Diagnosis of Skin cancer
Diagnosis is only confirmed with a skin biopsy. Most skin biopsies are done under local anesthesia with an injection. A shave biopsy is good for diagnosing basal cell carcinoma, while not as well for squamous cell carcinoma. A punch biopsy is preferred for diagnosing squamous cell carcinoma and melanoma.
Treatment of cancer of the skin:
Treatment is dependent on type of cancer, location of the cancer, age of the patient. Also based on the fact that the cancer is localized or spread to other organs.
Skin cancers are usually treated with surgery or local excision with adequate margins or by a specialized technique called Moh's surgery.
Topical chemotherapy using 5 fluorouracil or imiquimod cream, cryosurgery and electrosurgery can also be used for cure in early low risk stages.
In the case of disease that has spread (metastasized), further surgical procedures or chemotherapy may be required.
How to prevent skin cancer
Although it is impossible to completely eliminate the possibility of skin cancer, the risk of developing such a cancer can be reduced significantly with the following steps:
Reducing exposure to ultraviolet (UV) radiation by avoiding sun exposure during the day, (especially from 9 AM to 4 PM), when the sun is highest in the sky, wearing protective clothing (long sleeves and hats) when outdoors, using a broad-spectrum sunscreen that blocks both UVA and UVB radiation with high SPF can go a long way in preventing skin cancers, avoid toxic chemicals, coal, tars and smoking as much as possible, last but not the least, visit a dermatologist for any unusual growth or ulceration.
Skin cancer – Causes and Symptoms
Different Types of Skin Cancer
Diagnosis, Treatment and Prevention of Skin Cancer
Showing posts with label cancer. Show all posts
Showing posts with label cancer. Show all posts
Monday, May 4, 2009
Different Types of Skin Cancer
Basal cell carcinoma:
Usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head neck or shoulder. Crusting and bleeding in the centre of the tumor frequently develops. It is often mistaken for a sore that does not heal. This form of skin cancer is the least deadly and can be cured completely by surgery.
Squamous cell carcinoma:
Commonly a red, scaling, thickened patch on sun-exposed skin. Ulceration and bleeding may occur. When Squamous cell carcinoma is not treated, it may develop into a large mass. This is the second most common skin cancer. It is dangerous, but not nearly as dangerous as Melanoma. These are also treated with surgical excision.
Melanomas:
They are brown to blackish lesions. Signs that might indicate a malignant melanoma include change in size, shape, color or elevation of a mole. Other signs are the appearance of a new mole during adulthood or new pain, itching, ulceration or bleeding.
Skin cancer – Causes and Symptoms
Different Types of Skin Cancer
Diagnosis, Treatment and Prevention of Skin Cancer
Usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head neck or shoulder. Crusting and bleeding in the centre of the tumor frequently develops. It is often mistaken for a sore that does not heal. This form of skin cancer is the least deadly and can be cured completely by surgery.
Squamous cell carcinoma:
Commonly a red, scaling, thickened patch on sun-exposed skin. Ulceration and bleeding may occur. When Squamous cell carcinoma is not treated, it may develop into a large mass. This is the second most common skin cancer. It is dangerous, but not nearly as dangerous as Melanoma. These are also treated with surgical excision.
Melanomas:
They are brown to blackish lesions. Signs that might indicate a malignant melanoma include change in size, shape, color or elevation of a mole. Other signs are the appearance of a new mole during adulthood or new pain, itching, ulceration or bleeding.
Skin cancer – Causes and Symptoms
Different Types of Skin Cancer
Diagnosis, Treatment and Prevention of Skin Cancer
Skin cancers – Causes and symptoms
Cancers that form on the surface of the skin are called skin cancers. Skin cancer is the most common type of cancer seen in humans. It is estimated that over 1 million new cases occur annually across the globe. The annual rates of all forms of skin cancer are increasing each year, representing a growing public concern. Usually seen in fair skinned people above 50 but those not so fair and younger people can get it too.
Our skin is made up of mainly two layers -the dermis, which is the inner layer and the outer layer called the epidermis. Based on type of skin cell that develops cancer, the name is accorded to the skin cancer. Thus if the cancer develops from squamous cells it is called squamous cell carcinoma while if it develops from basal cell of epidermis it is called Basal cell carcinoma. If it develops from melanocytes (pigment-forming cells) it is called melanoma.
Though most skin cancers remain localized but melanoma is known to be notorious to spread to other parts of body if ignored early. Squamous cell carcinomas and basal cell can spread too if ignored early.
How skin cancer is formed?
Skin cancer is caused by damage to DNA either directly by sunlight or potential carcinogenic chemical exposures or by indirect mechanism after generation of free radicals which may result from environment pollution which then cause damage to DNA by an indirect mechanism. The cells of the skin thus start multiplying uncontrollably causing formation of skin cancer.
Causes of skin cancer
Based on our skin color or the melanin content in our skin, there are six different types of skin ranging from the extremely fair to the really dark complexion. Generally, Africans fall under the type 6 category, whites fall under type 1 and 2 category, with Indians falling under the 3,4 and 5 skin type. While people under the type 6 category are least prone to develop this cancer, the ones falling under type 1 and 2 are most susceptible to it.
The following are the risk factors of developing cancer of the skin:
#Over-exposure to UV-radiation can cause skin cancer. Both UVA and UVB are implicated in causing skin cancers. Sun exposure between 10 AM and 4 PM is most intense and therefore most harmful. People living close to the sea or beach and exposed to high levels of UV rays should take more precautions to avoid these harmful rays. Also, environmental damage like the depletion of the ozone layer makes us prone to excessive ultraviolet rays causing increase in the number of skin cancer patients.
#Chronic non-healing wounds can also develop skin cancers.
#Genetic predisposition is by far the most important factor implicated in all cancers and especially for skin cancers. A history in skin cancer also Increases the chances of a person developing this disease. People who have parents or some one in the family with skin cancer have a higher risk of getting it.
# Large moles or Nevi larger than 20 mm in size are at higher risk for becoming cancerous.
#Human papilloma virus (HPV) is associated with development of skin cancers.
#Occupational exposure to coal, tar, arsenic compounds, radium, and other chemicals increase the risk of skin cancer considerably.
#Regular smokers are more likely to get this cancer than non-smokers.
Symptoms of cancer of the skin:
Skin cancer is a disease, which has very visible signs when it occurs and any indication of it should immediately be consulted with a dermatologist. Some of the most common symptoms of this cancer are increase in the size of an existent mole, discoloring of some of the skin in some parts, increase or a sudden onset of growth in the skin, bleeding from growths or spots in the skin, non healing ulcers or growths that don't resolve with medication.
Skin cancer – Causes and Symptoms
Different Types of Skin Cancer
Diagnosis, Treatment and Prevention of Skin Cancer
Our skin is made up of mainly two layers -the dermis, which is the inner layer and the outer layer called the epidermis. Based on type of skin cell that develops cancer, the name is accorded to the skin cancer. Thus if the cancer develops from squamous cells it is called squamous cell carcinoma while if it develops from basal cell of epidermis it is called Basal cell carcinoma. If it develops from melanocytes (pigment-forming cells) it is called melanoma.
Though most skin cancers remain localized but melanoma is known to be notorious to spread to other parts of body if ignored early. Squamous cell carcinomas and basal cell can spread too if ignored early.
How skin cancer is formed?
Skin cancer is caused by damage to DNA either directly by sunlight or potential carcinogenic chemical exposures or by indirect mechanism after generation of free radicals which may result from environment pollution which then cause damage to DNA by an indirect mechanism. The cells of the skin thus start multiplying uncontrollably causing formation of skin cancer.
Causes of skin cancer
Based on our skin color or the melanin content in our skin, there are six different types of skin ranging from the extremely fair to the really dark complexion. Generally, Africans fall under the type 6 category, whites fall under type 1 and 2 category, with Indians falling under the 3,4 and 5 skin type. While people under the type 6 category are least prone to develop this cancer, the ones falling under type 1 and 2 are most susceptible to it.
The following are the risk factors of developing cancer of the skin:
#Over-exposure to UV-radiation can cause skin cancer. Both UVA and UVB are implicated in causing skin cancers. Sun exposure between 10 AM and 4 PM is most intense and therefore most harmful. People living close to the sea or beach and exposed to high levels of UV rays should take more precautions to avoid these harmful rays. Also, environmental damage like the depletion of the ozone layer makes us prone to excessive ultraviolet rays causing increase in the number of skin cancer patients.
#Chronic non-healing wounds can also develop skin cancers.
#Genetic predisposition is by far the most important factor implicated in all cancers and especially for skin cancers. A history in skin cancer also Increases the chances of a person developing this disease. People who have parents or some one in the family with skin cancer have a higher risk of getting it.
# Large moles or Nevi larger than 20 mm in size are at higher risk for becoming cancerous.
#Human papilloma virus (HPV) is associated with development of skin cancers.
#Occupational exposure to coal, tar, arsenic compounds, radium, and other chemicals increase the risk of skin cancer considerably.
#Regular smokers are more likely to get this cancer than non-smokers.
Symptoms of cancer of the skin:
Skin cancer is a disease, which has very visible signs when it occurs and any indication of it should immediately be consulted with a dermatologist. Some of the most common symptoms of this cancer are increase in the size of an existent mole, discoloring of some of the skin in some parts, increase or a sudden onset of growth in the skin, bleeding from growths or spots in the skin, non healing ulcers or growths that don't resolve with medication.
Skin cancer – Causes and Symptoms
Different Types of Skin Cancer
Diagnosis, Treatment and Prevention of Skin Cancer
Saturday, April 25, 2009
Diagnosis and Treatment of Gastric Cancer
Diagnosis of Gastric Carcinoma
Initial investigations to diagnose Gastric Carcinoma
Full blood count
Abnormalities on full blood count are usually non-specific. Occasionally anaemia can result from chronic blood loss or from chronic disease.
Liver profile
Raised liver enzymes may indicate liver metastasis, and raised alkaline phosphatase may result from bony metastasis.
Upper gastrointestinal endoscopy
A high index of suspicion is required in the older patient with new-onset dyspepsia, and the investigation of choice is an upper gastrointestinal endoscopy, which allows direct visualization of the stomach lining and facilitates biopsies for histological examination.
Barium swallow
Where facilities are not available for gastrointestinal endoscopy, a barium swallow may suggest gastric carcinoma if an ulcerated area or a narrowed distorted region is identified.
Investigations following the diagnosis of Gastric Carcinoma
Having established the diagnosis, further investigation is needed to stage the disease and plan further management.
Staging CT abdomen
A CT scan of the abdomen is the main staging investigation, giving an indication of local extent and any intra-abdominal spread
Staging laparoscopy
Prior to major surgery, most surgeons tend to perform a staging laparoscopy to screen for peritoneal metastasis or local fixity of the tumour, as these would preclude gastric resection.
Endoluminal ultrasound is able to assess accurately the depth of tumour invasion and is gaining in popularity.
Treatment of Gastric Carcinoma:
Surgery is the only curative management option for patients with gastric carcinoma. Prior to surgery, it is necessary to evaluate pulmonary function and any concomitant disease that may increase the risk of operative mortality.
The options for patients not suitable for curative surgery include palliative gastrectomy, gastric bypass procedures and chemotherapy.
Surgical management of Gastric Carcinoma
Gastrectomy
The aims of curative surgery are to excise the lesion with adequate resection margins and to remove local and regional lymph nodes. In the majority of cases it is possible to perform the necessary resection through a midline laparotomy incision. Occasionally a left thoraco-abdominal incision may be required.
A subtotal gastrectomy is appropriate for well-circumscribed tumours located away from the cardia. A total gastrectomy is required for tumours located in close proximity to the cardia and for infiltrative lesions (5 cm resection margins are required). In general, the first tier of draining lymph nodes is also excised for curative resection.
The stomach is mobilized en bloc with the greater omentum and local lymph nodes. Proximally, the upper stomach is closed (usually with a linear stapler), or in a total gastrectomy the lower oesophagus is transected. The first part of the duodenum is stapled closed and usually oversewn. Reconstruction is usually by a Roux loop or a Polya (Billroth II) gastroenterostomy.
Surgery to relieve the symptoms (Palliative surgery)
For unresectable lesions of the antrum, gastric bypass surgery in the form of a gastro-enterostomy (i.e. stomach to intestine) may be more appropriate. Non-curative gastrectomy often provides the best form of palliation and is usually necessary in patients with bleeding or obstructive lesions.
Medical management of Gastric Cancer
Chemotherapy
Adjuvant chemotherapy (after curative resection) is not established treatment. The impact of current regimens on survival is small (9% improvement at 3 years).
Radiotherapy
Radiotherapy has a limited role in the treatment of gastric cancer. It is occasionally used to treat residual disease from unsuccessful surgery. Combination chemo-radiotherapy has been shown to improve median survival by 9 months, and may be considered in patients at high risk of recurrence.
Palliative endoscopic therapy for gastric carcinoma
For patients unfit for surgery, or those with unresectable disease, various endoscopic therapies are available. Local tissue coagulation with laser or argon plasma coagulation may be helpful to control symptoms of upper gastrointestinal bleeding. Expandable metal stents or intubation with a rigid prosthesis may be employed to relieve gastric outflow obstruction.
Prognosis of Gastric Carcinoma
Gastric carcinoma has a poor prognosis, with an overall 5-year survival rate of around 5%.
Important point to note about gastric Carcinoma
Non-specific symptoms of gastric carcinoma often 'respond' to antacid therapy. It is important not to ignore initial complaints in the older patient.
Types, causes and symptoms of gastric carcinoma
Initial investigations to diagnose Gastric Carcinoma
Full blood count
Abnormalities on full blood count are usually non-specific. Occasionally anaemia can result from chronic blood loss or from chronic disease.
Liver profile
Raised liver enzymes may indicate liver metastasis, and raised alkaline phosphatase may result from bony metastasis.
Upper gastrointestinal endoscopy
A high index of suspicion is required in the older patient with new-onset dyspepsia, and the investigation of choice is an upper gastrointestinal endoscopy, which allows direct visualization of the stomach lining and facilitates biopsies for histological examination.
Barium swallow
Where facilities are not available for gastrointestinal endoscopy, a barium swallow may suggest gastric carcinoma if an ulcerated area or a narrowed distorted region is identified.
Investigations following the diagnosis of Gastric Carcinoma
Having established the diagnosis, further investigation is needed to stage the disease and plan further management.
Staging CT abdomen
A CT scan of the abdomen is the main staging investigation, giving an indication of local extent and any intra-abdominal spread
Staging laparoscopy
Prior to major surgery, most surgeons tend to perform a staging laparoscopy to screen for peritoneal metastasis or local fixity of the tumour, as these would preclude gastric resection.
Endoluminal ultrasound is able to assess accurately the depth of tumour invasion and is gaining in popularity.
Treatment of Gastric Carcinoma:
Surgery is the only curative management option for patients with gastric carcinoma. Prior to surgery, it is necessary to evaluate pulmonary function and any concomitant disease that may increase the risk of operative mortality.
The options for patients not suitable for curative surgery include palliative gastrectomy, gastric bypass procedures and chemotherapy.
Surgical management of Gastric Carcinoma
Gastrectomy
The aims of curative surgery are to excise the lesion with adequate resection margins and to remove local and regional lymph nodes. In the majority of cases it is possible to perform the necessary resection through a midline laparotomy incision. Occasionally a left thoraco-abdominal incision may be required.
A subtotal gastrectomy is appropriate for well-circumscribed tumours located away from the cardia. A total gastrectomy is required for tumours located in close proximity to the cardia and for infiltrative lesions (5 cm resection margins are required). In general, the first tier of draining lymph nodes is also excised for curative resection.
The stomach is mobilized en bloc with the greater omentum and local lymph nodes. Proximally, the upper stomach is closed (usually with a linear stapler), or in a total gastrectomy the lower oesophagus is transected. The first part of the duodenum is stapled closed and usually oversewn. Reconstruction is usually by a Roux loop or a Polya (Billroth II) gastroenterostomy.
Surgery to relieve the symptoms (Palliative surgery)
For unresectable lesions of the antrum, gastric bypass surgery in the form of a gastro-enterostomy (i.e. stomach to intestine) may be more appropriate. Non-curative gastrectomy often provides the best form of palliation and is usually necessary in patients with bleeding or obstructive lesions.
Medical management of Gastric Cancer
Chemotherapy
Adjuvant chemotherapy (after curative resection) is not established treatment. The impact of current regimens on survival is small (9% improvement at 3 years).
Radiotherapy
Radiotherapy has a limited role in the treatment of gastric cancer. It is occasionally used to treat residual disease from unsuccessful surgery. Combination chemo-radiotherapy has been shown to improve median survival by 9 months, and may be considered in patients at high risk of recurrence.
Palliative endoscopic therapy for gastric carcinoma
For patients unfit for surgery, or those with unresectable disease, various endoscopic therapies are available. Local tissue coagulation with laser or argon plasma coagulation may be helpful to control symptoms of upper gastrointestinal bleeding. Expandable metal stents or intubation with a rigid prosthesis may be employed to relieve gastric outflow obstruction.
Prognosis of Gastric Carcinoma
Gastric carcinoma has a poor prognosis, with an overall 5-year survival rate of around 5%.
Important point to note about gastric Carcinoma
Non-specific symptoms of gastric carcinoma often 'respond' to antacid therapy. It is important not to ignore initial complaints in the older patient.
Types, causes and symptoms of gastric carcinoma
Gastric Cancer - Types, Causes and Symptoms
Gastric carcinoma is the second most common cancer in the world. The incidence is highest in Japan, China, Eastern Asia and Eastern Europe, ranging between 36.3 and 77.8 per 100 000 in men and 16.8 and 33.3 per 100 000 in women, an approximate 2:1 male preponderance. It is primarily a disease of the elderly, with a peak incidence at age 70-80.
Types of Gastric Carcinoma
Approximately 90% of stomach cancers are adenocarcinomas (the remaining 10% are non-Hodgkin's lymphomas and leiomyosarcomas). Adenocarcinomas are subdivided into intestinal and diffuse histological types (Lauren classification). The intestinal variety arises from a background of chronic gastritis and is generally well circumscribed. The diffuse type usually arises within apparently normal gastric mucosa and tends to be poorly localized, infiltrating beneath the mucosa through the muscle of the stomach wall. In the advanced stage, this leads to a thickened and shriveled stomach known as linitis plastica (leather bottle stomach). Unfortunately it is this type of disease that is often seen in the younger patient.
Causes and risk factors of Gastric carcinoma:
Risk factors for intestinal-type gastric carcinoma (those for the diffuse type are largely undefined) include smoking and diet (in particular high consumption of preserved food and high salt intake); there is a weak association with excess alcohol intake. Other diseases associated with gastric carcinoma are pernicious anaemia, atrophic gastritis, gastric adenomatous polyps and H. pylori infection, an increasingly important risk factor associated with a 2-fold increase in risk of gastric cancer.
Course of Gastric Carcinoma
Local
In the early stages, when the disease is confined to the mucosa or submucosa, it may be either a prominent nodule or a depressed ulcer. Excavated cancers may cause upper gastrointestinal bleeding and anaemia, whilst large exophytic growths near the cardia can (rarely) produce dysphagia.
Metastatic
The majority of tumours present with local or with lymph node metastases. Spread may be lymphatic, haematogenous (to the liver, lungs and brain) or transcoelomic to the peritoneum, omentum or ovaries (Krukenberg tumour).
Symptoms of Gastric Carcinoma
A common presentation is that of new-onset dyspepsia in a middle-aged patient (over 45 years). Symptoms are often non-specific such as epigastric discomfort, post-prandial fullness, loss of appetite or vague indigestion. Other symptoms include dysphagia, nausea or vomiting (especially after eating), weight loss and those of iron deficiency anaemia.
Clinical examination is often unremarkable in early stage disease. In advanced disease, clinical findings may include a mass in upper abdomen, enlarged liver, enlargement of the lymph glands, classically in the left supraclavicular fossa (Virchow's node, Troisier's sign), ascites and jaundice.
Types,Causes and Symptoms of Gastric carcinoma
Diagnosis and Treatment of Gastric Carcinoma
Types of Gastric Carcinoma
Approximately 90% of stomach cancers are adenocarcinomas (the remaining 10% are non-Hodgkin's lymphomas and leiomyosarcomas). Adenocarcinomas are subdivided into intestinal and diffuse histological types (Lauren classification). The intestinal variety arises from a background of chronic gastritis and is generally well circumscribed. The diffuse type usually arises within apparently normal gastric mucosa and tends to be poorly localized, infiltrating beneath the mucosa through the muscle of the stomach wall. In the advanced stage, this leads to a thickened and shriveled stomach known as linitis plastica (leather bottle stomach). Unfortunately it is this type of disease that is often seen in the younger patient.
Causes and risk factors of Gastric carcinoma:
Risk factors for intestinal-type gastric carcinoma (those for the diffuse type are largely undefined) include smoking and diet (in particular high consumption of preserved food and high salt intake); there is a weak association with excess alcohol intake. Other diseases associated with gastric carcinoma are pernicious anaemia, atrophic gastritis, gastric adenomatous polyps and H. pylori infection, an increasingly important risk factor associated with a 2-fold increase in risk of gastric cancer.
Course of Gastric Carcinoma
Local
In the early stages, when the disease is confined to the mucosa or submucosa, it may be either a prominent nodule or a depressed ulcer. Excavated cancers may cause upper gastrointestinal bleeding and anaemia, whilst large exophytic growths near the cardia can (rarely) produce dysphagia.
Metastatic
The majority of tumours present with local or with lymph node metastases. Spread may be lymphatic, haematogenous (to the liver, lungs and brain) or transcoelomic to the peritoneum, omentum or ovaries (Krukenberg tumour).
Symptoms of Gastric Carcinoma
A common presentation is that of new-onset dyspepsia in a middle-aged patient (over 45 years). Symptoms are often non-specific such as epigastric discomfort, post-prandial fullness, loss of appetite or vague indigestion. Other symptoms include dysphagia, nausea or vomiting (especially after eating), weight loss and those of iron deficiency anaemia.
Clinical examination is often unremarkable in early stage disease. In advanced disease, clinical findings may include a mass in upper abdomen, enlarged liver, enlargement of the lymph glands, classically in the left supraclavicular fossa (Virchow's node, Troisier's sign), ascites and jaundice.
Types,Causes and Symptoms of Gastric carcinoma
Diagnosis and Treatment of Gastric Carcinoma
Monday, April 20, 2009
Cancer does not mean death!
Cancer is as old as mankind. It was found in an Egyptian mummy some 5,000 years old. Unfortunately, even now, people are unaware about its nature, its cause, its prevention and, most importantly, there are several misconceptions that make the problem even more complicated.
What is cancer?
The human body has the inherent capacity of repairing a dead or damaged tissue by multiplication of cells and there is a control system for this. When there is lack of control, the cells multiply excessively and form a lump. This is called a tumor. This can be benign — where the lump grows slowly, does not damage the neighboring structure and does not spread to other organs. These tumors are usually not fatal.
The other type of tumor is malignant (cancer), where the lump grows very rapidly, involves the neighboring and distant organs and can be fatal if not treated early.
What are the common types of cancer?
In males where tobacco addiction is a common problem, the common cancers are that of oral cavity, lung and prostate. In females, especially in rural areas, the common cancer is that of uterine cervix, whereas that in urban women it is breast cancer.
What are the causes of cancer?
Unfortunately the causes of two-thirds of all cancers are still not clear and several researches are going on worldwide to determine them. In one-thirds of cases, the causes are proved beyond doubt of which the most important is tobacco in any form such as smoking (Bidi, cigarette, hukah) and chewable (pan.paan masala, ghutka, khaini and jarda).
The other less common causative agents are diet (adulterated food, high fat and less fruits, vegetables and vitamins, more intake of junk, fast, stored and charred food), sunlight (causes skin cancer especially in the white race),
Genetic abnormality can predispose many members of the same family to can¬cers (mainly of breast, ovaries and bowel).
What are the symptoms of cancer?
Loss of appetite and body weight an ulcer which is not healing, lump which is rapidly increasing, persistent change of voice, bleeding with cough, vomits, stool or urine, inter menstrual bleeding, difficulty in swallowing, etc
Some common misconceptions about cancer:
Cancer means death -Most cancers, if detected early, can be cured completely.
Cancer is contagious - it is not (apart from uterine cancer which can spread by a virus through multiple partners).
Biopsy can cause cancer or spread of cancer - Biopsy or any surgery does not cause a benign tumor to turn cancerous. Taking a small sample of tissue (mostly done by fine needle or a small punch forceps) do not cause any spread. The doctors can guide you regarding the best way of doing it. Biopsy is important before embarking on a major surgery, radiotherapy or chemotherapy as the tumor may actually be not malignant at all. Even if malignant, the treatment strategy is completely different in different kinds of cancer, so it is important to plan beforehand by knowing the nature of it.
Summary:
Cancer is preventable by avoiding the risk factors and can be detected early if people come forward to the doctors with symptoms mentioned above without ignoring them. There is no need to think that one should not do tests as that may cause cancer or expose the fact that he or she is harboring cancer. On the contrary, it is prudent to detect a cancer or a pre-cancerous area, which can then be completely cured. Many organs like breast, limbs and larynx can be preserved in early stages with new modalities of treatment. It is not contagious (except in cervical cancer, which is why multiple partners and unprotected sex should be avoided). Biopsies are advisable before embarking on a treatment and surgery is the treatment in most of the cancers in early stage. There is no need to panic about radio-therapy and chemotherapy. In the hands of experts the side-effects are minimum and can improve the results significantly. Even in advanced stages, symptom control can be achieved with a palliative care team and different support groups. We must remove all the misconceptions and try and prevent this potentially preventable and curable disease.
Acknowledgement: Dr. Saroj Gupta
What is cancer?
The human body has the inherent capacity of repairing a dead or damaged tissue by multiplication of cells and there is a control system for this. When there is lack of control, the cells multiply excessively and form a lump. This is called a tumor. This can be benign — where the lump grows slowly, does not damage the neighboring structure and does not spread to other organs. These tumors are usually not fatal.
The other type of tumor is malignant (cancer), where the lump grows very rapidly, involves the neighboring and distant organs and can be fatal if not treated early.
What are the common types of cancer?
In males where tobacco addiction is a common problem, the common cancers are that of oral cavity, lung and prostate. In females, especially in rural areas, the common cancer is that of uterine cervix, whereas that in urban women it is breast cancer.
What are the causes of cancer?
Unfortunately the causes of two-thirds of all cancers are still not clear and several researches are going on worldwide to determine them. In one-thirds of cases, the causes are proved beyond doubt of which the most important is tobacco in any form such as smoking (Bidi, cigarette, hukah) and chewable (pan.paan masala, ghutka, khaini and jarda).
The other less common causative agents are diet (adulterated food, high fat and less fruits, vegetables and vitamins, more intake of junk, fast, stored and charred food), sunlight (causes skin cancer especially in the white race),
Genetic abnormality can predispose many members of the same family to can¬cers (mainly of breast, ovaries and bowel).
What are the symptoms of cancer?
Loss of appetite and body weight an ulcer which is not healing, lump which is rapidly increasing, persistent change of voice, bleeding with cough, vomits, stool or urine, inter menstrual bleeding, difficulty in swallowing, etc
Some common misconceptions about cancer:
Cancer means death -Most cancers, if detected early, can be cured completely.
Cancer is contagious - it is not (apart from uterine cancer which can spread by a virus through multiple partners).
Biopsy can cause cancer or spread of cancer - Biopsy or any surgery does not cause a benign tumor to turn cancerous. Taking a small sample of tissue (mostly done by fine needle or a small punch forceps) do not cause any spread. The doctors can guide you regarding the best way of doing it. Biopsy is important before embarking on a major surgery, radiotherapy or chemotherapy as the tumor may actually be not malignant at all. Even if malignant, the treatment strategy is completely different in different kinds of cancer, so it is important to plan beforehand by knowing the nature of it.
Summary:
Cancer is preventable by avoiding the risk factors and can be detected early if people come forward to the doctors with symptoms mentioned above without ignoring them. There is no need to think that one should not do tests as that may cause cancer or expose the fact that he or she is harboring cancer. On the contrary, it is prudent to detect a cancer or a pre-cancerous area, which can then be completely cured. Many organs like breast, limbs and larynx can be preserved in early stages with new modalities of treatment. It is not contagious (except in cervical cancer, which is why multiple partners and unprotected sex should be avoided). Biopsies are advisable before embarking on a treatment and surgery is the treatment in most of the cancers in early stage. There is no need to panic about radio-therapy and chemotherapy. In the hands of experts the side-effects are minimum and can improve the results significantly. Even in advanced stages, symptom control can be achieved with a palliative care team and different support groups. We must remove all the misconceptions and try and prevent this potentially preventable and curable disease.
Acknowledgement: Dr. Saroj Gupta
Genital Cancers in women
Gynaecological cancers involve the reproductive organs, namely ovaries, uterus and cervix (mostly), vulva (not uncommon) and fallopian tubes and vagina (very rare). Amongst these, the ovarian cancer is the most lethal gynaecological cancer and the fourth most common cause of cancer death in females. Cervical cancer was once a most deadly disease but with widespread screening by simple pap smear has reduced the complication rate to about 50 per cent. Mortality due to uterine (Endometrial) cancer has markedly fallen during last few years but still it occupies the eighth position in cancer death in females.
The cancers of the genital tract are mostly found in the ladies between 40 and 60 years of age, but it is not uncommon even in younger Germ cell tumors, Choriocarcinoma etc, can be seen in young ladies around 20, endometrial cancer is common in post-menopausal ladies between 55 and 65 years age.
Nulliparity, early menarche, late menopause, high fat diet, obesity, history of breast or colonic cancers are the common risk factors for ovarian and endometrial malignancies. Polycystic ovarian syndrome, chronic anovulation, unopposed estrogen replacement without progesterone as in HRT, tamoxifen use in breast cancer, etc favors the development of endometrial cancer.
Cervical cancer is common in poor socio-economic conditions, early sexual activities, multiple partners, multiparity, smoking, and infection by sexually transmitted virus called Human Papilloma Virus or HPV.
Carcinoma vulva is also thought to be associated with HPV infection. The cancers of the fallopian tubes and vagina are mostly secondary to cancer of other sites but primary lesions may also occur. A strong family history is the common risk factor for the development of ovarian cancer. In families with two or more first-degree relatives with ovarian cancer needs regular screening as the risk may exceed 50 per cent.
Symptoms of genital cancers in women
Patients suffering from genital cancers may present themselves with various symptoms. Some may remain asymptomatic even at the late stage of the disease. Patients with ovarian cancer usually present with non-gynecological complaints like vague lower abdominal discomfort, bowel dysfunction, feeling of heaviness or mass in the lower abdomen etc. Irregular or Postmenopausal bleeding, offensive vaginal discharge are common in uterine cancer. Patient with invasive stage of cervical cancer often complains of abnormal or inter menstrual vaginal bleeding, post-coital bleeding, yellowish vaginal discharge, lumbosacral pain, urinary obstruction, loss of appetite, weight loss, palpable lymph nodes etc. But non¬invasive types remain almost asymptomatic. Vulval cancer is associated with pruritus, pain, burning, swelling, color change (leukoplakia or hyperpigmentation) and ulceration. The cancer of the fallopian tubes may remain obscured, rarely there may be colicky pain in the lower abdomen followed by a profuse vaginal discharge and relief of pain. In vaginal carcinoma, symptoms are post-coital bleeding or offensive vaginal discharge.
Diagnosis of genital cancers in women
Diagnosis is made through clinical examina¬tions supported by different investigations. Ovaries being small organs lying within the huge abdominal cavity, any change of the organ usually remain obscured for many days and thus the diagnosis is difficult and often late. Suggestive history, feeling of a pelvic mass, presence of fluid in the abdomen, visualization of ulcers in the cervix, vagina or vulva need referral for proper investigations.
Ultrasonography, MRI or CT scan and testing of tumor markers as CA-125, Carcino-embryonic antigen, alpha-feto protein, beta HCG etc, FNAC or intra-operative frozen section biopsy, con¬firms the presence of malignant cells in ovarian cancer.
Endometrial biopsy (preferably hysteroscopy guided) concludes the diagnosis with 90 per cent accuracy in endometrial cancers. Cervico-vaginal cytology (introduced by George Papanicolaou, commonly known as PAP Smear) is simple, cheap yet almost 90-95 per cent accurate in detecting the early lesions of cervical cancer. Based on this smear report the cervical conditions are grouped in different categories. Normal or susceptible PAP cases are advised for regular follow up, but suspected cases are guided for further investigation like testing for HPV, Colposcopy guided cervical biopsy, endocervical biopsy etc. Non-invasive cases are treated conservatively with regular follow up but invasive cases are managed accordingly. When any lesion is clearly visible in cervix, cervical biopsy is directly done. Additional investigations are necessary for staging of the definite cervical cancer cases.
Treatment genital cancers in women
Treatment includes surgical intervention, chemotherapy and radiotherapy, if detected early, the ovarian, uterine and cervical carcinoma can be effectively cured by removal of uterus with both the ovaries (Hysterectomy with bilateral salpingo-oophorectomy), precancerous vulval lesions by simple vulvectomy. In advanced cases more extensive surgery is necessary which may include omentectomy, debulking of tumour mass, lymphadenectomy (ovarian cancer), extended total hysterectomy (uterine cancer) Wertheim's hysterectomy (cervical or vaginal cancer) radical vulvectomy (Vulval cancer) etc. All these surgical procedures should be followed by adequate chemo or radiotherapy, the schedule of which depends upon the stages, cell type and extent of metastasis.
"Carcinogenesis is not an event but a process" Taking some adequate preventive measures can certainly restrict the advancement of this process. One should be careful to avoid the risk factors, report early to the doctors and surrender her to the screening or investigation procedures. Emphasis must be given that there is no role of alternative medicines to treat the cases of cancer. One should try to avoid obesity, early sexual exposure, and multiple sex partners. Use of oral contraceptives, tubal ligation, breast-feeding, hysterectomy with bilateral oophorectomy, correction of unopposed use of estrogen with addition of progesterone etc can minimize the chances of genital cancer. Each pregnancy reduces the risk of ovarian cancer by 10 per cent. Screening of the suspected or high risk cases should be carried on simultaneously. Awareness should be generated amongst the women for a periodic check up, particularly when she feels something unusual deviating from her healthy life. Simple clinical examinations, a transvaginal sonography, tests for few tumour markers, aspiration or fractional curettage of endometrial tissue, PAP smear etc can be carried out as screening procedures.
Gardasil, a major breakthrough recently, a vaccine against Human papilloma virus, which is responsible for Cervical Carcinoma is now available. All the girl children should be protected by the recommended dosage with this vaccine.
Despite major advances in screening and diagnosis of cancer, the effective control of the disease is not yet possible due to poor understanding and various myths about the disease conditions. In India, women seek medical help when it is incurable. Awareness, modern methods of screening and diagnosis, improved techniques of surgery, chemotherapy or radiotherapy have significantly decreased the sufferings of cancer, better survival rates, lesser morbid conditions and improved life-styles. Reducing mortality and high cure rate can only be possible if diagnosis could be made in the first or second stage of the disease, and if possible, in susceptible cases, even much earlier.
The cancers of the genital tract are mostly found in the ladies between 40 and 60 years of age, but it is not uncommon even in younger Germ cell tumors, Choriocarcinoma etc, can be seen in young ladies around 20, endometrial cancer is common in post-menopausal ladies between 55 and 65 years age.
Nulliparity, early menarche, late menopause, high fat diet, obesity, history of breast or colonic cancers are the common risk factors for ovarian and endometrial malignancies. Polycystic ovarian syndrome, chronic anovulation, unopposed estrogen replacement without progesterone as in HRT, tamoxifen use in breast cancer, etc favors the development of endometrial cancer.
Cervical cancer is common in poor socio-economic conditions, early sexual activities, multiple partners, multiparity, smoking, and infection by sexually transmitted virus called Human Papilloma Virus or HPV.
Carcinoma vulva is also thought to be associated with HPV infection. The cancers of the fallopian tubes and vagina are mostly secondary to cancer of other sites but primary lesions may also occur. A strong family history is the common risk factor for the development of ovarian cancer. In families with two or more first-degree relatives with ovarian cancer needs regular screening as the risk may exceed 50 per cent.
Symptoms of genital cancers in women
Patients suffering from genital cancers may present themselves with various symptoms. Some may remain asymptomatic even at the late stage of the disease. Patients with ovarian cancer usually present with non-gynecological complaints like vague lower abdominal discomfort, bowel dysfunction, feeling of heaviness or mass in the lower abdomen etc. Irregular or Postmenopausal bleeding, offensive vaginal discharge are common in uterine cancer. Patient with invasive stage of cervical cancer often complains of abnormal or inter menstrual vaginal bleeding, post-coital bleeding, yellowish vaginal discharge, lumbosacral pain, urinary obstruction, loss of appetite, weight loss, palpable lymph nodes etc. But non¬invasive types remain almost asymptomatic. Vulval cancer is associated with pruritus, pain, burning, swelling, color change (leukoplakia or hyperpigmentation) and ulceration. The cancer of the fallopian tubes may remain obscured, rarely there may be colicky pain in the lower abdomen followed by a profuse vaginal discharge and relief of pain. In vaginal carcinoma, symptoms are post-coital bleeding or offensive vaginal discharge.
Diagnosis of genital cancers in women
Diagnosis is made through clinical examina¬tions supported by different investigations. Ovaries being small organs lying within the huge abdominal cavity, any change of the organ usually remain obscured for many days and thus the diagnosis is difficult and often late. Suggestive history, feeling of a pelvic mass, presence of fluid in the abdomen, visualization of ulcers in the cervix, vagina or vulva need referral for proper investigations.
Ultrasonography, MRI or CT scan and testing of tumor markers as CA-125, Carcino-embryonic antigen, alpha-feto protein, beta HCG etc, FNAC or intra-operative frozen section biopsy, con¬firms the presence of malignant cells in ovarian cancer.
Endometrial biopsy (preferably hysteroscopy guided) concludes the diagnosis with 90 per cent accuracy in endometrial cancers. Cervico-vaginal cytology (introduced by George Papanicolaou, commonly known as PAP Smear) is simple, cheap yet almost 90-95 per cent accurate in detecting the early lesions of cervical cancer. Based on this smear report the cervical conditions are grouped in different categories. Normal or susceptible PAP cases are advised for regular follow up, but suspected cases are guided for further investigation like testing for HPV, Colposcopy guided cervical biopsy, endocervical biopsy etc. Non-invasive cases are treated conservatively with regular follow up but invasive cases are managed accordingly. When any lesion is clearly visible in cervix, cervical biopsy is directly done. Additional investigations are necessary for staging of the definite cervical cancer cases.
Treatment genital cancers in women
Treatment includes surgical intervention, chemotherapy and radiotherapy, if detected early, the ovarian, uterine and cervical carcinoma can be effectively cured by removal of uterus with both the ovaries (Hysterectomy with bilateral salpingo-oophorectomy), precancerous vulval lesions by simple vulvectomy. In advanced cases more extensive surgery is necessary which may include omentectomy, debulking of tumour mass, lymphadenectomy (ovarian cancer), extended total hysterectomy (uterine cancer) Wertheim's hysterectomy (cervical or vaginal cancer) radical vulvectomy (Vulval cancer) etc. All these surgical procedures should be followed by adequate chemo or radiotherapy, the schedule of which depends upon the stages, cell type and extent of metastasis.
"Carcinogenesis is not an event but a process" Taking some adequate preventive measures can certainly restrict the advancement of this process. One should be careful to avoid the risk factors, report early to the doctors and surrender her to the screening or investigation procedures. Emphasis must be given that there is no role of alternative medicines to treat the cases of cancer. One should try to avoid obesity, early sexual exposure, and multiple sex partners. Use of oral contraceptives, tubal ligation, breast-feeding, hysterectomy with bilateral oophorectomy, correction of unopposed use of estrogen with addition of progesterone etc can minimize the chances of genital cancer. Each pregnancy reduces the risk of ovarian cancer by 10 per cent. Screening of the suspected or high risk cases should be carried on simultaneously. Awareness should be generated amongst the women for a periodic check up, particularly when she feels something unusual deviating from her healthy life. Simple clinical examinations, a transvaginal sonography, tests for few tumour markers, aspiration or fractional curettage of endometrial tissue, PAP smear etc can be carried out as screening procedures.
Gardasil, a major breakthrough recently, a vaccine against Human papilloma virus, which is responsible for Cervical Carcinoma is now available. All the girl children should be protected by the recommended dosage with this vaccine.
Despite major advances in screening and diagnosis of cancer, the effective control of the disease is not yet possible due to poor understanding and various myths about the disease conditions. In India, women seek medical help when it is incurable. Awareness, modern methods of screening and diagnosis, improved techniques of surgery, chemotherapy or radiotherapy have significantly decreased the sufferings of cancer, better survival rates, lesser morbid conditions and improved life-styles. Reducing mortality and high cure rate can only be possible if diagnosis could be made in the first or second stage of the disease, and if possible, in susceptible cases, even much earlier.
Sunday, April 19, 2009
Symptoms, Diagnosis, Treatment and Prevention of Prostate cancer
Facts one must know about Prostate Cancer
#Prostate cancer is a killer disease and the second largest killer of men worldwide.
#Early detection and diagnosis is essential for effective treatment of the cancer, and also to increase chances of survival
#Regular PSA check-ups after the age of 50 are mandatory.
#Yearly prostate health check-ups are essential for early detection of the disease.
Prostate cancer is a male cancer, that is, it only occurs in men, affecting the prostate gland and surrounding regions of the male anatomy. Men over the age of 50 are more susceptible to it, as that is the age when the prostate gland begins to enlarge, and 25 per cent of all prostate enlargements are affected by it. It can be a killer, and generally is, but less virulent forms of it have also been detected. In recent years, major advancement has been made in the early detection of the cancer.
Causes of cancer of the prostate gland
There is no direct cause of prostate cancer. An international study has shown that blacks get it more than whites and Asians settling abroad also face increased chances of being affected by this type of cancer. Though it is not very well established, there may be some dietary causes behind prostate cancer, such as regularly consuming food that is high in fat content and smoking. Some studies have shown that there may be a genetic or familial correlation, although this again has not yet been established.
Symptoms of cancers of the prostate gland
The prostate gland starts enlarging after the age of 50, due to changes in hormonal milieu. The phenomenon has some similarity to menopause which occurs in women. The symptoms of prostate cancer are symptoms of enlargement of the prostate gland.
These are:
*Obstruction to urinary flow
*Frequent passage of urine Slow urine flow, followed .by complete blockage.
Some general symptoms are
*Pain in the groin
*Pain in the bones, especially the back
*Weight loss
*Presence of blood in urine.
Diagnosis of cancer prostate
Earlier, the biggest hindrance to treatment of prostate cancer was that it was usually detected very late. The prostate gland is concealed behind the pubic bones, and for a long time, there was no known tumor marker, hence, it was not very easy to detect prostate cancer. Now, however, there is a marker - Prostate Specific Antigen (PSA), is identified, produced by the gland. In case of cancer, the level of production increases drastically. Although increased levels of PSA do not confirm the presence of cancer, they certainly give a signal of it. Further analysis of how much PSA is present as free radicals, and how much is in combined form, helps in confirming the presence of cancer. Digital Rectal Examinations, Isotope Bone Scans and MRI Scans of the prostate gland can also detect this type of cancer.
Treatment of prostatic cancer:
First, step is directed to reduce the enlargement of the gland. This can be done through a Gold Standard Surgery by Trans Urethral Resection of Prostate (TURP). After this, the tissue is sent for biopsy, which yields a diagnosis confirming the presence or absence of cancer.
If cancer is confirmed, PSA and Bone Scan are performed, along with a CT/MRI Scan. This gives the stage and grade of the disease, that is, it shows just how far the cancer has progressed. Unfortunately in most cases, it is found to be in advanced stages.
The cancer can then be controlled by hormonal manipulation. It means hormonal ablation - stopping testosterone from reaching the prostate gland, and can be done via two methods - surgically (chopping off the testicles, or medically (injections and tablets).
If the cancer is detected while it is still in the early stages, an operation called the Radical Prostatectomy, which removes the entire gland can be performed.
Another option is to completely burn out the gland through Radical Radiotherapy. While the operation preserves sexual functions and leaves the sexual organs intact, radiation affects the surrounding organs as well, which results in poor sexual performance, along with a very irritable bowel and bladder.
The treatments listed above can be performed only if the cancer is confined to the prostate gland, and has not spread outside it. In very advanced stages, the cancer becomes uncontrollable, when it spread to bones and spinal cord. In such cases treatment that can be given is mainly related to pain control and alleviation of discomfort.
Prevention of cancer of the prostate gland
There is no sure-shot way of preventing prostate cancer. Regular health checkups, including screenings and scans of the prostate gland, along with PSA detection help in detecting the cancer early and effectively treating it.
#Prostate cancer is a killer disease and the second largest killer of men worldwide.
#Early detection and diagnosis is essential for effective treatment of the cancer, and also to increase chances of survival
#Regular PSA check-ups after the age of 50 are mandatory.
#Yearly prostate health check-ups are essential for early detection of the disease.
Prostate cancer is a male cancer, that is, it only occurs in men, affecting the prostate gland and surrounding regions of the male anatomy. Men over the age of 50 are more susceptible to it, as that is the age when the prostate gland begins to enlarge, and 25 per cent of all prostate enlargements are affected by it. It can be a killer, and generally is, but less virulent forms of it have also been detected. In recent years, major advancement has been made in the early detection of the cancer.
Causes of cancer of the prostate gland
There is no direct cause of prostate cancer. An international study has shown that blacks get it more than whites and Asians settling abroad also face increased chances of being affected by this type of cancer. Though it is not very well established, there may be some dietary causes behind prostate cancer, such as regularly consuming food that is high in fat content and smoking. Some studies have shown that there may be a genetic or familial correlation, although this again has not yet been established.
Symptoms of cancers of the prostate gland
The prostate gland starts enlarging after the age of 50, due to changes in hormonal milieu. The phenomenon has some similarity to menopause which occurs in women. The symptoms of prostate cancer are symptoms of enlargement of the prostate gland.
These are:
*Obstruction to urinary flow
*Frequent passage of urine Slow urine flow, followed .by complete blockage.
Some general symptoms are
*Pain in the groin
*Pain in the bones, especially the back
*Weight loss
*Presence of blood in urine.
Diagnosis of cancer prostate
Earlier, the biggest hindrance to treatment of prostate cancer was that it was usually detected very late. The prostate gland is concealed behind the pubic bones, and for a long time, there was no known tumor marker, hence, it was not very easy to detect prostate cancer. Now, however, there is a marker - Prostate Specific Antigen (PSA), is identified, produced by the gland. In case of cancer, the level of production increases drastically. Although increased levels of PSA do not confirm the presence of cancer, they certainly give a signal of it. Further analysis of how much PSA is present as free radicals, and how much is in combined form, helps in confirming the presence of cancer. Digital Rectal Examinations, Isotope Bone Scans and MRI Scans of the prostate gland can also detect this type of cancer.
Treatment of prostatic cancer:
First, step is directed to reduce the enlargement of the gland. This can be done through a Gold Standard Surgery by Trans Urethral Resection of Prostate (TURP). After this, the tissue is sent for biopsy, which yields a diagnosis confirming the presence or absence of cancer.
If cancer is confirmed, PSA and Bone Scan are performed, along with a CT/MRI Scan. This gives the stage and grade of the disease, that is, it shows just how far the cancer has progressed. Unfortunately in most cases, it is found to be in advanced stages.
The cancer can then be controlled by hormonal manipulation. It means hormonal ablation - stopping testosterone from reaching the prostate gland, and can be done via two methods - surgically (chopping off the testicles, or medically (injections and tablets).
If the cancer is detected while it is still in the early stages, an operation called the Radical Prostatectomy, which removes the entire gland can be performed.
Another option is to completely burn out the gland through Radical Radiotherapy. While the operation preserves sexual functions and leaves the sexual organs intact, radiation affects the surrounding organs as well, which results in poor sexual performance, along with a very irritable bowel and bladder.
The treatments listed above can be performed only if the cancer is confined to the prostate gland, and has not spread outside it. In very advanced stages, the cancer becomes uncontrollable, when it spread to bones and spinal cord. In such cases treatment that can be given is mainly related to pain control and alleviation of discomfort.
Prevention of cancer of the prostate gland
There is no sure-shot way of preventing prostate cancer. Regular health checkups, including screenings and scans of the prostate gland, along with PSA detection help in detecting the cancer early and effectively treating it.
Cancer of the liver- Causes, Diagnosis and Treatment
Liver cancer is a frequently heard malady. In fact the liver gets cancer because of disorder in its own or, because trouble somewhere else in the body tries to find refuge in it. Liver is the sieving ground of the body. Whatever we eat passes through this 'kitchen' and it is our liver which guards our body from harmful agents present in our food. In this process of 'guarding; the liver often gets 'hurt'. Moreover, liver is the only organ of the body that has got a dual blood supply - through a portal vein and an artery. This makes it the most busy organ in the body. So, when cancer develops elsewhere and is present in the blood, it can affect the liver. This explains why liver cancer is so common.
Causes of liver cancer:
Liver cancer may be either primary or, secondary.
Primary Liver cancer or, Hepatocellular cancer
Sometimes liver's own cells called hepatocytes sometimes turn cancerous. These are called Hepato cellular cancer or primary liver cancer. There are different causes of this. The commonest are infections by Hepatitis B and C. Some fungal toxins called Aflatoxins can also cause this type of cancer. The predominant cause also varies across the globe. In India it is Hepatitis B, in the western countries, Hepatitis C. Therefore prevention of these viruses is the key to refrain from cancers of the liver.
Secondary or, Metastatic Liver Cancer
Uncontrolled and unregulated growth of cells leads to any kind of cancer. Cancerous cells often leave its harbour and sail into the big ocean called the body. This is called Metastasis, individual cancers differ in their tendency to roam - but lung, prostate, breast, thyroid and uterine cancers are some of the common ones that are detected often for the first time in its new home, the liver. These are called secondary cancers of the liver. In fact, of all liver cancers, secondary ones are by far the commonest.
Symptoms of cancer of the liver:
Liver cancer is mostly detected by an ultrasonography done for investigating ill-health, severe loss of appetite, weight etc. These patients are often better candidates for treatment by surgery, as the tumours in them are often localised . However, the vast majority will have some problem in the abdomen. In patients of secondary liver cancers, often the symptoms of the primary disease such as rectal bleeding in colon cancer, brings the person to the attention of a doctor. Pain is not a prominent symptom at early stage of liver cancer.
The other symptoms are:
* Distension of abdomen
* Swelling of feet
* Unconsciousness
* Jaundice
Diagnosis and Treatment of cancer of the liver:
The first step of treatment is obviously getting a diagnosis. Ultrasonography and CT scans are good modalities. However, MRI of the liver and angiography yields useful information for planning the therapy. In case the lesion is small, localized and has not invaded blood vessels, a good surgical resection can nearly cure the patient In case of multiple lesions, if they are localized to an area of the liver called a lobe, one of the emerging options is liver transplantation. Liver transplantation can get one back to a normal and healthy life. But in cases of primary liver cancer where the liver gets infected only, chemotherapy has no role to play. But in secondary liver cancer, chemotheraphy can indeed be effective.
Prevention of cancer of the liver:
Vaccination for Hepatitis- B is the best preventive route. This vaccination is most effective when administered in childhood. Environmental hygiene has also an important impact on one's health. Also, one must cut down unnecessary intake of medicine.
Causes of liver cancer:
Liver cancer may be either primary or, secondary.
Primary Liver cancer or, Hepatocellular cancer
Sometimes liver's own cells called hepatocytes sometimes turn cancerous. These are called Hepato cellular cancer or primary liver cancer. There are different causes of this. The commonest are infections by Hepatitis B and C. Some fungal toxins called Aflatoxins can also cause this type of cancer. The predominant cause also varies across the globe. In India it is Hepatitis B, in the western countries, Hepatitis C. Therefore prevention of these viruses is the key to refrain from cancers of the liver.
Secondary or, Metastatic Liver Cancer
Uncontrolled and unregulated growth of cells leads to any kind of cancer. Cancerous cells often leave its harbour and sail into the big ocean called the body. This is called Metastasis, individual cancers differ in their tendency to roam - but lung, prostate, breast, thyroid and uterine cancers are some of the common ones that are detected often for the first time in its new home, the liver. These are called secondary cancers of the liver. In fact, of all liver cancers, secondary ones are by far the commonest.
Symptoms of cancer of the liver:
Liver cancer is mostly detected by an ultrasonography done for investigating ill-health, severe loss of appetite, weight etc. These patients are often better candidates for treatment by surgery, as the tumours in them are often localised . However, the vast majority will have some problem in the abdomen. In patients of secondary liver cancers, often the symptoms of the primary disease such as rectal bleeding in colon cancer, brings the person to the attention of a doctor. Pain is not a prominent symptom at early stage of liver cancer.
The other symptoms are:
* Distension of abdomen
* Swelling of feet
* Unconsciousness
* Jaundice
Diagnosis and Treatment of cancer of the liver:
The first step of treatment is obviously getting a diagnosis. Ultrasonography and CT scans are good modalities. However, MRI of the liver and angiography yields useful information for planning the therapy. In case the lesion is small, localized and has not invaded blood vessels, a good surgical resection can nearly cure the patient In case of multiple lesions, if they are localized to an area of the liver called a lobe, one of the emerging options is liver transplantation. Liver transplantation can get one back to a normal and healthy life. But in cases of primary liver cancer where the liver gets infected only, chemotherapy has no role to play. But in secondary liver cancer, chemotheraphy can indeed be effective.
Prevention of cancer of the liver:
Vaccination for Hepatitis- B is the best preventive route. This vaccination is most effective when administered in childhood. Environmental hygiene has also an important impact on one's health. Also, one must cut down unnecessary intake of medicine.
Causes, Symptoms, Diagnosis and Treatment of Lung Cancer
Causes of Lung cancer
Smoking is the main cause of lung cancer. In America, it is said that smoking is not only injurious to health; but it also kills. Tobacco and nicotine are mainly responsible for negatively affecting our lungs. Genetic and hereditary factors can also be responsible, although it may not be a cause of lung cancer.
Are we careful about consuming a balanced diet? Because, presence of antioxidants in our food, i.e. the amount of antioxidant one has in his/her body is also responsible for lung cancer.
Pollution is also highly responsible for the dreaded disease. People dealing with heavy chemicals are also prone to lung cancer.
Symptoms of lung cancer
There are various symptoms of this type of cancer. Regular chest pain and weight loss should be immediately brought to the notice of the doctor. Coughing blood may be a symptom of lung cancer but in 95 per cent cases the patient suffers from bronchitis. However, at times, there may be no such symptoms at all.
Treatment of lung cancer
Operation is one of the main modes of treatments for this type of cancer. However, operation in the very first step can be avoided because lung cancer can also be cured by chemotherapy. Along with chemotherapy, one can also go for radiotherapy. Radiotherapy should be done soon after the chemotherapy to stop the cancer from coming back and spreading into the brain. People with early small cell cancer can have radiotherapy to kill the cancer cells at an early stage. The cancer detecting CT scan has not yet been properly introduced in India, but there are also many other tests like biopsy to detect the cancer.
Prevention of lung cancer
Smoking is not only injurious to health but it also kills. Chewable tobaccos like khaini lead to oral cancer. Besides this, one should have a balanced diet full of green vegetables and fruits, which contains antioxidants. Routine check-up and screening at proper times is very important. One should consult the concerned doctor to keep their health in good condition.
Smoking is the main cause of lung cancer. In America, it is said that smoking is not only injurious to health; but it also kills. Tobacco and nicotine are mainly responsible for negatively affecting our lungs. Genetic and hereditary factors can also be responsible, although it may not be a cause of lung cancer.
Are we careful about consuming a balanced diet? Because, presence of antioxidants in our food, i.e. the amount of antioxidant one has in his/her body is also responsible for lung cancer.
Pollution is also highly responsible for the dreaded disease. People dealing with heavy chemicals are also prone to lung cancer.
Symptoms of lung cancer
There are various symptoms of this type of cancer. Regular chest pain and weight loss should be immediately brought to the notice of the doctor. Coughing blood may be a symptom of lung cancer but in 95 per cent cases the patient suffers from bronchitis. However, at times, there may be no such symptoms at all.
Treatment of lung cancer
Operation is one of the main modes of treatments for this type of cancer. However, operation in the very first step can be avoided because lung cancer can also be cured by chemotherapy. Along with chemotherapy, one can also go for radiotherapy. Radiotherapy should be done soon after the chemotherapy to stop the cancer from coming back and spreading into the brain. People with early small cell cancer can have radiotherapy to kill the cancer cells at an early stage. The cancer detecting CT scan has not yet been properly introduced in India, but there are also many other tests like biopsy to detect the cancer.
Prevention of lung cancer
Smoking is not only injurious to health but it also kills. Chewable tobaccos like khaini lead to oral cancer. Besides this, one should have a balanced diet full of green vegetables and fruits, which contains antioxidants. Routine check-up and screening at proper times is very important. One should consult the concerned doctor to keep their health in good condition.
Saturday, April 18, 2009
Know about breast cancer – Diagnosis, Prevention and Treatment
About 25 to 30 per cent cases of cancer in women happen to be breast cancer. The increasing rate of this disease is alarming, especially in urban women. Although methods of diagnosis has also increased now, but unfortunately we find most cases in their advanced stage, where very little can be done other than operating the breast.
Causes of breast cancer
The exact cause of this cancer is not known. If there is a family history of this type of cancer, then the risk increases by 10 per cent. Late marriage followed by late pregnancy and absence of breast-feeding may be the causes in most cases. In western countries the disease generally strikes women above 50 whereas in our country, India, the age limit has gone down to even-early the early 30's.
Symptoms of breast cancer
Lumps in the breast are the main symptoms of this cancer, occasionally accompanied with nipple discharge, retraction and puckering of nipples and swelling of underarm. But often, breast cancer Is diagnosed with neither of such symptoms but rather as Infections elsewhere as In lungs.
Self check of the breasts:
Regular self check up helps in timely detection and it is not a very complicated process.
Procedure of self examination of the breasts
In the shower
Lift your right arm. Use your left palm, feel your right breast whether there is any lump on your breast. Any change in feel below the skin can also be easily discovered in this method. Repeat the same procedure for your left breast.
Before a mirror
Leave your arms at your sides. See both the breasts for anything abnormal discharge, puckering, dimpling or changes in skin texture. Put your hands behind your head and clasp. In this position look vigilantly for any changes in the shape or contour of your breasts. Gently press both the nipples and look for discharge.
Lying down
Recline flat on your back and keep your left arm over your head and a pillow under your left shoulder. Now with your right palm touch and feel your left breast gently but firmly.
Start feeling in your armpit and then move down to just below your breast. By repeated up and down movement feel the whole area of the breast for any unusual lump or, swelling. Now place your arm on a solid surface and repeat the same up-and-down movement to examine the region between the breast and the underarm, and the underarm itself.
Treatment of breast cancer
A good rapport is needed with the doctor for the treatment so it is better to stick to one doctor who will understand your disease much better. This cancer is absolutely curable, if detected early, only the lumps and the affected glands can be removed without removal of the entire breast. After the operation, the patient is treated with six courses of chemotherapy. Hair loss, the side effect which every patient is afraid of, is only temporary. After chemotherapy, radiotherapy is given, but it is to be planned carefully so that the radiation does not affect the heart and lungs. Proper nutrition is also needed.
To prevent further infection, regular blood test is a must. For the next five years, the patient needs to be in touch with the doctor in addition to regular checkups.
Things one should know about breast cancer
* All breast lumps are not cancerous, in fact most of them are benign in nature.
* It is completely curable if diagnosed early.
* Awareness about the symptoms of breast cancer can help in early diagnosis and thus increase the chance of complete cure.
* Family history increases the chance of contracting the disease to a large extent.
Causes of breast cancer
The exact cause of this cancer is not known. If there is a family history of this type of cancer, then the risk increases by 10 per cent. Late marriage followed by late pregnancy and absence of breast-feeding may be the causes in most cases. In western countries the disease generally strikes women above 50 whereas in our country, India, the age limit has gone down to even-early the early 30's.
Symptoms of breast cancer
Lumps in the breast are the main symptoms of this cancer, occasionally accompanied with nipple discharge, retraction and puckering of nipples and swelling of underarm. But often, breast cancer Is diagnosed with neither of such symptoms but rather as Infections elsewhere as In lungs.
Self check of the breasts:
Regular self check up helps in timely detection and it is not a very complicated process.
Procedure of self examination of the breasts
In the shower
Lift your right arm. Use your left palm, feel your right breast whether there is any lump on your breast. Any change in feel below the skin can also be easily discovered in this method. Repeat the same procedure for your left breast.
Before a mirror
Leave your arms at your sides. See both the breasts for anything abnormal discharge, puckering, dimpling or changes in skin texture. Put your hands behind your head and clasp. In this position look vigilantly for any changes in the shape or contour of your breasts. Gently press both the nipples and look for discharge.
Lying down
Recline flat on your back and keep your left arm over your head and a pillow under your left shoulder. Now with your right palm touch and feel your left breast gently but firmly.
Start feeling in your armpit and then move down to just below your breast. By repeated up and down movement feel the whole area of the breast for any unusual lump or, swelling. Now place your arm on a solid surface and repeat the same up-and-down movement to examine the region between the breast and the underarm, and the underarm itself.
Treatment of breast cancer
A good rapport is needed with the doctor for the treatment so it is better to stick to one doctor who will understand your disease much better. This cancer is absolutely curable, if detected early, only the lumps and the affected glands can be removed without removal of the entire breast. After the operation, the patient is treated with six courses of chemotherapy. Hair loss, the side effect which every patient is afraid of, is only temporary. After chemotherapy, radiotherapy is given, but it is to be planned carefully so that the radiation does not affect the heart and lungs. Proper nutrition is also needed.
To prevent further infection, regular blood test is a must. For the next five years, the patient needs to be in touch with the doctor in addition to regular checkups.
Things one should know about breast cancer
* All breast lumps are not cancerous, in fact most of them are benign in nature.
* It is completely curable if diagnosed early.
* Awareness about the symptoms of breast cancer can help in early diagnosis and thus increase the chance of complete cure.
* Family history increases the chance of contracting the disease to a large extent.
Difficulty in swallowing can be a symptom of Cancer of Esophagus
Oesophageal cancer is malignancy of the oesophagus. Cancer attack in the oesophagus is not uncommon. The oesophagus is a muscular tube that connects the oro-pharynx to the stomach. The food bolus goes to stomach from the mouth cavity through pharynx, by oesophageal motility.This oesophagus is divided into three parts: upper, middle and lower. Generally, cancer of this part affects middle aged persons both male and female, but it can strike earlier too. Oesophageal cancer can spread to surrounding structure, i.e. chest Smoking and consumption of alcohol, paan, zarda, etc are the most important factors for oesophageal malignancy.
Causes oesophageal cancer:
As there are no definite causes identified for oesophageal cancer, there is no definitive preventive strategy. But refraining from smoking and consumption of alcohol diminish somewhat the possibility of oesophageal cancer.
Symptoms of oesophageal cancer:
It is characterized by difficulty in swallowing (dysphagia), both solid and liquid. The patient has difficulty at first in swallowing solid food, then semi-solid and ultimately liquid also. The symptoms also include pain in the chest, weight loss, anaemia and fever. Ultimately, the patient may not even be able to swallow his saliva too.
Diagnosis of oesophageal cancer:
Diagnosis of oesophageal cancer could be through the following procedures:
1) Barium X-ray
2) Endoscopy and Biopsy from the suspected area
3) Oesophageal washings for examination of any cancer cell.
Treatment of oesophageal cancer:
The mode of treatment depends on which stage the disease is diagnosed. Treatment could be in the form of surgery, radiotherapy and chemotherapy and even a combination of all of these.
When the disease is in an advanced form, (the stage when the patient cannot swallow food) then palliative treatment consisting of oesophageal dilatation is followed by placement of a stent (which may be covered or uncovered) to enable the patient to swallow food.
Causes oesophageal cancer:
As there are no definite causes identified for oesophageal cancer, there is no definitive preventive strategy. But refraining from smoking and consumption of alcohol diminish somewhat the possibility of oesophageal cancer.
Symptoms of oesophageal cancer:
It is characterized by difficulty in swallowing (dysphagia), both solid and liquid. The patient has difficulty at first in swallowing solid food, then semi-solid and ultimately liquid also. The symptoms also include pain in the chest, weight loss, anaemia and fever. Ultimately, the patient may not even be able to swallow his saliva too.
Diagnosis of oesophageal cancer:
Diagnosis of oesophageal cancer could be through the following procedures:
1) Barium X-ray
2) Endoscopy and Biopsy from the suspected area
3) Oesophageal washings for examination of any cancer cell.
Treatment of oesophageal cancer:
The mode of treatment depends on which stage the disease is diagnosed. Treatment could be in the form of surgery, radiotherapy and chemotherapy and even a combination of all of these.
When the disease is in an advanced form, (the stage when the patient cannot swallow food) then palliative treatment consisting of oesophageal dilatation is followed by placement of a stent (which may be covered or uncovered) to enable the patient to swallow food.
Symptoms, Diagnosis, Treatment and Prevention of Cancers in the region of Ear Nose and Throat
Worldwide, cancers of the ear, nose and throat are not very common. In India, however, cancer of the mouth and back of throat (oropharynx) are the commonest cancers in adult men. Although, strictly speaking, throat includes back of nose (nasopharynx), back of throat (oropharynx), upper food passage (hypopharynx) and voice box (larynx). Cancer of the nasopharynx is the rarest form.
Causes of developing cancer in the throat region
The use of tobacco (smoked or chewed), consumption of alcohol and chewing of betel quid or paan, zarda and khaini are the main causes of development of cancer of the mouth, throat and voice box. People who do not have any of these habits may still develop these cancers; in some cases this is related to infection with the human papilloma virus (which is also a cause of cancer of the uterine cervix in women)/ while in other cases it may be the result of genetic susceptibility. Some cases of mouth cancer can arise in persistent ulcers because of catching of the cheek on a sharp tooth. Cancer of the ear is very rare, but usually follows many years of ear infection with constant discharge of pus.
Symptoms of cancer in the mouth (Oral cavity):
Nearly 50 per cent of mouth cancers arise from white or red patches (leukoplakia or erythroplakia) of damaged lining that may remain present for many months before they become cancerous. Warning symptoms are sensation of burning (especially in the presence of spicy food), progressive increase in the size of the patch, or bleeding from the patch on touching. Cancers of the tongue usually present as ulcers on the surface or edge,' which gradually increase in size, and may bleed. They are rarely painful to begin with.
A condition with a high chance of becoming cancer is oral submucous fibrosis (OSMF), in which areas of the tongue or cheek become painful in the presence of spicy food, and there is progressive difficulty in opening the mouth. This is always seen in people who take excessive paan, zarda and khaini.
Symptoms of cancer in the Throat (Oropharynx):
Common early symptoms are appearance of a lump in the neck which progressively increases in size (it will never become smaller), or a persistent pain in the ear in the absence of any ear infection. This is due to nerve involvement, and will be constant. Later symptoms include difficulty in swallowing food and/or liquids, and change in the quality of voice.
Symptoms of cancer in the Voice box (Larynx):
A persistent change in the voice or loss of voice for more than two weeks is always suspicious.
Symptoms of cancer in the Ear:
Onset of pain in an ear which has been discharging pus for many years may signal the appearance of cancer.
Symptoms of cancer in the Nose:
Blood-stained nasal discharge, persistent one-sided nasal obstruction, and, sometimes, deep-seated nasal or sinus pain.
Treatment of cancers of Ear Nose and Throat
In order to treat cancers of the ear, nose and throat it is essential to know three things:
1. The nature of the cancer (which includes the type, and whether it is high, mid or low-grade)
2. The extent of the cancer (which usually requires endoscopy of the nose or throat, and microscopy of the ear)
3. Whether there is any spread to the lymph glands of the neck (which usually requires a CT or MRI scan, and a needle test or FNAC
To know the nature and grade of the cancer, it is necessary to take a sample of the cancer tissue and have it examined in a pathology laboratory. Unfortunately, there are many myths regarding this biopsy procedure. People have the fear that taking a biopsy will convert a swelling into a cancer. This is absolutely false. There is also fear that biopsy will make the cancer spread faster. This will only happen if there is a delay in starting correct treatment after the biopsy report has been received, it must be emphasized that it is impossible to treat cancer appropriately without biopsy, as the nature and grade will not be known.
Once the above information has been gathered, the cancer can be correctly treated. For small cancers, either surgery (including laser surgery) or radiothera¬py may be enough for cure. More than 80 per cent of cancer of the throat can be cured if diagnosed at early stage. Larger cancers, cancers with involvement of neck lymph glands, and those of ear or nose usually require combination treatment with surgery and radiotherapy. In some cases, the radiotherapy may be preceded or combined with treatment with anti-cancer drugs (chemotherapy). With correct timely treatment more than 60 per cent of such cancers may be cured.
It must be emphasized that extensive studies performed by the respected US National Institutes of Health have found no role of homoeopathy in curing cancers of the ear, nose and throat.
Prevention of cancers of Ear Nose and Throat
Stop smoking, do not drink excessive amounts of alcohol, avoid passive smoking and do not take paan, zarda or khaini. Always see an ENT specialist if any of the symptoms mentioned above should occur.
Consult an ENT specialist if you suffer from
•White or red patches in the mouth which burn with spicy food
•Change of voice for more than two weeks
•Persistent pain in one ear in the absence of any ear infection
•Appearance of a lump in the neck
Causes of developing cancer in the throat region
The use of tobacco (smoked or chewed), consumption of alcohol and chewing of betel quid or paan, zarda and khaini are the main causes of development of cancer of the mouth, throat and voice box. People who do not have any of these habits may still develop these cancers; in some cases this is related to infection with the human papilloma virus (which is also a cause of cancer of the uterine cervix in women)/ while in other cases it may be the result of genetic susceptibility. Some cases of mouth cancer can arise in persistent ulcers because of catching of the cheek on a sharp tooth. Cancer of the ear is very rare, but usually follows many years of ear infection with constant discharge of pus.
Symptoms of cancer in the mouth (Oral cavity):
Nearly 50 per cent of mouth cancers arise from white or red patches (leukoplakia or erythroplakia) of damaged lining that may remain present for many months before they become cancerous. Warning symptoms are sensation of burning (especially in the presence of spicy food), progressive increase in the size of the patch, or bleeding from the patch on touching. Cancers of the tongue usually present as ulcers on the surface or edge,' which gradually increase in size, and may bleed. They are rarely painful to begin with.
A condition with a high chance of becoming cancer is oral submucous fibrosis (OSMF), in which areas of the tongue or cheek become painful in the presence of spicy food, and there is progressive difficulty in opening the mouth. This is always seen in people who take excessive paan, zarda and khaini.
Symptoms of cancer in the Throat (Oropharynx):
Common early symptoms are appearance of a lump in the neck which progressively increases in size (it will never become smaller), or a persistent pain in the ear in the absence of any ear infection. This is due to nerve involvement, and will be constant. Later symptoms include difficulty in swallowing food and/or liquids, and change in the quality of voice.
Symptoms of cancer in the Voice box (Larynx):
A persistent change in the voice or loss of voice for more than two weeks is always suspicious.
Symptoms of cancer in the Ear:
Onset of pain in an ear which has been discharging pus for many years may signal the appearance of cancer.
Symptoms of cancer in the Nose:
Blood-stained nasal discharge, persistent one-sided nasal obstruction, and, sometimes, deep-seated nasal or sinus pain.
Treatment of cancers of Ear Nose and Throat
In order to treat cancers of the ear, nose and throat it is essential to know three things:
1. The nature of the cancer (which includes the type, and whether it is high, mid or low-grade)
2. The extent of the cancer (which usually requires endoscopy of the nose or throat, and microscopy of the ear)
3. Whether there is any spread to the lymph glands of the neck (which usually requires a CT or MRI scan, and a needle test or FNAC
To know the nature and grade of the cancer, it is necessary to take a sample of the cancer tissue and have it examined in a pathology laboratory. Unfortunately, there are many myths regarding this biopsy procedure. People have the fear that taking a biopsy will convert a swelling into a cancer. This is absolutely false. There is also fear that biopsy will make the cancer spread faster. This will only happen if there is a delay in starting correct treatment after the biopsy report has been received, it must be emphasized that it is impossible to treat cancer appropriately without biopsy, as the nature and grade will not be known.
Once the above information has been gathered, the cancer can be correctly treated. For small cancers, either surgery (including laser surgery) or radiothera¬py may be enough for cure. More than 80 per cent of cancer of the throat can be cured if diagnosed at early stage. Larger cancers, cancers with involvement of neck lymph glands, and those of ear or nose usually require combination treatment with surgery and radiotherapy. In some cases, the radiotherapy may be preceded or combined with treatment with anti-cancer drugs (chemotherapy). With correct timely treatment more than 60 per cent of such cancers may be cured.
It must be emphasized that extensive studies performed by the respected US National Institutes of Health have found no role of homoeopathy in curing cancers of the ear, nose and throat.
Prevention of cancers of Ear Nose and Throat
Stop smoking, do not drink excessive amounts of alcohol, avoid passive smoking and do not take paan, zarda or khaini. Always see an ENT specialist if any of the symptoms mentioned above should occur.
Consult an ENT specialist if you suffer from
•White or red patches in the mouth which burn with spicy food
•Change of voice for more than two weeks
•Persistent pain in one ear in the absence of any ear infection
•Appearance of a lump in the neck
Monday, March 30, 2009
Causes and treatment of ulcers in the mouth (Oral cavity)
Recurrent ulceration (Apthous Ulcer) in the oral cavity (Mouth)
Recurrent aphthous ulceration of unknown aetiology (reason) is a common oral mucosa disorder affecting 20% of the population. It consists of recurrent bouts of one or more rounded, shallow, painful ulcers recurring at intervals of days to a few months.
Minor aphthous ulcers are the most common. They are less than 10 mm diameter, have a grey/white centre with a thin erythematous (red colored) halo and heal within 14 days without scarring.
Major aphthous ulcers are larger (more than 20 mm diameter), often persist for weeks or months and heal with scarring.
Most patients with recurrent ulcers are otherwise well. Various nutritional deficiencies of iron, folic acid or vitamin B12 (with or without gastrointestinal disorders) are occasionally found.
There are no specific, effective therapies. Corticosteroids may lessen the duration and severity of the attacks. Chlorhexidine gluconate mouthwash, dapsone, colchicine, systemic steroids and azathioprine have all been used with variable effect.
Ulceration associated with other diseases
Oral ulceration is seen in gastrointestinal disorders, such as Crohn's disease, ulcerative colitis and coeliac disease in approximately 10-20% of cases. Other diseases associated with oral ulceration include lupus erythematosus (systemic and discoid), Behcet's disease, neutropenia and immunodeficiency disorders (HIV). In Reiter's disease, ulceration occurs in approximately 25-30% of patients.
Ulceration associated with dermatological disorders / Skin Diseases
Oral cavity is also a part of our skin so many skin disorders also produce lesion in the oral cavity as well. These include erythema multiforme major, toxic epidermal necrolysis, lichen planus, pemphigus vulgaris, bullous pemphigoid , epidermolysis bullosa and dermatitis herpetiformis.
Ulceration associated with viral infection
Herpes simplex virus. Primary herpes simplex (usually type I but rarely type II) presents with fever and widespread confluent painful ulcers. After resolution, the virus remains latent and recurs as herpes labialis (ulcers in the angle of the mouth) also commonly known as cold sores.
Other viruses. Herpes zoster and cytomegalovirus are among many viruses that can produce mouth ulceration, usually during the acute infective phase.
Ulceration associated with bacterial infection
Syphilis and tuberculosis can rarely cause oral ulcerations and are seen mainly in developing countries.
Ulceration associated with drugs
Certain drugs can cause oral lichenoid eruptions. They include antimalarials, methyldopa, tolbutamide, penicillamine and gold salts.
Traumatic Ulcers
Traumatic ulcers may be due to ill-fitting dentures, tooth brushing or lacerations by sharp teeth.
Neoplastic lesions (squamous cell carcinoma)
The majority of such ulcers develop on the floor of the mouth or lateral borders of the tongue. Early tumours may be painless, but advanced tumours are easily recognizable as indurated aphthous ulcers with raised and rolled edges.
Causative agents include tobacco, heavy alcohol consumption and the areca nut.
Intra-oral lesions which undergo malignant transformation include leucoplakia, lichen planus, submucous fibrosis and erythroplaki a (a red patch). The previous male predominance has declined. Treatment is by surgical excision and/or radiotherapy.
Recurrent aphthous ulceration of unknown aetiology (reason) is a common oral mucosa disorder affecting 20% of the population. It consists of recurrent bouts of one or more rounded, shallow, painful ulcers recurring at intervals of days to a few months.
Minor aphthous ulcers are the most common. They are less than 10 mm diameter, have a grey/white centre with a thin erythematous (red colored) halo and heal within 14 days without scarring.
Major aphthous ulcers are larger (more than 20 mm diameter), often persist for weeks or months and heal with scarring.
Most patients with recurrent ulcers are otherwise well. Various nutritional deficiencies of iron, folic acid or vitamin B12 (with or without gastrointestinal disorders) are occasionally found.
There are no specific, effective therapies. Corticosteroids may lessen the duration and severity of the attacks. Chlorhexidine gluconate mouthwash, dapsone, colchicine, systemic steroids and azathioprine have all been used with variable effect.
Ulceration associated with other diseases
Oral ulceration is seen in gastrointestinal disorders, such as Crohn's disease, ulcerative colitis and coeliac disease in approximately 10-20% of cases. Other diseases associated with oral ulceration include lupus erythematosus (systemic and discoid), Behcet's disease, neutropenia and immunodeficiency disorders (HIV). In Reiter's disease, ulceration occurs in approximately 25-30% of patients.
Ulceration associated with dermatological disorders / Skin Diseases
Oral cavity is also a part of our skin so many skin disorders also produce lesion in the oral cavity as well. These include erythema multiforme major, toxic epidermal necrolysis, lichen planus, pemphigus vulgaris, bullous pemphigoid , epidermolysis bullosa and dermatitis herpetiformis.
Ulceration associated with viral infection
Herpes simplex virus. Primary herpes simplex (usually type I but rarely type II) presents with fever and widespread confluent painful ulcers. After resolution, the virus remains latent and recurs as herpes labialis (ulcers in the angle of the mouth) also commonly known as cold sores.
Other viruses. Herpes zoster and cytomegalovirus are among many viruses that can produce mouth ulceration, usually during the acute infective phase.
Ulceration associated with bacterial infection
Syphilis and tuberculosis can rarely cause oral ulcerations and are seen mainly in developing countries.
Ulceration associated with drugs
Certain drugs can cause oral lichenoid eruptions. They include antimalarials, methyldopa, tolbutamide, penicillamine and gold salts.
Traumatic Ulcers
Traumatic ulcers may be due to ill-fitting dentures, tooth brushing or lacerations by sharp teeth.
Neoplastic lesions (squamous cell carcinoma)
The majority of such ulcers develop on the floor of the mouth or lateral borders of the tongue. Early tumours may be painless, but advanced tumours are easily recognizable as indurated aphthous ulcers with raised and rolled edges.
Causative agents include tobacco, heavy alcohol consumption and the areca nut.
Intra-oral lesions which undergo malignant transformation include leucoplakia, lichen planus, submucous fibrosis and erythroplaki a (a red patch). The previous male predominance has declined. Treatment is by surgical excision and/or radiotherapy.
Wednesday, February 18, 2009
Cancers - An Overview
Almost 25 per cent of all deaths due to non-infectious and non-accidental causes occur due to cancer. Next to heart attacks, this is the biggest killer of mankind. It is usually a disease of middle age and beyond, though some childhood cancers do occur. The treatment is generally surgical which may be combined with chemotherapy and / or radiotherapy. Successful outcome depends on early detection and diagnosis. Once it has spread beyond the confines of the original tumor, radical cure becomes less likely, though palliative treatment is still possible.
What is Cancer?
Cancer consists of cells which have turned malignant. They start growing and multiplying at the cost of normal tissues, destroying the latter in the process. While innocent or benign tumors may show little growth over months or years, cancers have the property of enormously rapid growth.
In a matter of a few months, they may enlarge substantially. They also have the property of invading and spreading into the nearby lymph glands and to distant organs as secondary growths which are as malignant as the original tumor. An innocent tumor does not possess these lethal characteristics unless a malignant change occurs in it.
The ultimate diagnosis of malignancy /cancer or, innocence of the tumor depends in biopsy. Biopsy consists of taking out a piece of the suspected tissue which is then examined by a pathologist under the microscope.
Where can Cancer Appear?
A typical feature of cancer is its lack of pain and inflammation at early stages. It is important to recognize the fact that in early stages the swelling or mass, despite of its size and rapid growth is painless. No pain is produced even on pressure. No sign of inflammation like heat, or redness is found. On should not ignore any swelling if it is painless.
Tumors, including cancers, may appear on the visible surfaces like the skin, breast or penis, where they are open to inspection.
They may arise from one of the internal organs like the lung, kidney, prostate, ovary, brain, liver, etc.When arising from internal organs, cancer cannot be seen or felt but can be suspected from the symptoms it produces.
Warning Signals of cancers:
• Unusual bleeding or discharge from any internal or external body site.
• A lump or thickening in any area but especially the breast.
• A sore that does not heal.
• A change in bowel or bladder habits.
• Hoarseness of voice.
• Persistent cough.
• Indigestion and difficulty in swallowing.
• Change in the appearance, shape or size of a wart or mole.
• Unexplained loss of appetite.
• Unexplained fever.
• Unexplained loss of weight.
Am I having cancer?
• Successful outcome of treatment solely depends on one single factor—the earliest possible detection and diagnosis. Anyone with any of these following symptoms should visit the doctor immediately for check up.
• A mass on the visible surface like skin, breast, penis, etc. Or, a sore which is not healing.
• The mass is growing in size but painless.
• Any mass or masses (glands) in the neck, armpits, groins or elsewhere.
• Low grade fever, without obvious cause and which shows no sign of remitting.
• Unaccounted loss of weight and general weakness, i.e. without dieting or poor intake of food.
• Cough or breathlessness or cyanosis (blue tongue) without obvious cause.
• Persistent headache with vomiting without previous history of migraine or cluster headaches.
• Spitting of blood.
• Loss of appetite, not caused by such factors as drugs / medicines .
• Black tar-like stools or red blood from anus, not due to piles.
• Blood in urine.
• Irregular vaginal bleeding, at or after menopause.
Investigations done to diagnose cancer:
Clinical examination by the surgeon.
Laboratory investigations, like X-rays, barium meal test, endoscopy, intravenous pyelogram, ultrasonography, CAT scan, etc., are selected according to the site of the suspected growth.
Assay of different tumor markers
Ultimate test is biopsy without which it may not be possible to say if the growth is malignant or innocent.
It is comparatively easy to obtain a specimen from accessible sites such as the breast, but in the case of internal organs FNAC ( fine needle aspiration cytology) gives the idea about the nature the tumor. If suspected the patient is operated upon to remove the mass or, to have a proper biopsy from the site.
Prevention of cancers:
• All sources of chronic irritation, e.g. broken stumps of teeth, should be removed.
• Avoid application of chemicals to the skin.
• No smoking.
• Eat plenty of fresh vegetables and fruits; they are rich sources of anti-oxidants which prevent cancers and many other diseases of degeneration.
• Regular self examination of the breast.
• Women should have regular PAP smear of the cervix after the age of 35 at least once in 2 years.
• Gardasyl a vaccine has been launched recently to protect the women from cervical cancers.
This article is published in India Study Channel
What is Cancer?
Cancer consists of cells which have turned malignant. They start growing and multiplying at the cost of normal tissues, destroying the latter in the process. While innocent or benign tumors may show little growth over months or years, cancers have the property of enormously rapid growth.
In a matter of a few months, they may enlarge substantially. They also have the property of invading and spreading into the nearby lymph glands and to distant organs as secondary growths which are as malignant as the original tumor. An innocent tumor does not possess these lethal characteristics unless a malignant change occurs in it.
The ultimate diagnosis of malignancy /cancer or, innocence of the tumor depends in biopsy. Biopsy consists of taking out a piece of the suspected tissue which is then examined by a pathologist under the microscope.
Where can Cancer Appear?
A typical feature of cancer is its lack of pain and inflammation at early stages. It is important to recognize the fact that in early stages the swelling or mass, despite of its size and rapid growth is painless. No pain is produced even on pressure. No sign of inflammation like heat, or redness is found. On should not ignore any swelling if it is painless.
Tumors, including cancers, may appear on the visible surfaces like the skin, breast or penis, where they are open to inspection.
They may arise from one of the internal organs like the lung, kidney, prostate, ovary, brain, liver, etc.When arising from internal organs, cancer cannot be seen or felt but can be suspected from the symptoms it produces.
Warning Signals of cancers:
• Unusual bleeding or discharge from any internal or external body site.
• A lump or thickening in any area but especially the breast.
• A sore that does not heal.
• A change in bowel or bladder habits.
• Hoarseness of voice.
• Persistent cough.
• Indigestion and difficulty in swallowing.
• Change in the appearance, shape or size of a wart or mole.
• Unexplained loss of appetite.
• Unexplained fever.
• Unexplained loss of weight.
Am I having cancer?
• Successful outcome of treatment solely depends on one single factor—the earliest possible detection and diagnosis. Anyone with any of these following symptoms should visit the doctor immediately for check up.
• A mass on the visible surface like skin, breast, penis, etc. Or, a sore which is not healing.
• The mass is growing in size but painless.
• Any mass or masses (glands) in the neck, armpits, groins or elsewhere.
• Low grade fever, without obvious cause and which shows no sign of remitting.
• Unaccounted loss of weight and general weakness, i.e. without dieting or poor intake of food.
• Cough or breathlessness or cyanosis (blue tongue) without obvious cause.
• Persistent headache with vomiting without previous history of migraine or cluster headaches.
• Spitting of blood.
• Loss of appetite, not caused by such factors as drugs / medicines .
• Black tar-like stools or red blood from anus, not due to piles.
• Blood in urine.
• Irregular vaginal bleeding, at or after menopause.
Investigations done to diagnose cancer:
Clinical examination by the surgeon.
Laboratory investigations, like X-rays, barium meal test, endoscopy, intravenous pyelogram, ultrasonography, CAT scan, etc., are selected according to the site of the suspected growth.
Assay of different tumor markers
Ultimate test is biopsy without which it may not be possible to say if the growth is malignant or innocent.
It is comparatively easy to obtain a specimen from accessible sites such as the breast, but in the case of internal organs FNAC ( fine needle aspiration cytology) gives the idea about the nature the tumor. If suspected the patient is operated upon to remove the mass or, to have a proper biopsy from the site.
Prevention of cancers:
• All sources of chronic irritation, e.g. broken stumps of teeth, should be removed.
• Avoid application of chemicals to the skin.
• No smoking.
• Eat plenty of fresh vegetables and fruits; they are rich sources of anti-oxidants which prevent cancers and many other diseases of degeneration.
• Regular self examination of the breast.
• Women should have regular PAP smear of the cervix after the age of 35 at least once in 2 years.
• Gardasyl a vaccine has been launched recently to protect the women from cervical cancers.
This article is published in India Study Channel
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