Monday, 21 November 2016

Diagnosis and treatment of skin cancer (1)

Diagnosis and treatment of skin cancer (1)
To diagnose skin cancer, the doctor may:
·         Examine the skin. The doctor may look at the skin to determine whether the skin changes are likely to be skin cancer. Further testing may be needed to confirm that diagnosis.
·         Remove a sample of suspicious skin for testing (skin biopsy). The doctor may remove the suspicious-looking skin for lab testing. A biopsy can determine whether the patient has skin cancer and, if so, what type of skin cancer he has.
If the doctor determines that the patient has skin cancer, he may have additional tests to determine the extent of the skin cancer.
Because superficial skin cancers such as basal cell carcinoma rarely spread, a biopsy which removes the entire growth often is the only test needed to determine the cancer stage. But if the patient has a large squamous cell carcinoma, Merkel cell carcinoma or melanoma, the doctor may recommend further tests to determine the extent of the cancer.
Additional tests might include imaging tests to examine the nearby lymph nodes for signs of cancer or a procedure to remove a nearby lymph node and test it for signs of cancer (sentinel lymph node biopsy). The skin cancer's stage helps determine which treatment options will be most effective.

The main treatments

The main treatment for skin cancer is surgery. For most people this will be all the treatment they need. Radiotherapy can also be used to treat and cure skin cancers. The patient may have this instead of surgery if an operation is not suitable for him. Radiotherapy can also be given after surgery to reduce the chances of the cancer coming back. Another alternative to an operation for basal cell skin cancer is treatment with a drug to make the skin sensitive to light. This is followed by treatment with a bright light to the affected area. This treatment is called photodynamic therapy (PDT). Chemotherapy is only occasionally used for skin cancer.

Surgery

Most basal cell and squamous cell skin cancers can be successfully treated with surgery. In most cases the surgery is minor. The affected area is completely removed, usually under local anaesthetic. There are several different types of surgical techniques that can be used. What is done will depend on
  • The type of skin cancer you have
  • The size of the cancer
  • Where the cancer is
  • The stage of the cancer.


Skin cancer

Skin cancer
Skin cancer most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight. Skin cancers are growths with differing causes and varying degrees of malignancy.
The three most common malignant skin cancers are:
ü  Basal cell carcinoma,
ü  Squamous cell carcinoma,
ü  Melanoma.
Each of which is named after the type of skin cell from which it arises.
The risk of skin cancer can be reduced by limiting or avoiding exposure to ultraviolet (UV) radiation. Checking your skin for suspicious changes can help detect skin cancer at its earliest stages. Early detection of skin cancer gives the patient the greatest chance for successful skin cancer treatment.
Symptoms generally are:
·         Any change on skin, especially in the size or color of a mole, growth, or spot, or a new growth (even if it has no color)
·         Scaliness, roughness, oozing, bleeding, or a change in the way an area of skin looks
·         A sore that doesn’t heal
·         A change in sensation, such as itchiness, tenderness, or pain
·         The spread of pigment (color) beyond its border, such as dark coloring that spreads past the edge of a mole or mark

Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day like palms, beneath your fingernails or toenails, and or genital area.
The exact cause of skin cancer is unknown. It appears basal cell skin cancers arise from basaloid cells in the upper layer of the skin. Uncontrolled growth of these cells is regulated by other factors in the skin. When that regulation is lost, skin cancer cells begin to grow into tumors.
In squamous cell skin cancers, the tumors arise from a normal cell in the top layer of the skin, the epidermis. As with basal cell cancers, these cells are prevented from growing wildly by genetically controlled factors. When there is an alteration in the genes that regulate these cells, the control is lost and skin cancers start to grow. In many instances, the genes are altered by sunlight exposure. The sooner a skin cancer is identified and treated, the better your chance of avoiding surgery or, in the case of a serious melanoma or other skin cancer, potential disfigurement or even death.

Thyroid cancer symptoms and treatment

Thyroid cancer symptoms and treatment
Experts don't know what causes thyroid cancer. Like other cancers, changes in the DNA of the cells seem to play a role. These DNA changes may include changes that are inherited as well as those that happen as you get older
Thyroid carcinoma most commonly manifests as a painless, palpable, solitary thyroid nodule. Patients or clinicians discover most of these nodules during routine palpation of the neck.
Some thyroid cancer signs and symptoms include a hoarse voice, neck pain, and enlarged lymph nodes. Although as much as 75% of the population will have thyroid nodules, the vast majority are benign. Young people usually don't have thyroid nodules, but as people age, they're more likely to develop a nodule. By the time we are 80, 90% of us will have at least one nodule.
Signs and symptoms associated with malignancy in thyroid nodules include the following:
  • A lump or swelling in your neck. This is the most common symptom.
  • Pain in your neck and sometimes in your ears.
  • Difficulty swallowing.
  • Difficulty breathing or constant wheezing.
  • Hoarseness that is not related to a cold.
  • cough that continues and is not related to a cold.
Depending on the type and stage of your thyroid cancer, you may need more than one type of treatment. Doctors on your cancer treatment team may include:
§  A surgeon: a doctor who uses surgery to treat cancers or other problems
§  An endocrinologist: a doctor who treats diseases in glands that secrete hormones
§  A radiation oncologist: a doctor who uses radiation to treat cancer
§  A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer
Many other specialists may be involved in your care as well, including nurse practitioners, nurses, psychologists, social workers, rehabilitation specialists, and other health professionals.
After thyroid cancer is found and staged, your cancer care team will discuss your treatment options with you. It is important to take the time to consider each of your options. In choosing a treatment plan, factors to consider include the type and stage of the cancer and your general health. The treatment options for thyroid cancer might include:
§  Surgery
§  Radioactive iodine treatment
§  Thyroid hormone therapy
§  External beam radiation therapy
§  Chemotherapy
§  Targeted therapy

Often 2 or more of these options are combined.
Most thyroid cancers can be cured, especially if they have not spread to distant parts of the body.

Thursday, 10 November 2016

Thyroid cancer

Thyroid cancer
The thyroid gland is below the thyroid cartilage (Adam’s apple) in the front part of the neck. In most people, the thyroid cannot be seen or felt. It is butterfly shaped, with 2 lobes joined by a narrow isthmus. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should. Cancer of the thyroid is a disease in which cancer cells are found in the tissues of the thyroid gland. Cancer of the thyroid is more common in women than in men. Most patients are between 25 and 65 years old. People who have been exposed to large amounts of radiation, or who have had radiation treatment for medical problems in the head and neck have a higher chance of getting thyroid cancer. The cancer may not occur until 20 years or longer after radiation treatment. Thyroid cancer is an uncommon type of cancer. Most people who have it do very well, because the cancer is usually found early and the treatments work well. After it is treated, thyroid cancer may come back, sometimes many years after treatment. Most thyroid cancers are differentiated cancers. The cells in these cancers look a lot like normal thyroid tissue when seen with a microscope. These cancers develop from thyroid follicular cells.
Types of Thyroid Cancer
There are 4 main types of thyroid cancer, and some are more common than others.
Thyroid cancer type and incidence:
·         Papillary and/or mixed papillary/follicular thyroid cancer: 80%
·         Follicular and/or Hurthle cell thyroid cancer: 15%
·         Medullary thyroid cancer: 3%
·         Anaplastic thyroid cancer: 2%

Most thyroid cancers are very curable. In fact, the most common types of thyroid cancer are the most curable. In younger patients, both papillary and follicular cancers have a more than 97% cure rate if treated appropriately. The genes in our cells carry the hereditary information from our parents. An abnormal gene has been found in patients with some forms of thyroid cancer. If medullary thyroid cancer is found, the patient may have been born with a certain abnormal gene which may have led to the cancer.
If there are symptoms, a doctor will feel the patient's thyroid and check for lumps in the neck. The doctor may order blood tests and special scans to see whether a lump in the thyroid is making too many hormones.

Prostate cancer diagnosis and treatment

Prostate cancer diagnosis and treatment
Prostate screening tests include:
·         Digital rectal exam (DRE). During a DRE, the doctor inserts a gloved, lubricated finger into therectum to examine the prostate, which is adjacent to the rectum. If the doctor finds any abnormalities in the texture, shape or size of the gland, the patient may need more tests.
·         Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in the arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer.
PSA testing combined with DRE helps identify prostate cancers at their earliest stages, but studies have disagreed whether these tests reduce the risk of dying of prostate cancer. For that reason, there is debate surrounding prostate cancer screening.
Diagnosing prostate cancer
If an abnormality is detected on a DRE or PSA test, your doctor may recommend tests to determine whether you have prostate cancer, such as:
·         Ultrasound. If other tests raise concerns, the doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into the  rectum. The probe uses sound waves to make a picture of the prostate gland.
·         Collecting a sample of prostate tissue. If initial test results suggest prostate cancer, the doctor may recommend a procedure to collect a sample of cells from the prostate (prostate biopsy).
Treatment
No treatment needed in some cases
For men diagnosed with very early-stage prostate cancer, treatment may not be necessary right away. Some men may never need treatment. Instead, doctors sometimes recommend active surveillance.

Radiation therapy
Radiation therapy uses high-powered energy to kill cancer cells. Prostate cancer radiation therapy can be delivered in two ways:
·         Radiation that comes from outside of the body.
·         Radiation placed inside your body (brachytherapy).Brachytherapy involves placing many rice-sized radioactive seeds in your prostate tissue. The radioactive seeds deliver a low dose of radiation over a long period of time.
Hormone therapy
Hormone therapy is treatment to stop the body from producing the male hormone testosterone. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly.
Surgery to remove the prostate
Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. Ways the radical prostatectomy procedure can be performed include:
Freezing prostate tissue
Cryosurgery or cryoablation involves freezing tissue to kill cancer cells.
During cryosurgery for prostate cancer, small needles are inserted in the prostate using ultrasound images as guidance. A very cold gas is placed in the needles, which causes the surrounding tissue to freeze. A second gas is then placed in the needles to reheat the tissue. The cycles of freezing and thawing kill the cancer cells and some surrounding healthy tissue.
Chemotherapy
Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both. Chemotherapy may be a treatment option for men with prostate cancer that has spread to distant areas of their bodies. Chemotherapy may also be an option for cancers that don't respond to hormone therapy.

Biological therapy
Biological therapy (immunotherapy) uses the body's immune system to fight cancer cells. One type of biological therapy called sipuleucel-T (Provenge) has been developed to treat advanced, recurrent prostate cancer.

Tuesday, 8 November 2016

Prostate cancer


Prostate cancer is a disease which only affects men. Cancer begins to grow in the prostate, a gland in the male reproductive system. The prostate gland makes fluid that forms part of semen. The prostate lies just below the bladder in front of the rectum. It surrounds the urethra. In most cases, the prostate cancer starts in the gland cells - this is called adenocarcinoma. Prostate cancer often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions.
Symptoms
There are no warning signs of early prostate cancer. Once a tumor causes the prostate gland to swell, or once cancer spreads beyond the prostate, the following symptoms may happen:
  • A frequent need to urinate, especially at night
  • Difficulty starting or stopping a stream of urine
  • A weak or interrupted urinary stream
  • A painful or burning sensation during urination or ejaculation
  • Blood in urine or semen
·         It's not clear what causes prostate cancer.
  • Leaking of urine when laughing or coughing
  • Inability to urinate standing up
Prostate cancer begins when some cells in your prostate become abnormal. Mutations in the abnormal cells' DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can break off and spread (metastasize) to other parts of the body.


Risk factors
Factors that can increase the risk of prostate cancer include:
·         Older age. The risk of prostate cancer increases with age.
·         Being black. Black men have a greater risk of prostate cancer than do men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced. It's not clear why this is.
·         Family history of prostate or breast cancer. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
·         Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.


Colorectal cancer prevention


Getting regular screening tests for colon cancer is the single best way for protection from the colorectal cancer. Although there is no sure way to prevent colorectal cancer, but there are things we can do that might help decrease the risk such as avoiding risk factors and increasing protective factors. Screening is recommended starting at age 50 for people who are not at increased risk of colorectal cancer. There are several different screening options available. People at higher risk, such as those with a strong family history of colorectal cancer, might start screening at a younger age. In the previous article, we mentioned that the following risk factors increase the risk of colorectal cancer:
    • Age
    • Family history of colorectal cancer
    • Personal history
    • Inherited risk
    • Alcohol
    • Cigarette smoking
    • Obesity
We have to state that these following protective factors decrease the risk of colorectal cancer:
    • Physical activity
    • Aspirin
    • Combination hormone replacement therapy
    • Polyp removal
Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers.

o   Avoid obesity and weight gain.
o   Limit red meats.
o   Eat more vegetables and fruits.
o   Limit processed meat.
o    Increase the intensity and amount of your physical activity.
o   Get the recommended levels of calcium and vitamin D (see below).
o   Avoid excess alcohol.

Some studies suggest that taking a daily multi-vitamin containing folic acid, or folate, may lower colorectal cancer risk, but not all studies have found this. Also, some studies have suggested that vitamin D, which you can get from sun exposure, in certain foods, or in a vitamin pill, might lower colorectal cancer risk. Because of concerns that excess sun exposure can cause skin cancer, most experts do not recommend this as a way to lower colorectal cancer risk at this time. Other studies suggest that increasing calcium intake may lower colorectal cancer risk. Calcium is important for a number of health reasons aside from possible effects on cancer risk. Calcium and vitamin D might work together to reduce colorectal cancer risk, as vitamin D aids in the body’s absorption of calcium.  A few studies have found a possible link between a diet that is high in magnesium and reduced colorectal cancer risk, especially among women.