Thursday, 22 September 2016
Colorectal cancer treatment
Treatment for colorectal cancer depends on the stage at which cancer was discovered. Early stage colorectal cancer is best treated with surgery. Rectal cancer however may require additional radiation therapy to minimize the risk of recurrence. Treatment depends on many things, including stage of the cancer. Treatments may include:
· Surgery to remove cancer cells,
· Chemotherapy to kill cancer cells,
· Radiation therapy to destroy cancerous tissue.
This is the most common treatment for colorectal cancer and is often called surgical resection. Part of the healthy colon or rectum and nearby lymph nodes can also be removed.
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). A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs at the same time. Chemotherapy is also used to improve symptoms and prolong survival in patients with stage IV colon cancer. Chemotherapy may be given after surgery to eliminate any remaining cancer cells. For some people with rectal cancer, the doctor will give chemotherapy and radiation therapy before surgery to reduce the size of a rectal tumor and reduce the chance of the cancer returning.
Radiation therapy is the use of high-energy x-rays to destroy cancer cells. It is commonly used for treating rectal cancer because this tumor tends to recur near where it originally started. A radiation therapy schedule usually consists of a specific number of treatments given over a set period of time. Radiation therapy is sometimes used in patients with colon cancer.
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. The types of targeted therapies used in the treatment of colon cancer include the following:
· Monoclonal antibodies: The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
· Angiogenesis inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels that tumors need to grow.
The and the rectum are parts of the large intestine, which is the lower part of the body’s digestive system. During digestion, food moves through the stomach and small intestine into the . The absorbs water and nutrients from the food and stores waste matter (stool). Stool moves from the into the rectum before it leaves the body.
is cancer that starts in the or rectum. Most colorectal cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). often begins as a growth called a polyp, which may form on the inner wall of the or rectum. Some polyps become cancer over time. Finding and removing polyps can prevent .
is the third most common type of cancer in men and women.
Symptoms of colorectal cancer
Signs and symptoms of colon cancer tend not to be specific. In other words, the signs and symptoms can occur due to a number of different conditions. When colon cancer is detected in its early stages, it may not have even caused symptoms.
§ A feeling that the bowel does not empty properly after a bowel movement.
§ Blood in feces (stools).
§ Pains in the abdomen.
§ Bloating in the abdomen.
§ A feeling of fullness in the abdomen (maybe even after not eating for a while).
§ Fatigue (tiredness).
§ Inexplicable weight loss.
§ A lump in the tummy or a lump in the back passage felt by your doctor.
§ Unexplained iron deficiency in men, or in women after the menopause.
Causes of colorectal cancer
Several risk factors have been identified over the years. The possible risk factors for colorectal factors are:
§ Being elderly - the older you are the higher the risk is.
§ A diet that is very high in animal protein.
§ A diet that is very high in saturated fats.
§ A diet that is very low in dietary fiber.
§ A diet that is very high in calories.
§ A diet that is very high in alcohol consumption.
§ Women who have had breast, ovary and uterus cancers.
§ A family history of colorectal cancer.
§ Patients with ulcerative colitis.
§ Being overweight/obese.
§ Smoking. This study found that smoking is significantly associated with an increased risk for colorectal cancer and death.
§ Being physically inactive.
§ Presence of polyps in the colon/rectum. Untreated polyps may eventually become cancerous.
§ Having Crohn's disease or Irritable Bowel Disease have a higher risk of developing colorectal cancer.
is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.
Weight: Maintaining a healthy weight is an important goal for everyone. Being overweight can increase the risk of many different cancers, including breast cancer.
Physical activity: Women who are physically active for at least 30 minutes a day have a lower risk of breast cancer. Regular exercise is also one of the best ways to help keep weight in check.
Diet: A healthy diet can help lower the risk of breast cancer.
Cigarettes: On top of lowering quality of life and increasing the risk of heart disease, it can also cause stroke, and cancers including breast cancer.
Breastfeeding: Breastfeeding for a total of one year or more (combined for all children) lowers the risk of breast cancer. It also has great health benefits for the child.
Birth control pills: Birth control pills have both risks and benefits. The younger a woman is, the lower the risks are. While women are taking birth control pills, they have a slightly increased risk of breast cancer. This risk goes away quickly, though, after stopping the pill. The risk of stroke and heart attack is also increased while on the pill – particularly if a woman smokes.
Post-menopausal hormones: Post-menopausal hormones shouldn’t be taken long term to prevent chronic diseases, like osteoporosis and heart disease. Studies show they have a mixed effect on health, increasing the risk of some diseases and lowering the risk of others, and both estrogenonly hormones and estrogen-plus-progestin hormones increase the risk of breast cancer. If women do take post-menopausal hormones, it should be for the shortest time possible.
Family History: Women with a strong family history of cancer can take special steps to protect themselves, so it’s important for women to know their family history.
Despite some controversy, studies show that breast cancer screening with mammography saves lives. It doesn’t help prevent cancer, but it can help find cancer early when it’s most treatable. For most women, regular mammograms can begin at age 40, but specific recommendations vary by age and risk.
Between 40 – 44: It is important to talk to a doctor about the risk and benefits of mammograms at these ages.
Between 45 – 54: Mammograms are recommended every year.
From age 55 or over: Mammograms are recommended every other year. You can choose to continue to have them every year.
Breast cancer treatment
Breast cancer treatments are getting better all the time, and people have many more options today than ever before. The patient may have a combination of the following treatments, depending on your situation.
Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Surgery is also used to examine the lymph nodes. The types of surgery include the following:
· A lumpectomy: The removal of the tumor and a small, cancer-free margin of healthy tissue around the tumor. A lumpectomy may also be called breast-conserving surgery or a partial mastectomy.
· A mastectomy: The surgical removal of the entire breast.
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A radiation therapy regimen schedule usually consists of a specific number of treatments given over a set period of time. Radiation therapy is given after a lumpectomy, and following adjuvant chemotherapy if recommended. Radiation therapy is usually given daily for a set number of weeks to get rid of any remaining cancer cells near the tumor site or elsewhere in the breast. This helps lower the risk of recurrence in the breast. It has been shown that with modern surgery and radiation therapy, recurrence rates in the breast are now less than 5% in the 10 years after treatment, and survival is the same with lumpectomy or mastectomy.
Chemotherapy is the use of drugs to destroy cancer cells, which work by stopping the cancer cells’ ability to grow and divide. 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).
Not every person diagnosed with breast cancer needs chemotherapy. The doctor considers several factors when deciding if chemotherapy is an appropriate option, including:
· The type and stage of breast cancer
· How likely chemotherapy will work
· The overall goals of treatment
Chemotherapy may be given before surgery to shrink a large tumor and make surgery easier, called neoadjuvant or preoperative chemotherapy. It may also be given after surgery to reduce the risk of recurrence, called adjuvant chemotherapy.
Hormone therapy uses drugs to prevent hormones, especially estrogen, from fueling the growth of breast cancer cells. Some types of this therapy work by stopping the ovaries from making hormones, either through surgery or medication.
Targeted therapies prompt the body's immune system to destroy cancer. They target breast cancer cells that have high levels of a protein called HER2.
Causes of breast cancer
Women with certain are more likely than others to develop breast cancer even if it is not totally clear what causes breast cancer. Breast cancer cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass.
About 5 to 10 percent of breast cancers are linked to gene mutations passed through generations of a family. A number of inherited mutated genes that can increase the likelihood of breast cancer have been identified. The most common are breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of both breast and ovarian cancer.
A breast cancer risk factor is anything that makes it more likely to get breast cancer. But having one or even several breast cancer risk factors doesn't necessarily mean the person will develop breast cancer. Factors that are associated with an increased risk of breast cancer include:
· Gender: Women are much more likely than men are to develop breast cancer.
· History of breast cancer: If the subject had breast cancer in one breast, he has an increased risk of developing cancer in the other breast.
· Age. The risk of breast cancer increases with age.
· Inherited genes that increase cancer risk: Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most common gene mutations are referred to as BRCA1 and BRCA2.
· Radiation exposure.
· Period at a younger age: Beginning the period before age 12 increases the risk of breast cancer.
· A family history of breast cancer: If the mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, the risk of breast cancer is increased.
· Obesity: Being obese increases the risk of breast cancer.
· Menopause at an older age.
· Having never been pregnant: Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.
· Having the first child at an older age: Women who give birth to their first child after age 30 may have an increased risk of breast cancer.
· Postmenopausal hormone therapy: Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
· Alcohol: Drinking alcohol increases the risk of breast cancer.
The breast is made up of glands called lobules that can make milk and thin tubes called ducts that carry the milk from the lobules to the nipple. Breast tissue also contains fat and connective tissue, lymph nodes, and blood vessels.
. Breast usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant can spread to other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma.
There are several different types of breast cancer, which can develop in different parts of the breast. Breast cancer is often divided into non-invasive and invasive types.
· Non-invasive breast cancer
Non-invasive breast cancer is also known as cancer or carcinoma in situ. This cancer is found in the ducts of the breast and hasn't developed the ability to spread outside the breast.
· Invasive breast cancer
Invasive cancer has the ability to spread outside the breast, although this doesn't necessarily mean it has spread. The most common form of breast cancer is invasive ductal breast cancer, which develops in the cells that line the breast ducts. Invasive ductal breast cancer accounts for about 80% of all breast cancer cases and is sometimes called "no special type".
· Other types of breast cancer
Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget's disease of the breast.
Often, an abnormal area turns up on a screening mammogram (X-ray of the breast), which leads to further testing. In some cases, however, the first sign of breast cancer is a new lump or mass in the breast that you or your doctor can feel. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But sometimes cancers can be tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.
According to the American Cancer Society, any of the following unusual changes in the breast can be a symptom of breast cancer:
· swelling of all or part of the breast
· skin irritation or dimpling
· breast pain
· nipple pain or the nipple turning inward
· redness, scaliness, or thickening of the nipple or breast skin
· a nipple discharge other than breast milk
· a lump in the underarm area
Do alternative cancer treatments work?
Complementary or alternative medical therapies are remedies that lie outside what is traditionally considered conventional medical treatment for cancer. These include the use of herbal, vitamin, and nutritional supplements, as well as physical and psychological interventions such as exercise, relaxation, massage, prayer, hypnotherapy, and acupuncture. These therapies are used to enhance physical and emotional strength during and after mainstream cancer treatment. They are non invasive and evidence based therapies that have been subjected to study to determine their value and document the problems they aim to ameliorate. Unfortunately, they lack scientific evidence of safety and efficacy. The practice of integrative oncology combines the helpful complementary therapies with mainstream oncology care to address patients' physical, psychological and spiritual needs.
There are many alternative treatments for cancer. These treatments can usually be combined to increase the effectiveness of protocols. For example, mind body modalities focus on interactions between the brain, mind, body and behavior with the intention of reducing symptoms and promoting health. Some of these therapies, such as meditation, relaxation techniques, hypnotherapy, yoga, Tai Chi and music therapy have very ancient roots. The common goal of mind body therapies is to reduce the effects of anxiety, resentment, depression and pain on the patient while promoting a sense of emotional, physical and spiritual well being. Mind body therapies do not treat cancer but they help with the symptoms. Many trials of good quality have been conducted to show the benefits of these techniques. These helpful complementary modalities can be used as part of a multidisciplinary approach for the patient care.
Complementary or alternative medicine is a topic that patients with cancer are highly interested in but also find quite confusing. Safe and beneficial complementary therapies should be integrated into regular cancer care to improve patient quality of life. However, patients should be steered away from alternative cancer therapies that are risky and do not have clinical value. Integrative oncology combines complementary therapies with mainstream care, trying to optimize the patient’s physical, psychological and spiritual well-being, taking into consideration the individual’s values and priorities in life. The conventional cancer treatment system and the pharmaceutical companies that control it are dedicated to limiting the development of all other forms of cancer treatment. The reason is that most alternative cancer treatments are much less expensive than surgery, radiation, and chemo. They are also more effective and have many fewer unwanted side effects.
Types of alternative cancer treatments (3)
· Music therapy. Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. During music therapy sessions, subjects might listen to music, play instruments, sing songs or write lyrics. A trained music therapist may lead them through activities designed to meet their specific needs, or they may participate in music therapy in a group setting. Music therapy may help relieve pain and control nausea and vomiting. Music therapy is safe and doesn't require any musical talent to participate. Many medical centers have certified music therapists on staff.
· Yoga. Yoga is a Hindu philosophy that teaches a person to experience inner peace by controlling the body and mind. It is a relaxing form of exercise that was developed in India and involves assuming and holding postures that stretch the limbs and muscles, doing breathing exercises, and using meditation techniques to calm the mind. Yoga combines stretching exercises with deep breathing. During a yoga session, the position of the body changes through various poses that require bending, twisting and stretching. There are many types of yoga, each with its own variations. Yoga may provide some stress relief for people with cancer. It has also been shown to improve sleep and reduce fatigue. Before starting a yoga class, patients should ask the doctor to recommend an instructor who regularly works with people with health concerns, such as cancer.
· Relaxation techniques. Relaxation techniques are ways of focusing the attention on relaxing the muscles and calming the mind. Relaxation techniques may be helpful in relieving anxiety and fatigue. They may also help people sleep better. These techniques are safe, a therapist leads you through these exercises and eventually you may be able to do them on your own or with the help of guided relaxation recordings.
· Tai chi. Tai chi is a Chinese martial art and form of stylized, meditative exercise, characterized by methodically slow circular and stretching movements and positions of bodily balance. It is a form of exercise that incorporates gentle movements and deep breathing. Practicing tai chi may help relieve stress. Tai chi is generally safe. The slow movements of tai chi don't require great physical strength, and the exercises can be easily adapted to the body abilities. Still, it is recommended to talk to the doctor before beginning tai chi. People should avoid doing any tai chi moves that cause pain.