What is Cancer?
Cancer is a group of many different diseases (with more than 100 different types) that generally all affect cells, the body's basic unit of life. The body is made up of many types of cells. Normally, cells grow and divide to produce more cells only when the body needs them. But if cells keep dividing when new cells are not needed, they form too much tissue. Excess tissue can form a mass called a tumor, and this mass can be either benign or malignant. Benign tissue is not cancer. The cells do not invade nearby tissue or spread to other parts of the body. Malignant tissue is cancer. The cancer cells divide out of control. They can invade and destroy nearby healthy tissue. Also, cancer cells can break away from the tumor they form and enter the bloodstream and lymphatic system. This is how cancer spreads from the original or primary tumor to form new tumors in other parts of the doby. The spread of cancer is called metastasis. Most cancers are named for the type of cell or organ in which they begin. When cancer spreads to other parts of the body, the new tumor has the same malignant cells and the same name as the primary tumor. For example, if prostate cancer spreads to the bones, the cancer cells in the new tumor are prostate cancer cells. The disease is metastatic prostate cancer; it is not bone cancer.
|Brain Tumors||Benign brain tumors do not contain cancer cells. Usually these tumors can be removed, and they are not likely to recur. Although they do not invade nearby tissue, they can press on sensitive areas of the brain and cause symptoms. Malignant brain tumors contain cancer cells. They interfere with vital functions, are life threatening, and are likely to grow rapidly and crowd or invade the tissue around them. These tumors may grow into the healthy brain tissue. If a malignant tumor remains compact and does not grow, it is said to be encapsulated. When an otherwise benign tumor is located in a vital area of the brain and interferes with vital functions, it may be considered malignant even though it contains no cancer cells.
Doctors refer to some brain tumors by grade, ranging from low grade (grade I) to high grade (grade IV). The grade of a tumor refers to the way the cells look under a microscope. Cells from higher grade tumors are more abnormal looking and generally grow faster than cells from lower grade tumors; higher grade tumors are more malignant than lower grade tumors.
|Although brain tumors can occur at any age, studies show that they are most common in two age groups: the first group is children 3 to 12 years old; the second is adults 40 to 70 years old. Researchers have also found that some types of brain tumors are more frequent among workers in certain industries, such as oil refining, rubber manufacturing, and drug manufacturing. Other studies have shown that chemists and embalmers have a higher incidence of brain tumors. Other factors researchers look at are exposure to viruses and the incidence rate among members o the same family with a history of brain tumors.||The symptoms of brain tumors depend mainly on their size and their location in the brain. Symptoms are caused by damage to vital tissue and by pressure on the brain as the tumor grows within the limited space in the skull. They also may be caused by swelling and a buildup of fluid around the tumor, a condition called edema. Symptoms may also be due to hydrocephalus, which occurs when the tumor blocks the flow of cerebrospinal fluid and causes it to build up in the ventricles.
The most frequent symptoms of brain tumors include:
|In addition to asking about a patient's personal and family medical history and checking general signs of health, the doctor does a neurologic exam. This includes checks for alertness, muscle strength, coordination, reflexes, and response to pain. The eyes are also examined to look for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.
Depending on the results of the physical and neurologic examinations, the doctor may perform a combination of the following:
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|Breast Tumors||The most common type of breast cancer begins in the lining of the ducts and is called ductal carcinoma. Another type, called lobular carcinoma, arises in the lobules. When breast cancer spreads outside the breast, cancer cells are often found in the lymph nodes under the arm (axillary lymph nodes). If the cancer has reached these nodes, it may mean that cancer cells have spread to other parts of the body -- other lymph nodes and other organs, such as the bones, liver, or lungs -- via the lymphatic system or the bloodstream.
Cancer that spreads has the same name as the original (primary) cancer. When breast cancer spreads, it is called metastatic breast cancer, even though the secondary tumor is in another organ. Doctors sometimes call this "distant" disease.
|The risk of breast cancer increases gradually as a woman gets older. This disease is uncommon in women under the age of 35. All women age 40 and older are at risk for breast cancer. However, most breast cancers occur in women over the age of 50, and the risk is especially high for women over age 60. Research has shown that the following conditions place a woman at increased risk for breast cancer:
Other factors associated with an increased risk for breast cancer include:
Also at a somewhat increased risk for developing breast cancer are women who started menstruating at an early age (before age 12), experienced menopause late (after age 55), never had children, or took hormone replacement therapy or birth control pills for long periods of time. Each of these factors increases the amount of time a woman's body is exposed to estrogen. The longer this exposure, the more likely she is to develop breast cancer.
In most cases, doctors cannot explain why a woman develops breast cancer. Studies show that most women who develop breast cancer have none of the risk factors listed above, other than the risk that comes with growing older. Also, most women with known risk factors do not get breast cancer. Scientists are conducting research into the causes of breast cancer to learn more about risk factors and ways of preventing this disease.
|Early breast cancer usually does not cause pain. In fact, when breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for:
A lump or thickening in or near the breast or in the underarm area;
A change in the size or shape of the breast;
Nipple discharge or tenderness, or the nipple pulled back (inversion) into the breast;
Ridges or pitting of the breast (the skin looks like the skin of an orange; or
A change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red, or scaly).
A woman should see her doctor when symptoms like these appear. Quite often, they are not cancer, but it's important to check with a doctor to diagnose and treat any problems as early as possible.
|To learn if sn abnormal area on a mammogram, a lump, or other changes in the breast has been caused by cancer or by other, less serious problems a woman's doctor does a careful physical exam and asks about her personal and family medical history. In addition to checking general signs of health, the doctor may do one or more of the following breast exams:
Based on these exams, the doctor may decide t hat no further tests are needed and no treatment is necessary. (In such cases, the doctor may need to check the woman regularly to watch for any changes.) Usually, however, fluid or tissue must be removed from the breast to make a diagnosis. A woman's doctor may refer her for further evaluation to a surgeon or other health care professional who has experience with breast diseases. These doctors may perform:
|Stage 0 is sometimes called noninvasive carcinoma or carcinoma in situ. Lobular carcinoma in situ, or LCIS, refers to abnormal cells in the lining of a lobule. These abnormal cells seldom become invasive cancer. However, their presence is a sign that a woman has an increased risk of developing breast cancer. This risk of cancer is increased for both breasts. Some women with LCIS may choose to take a medication called tamoxifen to try to prevent breast cancer. Other options may include not to receive any treatment, but return to the doctor regularly for checkups; have surgery to remove both breasts to try to prevent cancer from developing, but in which underarm lymph nodes are not usually removed.
Ductal carcinoma in situ, also called intraductal carcinoma or DCIS, refers to cancer cells in an area of abnormal tissue in the lining of a duct that have not invaded the surrounding breast tissue. If DCIS lesions are left untreated, over time cancer cells may break through the duct and spread to nearby tissue, becoming an invasive breast cancer. Patients with DCIS may have a mastectomy or may have breast-sparing surgery followed by radiation therapy. Underarm lymph nodes are not usually removed. Women with DCIS may want to talk with their doctors about the possible usefulness of treatment with tamoxifen.
Stage I and stage II are early stages of breast cancer, but the cancer has invaded nearby tissue. Stage I means that cancer cells have not spread beyond the breast and the tumor is no more than about an inch across. Stage II means one of the following: the tumor in the breast is less than 1 inch across and the cancer has spread to the lymph nodes under the arm; the tumor is between 1 and 2 inches with or without spread to the lymph nodes under the arm; or the tumor is larger than 2 inches but has not spread to the lymph nodes under the arm.
Women with early stage breast cancer may have breast-sparing surgery followed by radiation therapy as their primary local treatment, or they may have a mastectomy, with or without breast reconstruction (plastic surgery) to rebuild the breast. Sometimes radiation therapy is also given to the chest wall after mastectomy. These approaches are equally effective in treating early stage breast cancer. The choice of breast-sparing surgery or mastectomy depends mostly on the size and location of the tumor, the size of the woman's breast, certain features of the cancer, and how the woman feels about preserving her breast. With either approach, lymph nodes under the arm usually are removed.
Many women with stage I and most with stage II breast cancer have chemotherapy and/or hormonal therapy in addition to surgery or surgery and radiation therapy. This added treatment is called adjuvant therapy. It is given to try to destroy any remaining cancer cells and prevent the cancer from recurring, or coming back.
Stage III is also called locally advanced cancer. The tumor in the breast is large (more than 2 inches across), the cancer is extensive in the underarm lymph nodes, or it has spread to other lymph nodes or tissues near the breast. Inflammatory breast cancer is a type of locally advanced breast cancer. Patients with stage III breast cancer usually have both local treatment to remove or destroy the cancer in the breast and systemic treatment to stop the disease from spreading. The local treatment may be surgery and/or radiation therapy to the breast and underarm. The systemic treatment may be chemotherapy, hormonal therapy, or both; it may be given before or after the local treatment.
Stage IV is metastatic cancer. The cancer has spread from the breast to other parts of the body. Women who have stage IV breast cancer receive chemotherapy and/or hormonal therapy to destroy cancer cells and control the disease. They may have surgery or radiation therapy to control the cancer in the breast. Radiation may also be useful to control tumors in other parts of the body.
Recurrent cancer means the disease has come back in spite of the initial treatment. Even when a tumor in the breast seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained in the area after treatment or because the disease had already spread before treatment. Most recurrences appear within the first 2 or 3 years after treatment, but breast cancer can recur many years later.
Cancer that returns only in the area of the surgery is called a local recurrence. If the disease returns in another part of the body, it is called metastatic breast cancer. The patient may have one type of treatment or a combination of treatments.
|Treatment decisions are complex. They are often affected by the judgment of the doctor and by the desires of the patient. A patient's treatment options depend on a number of factors. These factors include her age and menopausal status; her general health; the size, location, and stage of the tumor; whether the doctor can feel lymph nodes under her arm; and the size of her breast. Certain features of the tumor cells (such as whether they depend on hormones to grow) are also considered. The most important factor is the stage of the disease. The stage is based on the size of the tumor and whether the cancer has spread.
Methods of treatment for breast cancer are local or systemic. Local treatments are used to remove, destroy, or control the cancer cells in a specific area. Surgery and radiation therapy are local treatments. Systemic treatments are used to destroy or control cancer cells throughout the body. Chemotherapy and hormonal therapy are systemic treatments. A patient may have just one form of treatment or a combination. Different forms of treatment may be given at the same time or one after another.
Surgery is the most common treatment for breast cancer. Several types of surgery may be used. The doctor can explain each of them in detail, discuss and compare the benefits and risks of each type, and describe how each will affect the patient's appearance. An operation to remove the breast (or as much of the breast as possible) is a mastectomy. Breast reconstruction is often an option at the same time as the mastectomy, or later on. An operation to remove the cancer but not the breast is called breast-sparing surgery or breast-conserving surgery. Lumpectomy and segmental mastectomy (also called partial mastectomy) are types of breast-sparing surgery. They usually are followed by radiation therapy to destroy any cancer cells that may remain in the area. In most cases, the surgeon also removes lymph nodes under the arm to help determine whether cancer cells have entered the lymphatic system.
In lumpectomy, the surgeon removes the breast cancer and some normal tissue around it. Often, some of the lymph nodes under the arm are removed.
In segmental mastectomy, the surgeon removes the cancer and a larger area of normal breast tissue around it. Occasionally, some of the lining over the chest muscles below the tumor is removed as well. Some of the lymph nodes under the arm may also be removed.
In total (simple) mastectomy, the surgeon removes the whole breast. Some of the lymph nodes under the arm may also be removed.
In modified radical mastectomy, the surgeon removes the whole breast, most of the lymph nodes under the arm, and often the lining over the chest muscles. The smaller of the two chest muscles is also taken out to help in removing the lymph nodes.
In radical mastectomy (also called Halsted radical mastectomy), the surgeon removes the breast, the chest muscles, all of the lymph nodes under the arm, and some additional fat and skin. For many years, this operation was considered the standard one for women with breast cancer, but it is very rarely used today and only in cases of advanced cancer in which the cancer has spread to the chest muscles.
Breast reconstruction (surgery to rebuild a breast's shape) is often an option after mastectomy. Women considering reconstruction should discuss this with a plastic surgeon before having a mastectomy.
Radiation therapy (also called radiotherapy) is the use of high-energy rays to kill cancer cells and stop them from growing. The rays may come from radioactive material outside the body and be directed at the breast by a machine (external radiation). The radiation can also come from radioactive material placed directly in the breast in thin plastic tubes (implant radiation). Some women receive both kinds of radiation therapy.
For external radiation therapy, patients go to the hospital or clinic each day. When this therapy follows breast-sparing surgery, the treatments are given 5 days a week for 5 to 6 weeks. At the end of that time, an added dose of radiation is sometimes given to the place where the tumor was removed. It may be either external or internal (using an implant). Patients stay in the hospital for a short time for implant radiation.
Radiation therapy, alone or with chemotherapy or hormone therapy, is sometimes used before surgery to destroy cancer cells and shrink tumors. This approach is most often used in cases in which the breast tumor is large or not easily removed by surgery.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for breast cancer is usually a combination of drugs. The drugs may be given by mouth or by injection. Either way, chemotherapy is a systemic therapy because the drugs enter the bloodstream and travel throughout the body.
Chemotherapy is given in cycles: a treatment period followed by a recovery period, then another treatment, and so on. Most patients have chemotherapy in an outpatient part of the hospital, at the doctor's office, or at home. Depending on which drugs are given and the woman's general health, however, she may need to stay in the hospital during her treatment.
Hormonal therapy is used to keep cancer cells from getting the hormones they need to grow. This treatment may include the use of drugs that change the way hormones work or surgery to remove the ovaries, which make female hormones. Like chemotherapy, hormonal therapy is a systemic treatment; it can affect cancer cells throughout the body.
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|Colon and Rectum||The colon and rectum are parts of the body's digestive system, which removes nutrients from food and stores waste until it passes out of the body. Together, the colon and rectum form a long tube called the large intestine. The colon is the first 6 feet of the large intestine and the rectum is the last 8 to 10 inches. Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Cancers affecting either of these organs may also be called colorectal cancer.||Exact causes of colorectal cancer are not known, however the following risk factors increase a person's chances of developing colorectal cancer:
||Common signs and symptoms of colorectal cancer include:
||Tests are used to detect polyps, cancer, or other abnormalities, even when a person does not have symptoms.
||Cancer Information Service (CIS) provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. You can reach them toll free at: 1-800-4-CANCER|
|Hodgkin's Disease||Hodgkin's disease is one of a group of cancers called lymphomas. Lymphoma is a general term for cancers that develop in the lymphatic system. Other cancers of the lymphatic system are called non-Hodgkin's lymphomas. The lymphatic system is part of the body's immune system which helps fight disease and infection. The lymphatic system includes a network of thin lymphatic vessels that branch, like blood vessels, into tissues throughout the body. Lymphatic vessels carry lymph, a colorless, watery fluid that contains infection-fighting cells called lymphocytes. Also included in the network of vessels are small organs called lymph nodes. Lymph nodes are found in the underarms, groin, neck, chest and abdomen. Other parts of the lymphatic system are the spleen, thymus, tonsils and bone marrow. Lymphatic tissue is also found in other parts of the body, including the stomach, intestines and skin.
Because lymphatic tissue is present in many parts of the body, Hodgkin's disease can start almost anywhere. Hodgkin's disease may occur in a single lymph node, a group of lymph nodes, or sometimes, or sometimes in other parts of the lymphatic system such as the bone marrow and spleen. This type of cancer tends to spread in a fairly orderly way from one group of lymph nodes to the next group.
|At this time, the cause or causes of Hodgkin's disease are not precisely known. By studying patterns of cancer in the population, researchers have found certain risk factors that are more common in people who get Hodgkin's disease than in those who do not. However, most people with the risk factors may not get Hodgkin's disease, while many who do get Hodgkin's disease have none of the known risk factors.
The following are some of the risk factors associated with the disease:
|Symptoms of Hodgkin's disease may include the following:
||If Hodgkin's disease is suspected, the doctor asks about the person's medical history and performs a physical exam to check general signs of health. The exam includes feeling to see if the lymph nodes in the neck, underarm or groin are enlarged. Blood tests may be needed.
The doctor may also order tests that produce pictures of the inside of the body. They include:
The diagnosis depends on a biopsy. A surgeon removes a sample of lymphatic tissue so that a pathologist can examine it under a microscope to check for cancer cells. The pathologist studies the tissue and checks for Reed-Sternberg cells, large abnormal cells that are usually found with Hodgkin's disease.
|A doctor considers the following to determine the stage of Hodgkin's disease:
In staging, the doctor may use some of the same tests used for the diagnosis of Hodgkin's disease. Other staging procedures may include additional biopsies of lymph nodes, the liver, bone marrow, or other tissue. A bone marrow biopsy involves removing a sample of bone marrow through a needle inserted into the hip or another large bone. Rarely, an operation called a laparotomy may be performed. During this operation, a surgeon makes an incision through the wall of the abdomen and removes samples of tissue. A pathologist examines tissue samples under a microscope to check for cancer cells
|Hodgkin's disease is often treated by a team of specialists that may include a medical oncologist, oncology nurse, and//or radiation oncologist. Hodgkin's disease is usually treated with radiation therapy or chemotherapy. The doctors may decide to use one treatment method or a combination of methods.
Treatment for Hodgkin's disease also depends on the stage of the disease, the size of the enlarged lymph nodes, which symptoms are present, the age and general health of the patient, and other factors.
|Patients can get the names of doctors from their local medical society, a nearby hospital, or a medical school.
The Official ABMS Directory of Board Certified Medical Specialists lists doctors' names along with their specialty and medical background. This resource, produced by the American Board of Medical Specialties, is available in most public libraries and on the Internet.
|Lung Cancer||The lungs, a pair of sponge-like, cone-shaped organs, are part of the respiratory system. The right lung has three sections called lobes; it is a little larger than the left lung which has two lobes. Cancers that begin in the lungs are divided into two major types: nonsmall cell lung cancer and small cell lung cancer, depending on how the cells look under a microscope. Each type of lung cancer grows and spreads in different ways and is treated differently.
Nonsmall cell lung cancer is more common than small cell lung cancer, and it generally grows and spreads more slowly. There are three main types of nonsmall cell lung cancer. They are named for the type of cells in which the cancer develops: squamous cell carcinoma (also called epidermoid carcinoma), adenocarcinoma, and large cell carcinoma.
Small cell lung cancer sometimes called oat cell cancer, is less common than nonsmall cell lung cancer. This type of lung cancer grows more quickly and is more likely to spread to other organs in the body.
|Researchers have discovered several causes of lung cancer, and most are related to the use of tobacco:
The best known way to prevent lung cancer is to quit or never start smoking.
|Common signs and symptoms of lung cancer include:
||Preliminary testing to detect a lung condition can include a review of a person's medical history, smoking history and any occupational hazards. A chest x-ray and other tests may also be given. If lung cancer is suspected, sputum cytology (a microscopic examination of cells obtained from a deep-cough sample of mucus in the lungs) is a simple test that may be useful in detecting lung cancer. To confirm the presence of lung cancer, the doctor must examine tissue from the lung. The removal of a small sample of tissue for examination under a microscope by a pathologist is called a biopsy, and can detect cancer. A number of procedures may be used to obtain the tissue:
||Lung cancer often spreads to the brain or bones. Knowing the stage of the disease helps the doctor plan treatment. Some tests used to determine whether the cancer has spread include:
||Treatment depends on a number of factors, including the type of lung cancer (nonsmall cell or small cell lung cancer), the stage of the disease and the general health o the patient.
Patients with nonsmall cell lung cancer may be treated in different ways. The choice of treatment depends mainly on the extent of the disease. Surgery is the most common way to treat this type of lung cancer. Cryosurgery, a treatment that freezes and destroys cancer tissue, may be used to control symptoms in the later stages of nonsmall cell lung cancer. Radiation therapy and chemotherapy may also be used to slow the progress of the disease and to manage symptoms.
Small cell lung cancer spreads quickly. In many cases, cancer cells have already spread to other parts of the body when the disease is diagnosed. In order to reach cancer cells throughout the body, doctors almost always use chemotherapy. Treatment may also include radiation therapy aimed at the tumor in the lung or tumors in other parts of the body (such as in the brain). Some patients have radiation therapy to the brain even though no cancer is found there. This treatment, called prophylactic cranial iradiation (PCI), is given to prevent tumors from forming in the brain. Surgery is part of the treatment plan for a small number of patients with small cell lung cancer.
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|Melanoma||Melanomoa is a type of skin cancer that begins in certain cells in the skin called melanocytes. Melanocytes (pigment cells) are spread throughout the lower part of the epidermis. They produce melanin, the pigment that gives our skin its natural color. When skin is exposed to the sun, melanocytes produce more pigment, causing the skin to tan or darken. Clusters of melanocytes and surrounding tissue can form benign or noncancerous growths called moles. Most people can have between 10 and 40 moles which are usually flesh colored and are also known as nevus, or the plural nevi. Moles can be flat or raised, but are usually round or oval and smaller than a pencil eraser. Moles can grow or change slightly over a long period of time. When moles are surgically removed, they usually do not return.
Melanoma occurs when melanocytes become malignant. Most pigment cells are in the skin; when melanoma starts in the skin, the disease is called cutaneous melanoma. Melanoma may also occur in the eye and is called ocular melanoma or intraocular melanoma. Rarely, melanoma may arise in the meninges, the digestive tract, lymph nodes, or other areas when melanocytes are found. Melanoma can occur on any skin surface. In men, it is often found on the trunk (the area from the shoulders to the hips) or the head and neck. In women, melanoma often develops on the lower legs. Melanoma is rare in black people and others with dark skin. When it does develop in dark-skinned people, it tends to occur under the fingernails or toenails or on the palms or soles. The chance of developing melanoma increases with age, but is still one of the most common cancers in young adults.
When melanoma spreads, cancer cells are also found in the lymph nodes. If the cancer has reached the lymph nodes, it may mean that cancer cells have spread to other parts of the body such as the liver, lungs or brain. In such cases, the cancer cells are still melanoma cells, and the disease is called metastatic melanoma rather than brain, lung or liver cancer.
|Research into most cancers is usually ongoing. Researchers study patterns of cancer in the population to look for factors that are more common in people who develop melanoma than in people who don't develop the disease. It is worthwhile to note that most people with these risk factors do not get the cancer, and people who do develop melanoma may have none of the factors.
Risk factors for melanoma can include:
Nonetheless, scientists have observed that certain factors do increase a person's chance of developing melanoma. For example, having two or more close relatives who have had this disease is a risk factor because melanoma sometimes runs in families. Certain types of mole patterns are associated with an increased risk of developing melanoma, such as having dysplastic nevi or atypical moles. Dyplastic nevi are more likely than ordinary moles to become cancerous.
The number of people who develop melanoma is increasing. Researchers believe that the number of melanomas may be increasing because people are spending more time in the sun. It is known that ultraviolet (UV) radiation from the sun causes premature aging of the skin and skin damage that can lead to melanoma. Two types of ultraviolet radiation, UVA and UVB, should be of concern. Artificial sources of UV radiation can be just as harmful.
People who have had one or more severe, blistering sunburns as a child or teenager are at increased risk for melanoma. Sunburns in adulthood are also a risk factor for melanoma. Melanoma occurs more frequently in people who have fair skin that burns or freckles easily than in people with dark skin. To help prevent and reduce the risk of melanoma, people should avoid exposure to the midday sun (from 10 a.m. to 2 p.m. standard time, or from 11 a.m. to 3 p.m. daylight saving time) whenever possible. Another indication of intense sun, and a good time to protect yourself, is when your shadow is shorter than you are. Many doctors believe sunscreens may help prevent melanoma, especially those that block or absorb both types of ultraviolet radiation.
|Usually the first sign of melanoma is a change in the size, shape, color or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new, black, abnormal mole. Some abnormalities of the moles can be that the shape of one half does not match the other; the edges are often ragged, notched, blurred or irregular in outline; the pigment may spread into the surrounding skin; the color is uneven with shades of black, brown and tan present, and areas of white, grey, red, pink or blue also seen; melanomas that are usually larger than the eraser of a pencil.
Early melanomas may be found when a pre-existing mole changes slightly, such as forming a new black area. Other findings are newly formed fine scales or itching in a mole. In more advanced melanoma, the texture of the mole may change. For example, it may become hard or lumpy. Although melanomas may feel different and more advanced tumors may itch, ooze, or bleed, melanomas usually do not cause pain.
|If an examining doctor suspects that a spot on the skin is melanoma, the patient will need to have a biopsy. A biopsy is the only procedure to make a definite diagnosis. In this procedure, the doctor tries to remove all of the suspicious-looking growth. If the growth is too large to be removed entirely, the doctor removes a sample of the tissue. A pathologist then examines the tissue under a microscope to check for cancer cells. If melanoma is found, the doctor needs to learn the extent or stage of the disease before planning treatment. The treatment plan takes into account the location and thickness of the tumor, how deeply the melanoma has invaded the skin, and whether melanoma cells have spread to nearby lymph nodes or other parts of the body.||Melanoma can be cured if it is diagnosed and treated when the tumor is thin and has not deeply invaded the skin. However, if a melanoma is not removed at its early stages, cancer cells may grow downward from the skin surface, invading healthy tissue. When a melanoma becomes thick and deep, the disease often spreads to other parts of the body and is difficult to control.||The standard treatment for melanoma is surgery. It is necessary to remove not only the tumor but also some normal tissue around it in order to minimize the chances that any cancer will be left in the area. The width and depth of surrounding skin that needs to be removed depends on the thickness of the melanoma and how deeply it has invaded the skin. In cases in which the melanoma is very thin, enough tissue is often removed during the biopsy, and no further surgery is necessary. If the melanoma was not completely removed during the biopsy, the doctor also takes out the remaining tumor. In most cases , additional surgery is performed to remove normal-looking tissue around the tumor to make sure all melanoma cells are removed. For thick melanomas, it may be necessary to do a wider excision to take out a larger margin of tissue. This is necessary to provide adequate surgical margins around the removed tumors.
In some cases, doctors may also use chemotherapy, biological therapy, or radiation therapy. The doctors may decide to use one treatment method or a combination of methods. Apart from other cancers, the treatment team or specialists for treating melanoma can include a dermatologist and plastic surgeon.
|The National Cancer Institute publishes the booklets:
To order them and/or learn about others that are available, call the Cancer Information Service at 1-800-4-CANCER.
|Non-Hodgkin's Lymphoma||Lymphoma is a general term for cancers that develop in the lymphatic system. Hodgkin's disease is one type of lymphoma. All other lymphomas are grouped together and are called non-Hodgkin's lymphoma.
The lymphatic system is part of the body's immune system. It helps the body fight disease and infection. The lymphatic system includes a network of thin tubes that branch, like blood vessels, into tissues throughout the body. Lymphatic vessels carry lymph, a colorless, watery fluid that contains infection-fighting cells called lymphocytes. Along this network of vessels are small organs called lymph nodes. Clusters of lymph nodes are found in the underarm, groin, neck, chest, and abdomen. Other parts of the lymphatic system are the spleen, thymus, tonsils, and bone marrow. Lymphatic tissue is also found in other parts of the body, including the stomach, intestines, and skin.
In non-Hodgkin's lymphoma, cells in the lymphatic system become cancerous, that is, they divide and grow without any order or control, or old cells do not die as cells normally do. Because lymphatic tissue is present in many parts of the body, non-Hodgkin's lymphoma may occur in a single lymph node, a group of lymph nodes, or in another organ. This type of cancer can spread to almost any part of the body, including the liver, bone marrow and spleen.
Over the years, doctors have used a variety of terms to classify the many different types of non-Hodgkin's lymphoma. Most often, they are grouped by how quickly they are likely to grow and spread. Aggressive lymphomas, also known as intermediate and high-grade lymphomas, tend to grow and spread quickly and cause severe symptoms. Indolent lymphomas, also referred to as low-grade lymphomas, tend to grow slowly and cause fewer symptoms.
|The following are some of the factors associated with getting non-Hodgkin's lymphoma:
People who are concerned about non-Hodgkin's lymphoma should talk with their doctor about the disease, the symptoms to watch for, and an appropriate schedule for checkups. The doctor's advice will be based on the person's age, medical history and other factors.
|The most common symptom of non-Hodgkin's lymphoma is a painless swelling of the lymph nodes in the neck, underarm, or groin. Other symptoms may include the following:
When symptoms are present, it is important to see a doctor so that any illness can be diagnosed and treated as early as possible.
|If non-Hodgkin's lymphoma is suspected, the doctor asks about the person's medical history and performs a physical exam. The exam may include feeling to see if the lymph nodes in the neck, underarm, or groin are enlarged. In addition to checking general signs of health, the doctor may perform blood tests. Imaging tests that produce pictures of the inside of the body are also an option. In most cases, a biopsy is needed to make a diagnosis. A surgeon removes a sample of tissue so that a pathologist can examine it under a microscope to check for cancer cells. A biopsy for non-Hodgkin's lymphoma is usually taken from a lymph node, but other other tissues may be sampled as well. Sometimes an operation called a laparotomy may be performed. During this operation, a surgeon cuts into the abdomen and removes samples of tissue to check under a microscope.||The doctor considers the following to determine the stage of non-Hodgkin's lymphoma:
In staging, the doctor may use some of the same imaging tests used for diagnosis of non-Hodgkin's lymphoma. A bone marrow biopsy involves removing a sample of bone marrow through a needle inserted into the hip or another large bone. A pathologist examines the sample under a microscope to check for cancer cells.
|Treatment for non-Hodgkin's lymphoma depends on the stage of the disease, the type of cells involved, whether they are indolent or aggressive, and the age and general health of the patient. Non-Hodgkin's lymphoma is often treated by a team of specialists that includes a hematologist, medical oncologist, and/or radiation oncologist. Non-Hodgkin's lymphoma is usually treated with chemotherapy, radiation therapy, or a combination of these treatments. In some cases, bone marrow transplantation, biological therapies, or surgery may be an option. For indolent lymphomas, the doctor may decide to wait until the disease causes symptoms before starting treatment.||Yet to be provided.|
|Oral Cancer||The oral cavity susceptible to cancer includes many areas of the mouth including the lips, the lining inside the lips and cheeks called buccal mucosa, the teeth, the bottom of the mouth under the tongue, the front two-thirds of the tongue, the bony top of the mouth (hard palate), the gums and the small area behind the wisdom teeth. The oropharynx includes the back one-third of the tongue, the soft palate, the tonsils, and the part of the throat behind the mouth.
Like all organs of the body, the mouth and throat are made up of many kinds of cells. Almost all oral cancers are squamous cell carcinomas. Squamous cells line the oral cavity. When oral cancer spreads, it usually travels through the lymphatic system. Cancer cells that enter the lymphatic system are carried along by lymph, the colorless, watery fluid containing cells that help the body fight infection and disease. Oral cancer that spreads usually travels to the lymph nodes in the neck. It can also spread to other parts of thebody,
|Two known causes of oral cancer are tobacco and alcohol use. Smoking cigarettes, cigars or pipes, chewing tobacco or dipping snuff accounts for 80 to 90 percent of oral cancers. Studies have shown that cigar and pipe smokers have the same risk as cigarette smokers. Studies further indicate that smokeless tobacco users are at particular risk for developing oral cancer. People who stop using tobacco, even after many years of use, can greatly reduce their risk of oral cancer.
Heavy users of alcohol also have an increased risk of getting oral cancer, even if they don't use tobacco. And of course, those that use both have an especially high risk of oral cancer. Scientists believe that these substances increase each other's harmful effects.
Cancer of the lip can be caused by exposure to the sun. The risk can be avoided with the use of a lotion or lip balm containing sunscreen. Pipe smokers are especially prone to cancer of the lip. Some studies have shown that many people who develop oral cancer have a history of leukoplakia, a whitish patch inside the mouth. Although the causes of leukoplakia are not well understood, it is commonly associated with heavy use of tobacco and alcohol. The condition usually occurs in irritated areas such as the gums and mouth lining of smokeless tobacco users and the lower lip of pipe smokers. Another condition that most often occurs in people 60 to 70 years of age is Erythroplakia which appears as a red patch in the mouth. Early diagnosis and treatment of leukoplakia and erythroplakia are important because cancer may develop in these patches.
|Oral cancer usually occurs in people over the age of 45 but can develop at any age. Here are some symptoms:
Symptoms such as these may or may not be caused by cancer, so it is important to see a dentist or doctor about any symptoms like these to have them properly diagnosed.
|If an abnormal area has been found in the oral cavity, a biopsy is the only way to know whether it is cancer. Usually the patient is referred to an oral surgeon or an ear, nose, and throat surgeon, who removes part or all of the lump or abnormal-looking area. A pathologist examines the tissue under a microscope to check for cancer cells.||If the pathologist finds oral cancer, the patient's doctor needs to know the stage, or extent, of the disease to plan treatment. When oral cancer spreads, it usually travels through the lymphatic system. Cancer cells that enter the lymphatic system are carried along by lymph, the colorless, watery fluid containing cells that help the body fight infection and disease. Oral cancer that spreads usually travels to the lymph nodes in the neck. It can also spread to other parts of the body,||Diagnosis of oral cancer usually means having dental x-rays and x-rays of the head and chest. The doctor may also want the patient to have a CT (CAT) scan, a series of x-rays put together by a computer, to form a detailed picture of areas inside the body. Ultrasonography is another way to produce pictures of areas in the body. High-frequency sound waves (ultrasound) are bounced off organs and tissue. The pattern of echoes produced by these waves creates a picture called a sonogram. Sometimes the doctor asks for MRI, where computerized pictures are formed using a powerful magnet. The doctor also feels the lymph nodes in the neck to check for swelling or other changes.||Yet to be provided.|
|Prostate Cancer||The prostate is a male sex gland. It produces a thick fluid that forms part of semen. The prostate is about the size of a walnut. It is located below the bladder and in front of the rectum. The prostate surrounds the upper part of the urethra, the tube that empties the urine from the bladder. The prostate needs male hormones to function, and the primary male hormone is testosterone, which is made mainly by the testicles.
Benign prostatic hyperplasia (BPH) is the abnormal growth of benign prostate cells. It may be worth noting that although benign, symptoms may appear remarkably similar for those of a cancerous condition. In BPH, the prostate grows larger and pushes against the urethra and bladder, blocking the normal flow of urine. More than half of the men in the United States between the ages of 60 and 70 and as many as 90 percent between the ages of 70 and 90 have symptoms of BPH.
|Studies in the United States show that prostate cancer is found mainly in men over age 55; the average age of patients at the time of diagnosis is 72. This disease is known to be more common among negro males, particularly in the U.S. where they are known to have the highest rate of prostate cancer in the world. Some studies have shown that a man has a higher risk for prostate cancer if his father or brother has had the disease. Studies on the effects of diet suggest that diet high in fat increases the risk, while a diet high in fruits and vegetables decreases the risk, although these claims are not conclusively proven. There are also beliefs, without hard evidence, that a vasectomy increases a man's risk; that farmers and workers exposed to the metal cadmium during welding, electroplating, or making batteries are at risk; that workers in the rubber industry are at risk.||Early prostate cancer often not cause symptoms. When symptoms of prostate cancer do occur, they may include some of the following problems:
Any of these symptoms may be caused by cancer or by other, less serious health problems such as BPH or an infection. A man who has symptoms like these should see his family doctor or a urologist. Do not wait to feel pain, as early prostate cancer does not cause pain.
|If symptoms occur, the doctor asks about the patient''s medical history, performs a physical exam, and may order laboratory tests which may include the following:
If the test results suggest that cancer may be present, the patient will need to have a biopsy. A biopsy is a definite way of knowing whether a problem is cancer or not. During a biopsy, the doctor removes a small amount of prostate tissue, usually with a needle.
|When a pathologist looks at a tissue sample under a microscope to check for cancer cells, if cancer is present, the pathologist will assess the grade of the tumor. The grade tells how closely the tumor resembles normal prostate tissue and suggests how fast the tumor is likely to grow. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. Tumors with lower scores are less likely to grow or spread than tumors with higher scores. If the presence of cancer from the exam is negative, the doctor may recommend medicine or surgery to reduce the symptoms caused by an enlarged prostate.
If cancer is found in the prostate, the doctor needs to know the stage, or extent, of the disease. Various blood and imaging tests can be employed to learn the stage of the disease, and treatment decisions can depend on these findings:
|Decisions about prostate cancer treatment are known to be complex, so it's usually advisable to have a second opinion. Ways in which to find a doctor who can render a second opinion are:
||Men over age 55 can take part in a study of finasteride (trade name Proscar®), a drug used to treat BPH. This nationwide NCI study, called Prostate Cancer Prevention Trial, is designed to help doctors learn whether finasteride can prevent prostate cancer.|
|Skin Cancer||The two most common kinds of skin cancer are basal cell carcinoma and squamous cell carcinoma. Carcinoma is cancer that begins in the cells that cover or line an organ. Basal cell carcinoma accounts for more than 90 percent of all skin cancers in the United States. It is a slow-growing cancer that spreads to other parts of the body. Squamous cell carcinoma seldom spreads also, but is more likely to spread than basal cell carcinoma. In spite of all this, skin cancers need to be detected early and treated since they can invade and destroy nearby tissue. Basal cell carcinoma and squamous cell carcinoma are sometimes called nonmelanoma skin cancer. Another type of cancer that occurs in the skin is melanoma, which begins in the melanocytes.||Although anyone can get skin cancer, the risk is greatest for people who have fair skin that freckles easily. Ultraviolet (UV) radiation from the sun is a prime cause of skin cancer. The two types of radiation to be concerned with are UVA and UVB. In addition, artificial sources of UV radiation, such as sunlamps and tanning booths, can also cause skin cancer.
The risk of developing skin cancer is affected by where a person lives. People who live in areas that get high levels of UV radiation from the sun are more likely to get skin cancer. For instance, skin cancer rates are high in the U.S. where an estimated 40 to 50 percent of Americans who live to age 65 are expected to have skin cancer at least once. Worldwide, the highest rates of skin cancer are found in South Africa and Australia. Interestingly, skin cancer is related to lifetime exposure to UV radiation. Most skin cancers appear after age 50, but the sun's damaging effects begin at an early age. Protection of the skin from the sun should start at childhood to prevent skin cancer later in life.
The greatest chance for harmful exposure is during the time of the midday sun, approximately from 10 a.m. to 2 p.m. standard time, or from 11 a.m. to 3 p.m. daylight savings time.
Changes in the skin are not sure signs of cancer, however, it is important to see a doctor if any symptom lasts longer than 2 weeks. Don't wait for the area to hurt since skin cancers like most other cancers in the early stages seldom cause pain.
|A common warning sign of skin cancer is a change on the skin, particularly a new growth or a sore that does not heal easily. Skin cancers may not all look the same. For example, the cancer may start as a small, smooth, shiny, pale, waxy or firm red lump. Sometimes the lump bleeds or develops a crust. Skin cancer can also start as a flat red spot that is rough, dry, or scaly.
Both basal and squamous cell cancers are found primarily on areas of the skin that are exposed to the sun, such as the head, face, neck, hands and arms. However, skin cancer can occur anywhere.
Actinic keratosis can appear as a rough, red or brown, scaly patch on the skin. It is known as a precancerous condition because it sometimes develops into squamous cell cancer.
People should check themselves regularly for new growths or any other changes in the skin. Any new, colored growths or any changes in growths that are already present should be reported to the doctor without delay. People who have already had skin cancer should be sure to have regular exams so that the doctor can check the skin in both the treated areas and other places where cancer may develop.
|Basal cell carcinoma and squamous cell carcinoma are generally diagnosed and treated in the same way. When an area of skin does not look normal, the doctor may remove all or part of the growth. This is called a biopsy. A pathologist or a dermatologist may examine the tissue sample under a microscope to check for cancer cells.||Doctors divide skin cancer into two stages: local (affecting only the skin), or metastatic (spreading beyond the skin). Because skin cancer rarely spreads, a biopsy can be the only test needed to determine the stage. In cases where a growth has been prominent for a long time, the doctor may check the lymph nodes in the area, and the patient may need to undergo addtional tests such as x-rays to determine whether the cancer has spread to other parts of the body.||Treatment for skin cancer usually involves some type of surgery, but radiation therapy or chemotherapy can also be used. Common strategies considered for treating skin cancer aim to remove or destroy the cancer completely while minimizing to the greatest degree the chances of scarring. To plan the best treatment for each patient, the doctor considers the location and size of the cancer, the risk of scarring, and the person's age, general health and medical history. It is known to be helpful to have the advice of more than one doctor before starting treatment.
Procedures for treating skin cancer include
Although skin cancer is highly curable, the disease can recur in the same place. Also, people who have been treated for skin cancer have a higher-than-average risk of developing a new cancer elsewhere on the skin.
|Yet to be provided.|
Primary source of information: National Cancer Institute, Bethesda, MD