophthalmic artery infusion chemotherapy
    • Intravitreal chemotherapy
  • Enucleation (Surgery)
    If the tumor is very large and the vision in the eye is lost, an operation to remove the eye is recommended. The specialist will only do this if it is absolutely necessary. An artificial eye is then fitted.
  • Radiotherapy
    Radiotherapy treats Cancer by using high-energy rays from a machine to destroy the Cancer cells while doing as little harm as possible to normal cells. It can be given to the whole eye but does have some effect on the surrounding tissue. Radiotherapy for Retinoblastoma is normally only used when other treatments have not worked well.

Is there curative treatment for Retinoblastoma Cancer?

Retinoblastoma is a very rare disease having a high curative rate. When detected at an early stage it can be cured with surgery, chemotherapy, focal therapy and radiation without causing much harm to the eyes.

How frequently should one visit doctor for early diagnosis?

In case of experiencing any of the mentioned symptoms or having a familial history of Retinoblastoma Cancer, a complete diagnostic is recommended once in a year.

How can I as a patient know it early?

The age of the patients is generally very low, so the parents and relatives should take responsibility to keep a vigilant eye on the child’s behavior and consult the doctor in case of any suspicion.

Prostate Cancer

What is Prostate Cancer?

Prostate

Prostate is a gland found only in males and is a vital part of male reproductive system. The prostate gland makes fluid that forms part of semen. It lies just below the bladder in front of the rectum. It surrounds the urethra.

Functions:

  • Prostate gland produces a thick, clear fluid that makes the semen more fluid and protects and nourishes sperm cells in the semen.
  • The prostate mixes its fluids with those from the seminal vesicles to transport the sperm made in the testicles.
  • The prostate also filters and removes toxins for protection of the sperm, which enhances the chance of impregnation and ensures that men seed with the optimum quality of sperm.
  • The prostate erection nerves are responsible for erections. These nerves trigger the penis to swell and harden with extra blood flow into it, producing an erection.

Prostate Cancer

Prostate cancer can develop when cells in the prostate start to grow in an uncontrolled way. It is usually a very slow growing cancer and most patients do not have significant symptoms until the cancer reaches an advanced stage.

Types of Prostate Cancer

Acinar Adenocarcinomas: Adenocarcinomas are cancers that develop in the gland cells that line the prostate gland. They are the most common type of prostate cancer.

Ductal Adenocarcinoma: Ductal adenocarcinoma starts in the cells that line the ducts of the prostate gland. It tends to grow and spread more quickly than acinar adenocarcinoma.

Transitional cell cancer: Transitional cell cancer of the prostate starts in the cells that line the tube carrying urine to the outside of the body. This type of cancer usually starts in the bladder and spreads into the prostate.

Squamous cell cancer: These cancers develop from flat cells that cover the prostate. They tend to grow and spread more quickly than adenocarcinoma of the prostate.

Small cell prostate cancer: Small cell prostate cancer is made up of small round cells. It’s a type of neuroendocrine cancer.

Prostate Cancer Occurrence Rate in India

Previously it was thought, that prevalence of prostate cancer in India is far lower as compared to the western countries but with the changing life styles, increased awareness, and easy access to medical facility, more cases of prostate cancer are being picked up and it is coming to the knowledge that we are not very far behind the rate from western countries.

Prostate is the second leading site of cancer among males in large Indian and it is among the top ten leading sites of cancers in the rest of the PBRCs of India.

Incidence Mortality 5 years Prevalence
19,095 12,231 63,818

The incidence rates of this cancer are constantly and rapidly increasing in all the PBRCs. The cancer projection data shows that the number of cases will become doubled by 2020.

Anatomy of Prostate Cancer (Gastric)

prostate cancer

What are the general symptoms of Prostate Cancer?

Prostate cancer, at its early stage, usually causes no symptoms. But more advanced prostate cancers can sometimes cause symptoms, such as:

  • Problems passing urine, including a slow or weak urinary stream or the need to urinate more often, especially at night.
  • Urgency to pass urine.
  • Discomfort in the pelvic area.
  • Blood in the urine/ semen.
  • Erectile dysfunction.
  • Pain in the hips, back (spine), chest (ribs).
  • Weakness or numbness in the legs or feet.
  • Loss of bladder or bowel control from cancer pressing on the spinal cord.

What are the general causes of Prostate Cancer?

Every type of Cancer has risk factors, but they don’t tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors. Some risk factors for Prostate Cancer include:

Age: Risk of Prostate Cancer increases with increasing age. Prostate Cancer is very rare in men below 40 and the risk increases rapidly after the age 50.

Family history: Men who have a family history of Prostate Cancer (father or brother) have a higher chance of developing it themselves. The risk is more in case of an effected brother than father.

Gene changes: Including inherited mutations of the BRCA1 or BRCA2 genes raises chances of developing Prostate Cancer and men with Lynch syndrome have an increased risk for a number of cancers, including Prostate Cancer.

Workplace exposures: Firefighters are exposed to substances (toxic combustion products) that may increase their risk of Prostate Cancer.

Cadmium: Cadmium and cadmium compounds are possible causes of Prostate Cancer. Cadmium is a type of metal that is in tobacco smoke and food. Non smokers are exposed to it through food. It is in most types of food including vegetables, meats, grains and fish.

Can Prostate Cancer be prevented?

The exact cause of Prostate Cancer is currently unknown. Hence, at this time it is not possible to prevent most cases of the disease. Natural and genetic factors are uncontrollable, but there are some precautions one may be able to take.

  • Maintain a healthy weight.
  • Regular physical activity.
  • Limited intake of high-calorie foods and drinks.
  • Eat at least 2½ cups of vegetables and fruits each day.
  • Limit the intake of processed meat and red meat.
  • Limit the alcohol intake to no more than 2 drinks per day.
  • Reduce intake of dairy foods and diets rich in calcium.

What are the stages of Prostate Cancer?

Stage I: Tumor is limited to prostate

  • The PSA level is lower than 10
  • Tumor is found in one-half or less of one lobe of the prostate.

Stage II: Tumor is limited to prostate but PSA levels are higher

  • The PSA level is more than 10 but lower than 20
  • Tumor is found in one-half or less of one lobe of the prostate.

Stage III: Tumor has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles. The PSA can be any level.

Stage IV: Tumor has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, lymph nodes, bones or pelvic wall. The PSA can be any level.

Survival rates of Prostate Cancer?

Survival depends on many different factors. It depends on your individual condition, type of cancer subtype, treatment and level of fitness. So it is difficult to predict as to how long a particular Prostate Cancer patient will live.

10 year survival rate according to AJCC staging

Stage Survival Rate
StageI 85%
StageII 72%
StageIII 55%
StageIV 30%

Can Prostate Cancer be detected early?

Various methods can be used for screening and diagnosis. Most important of them for screening high risk patients is the blood levels of Prostate specific Antigen (PSA). Other methods for confirming Prostate Cancer is digital rectal examination, CT, MRI or bone scan as recommended by a consultant.

Medical history and physical exam: A general physical examination is conducted by the doctor to investigate the signs and symptoms of the disease. Further, a digital rectal examination (DRE) is conducted where a lubricated gloved finger is inserted into the rectum to feel for any hard areas on prostate.

PSA blood test: Prostate specific antigen (PSA) blood test is mainly used as a screening test to detect Prostate Cancer early in asymptomatic men.

The levels of PSA are < 4 nanograms/mililitre (ng/ml) in most healthy men. As PSA levels go up, the chances of having Prostate Cancer increase. However, a PSA level of

Imaging tests: Imaging tests help to identify the spread of the Prostate Cancer.

Bone Scan: Prostate Cancer often spreads to bones first (metastases), among the various sites for distant spread, which is detected by bone scan.

Computed Tomography (CT) scan: Helps in detecting spread of Prostate Cancer to nearby lymph nodes or other organs.

Magnetic Resonance Imaging (MRI): Produces a clear picture of prostate and is useful to detect whether the cancer has spread outside the prostate into the seminal vesicles or nearby structures.

What are the Treatments available?

Prostate cancer is the most common cancer among men, but it can often be treated successfully. Depending on the stage of disease, prostate cancer can be treated in various ways.

Stage I and Stage II

  • Surgery for prostate cancer involves removing the prostate gland, some surrounding tissue and a few lymph nodes.
  • Radiation therapy: Uses non-invasive beam therapy using electron, proton, or neutron beams.

Stage III

  • Surgery
  • Radiation / hormonal therapy
  • Cryotherapy is a revolutionary minimally invasive therapy that uses ultrathin needles and freezing gases to destroy the cancerous tissue

Stage IV

  • Hormone therapy is treatment to stop the body from producing the male hormone testosterone. Medications that stop the body from producing testosterone are given.
  • Surgery to remove the testicles. Removing the testicles reduces testosterone levels in the body.
  • Chemotherapy: works by destroying quickly-dividing cells and is usually reserved for patients with advanced prostate cancer.

Is there curative treatment for Prostate Cancer?

This is dependent on the stage the Cancer has reached. However, if the Cancer is detected at an advanced stage, where the cancer cells have spread to distant parts of the body, then in spite of treatment it can be rarely cured.

How frequently should one visit doctor for early diagnosis?

Having some of the symptoms associated with Prostate Cancer may not necessarily indicate the presence of the disease. However, expert advice to rule out the possibility is prudent, making curative treatment possible. So, regular self examination and a physical examination at least once a year is recommended to facilitate early diagnosis of the disease.

How can I as a patient know it early?

If any of the symptoms mentioned in the Symptoms section is experienced, then consulting a doctor is highly recommended. Furthermore, a genetic make-up test can also be done to see if one is prone to Prostate Cancer.

Testicular Cancer

What is Testicular Cancer?

Testicles

Testicles are part of the male reproductive system. The testicles are 2 egg-shaped glands located inside the scrotum. The scrotum is a sac of loose skin that hangs beneath the base of the penis.

Functions:

  • They synthesize male hormones such as testosterone.
  • They make sperm.

Testicular Cancer

The growth of uncontrolled mutated cells in the testicles is called esticular Cancer. Almost all Testicular Cancers start in the germ cells. Compared with other types of Cancer, Testicular Cancer is rare and is highly treatable even when Cancer has spread beyond the Testicle.

Types of Testicular Cancer

  • Seminomas: Though this cancer is malignant, it is highly curable if detected at an early stage. Seminomas also have a good prognosis with patients stage I to stage IIB having a 5 year survival rate of 98% to 92%. These are very sensitive to radiation. Generally, it occurs in the age group 30-50 years.

    Types
    • Classical Seminoma: More than 95% of seminomas are classical. These usually occur in men between 25 and 45.
    • Spermatocytic Seminoma: This rare type of seminoma tends to occur in older men. The average age of men diagnosed with spermatocytic seminoma is about 65. Spermatocytic tumors tend to grow more slowly and are less likely to spread to other parts of the body.
  • Nonseminomas: They tend to grow and spread more quickly than seminomas. A testicular tumor that contains both seminoma and nonseminoma cells are treated as a nonseminoma. They are more likely to affect between teenage to early 40s. They grow and spread rapidly and possibly faster than seminomas.

    Types
    • Embryonal Carcinoma: Pure embryonal carcinomas occur only 3% to 4% of the time. This type of non-seminoma tends to grow rapidly and spread outside the testicle.
    • Yolk sac Carcinoma: This is the most common form of testicular cancer in children (especially in infants), but pure yolk sac carcinomas are rare in adults. When they occur in children, these tumors usually are treated successfully.
    • Choriocarcinoma: This is a very rare and aggressive type of Testicular Cancer in adults. Pure choriocarcinoma is likely to spread rapidly to distant organs of the body, including the lungs, bones, and brain.
    • Teratoma: Pure teratomas of the testicles are rare and do not increase AFP (alpha-fetoprotein)or HCG (human chorionic gonadotropin) levels. More often, teratomas are seen as parts of mixed germ cell tumors. They are further classified as:
      • Mature teratomas are tumors formed by cells similar to cells of adult tissues. They rarely spread to nearby tissues and distant parts of the body. They can usually be cured with surgery, but some come back (recur) after treatment.
      • Immature teratomas are less well-developed cancers with cells that look like those of an early embryo. This type is more likely than mature teratomas to grow into surrounding tissues, to spread outside the testicle, and recur years after treatment.
      • Teratomas with somatic type malignancy are very rare Cancers.

Occurrence Rate of Testicular Cancer in India

Testicular Cancer is a rare tumor type accounting for 1% of malignancies in men. India had the lowest incidence of 0.5 per 100,000 men. Testicular Cancer is increasing in incidence in many countries; however, mortality rates remain low and most men are cured. An in-depth understanding of the risks and long-term side effects of treatment are important in prognosis.

Anatomy of Testicular Cancer

Testicular CancerTesticular Cancer

What are the general symptoms of Testicular Cancer?

Detection of testicular cancer at an early stage is aided by the following symptoms:

  • A lump or enlargement in either testicle.
  • A feeling of heaviness in the scrotum.
  • A dull ache in the abdomen or groin.
  • A sudden collection of fluid in the scrotum.
  • Pain or discomfort in a testicle or the scrotum.
  • Enlargement or tenderness of the breasts.
  • Back pain.

What are the general causes of Testicular Cancer?

The exact causes of testicular cancer are yet not confirmed. However, there are a few factors that considerably increase the chances of getting the disease. Some of the risk factors are discussed below.

An undescended testicle (cryptorchidism):

The testicles usually develop inside the abdomen of the fetus and they descend into the scrotum before birth. Sometimes the testicle remains in the abdomen. In other cases, the testicle starts to descend but remains stuck in the groin area. Cryptorchidism with at least one testicle is found to the extent of 3% in prematurely born babies.

Undescended testicles continue moving down into the scrotum during the child’s first year of life. If the testicle has not descended by the time a child is a year old, it probably won’t go down on its own.

Males with cryptorchidism are several times more likely to get Testicular Cancer than those with normally descended testicles. In 90% of the cases, the undescended testis is confined to inguinal canal. It can be rectified through surgery.

Abnormal testicle development or Carcinoma in situ:

Carcinoma in situ (CIS) means that there are abnormal cells in the testicle. It isn't Cancer. There is no lump and usually no other symptoms.

These abnormal cells are completely contained. Unlike cancer cells, they can't spread, if left untreated CIS develops into cancer in about half (50%) the men who have it.

CIS is most often found when a man has a testicular biopsy to check for infertility. It can be treated by removing the testicle to prevent testicular cancer from developing.

Family history: If family members have had testicular cancer, you may have an increased risk.

Age: Testicular Cancer affects teens and younger men, particularly those between ages 20 and 35. However, it can occur at any age.

Race: Testicular Cancer is more common in white men than in black men. It is 4 to 5 times more in white man than that of black men or Asian-American men.

HIV or AIDS: Some evidence has shown that men infected with the human immunodeficiency virus (HIV), particularly those with AIDS, are at increased risk.

Injury to the testicles: Severe injury to the testicles can also cause Testicular Cancer.

Hypospadias: A congenital condition in males in which the opening of the urethra is on the underside of the penis.

Can Testicular Cancer be prevented?

Many cases ofTesticular Cancer have no known factors. Also, the known factors of Testicular Cancer are natural and beyond one’s control. So it becomes quite impossible to prevent most cases of Testicular Cancer.

Regular examination and treating cryptorchidism might reduce the chances of occurrence of Testicular Cancer.

What are the stages of Testicular Cancer?

Testicular Cancer can be staged as:

  • T refers to the spread of Cancer cells to tissues next to the testicle.
  • N describes the spread of Cancer cells to regional lymph nodes.
  • M indicates whether the Cancer has metastasized.
  • S indicates the serum levels of tumor markers that are made by some Testicular Cancers.

These stages are explained in details below:

T suffixed with a numerical or letter indicates the size and location of the tumor.

  • TX: The primary tumor cannot be assessed.
  • T0: There is no prominent evidence indicating a primary tumor.
  • Tis: Carcinoma in situ i.e. non-invasive cancer cells are detected in the testicles.
  • T1: The tumor has not spread beyond the testicle. The cancer might have grown through the inner layer surrounding the testicle, but it has not reached the outer layer covering the testicle.
  • T2: The cancer has spread to blood or lymph vessels near the tumor, or the tunica vaginalis.
  • T3: The tumor is growing into the spermatic cord which contains blood vessels, lymph vessels, nerves, and the vas deferens.
  • T4: The tumor is growing into the skin surrounding the testicles.

N stands for lymph nodes. Lymph is a fluid that flows from different tissues and organs of the body and eventually drains into the bloodstream. N indicated the size of the cancer cells and its size in the lymph node.

  • NX: Regional lymph nodes cannot be assessed.
  • N0: The mutated cells did not spread to regional lymph nodes.
  • N1: The Cancer has spread to at least one lymph node, but the size is limited to 2 cm.
  • N2: The Cancer has spread to at least one lymph node and the size ranges between 2 cm to 5 cm.
  • N3: The Cancer has spread to at least one lymph node that is larger than 5 cm.

M indicates if the cancer cells have spread to distant cells of the body.

  • MX: Distant metastasis cannot be evaluated.
  • M0: The disease has not metastasized to distant parts of the body.
  • M1: There is atleast 1 distant metastasis present in the body.
  • M1a: The tumor has metastasized to distant lymph nodes or to the lung.
  • M1b: The tumor has metastasized to other organs, such as the liver, brain, or bone.

S indicates the level of serum makers.

  • SX: Tumor marker levels are not available, or the tests have not been done.
  • S0: Tumor marker levels are normal.
  • S1: At least 1 tumor marker level is above normal.
  • S2: At least 1 tumor marker level is substantially above normal.
  • S3: 1 or more tumor marker level is very highly elevated.

Survival rates of Testicular Cancer?

Survival rates indicate an average outcome of a large number of people who had the disease, but they cannot precisely predict the expectancy of any particular case. Multiple factors may affect a person's outlook; however, the survival rate of testicular cancer is quite high.

Stage 5 year Survival Rate
Localized 99%
Regional 96%
Distant 73%

Here,

Localized means the cancer is still only in the testicle.

Regional means that the cancer has spread to nearby lymph nodes or tissues

Distant means that the cancer has spread to organs or lymph nodes away from the tumor.

Can Testicular Cancer be detected early?

  • Physical exam and history: The testicles are physically examined to check for lumps, swelling or pain. A history of the patient's health habits, past illnesses and treatments are also taken in account.
  • Ultrasound exam: High-energy sound waves are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
  • Serum tumor marker test: It is a procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. The following tumor markers are used to detect Testicular Cancer:
    • Alpha-fetoprotein (AFP).
    • Beta-human chorionic gonadotropin (β-hCG).
  • Inguinal orchiectomy: A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. If cancer is found, the cell type seminoma or nonseminoma is determined in order to help plan treatment.
  • Biopsy: Biopsy is the removal of a small amount of tissue for examination under a microscope.

What are the Treatments available?

Depending on the type, stage of the cancer and other factors, treatment options for testicular cancer can include

  • Surgery
    • Surgery to remove the complete testicles is the primary treatment option for nearly all stages and types of testicular cancer. An incision in the groin is made and the entire testicle is extracted through the opening.
    • Surgery to remove nearby lymph nodes: An incision is made in the abdomen. Generally, extensive care is taken to avoid damaging nerves surrounding the lymph nodes but in some cases, it might be unavoidable.
  • Radiation therapy: Radiation therapy uses high-powered energy beams, such as gamma rays or X-rays, to kill Cancer cells. However, radiation therapy has got a few side effects as well that may include fatigue, as well as skin redness and irritation in your abdominal and groin areas. Radiation therapy is also likely to cause infertility.
  • Chemotherapy (chemo): Chemotherapy treatment uses drugs to kill Cancer cells. Chemotherapy drugs travel throughout your body to kill Cancer cells that may have migrated from the original tumor. Chemotherapy is also likely to cause infertility, which can be permanent.
  • High-dose chemotherapy and stem cell transplant: A stem cell transplant is a highly effective treatment for Testicular Cancer.

Is there curative treatment for Testicular Cancer?

Testicular Cancer is highly treatable, even when cancer has spread beyond the testicle. The most common method to treat Testicular Cancer is through surgery.

How frequently should one visit doctor for early diagnosis?

In case of experiencing any of the mentioned symptoms or having a prior or familial history of testicular cancer, a physical examination by a doctor is highly recommended.

How can I as a patient know it early?

Being aware of the signs and symptoms will definitely help a patient to suspect the disease. In some cases, men discover Testicular Cancer themselves, either unintentionally or while doing a testicular self-examination to check for lumps. In other cases, your doctor may detect a lump during a routine physical exam.

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