A Simple Guide to Cancer

A Simple Guide to Cancer
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This is a summary of all the articles that I have done on the different types of Cancer.

There is a common thread which runs through all the articles such as the risk factors, causes and treatments.

What is Cancer?

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A normal cell can be compared to a "hero" because it saves the body by repairing any damage or injury to the tissues of the body.

A person's body is made up of many types of cells which normally grow, divide and die. Sometimes, the cells mutate (change to abnormal cells) and begin to grow and divide more quickly than normal cells.

Rather than dying, these abnormal cells clump together to form tumors.

If these tumors are cancerous (also called "malignant"), the cancer cells can invade and kill your body's own healthy tissues becoming a "villian" in the process.

By contrast, noncancerous tumors (also called "benign") do not spread to other parts of the body.

What are the dangers of Cancer?
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Normal healthy cells grow and multiply in an orderly, controlled manner.

Cancer cells on the other hand multiply uncontrollably.

They do not function normally and instead form a growth or tumour which can enter the blood and spread to nearby tissues and organs as well as to other parts of the body.

Cancer kills by:

Destroying important organs
Disturbing normal body functions
Blocking important blood vessels or air passages.

Cancer is really a group of diseases. There are many types of cancer which can arise from the different types of cells in the body.

What are the most common cancers?
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MOST COMMON TYPES OF CANCER IN THE WORLD ARE:
Lung
Colon & rectum(large intestine)
Breast
Ovary
Stomach
Cervix(neck of the womb)
Liver
Prostate
Nasopharynx(back of the nose)
Lymphomas

What are the causes of Cancer?
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1. Genetic -family history,chromosonal abnormality

2. Viruses & Bacteria -hepatitis B, Epstein Barr, HIV : Helicobacter pyrori

3. Smoking - chemicals from cigarette smoke

4. Alcohol - liver cirrhosis

5. Chemicals -pesticides, asbestos,preservatives,chemotherapy, aflatoxins

6. Radiation -from sun rays, x-rays, radiotherapy,nuclear plants

7. Obesity - fat can cause breast, ovarian cancer

8. Age - mutations increase with age

How can you prevent yourself from cancer?
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Cancer can be prevented.

Cancer is not contagious like the flu or chickenpox.

About one-third of all cancers can be prevented from occurring:
1. A healthy lifestyle
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get some exercise, a well balanced diet and avoid stress.

2. Smoking
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avoid cigarettes and cigarette smoke.

Cigarette smoke contains about 40 different cancer-causing substances.

Almost all of those who develop lung cancer are smokers.
Smoking also causes cancers of the mouth, throat, larynx , oesophagus, stomach, pancreas, kidney and bladder.

Breathing in other people's smoke can increase your risk of developing lung cancer, so ask any smokers not to smoke in your presence.

What you can do
Don't smoke.
If you do, then stop.
Ask your family and friends to support your efforts to quit.
Get rid of all your cigarettes and lighters.
Enrol in a programme that helps smokers to quit.
Spend less time with friends who smoke.
Spend more time with non-smoking friends in smoke-free places.
There are chewing gum and skin patches with nicotine to help you to stop smoking.

3.Food and chemicals
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avoid any cancer causing chemicals such as asbestos or nitrosamines from preserved food.
The chemicals used to preserve foods like ham, bacon, luncheon meat may form cancer-causing substances when they are digested.

These substances have also been found in salted or preserved foods (such as salted fish or pickled vegetables) and may lead to cancer of the stomach and nasopharynx.
Eat them less often.

Peanuts, seeds and grains that are not stored properly often become mouldy.
Some of these moulds produce toxins(aflatoxins) that can cause liver cancer.

What you can do:
1.Have some fresh fruits and vegetables at every meal. Fruits and vegetables contain vitamins and fibre which help to reduce the risk of developing colorectal and stomach cancer.
Choose dark-green leafy vegetables and orange-yellow fruits as these contain greater amounts of vitamins and minerals.

2.Take more fibre by eating wholemeal bread or wholegrain cereals such as brown rice.

3.Eat less salted, pickled, preserved and processed foods.
Store nuts in air-tight containers to prevent them from going mouldy.

4.Obesity
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People who are overweight are more likely to develop cancers of the colon, rectum, breast and prostate.

What you can do
Exercise regularly .
To maintain a healthy weight, take up a regular exercise or sport.
Aim to stay in the healthy weight range.
Exercise for at least 20 minutes three times a week.
Play a game or sport that you enjoy and can do with your friends or family.

Eat less foods high in fat or sugar.
Trim away fat from meat and skin from poultry before cooking.
Change to foods low in fat like skimmed milk, reduced fat cheese or low-fat yoghurt.
Use low-fat cooking methods like stewing, baking, steaming or boiling instead of deep frying.
Choose healthier snacks like fresh fruit or wholemeal crackers.

5.Radiation
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radiation from sun, x-rays, nuclear plants can cause damage to the skin,bones and other organs of the body resulting in cancer.


What you can do
Avoid sunburn and prevent overexposure to the sun.
The ultraviolet rays from the sun damage the skin.
Sunburn may lead to skin cancer.
Avoid overexposure to the sun, especially if you are fair-skinned.
Stay in the shade whenever possible.
Wear a hat or a cap.
Use a sunscreen or sunblock with a sun protection factor of at least 15 on any exposed areas of skin.


6. Workplace chemicals
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exposure to cancer-causing substances at work can lead to cancer of lungs, liver, kidneys, skin. Always follow the safety regulations as they are meant to protect you.

What you can do
Hide behind protective shields or stay in the "safe" area.
Remember to wear protective equipment (like gloves, masks or goggles).
Be careful when you handle the equipment or the chemicals.
Learn about safety drills and what to do in case of emergencies.

6.Alcohol
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People who frequently drink large amounts of alcohol are likely to develop liver cancer.
They are also at risk of developing cancer of the mouth, throat and oesophagus .

What you can do
Limit yourself to not more than two standard drinks a day.
One standard drink is roughly equal to:
One can of beer(285 mls)
One glass of wine (120 mls)
One measure of spirits(30 mls)

Alternate your drinks with non-alcoholic ones.
Drink them slowly so they last longer.

How to screen for Cancer:
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Mneumonics for Warning Signs of Cancer
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Be on the alert for: CANCERS

1.Changes in bowel or bladder

2.A lump in breast or elsewhere

3.Nagging cough, hoarseness,

4.Changes in the size, shape or colour of a mole on the skin

5.Extraordinary bleeding from the nose or any other part of the body, and blood in the stools.

6.Reccuring Indigestion

7.Sore or an ulcer anywhere on the body, including the mouth, which does not heal properly.


Look out for these early warning signs and let your doctor know.

What you can do
Inform your doctor about it right away.
He can examine you and do some tests to find out if your problem is serious.

Regular breast self examination (BSE) helps to detect breast cancer at a stage when it can still be treated and even cured.
Learn how to do BSE properly and then do it every month.
See your doctor for a breast examination once every two years.
Women over 40 should see their doctor once a year.
Mammograms are special X-rays of the breasts to look for lumps.
They are usually recommended for women over 50.

Regular Pap Smears at least once in 2 years should be done for women who are sexually active. A Pap smear is a simple, quick and painless test that detects cervical cancer at an early stage when it has a good chance of cure.

Women infected with certain sexually transmitted diseases have a higher chance of getting cervical cancer.

Speak to your doctor about your personal and family medical history of cancer.
Certain medical conditions may increase your risk of developing some cancers.
Examples are people who are carriers of the Hepatitis B virus are more likely to develop liver cancer.
Some cancers (like breast and colorectal cancers) tend to run in families.
If your parents, brothers or sisters have had cancer, discuss it with your doctor.
If you have any risks of cancer, the doctor can tell you what steps you can take to reduce your risk of developing cancer.
He may recommend some screening tests to help determine your risk for developing the same cancer.

In fact, about one-third of all cancers can be cured if they are detected and treated early enough.
Recognising the early warning signs and going for regular check-ups can save your life if cancer strikes.

What are the Treatment of Cancers ?
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Basic treatments for cancer are traditionally surgery, radiotherapy and chemotherapy.

However with the advancement of medical treatment, there are more choices of treatments.

Surgery - is still the mainstay of cancer treatment in the early stages and other stages except for leukemia, nasopharyngeal and some rare cancer.

Radiotherapy-standard, intensity modulated radiotherapy, stereotactic radiotherapy, interventional radiotherapy.

Radiotherapy is used particularly in nasopharyngeal cancer, brain cancer and in conjuction with surgery. It can be curative as well as palliative( help to relieve pain)

Chemotherapy - standard,molecular targetted therapy is fast becoming the choice for many cancers because of newer drugs with lesser effects and more effective than before.

Hormonotherapy - espcially for breast,ovary,uterine,prostate, testicular cancer

Immunotherapy - immune systems are boosted with vaccines against certain viruses such as HPV(Human Papilloma Virus)

Stem cells - can help in replacing killed cancer cells with normal cells usually used in conjunction with chemotherapy

Bone marrow transplant - similar to stem cells therapy

Organ transplant especially in liver cancer

Other ways of treatments:

Healthy life style will help to strengthen the patient during the cancer treatment

Well balanced Diet will also help to improve the healing process

Meditation and avoidance of stress reduce the reduced immunity of patients and pyschological effect of cancer treatment

Finally:

Cancer can be cured.

Many people are afraid of cancer because they think it is incurable.

In fact, about one-third of all cancers can be cured if they are detected and treated early enough.

Modern medicine has also improved the survival rates of most cancers.

A Simple Guide to Multiple Myeloma

A Simple Guide to Multiple Myeloma
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What is Multiple Myeloma?
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Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.
Normally plasma cells make antibodies to fight infections.
The disease is called multiple myeloma because myeloma cells can occur in multiple bone marrow sites in your body.

What are the Risk factors in Multiple Myeloma?
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1.Age. The majority of people who develop multiple myeloma are older than 50, with most diagnosed around age 70.

2.Sex. Men are more likely to develop the disease than are women.

3.Exposure to radiation and working in petroleum-related industries.

4.History of a monoclonal gammopathy of undetermined significance.

5.Obesity. Your risk of multiple myeloma is increased if you're overweight or obese.

What are the causes of Multiple Myeloma?
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The exact cause of Multiple Myeloma is not known.
However doctors do know that multiple myeloma begins with one abnormal plasma cell in your bone marrow . This abnormal cell then starts to multiply. Because abnormal cells don't mature and then die as normal cells do, they accumulate slowly reducing the number of healthy cells.
Myeloma cells may circulate in low numbers in the blood, populating other bone marrow sites far from where they began. Uncontrolled plasma cell growth can damage bones and surrounding tissue.

What are the Symptoms of Multiple Myeloma?
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Common symptoms include:
1.Anemia or pallour can occur as myeloma cells replace oxygen-carrying red blood cells in your bone marrow,
2.fatigue
3.Bone pain.
4.Nausea
5.Loss of appetite
6.Mental confusion
7.Presence of abnormal proteins produced by myeloma cells in your blood or urine. These proteins which are antibodies are called monoclonal, or M, proteins.
8.High level of calcium in your blood. This can occur when calcium from affected bones dissolves into your blood. A high calcium level in your blood may cause symptoms such as:
9.Excessive thirst and urination
10.Constipation

How do you diagnose Multiple Myeloma?
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Multiple myeloma can be diaqgnosed before you ever have symptoms through blood and urine tests.Blood and urine tests
1.blood test called serum protein electrophoresis separates your blood proteins and can detect the presence of M proteins in your blood.
When found in urine, they're referred to as Bence Jones proteins.
2.Another blood test to check for beta2-microglobulin — another protein produced by myeloma cells
3. Imaging.
a.X-rays of your skeleton can show whether your bones have any thinned-out areas, common in multiple myeloma.
b. magnetic resonance imaging (MRI) or computerized tomography (CT) scanning.
4.Bone marrow examination is done by using a needle to remove a small sample of
bone marrow tissue. The sample is then examined under a microscope to check for myeloma cells.

What are the Complications of multiple myeloma?
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Multiple myeloma can result in several complications:
1.Impaired immunity. Myeloma cells inhibit the production of antibodies needed for normal immunity which may make you more likely to develop infections, such as pneumonia, sinusitis, bladder or kidney infection, skin infections and shingles.

2.Bone problems. Multiple myeloma also can affect your bones, leading to erosion of bone mass and fractures. The condition may cause compression of your spinal cord. Signs of this medical emergency include weakness, or even paralysis, in your legs.

3.Impaired kidney function.
Higher calcium levels in the blood related to eroding bones can interfere with your kidneys' ability to filter your blood's waste. The proteins produced by the myeloma cells can cause similar problems, especially if you become dehydrated.

4.Anemia. As cancerous cells crowd out normal blood cells, multiple myeloma can also cause anemia and other blood problems.

What are the Treatment of Multiple myeloma ?
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There is no cure for multiple myeloma.
However, with good treatment results you can usually return to near-normal activity.
The appropriate multiple myeloma treatment depends on the stage of the illness, medical status and general health.
Chemotherapy.
Chemotherapy involves using
1.Anti Cancer medicines taken orally as a pill or given through an intravenous (IV) injection to kill myeloma cells. Chemotherapy is often given in cycles over a period of months, followed by a rest period.
2.Corticosteroids. Corticosteroids such as prednisone and dexamethasone (Decadron) have been used for decades to treat multiple myeloma.
3.Thalidomide is currently FDA-approved in conjunction with the corticosteroid called dexamethasone for the treatment of newly diagnosed cases of multiple myeloma. This drug is given orally.

Radiation therapy.
This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to target myeloma cells in a specific area to more quickly shrink a tumor that's causing pain or destroying a bone.

Stem cell transplantation.
This treatment involves using high-dose chemotherapy usually high doses of melphalan along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells can come from you or from a donor, and they may be from either blood or bone marrow

Treating complications
Back pain. Taking pain medication or wearing a back brace can help relieve the back pain you might experience with multiple myeloma.
Infections. Antibiotics may be necessary to help treat infections or to help reduce your risk of them.
Bone loss. You may take medications called bisphosphonates which bind to the surface of your bones and help prevent bone loss.
Anemia. If you have persistent anemia, your doctor may prescribe erythropoietin injections. Erythropoietin is a naturally occurring hormone made in the kidneys that stimulates the production of red blood cells. .
Kidney complications. People with severe kidney damage may need dialysis

A Simple Guide to Lymphoma

A Simple Guide to Lymphoma
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What is Lymphoma?
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Lymphoma is a cancer of the tissue of the lymphatic system where there is a large number of abnormal white blood cells called lymphocytes causing swelling of lymph nodes or involvement of the other organs.
This can disrupt the immune-system cells and reduce a person's ability to resist infections and diseases. The lymph nodes become swollen forming painless lumps or tumours.
Although lymphomas usually begin in a lymph node, it also can originate in the stomach, intestines, skin or any other organ that contains lymphoid tissue.
Lymph nodes are found anywhere in the body, particularly in the neck, armpits, groin, above the heart and around the big blood vessels inside the abdomen.

Who are at risk of getting Lymphomas?
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1.Men are at a higher risk of getting lymphomas.
The disease is uncommon among younger men.
It often develops after the age of 50.

2. past history of severe viral infections which lowers your immune system eg. HIV virus

3.history of organ transplants and on immuno suppressive drugs

4.history of cancer and previous treatment with chemtherapy or radiation therapy

5. frequent exposure to chemicals, solvents,pesticides

6.family history of lymphoma

What are the types of Lymphoma?
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There are two main types of lymphoma.
They are:
Hodgkin's Disease
Hodgkin's disease is characterised by the presence of a specific type of abnormal cell called the Reed-Sternberg cell. This cancer can spread throughout the lymphatic system, affecting any organ or lymph tissue in the body.
Hodgkin's disease usually attack people in their late 20s or older than 50.

Non-Hodgkin's Lymphoma
Most lymph cancers are non-Hodgkin's lymphomas.
There are many types of non-Hodgkin's lymphomas.
Non-Hodgkin's lymphomas develops in the age group of 60 - 70.
Different types of lymphoma occur in different age groups.

1.Adult non-Hodgkin's lymphoma is classified by the size, shape and arrangement of the cancer cells in the lymph node. The appearance will determine the type of non-Hodgkin's lymphoma. The degree or seriousness of the disease is broken into three types (grades) -
1.low-grade (slower-growing),

2.intermediate grade and

3.high-grade (aggressive).

These grades are crucial in determining the treatment options to treat the cancer.

2.Childhood non-Hodgkin's lymphomas include lymphoblastic lymphoma, large cell lymphoma and small non-cleaved cell lymphoma (including Burkitt's and non-Burkitt's lymphomas).

What are the Symptoms of Lymphoma?
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The most common symptom associated with lymphoma is
1.lymph node swelling. A painless swelling initially surfaces in the early stages of the cancer. This swelling may persist or increase in size. The most common affected areas would be the neck, armpits or groin.
Other symptoms are:

2.unexplained constant fever,

3.sudden weight loss,

4. itchy skin or rashes,

5. night sweats and

6. abdominal pain

What are the causes of Lymphomas?
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There is no known cause for lymphomas.
However, it has been closely linked to several factors -
1) environmental influences, Environmental influences may take the form of extreme exposure to certain chemicals like herbicides and insecticides.

2) genetic factors
There are inherited immune-deficiency disorders from birth such as Wiskott-Aldrich syndrome which have been blamed for the cause of genetic factors that result in lymphomas.

3) viral infections. Viral infections such as the Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV) have been associated with lymphomas.

What is the Treatment of Lymphoma?
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Hodgkin's Disease can only be treated with radiation therapy using high-energy X-rays to kill lymphoma cells in the affected area. This procedure may also be combined with chemotherapy.

Treatment for non-Hodgkin's lymphoma, can vary.
The treatment is based on the degree of grade of the disease.
1.Early stage and low-grade (slow-growing) lymphoma can be treated with radiation therapy and sometimes just simple observation is enough.

2. intermediate-grade lymphoma may be treated with chemotherapy.
The drugs are either injected directly into the bloodstream or swallowed as pills.
Each course of treatment is given at regulated intervals to kill cancer cells and allow the body to recover. The drugs circulate throughout the body and will reach cancer cells even when they are widespread.

Patients who are suffering from the more advanced stages and high-grade (aggressive) lymphomas will require a higher dosage of chemotherapy.
However, the high dosage has its own side effects.
Too much of it may kill healthy bone marrow that produces white and red blood cells and platelets (cells that prevent bleeding). Therefore, to assist patients tolerate the high dosage of chemotherapy treatment, stem cells or bone marrow from the patient or donor are collected beforehand. After a patient has received the chemotherapy, the stem cells or bone marrow are returned to the patient through a drip in a vein.

In addition to the above treatment methods, another option for treating lymphomas would be biological therapy. This procedure uses products such as immunoglobulin that boost the body's own immune system to fight cancer.
This therapy may be used alone or combined with chemotherapy.

In conclusion, the type of treatment sought or used depends very much on the stage, and grade of the lymphoma when diagnosed and the age and health of the patient.
Most doctors will advise their patients on the various treatment options that are the most beneficial and appropriate whilst considering the factors mentioned above.

What are the Prevention measures for Lymphomas?
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1.Where exposure to some toxins and chemicals which are known to cause lymphomas are possible, one should be properly attired and guarded from these chemicals, so as to decrease the risk of developing the disease.

2.Since HIV / AIDS carriers are also related to lymphomas, one should be aware of the importance of safe sex and should stay away from drugs, as far as possible.

3.regular visits to the family doctor helps in detecting any sign or symptom that may eventually lead to the cancer.

4.healthy lifestyle and proper balanced diet are always important in the prevention of any cancer.

A Simple Guide to Stomach Cancer

A Simple Guide to Stomach Cancer
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What is Stomach Cancer?
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Stomach cancer (also called “gastric cancer”) is the growth of abnormal cells in the lining and wall of the stomach which mutates and proliferates giving rise to the stomach cancer .
Stomach Cancer can spread to the surrounding organs like liver,pancreas and colon.
Once in the blood stream it can spread to the brain, bones and kidneys.

Who is at risk of getting Stomach Cancer?
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1. Chronic Helicobacter pylori bacteria infection. This bacteria is found in the stomach and has been found to cause gastric ulcers and stomach cancer.

2. family history of stomach cancer

3. frequent consumption of preserved or smoked food such as salted vegetables,fish,meat. Cancer causing nitrosamines are released when these food are cooked.

4.previous stomach surgery with partial removal of stomach (gastric ulcers or polyps)

5. Pernicious anaemia- a rare blood disorder affecting the red blood cells

6. Smoking

7. Men are affected more than women

8. Age above 50 years of age

9.People with blood group A has a higher incidence

What are the symptoms of Stomach Cancer?
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In the early stages, stomach cancer may have no symptoms.

As it spread it can cause the following symptoms:

1.Indigestion, stomach discomfort or heartburn

2.A fullness feeling or bloating after eating a small meal

3. loss of appetite

4.Nausea or belching

5. Feeling tired

When the cancer is larger, it can cause the following symptoms:

1.Stomach pain

2.Vomiting

3.Blood in your stool or black tarry stools

4.Unexplained weight loss

5.pallour due to anaemia from loss of blood

Many of these symptoms can be caused by other conditions besides cancer.
So the earlier stomach cancer is found, the better are the chances of it being cured.

How do you diagnose Stomach Cancer?
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1.medical history and complete physical exam.

2.Abdominal X-ray for any other condition in the abdomen causing pain or swelling in the abdomen

3.Gastroscopy:
a thin, lighted tube is put into your mouth and passed down to your stomach.

4.Biopsy:
During gastrocopy, a small piece of your suspicious stomach tissue is taken to check for cancer cells. This is called a biopsy sample which is then examined under a microscope for cancer cells.

How is stomach cancer treated?
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Treatment for stomach cancer may include surgery, chemotherapy or radiation therapy, or a combination of these treatments. The choice of treatment depends on whether the cancer is just in the stomach or if it has spread to other places in the body. A person’s age and overall health will also affect the choice of treatment.

Surgery
Surgery is still the best form of treatment for stomach cancer.
For smaller cancers -partial removal of the stomach is done.
In early stages cure rate is about 90%.
For later stages of cancer, the whole stomach including the spleen and surrounding tissues may be removed.

Chemotherapy
Chemotherapy is used in conjunction with surgery in later stges of cancer.

Radiotherapy:
Radiation can help to kill the cancer cells surrounding the stomach cancer as well as to relieve pain.

Can I prevent stomach cancer?
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There is no way to prevent stomach cancer.
However, you can help reduce your risk of getting stomach cancer by:
Living a healthy lifestyle

Not drinking a lot of alcohol or smoking.

Avoid preserved food

Treat H.pyrori infections of the stomach early.

Eat a diet high in fresh fruits and vegetables, and vitamin C.
Vitamin C is found in foods such as oranges, grapefruit and broccoli.

AS IN ALL CANCERS, EARLY DETECTION IS THE BEST CURE!!

A Simple Guide to Bladder Cancer

A Simple Guide to Bladder Cancer

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What is Bladder Cancer?

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Bladder cancer is a growth of abnormal cells forming a malignant tumour in the bladder. Most bladder cancers start in the inner lining of the bladder.

What are the different types of Bladder Cancer?

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There are 2 main types of Bladder Cancer:

1.superficial cancer

the cancer is contained on the inner lining of the bladder.

They may occur as a small, wart-like growths on the inside of the bladder, which can be removed in a simple operation and usually will never recur.

2.invasive cancer

where the cancer has spread into the muscle wall of the bladder.

Examples are:

a.large growth in the muscle wall of the bladder, which requires major surgery to remove.

b.mushroom-like growths( papillary cancers)on the inside lining of the bladder. They have a short stem attached to the lining of the bladder and can spread into the wall of the bladder.

Treatment is different for these two types of bladder cancer.

What are the causes of Bladder Cancer?

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There are a few factors which increase the risk of getting bladder cancer:

1.Smoking

chemicals in a cigarette have been found to contribute to bladder cancer. The more cigarettes smoked, the greater the risk.

2.Exposure to harmful, cancer-causing chemicals

Certain chemicals at the workplace, for example, those used in dye factories, rubber, gasworks, plastics and other chemical industries, can cause a higher risk of contracting bladder cancer in workers.

It can take about 25 years after exposure to these chemicals before bladder cancer develops.These chemicals may have been banned in some countries.

3.Frequent bouts of cystitis

Cystitis caused by repeated bacterial infections and bladder stones can lead to the development of bladder cancer.

4.Age and Gender

Bladder cancer occurs mostly among people aged between 50 - 70 years.

It is twice as common in men as in women.

It is rare in people below age 40.

What are the symptoms of Bladder Cancer?

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The most common symptom is

1.blood in the urine which usually occurs suddenly and is generally not painful.

The blood may not be present constantly but eventually it does recur.

In some cases, blood clots can form and these may cause painful muscle spasms in the bladder. The amount of blood present is however not related to the extent of the cancer.

2. burning feeling when they pass urine.

3. frequency of urination.

While these are also symptoms of bladder irritation, further tests would be necessary if they persist and do not clear with antibiotics.

How can Bladder Cancer be treated?

------------------------------------------

The treatment for bladder cancer depends on the type of cancer, the stage and grade.

It also depends on the health of the patient.

Superficial cancers:

Superficial cancers, which can be single or multiple, are usually removed using a cystoscope. Anti-cancer drugs (chemotherapy or immunotherapy) may be instilled into the bladder to try to prevent the cancer recurring.

Invasive cancers

the options are as follows:

Surgery

The most common treatment method is surgery to remove a part of the bladder.

A new bladder is sometimes constructed if it has to be removed.

Radiotherapy

Radiotherapy may be used instead of surgery to avoid removal of the bladder. Radiotherapy may also be used before surgery in cases of large tumours to facilitate the tumour removal or if there is a high risk of cancer cells left behind after surgery.

Chemotherapy

In some cases, chemotherapy is given before surgery or radiotherapy to shrink the tumour so that it can be treated more effectively. Chemotherapy is also applied after surgery to reduce the recurrence of the tumour.The drug can be instilled into the bladder to maximise contact with the cancer cells.

Once the cancer has spread outside the bladder, the main treatment is chemotherapy.

Removal of bladder

------------------------

In a small proportion of people with bladder cancer, the bladder may completely removed.

The surgeon will then give the patients an urostomy - an artificial opening from the urinary tract.The opening is usually formed on the abdomen, to the right of the navel. Wrinkles, scars and prominent underlying bones must be avoided, as placing the opening near them may cause problems with leakage later on.

Ensure that the bag is emptied and changed as often as necessary.

At first the opening will be slightly swollen.

It may take several weeks for it to reduce to its normal size.

There may also be mucus (a thick white substance) from the opening. The amount of mucus will gradually reduce over time but will never disappear completely.
Most people with an urostomy live a normal life. Many return to their jobs and take up their favourite pastimes again, including swimming.
Now with advancement of plastic surgery a new bladder can be constructed easily and the days of urostomy may be over.

A Simple Guide to Ovarian Cancer

A Simple Guide to Ovarian Cancer
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What is Ovarian Cancer?
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Ovarian Cancer is a disease which cause abnormal cells in the ovary to proliferate and spread to the rest of the ovary or outside the ovary.

What are the different types of Ovarian Cancer?
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Most experts group ovarian cancers within three major categories, according to the kind of cells from which they were formed:

1.epithelial tumors arise from cells that line or cover the ovaries;

2.germ cell tumors originate from cells that are destined to form eggs within the ovaries; and

3.sex cord-stromal cell tumors begin in the connective cells that hold the ovaries together and produce female hormones.

The most common type, the epithelial carcinoma, that begins from the surface of the ovary is discussed here.

Who is at risk of Ovarian Cancer?
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The cause of cancer of the ovary is unknown.
However, studies show that certain factors may increase the chance of developing this disease. 1.family history of ovarian cancer.

2.history of cancer of the breast or colon.

3.age over 60 years.

4. Infertility or not having children. The more children you have, the lesser your risk is.

5.Early menstruation before the age of 12

6.late menopause

7.high fat diet

8.Use of fertility drugs, or Hormone Replacement Therapy (HRT).

Attempts are being made to detect early stages of ovarian cancer, especially among women who have an increased risk. A blood test is done to check for a substance called CA 125.
If the sample contains raised amounts of CA 125, an ultrasound scan may be done to see if your ovaries appear abnormal in any way.

What are the Symptoms of Ovarian Cancer?
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Ovarian cancer is the most dangerous of gynaecological cancers because it is often silent and difficult to detect.There is no early detection method, so you must be vigilant and take note of persistent warning signs seriously.

If you are having some of the following symptoms persisting for more than a week or so, see your doctor.
1.Vague gastrointestinal symptoms such as gas, indigestion, nausea and a bloated feeling

2.Swelling in the abdomen, unexplained weight gain

3.Pelvic or abdominal pain or discomfort, and/or feeling of fullness

4.Urinary symptoms e.g. frequency and/or urgency of urination in the absence of an infection

5.Unexplained or changes in bowel habits

6.Loss of appetite/loss of weight

7.backache or pain inthe legs

8.Abnormal vaginal bleeding, although this is rare

If you do have any of the above symptoms you must have them checked by your doctor. Remember, they are non specific and most women with these symptoms will not have cancer.

How do you make the diagnosis of Ovarian Cancer?
-----------------------------------------------------------

If you are at risk of ovarian cancer, see your gynaecologist regularly.

The following may be done:
recto-vaginal bimanual pelvic exam,

Pap smear,

blood test for CA-125

transvaginal ultrasound

What are the treatment of Ovarian Cancer?
---------------------------------------------------

Treatment depends on a number of factors, including the stage of the disease (the extent of spread of the disease) and the general health of the patient.
Surgery, chemotherapy and various types of radiotherapy may be used alone, or in combination to treat ovarian cancer.

Surgery
Surgery is normally the first choice of treatment for ovarian cancer, and may sometimes also be needed to make the diagnosis. If detected is in the early stages, surgery is all the treatment that may be required. The ovaries, fallopian tubes, uterus and cervix are usually removed. The omentum and lymph nodes in the abdomen are often removed too.

If the surgeon feels the cancer may be difficult to remove, a few cycles of chemotherapy may be applied first and surgery carried out thereafter, in the hope that the tumour would have been reduced.

Chemotherapy
Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control cancer growth or to relieve symptoms of the disease. Sometimes a few cycles of chemotherapy may have to be applied before surgery is carried out.

Radiotherapy
Radiotherapy is less commonly used in this cancer but may sometimes be used to treat individual areas of cancer which have recurred after surgery and chemotherapy.

Hormone Therapy

There have been many reports of the potential benefits of hormone treatments in patients with ovarian cancer that does not respond to conventional therapy.

Some patients with treatment-resistant (refractory) epithelial cancers have been treated with:
1.progestins - crude forms of the female sex hormone progesterone;

2.estrogens - for example, diethylstilbestrol
3.combination estrogen/progestin therapy;
4.antiestrogens - tamoxifen;
5.androgens - male sex hormones for example, Halotestin
6.gonadotropin-releasing hormone (GnRH) - a hormone of the hypothalamus that stimulates the release of ovary-related hormones from the pituitary gland.

Gene Therapy

Gene therapy eventually may provide some control over cancer susceptibility and its treatment. Ovarian cancer, like all cancers, is believed to result from a build-up of genetic defects within the cells.Genetic engineers hope to correct such damage by transplanting copies of normal genes into cells with genetic defects. However at the moment gene therapy is still experimental.

A Simple Guide to Alopecia(Hair Loss)

A Simple Guide to Alopecia(Hair Loss)
------------------------------------

What is Alopecia(Hair Loss)?
-----------------------------------

Alopecia or Hair Loss is the partial or complete loss of hair in the scalp, armpit or other areas of the body to the extent that skin is evident and sparse amount of hair is present or completely absent. Hair loss usually develops gradually and may be patchy or diffuse (all over)

Who get Alopecia?
-----------------------

Hair loss is experienced by both men and women, young or old.

The most common type of hair loss is called

1.male pattern baldness or androgenetic alopecia.

Its causes have been linked to genes, hormones and age.

Other types of hair loss are:

2. an auto-immune condition known as patchy hair loss (alopecia areata),

3.temporary hair loss (telogen effluvium),

4.compulsive hair pulling (trichotillomania) and

5.traction alopecia.

What is the cause of Alopecia?
-------------------------------------

The hair is made up of keratin, the same protein that is found in nails and the outer layer of our skin. The average adult has more than 100,000 strands of hair on his scalp.

It is normal to lose about 50 to 100 strands every day.

Old strands of hair are shed so that new ones can grow out of the hair follicles.

However, various factors can lead to sudden or excessive shedding such as:
1.genes(Male pattern baldness, Congenital),

Genetic baldness is caused by the body's failure to produce new hairs and not by excessive hair loss.

Some women also develop a particular pattern of hair loss due to genetics, age, and male hormones that tend to increase in women after menopause.

The pattern is different from that of men. Female pattern baldness involves a thinning throughout the scalp while the frontal hairline generally remains intact.

Congenital Alopecia occurs in a new born who does not develop any more hairs.

2.hormones(excessive DHT or dihydrotestosterone)

Androgens appear to play a role in male pattern baldness. These very same hormones trigger the growth of hair in the pubic, underarm and facial areas at puberty. People with male pattern baldness may have the same male hormone levels as normal people, but these hormones seem to accumulate in certain areas of their scalp and cause the hair follicles there to regress.
Women are protected from male pattern baldness because they produce less androgens, and because their female hormones, estrogen can counter the effect of their male hormones. However, women who produce excess androgens may have male pattern baldness.

Other hormones, such as those from your thyroid glands, can also affect your hair.

Too much or too little hormones from your thyroid gland can cause hair loss.

3.stress,

Sudden emotional stress can also trigger patchy baldness (alopecia areata) or temporary hair loss (telogen effluvium). Temporary hair loss may also be triggered by the stress of giving birth or losing a loved one.

4. Medical conditions

Some medicines, such as blood thinners (anti-coagulants), birth control pills, anti-depressants, anti-thyroid drugs or drugs used in chemotherapy, may cause hair loss.

5.Improper hair care

Having a hairstyle that exerts too much pull(traction) on the scalp can cause your hair to turn brittle and break. Hair breakage can also be caused by over-shampooing and the excessive use of chemical treatments such as dyes, tints, bleaches, and permanent waves.

6.Burns - Excessive heat damages the cells of the skin including the hair roots.

7.Infectious diseases such as syphilis and fungal infection can cause damage to the hair roots.

What are the Signs and Symptoms of Alopecia?
-------------------------------------------------------

Male pattern baldness (or androgenetic alopecia) accounts for the majority of all hair losses. This is the most common type of baldness in men, especially older men.

It can also occur in some women, though the instances are rare.

Hair loss is usually gradual.

The hair loss pattern differs between the sexes.

In men, the hair loss usually starts with a receding hairline.

In women, there is a diffuse thinning of the crown.

Male pattern baldness in women is usually not as severe.

Besides male pattern baldness, there are various other types of hair loss.

Patchy baldness (alopecia areata): Here a few bald patches suddenly appear.

Emotional stress(eg examinations) appears to be a triggering factor.

This condition can progress to more serious forms in which all the scalp and body hair may be lost (alopecia totalis).

Temporary hair loss (telogen effluvium): Here clumps of hair begin to fall out suddenly over a few days. It can be caused by severe stress, childbirth, severe illnesses, surgery and some medications. As its name implies, its effect is usually temporary.

Recovery though may take a year or longer depending on the cause.

Compulsive hair pulling (trichotillomania): This causes hair breakage and usually leaves the scalp undamaged. It usually affects children and women and has been linked to a psychological cause.

Traction alopecia: This is hair loss caused by certain hairstyles such as ponytails, buns or braids that pull excessively on the hair.

What tests can be done in Alopecia?
-------------------------------------------

1.Microscopic examination of a plucked hair

2.Skin biopsy (if skin changes are present)

Ringworm on the scalp may require the use of an oral drug, such as griseofulvin, because creams and lotions applied to the affected area may not get into the hair follicles to kill the fungus.

What is the Treatment and Prevention of Alopecia?
--------------------------------------------------------------

It is important to determine the underlying cause before treatment.

Most of the conditions are temporary and can be resolved once the underlying cause such as stress is removed.

However, male pattern baldness may have a permanent effect.

There has been some medical progress in helping these people regain their hair.

Two medications Finasteride and Minoxidil work by stimulating the regrowth of hair in hair follicles.

1.Finasteride counteracts the effects of the male hormone testosterone. It is available only by prescription and is taken orally. It is approved for use only in men and is not recommended in women because of its link to birth defects. Finasteride takes a few months to show its effect.
2.Minoxidil is available over the counter. . It is applied on the scalp and works by reversing the regression of hair follicles caused by hormones.It takes a few months before any effect can be seen.

Alopecia areata is sometimes treated by steroid injections into the affected scalp areas while any underlying scalp problems such as tinea capitis (fungal infection) should be treated accordingly.

Causes of telogen effluvium should be addressed and given professional guidance by psychiatrist if necessary. Those due to childbirth should recover spontaneously within a year.
Hair loss from menopause or childbirth often returns to normal 6 months to 2 years later.

For hair loss caused by illness (such as fever), radiation therapy, or medication use, no treatment is necessary. The hair will usually grow back when the illness has ended or the therapy is finished. A wig, hat, or other covering may be desired until the hair grows back.

For hair loss due to heredity, age, and hormones, the topical medication minoxidil can be helpful for both male and female pattern baldness. You may need to wait 6 months before you see results.

The oral medication Propecia (finasteride) is effective in some men. This medicine can decrease sex drive.

When either medication is stopped, the former baldness pattern returns.

Hair transplants performed by a physician is a surgical approach to transferring growing hair from one part of the head to another. It is somewhat painful and expensive, but usually permanent.

Hair weaves, hair pieces, or changes of hair style may disguise hair loss. This is generally the least expensive and safest approach to hair loss. Hair pieces should not be sutured to the scalp because of the risk of scars and infection.

A Simple Guide to Prostate Cancer

A Simple Guide to Prostate Cancer

-----------------------------------------

What is prostate cancer?

------------------------------

Cancer of the prostate occurs when the cells of the prostate gland mutates and turn cancerous.

Prostate cancer is a group of abnormal cells in the prostate which is a gland about the size of a walnut found in men between the bladder and rectum.

It produces and secretes prostatic fluid, one of the main components of semen.

How does prostate cancer occur?

---------------------------------------

Prostate cancer occurs when a malignant (harmful) tumour develops inside the gland. This could be caused by the male hormone testosterone.

However, the exact cause of prostate cancer is not known.

What are the types of Prostate Cancer?

----------------------------------------------

Prostate cancer can be

1.aggressive, which means it grows quickly and spreads to other parts of the body, such as the bone.

2.slow-growing, where the cancer patient can expect to live as long as men who do not have cancer. Most patients with slow-growing cancer will never have symptoms.

Three out of four cases of prostate cancer are of the slow-growing type that is relatively harmless.

What are the symptoms of prostate cancer?

----------------------------------------------------

Those with prostate cancer may experience similar symptoms to those with enlarged prostate gland and prostatitis (infection of the prostate gland), such as:
1.Difficulty starting to urinate

2.Having an interrupted or weak flow of urine

3.Dribbling after you finish urinating

4.Urinating too frequently, especially at night

5.Blood or pus in the urine

6.Pain or burning feeling while urinating

Other symptoms include:

1.Being unable to have an erection

2.Having blood in the semen

3.Constant pain in the hips, upper thighs or lower back area

Who is affected by prostate cancer?

------------------------------------------

Prostate cancer usually develop slowly, and is seldom the sole or final cause of death.

Men over 65 years of age are more likely to be diagnosed with prostate cancer.

However, men aged 50 and above with a close relative who has had prostate cancer before 60 years of age, have a higher risk and should go for screening.

How can prostate cancer be detected?

--------------------------------------------

Your doctor may examine your prostate by putting a gloved, lubricated finger a few inches into your rectum to feel your prostate gland. A normal prostate feels firm. If there are hard spots on the prostate, your doctor may suspect cancer.It is difficult to detect prostate cancer accurately.

The current approach is to measure the amount of prostate-specific antigen (PSA) present in the blood. PSA is a protein produced by the prostate. However, this test is not always reliable. This is because infections or an enlarged prostate can also increase PSA levels and affect the test results.

Thus, a biopsy is normally used to confirm the diagnosis.

How is prostate cancer treated?

-------------------------------------

Surgery, radiation and drugs are the main treatment options.

They can cure prostate cancer if it's caught early.

However, these treatments can cause serious problems, such as impotence and incontinence.

Surgery or radiation may help treat the more aggressive cancers that are most often found in middle-aged men.

In serious cases, the tumour in the prostate gland can be removed with surgery.

After surgery, it is important that the patient has a healthy diet to build up strength and resistance. The patient must also be monitored closely, as in some cases the cancer could recur.

In rare cases,chemotherapy may be necessary for cancer which has spread to outside of the prostate.

Some mild cases may not require surgery, but require regular monitoring by doctors.

The treatment decision will depend on a combination of clinical and psychological factors.

Men diagnosed with localised prostate cancer today will likely live for many years.

Careful consideration of the different options is an important first step in deciding on the best treatment course.
Consultation with all three types of prostate cancer specialists—a urologist, a radiation oncologist and a medical oncologist—will offer the most comprehensive assessment of the available treatments and expected outcomes.

A Simple Guide to Colorectal Cancer

A Simple Guide to Colorectal Cancer
--------------------------------------------

What is Colorectal Cancer?
--------------------------------

is one of the commonest cancer among males and females in the world. Colorectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Colorectal cancer can be effectively treated if detected early.

What is the cause of Colorectal Cancer?
-----------------------------------------------

Colorectal cancer occurs when cells from the intestinal wall grow and spread uncontrollably.
It may begin as polyps (growths) in the large intestine and rectum. Polyps should be monitored regularly and removed upon detection to prevent them from developing into cancer.

Who are at risk of Colorectal Cancer?
--------------------------------------------

As with most cancers, the risk of developing colorectal cancer increases with age.
People at high risk include those with:
1. family history of personal history of endometrial, ovarian or breast cancer
3. personal history or family history of gastrointestinal polyps
4. history of inflammatory bowel disease such as chronic ulcerative colitis or Crohn's disease.
5. Cancer elsewhere in the body
6. Certain genetic syndromes also increase the risk of developing colon cancer.

What you eat may play a role in your risk of colon cancer.
Colon cancer may be associated with a high-fat, low-fiber diet and red meat.
However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear.

What are the Symptoms of Colorectal Cancer?
------------------------------------------------------------------

In its early stages, the cancer usually has no symptoms, which is why regular screening is important to see if it could be present.
The most common symptom of colorectal cancer, especially if it is located in the lower part of the large intestine, is changes in bowel habits. For some, it may be an increase in the number of bowel visits to the toilet, and for others, it may be constipation. Still others may complain of constipation with overflow diarrhoea, i.e., difficulty in passing motion but stools flow out without any control.
Other symptoms include
bloody or black stools from bleeding of the tumour (blood appears black on digestion in the intestines),
fatigue, appetite and weight loss of unknown cause,
Unexplained anemia
abdominal pains, cramps or bloating in the lower abdomen
Intestinal obstruction
Narrow stools
With proper screening, colon cancer can be detected BEFORE the development of symptoms, when it is most curable.

What are the signs of Colorectal Cancer?
-----------------------------------------------

The physical exam rarely shows any problems, although an abdominal mass may be felt in late cases.
A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.

How do you Screen for Colorectal Cancer?
--------------------------------------------------

People over the age of 50 years are advised to screen for colorectal cancer, even if they have no symptoms.
A Faecal Occult Blood Test (FOBT>) is recommended once every year.
If the results are positive, other tests like a sigmoidoscopy, barium enema and colonoscopy may be required.
A complete blood count may reveal show signs of anemia with low iron levels.

What is the treatment of Colorectal Cancer?
-----------------------------------------------------

Surgery:
is the main treatment.
In surgery, the part of the large intestine containing the cancer is removed.
In some cases, the two ends of the colon can be rejoined.
Sometimes an opening called a stoma has to be left in the abdominal for the removal of waste. This opening may be temporary or permanent.
Radiation Therapy:
destroy the cancer cells with minimal damage to surrounding tissue. It is used to prevent recurrence of the cancer and for pain relief. Side effects include skin irritation,nausea,vomiting and lethargy.
Chemotherapy:
is used to kill the cancer cells in the colon and rectum as well as to prevent a recurrence.
Side effects may be quite severe with loss of hair, weight, appetite, nausea, vomiting, rashes.

Which treatment is used depends on the staging of the cancer using additional tests.
Staging of the Cancer:
---------------------------
Stage 0: Very early cancer on the innermost layer of the intestine
Stage I: Cancer is in the inner layers of the colon
Stage II: Cancer has spread through the muscle wall of the colon
Stage III: Cancer has spread to the lymph nodes
Stage IV: Cancer that has spread to other organs

Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy.
For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous.
There is some debate as to whether patients with stage II colorectal cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.
Almost all patients with stage III colorectal cancer should receive chemotherapy after surgery for approximately 6 - 8 months. The chemotherapy drug 5-fluorouracil given has been shown to increase the chance of a cure in certain patients.
Chemotherapy is also used to treat patients with stage IV colon cancer.

Irinotecan, oxaliplatin, and 5-fluorouracil are commonly used drugs. You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluroruracil.

For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include cutting out the cancer, burning it (ablation), or freezing it (cryotherapy). Chemotherapy or radiation can sometimes be delivered directly into the liver.
While radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.

What is the Prognosis(outcome) of Colorectal Cancer?
----------------------------------------------------------------

How well a patient does depends on many things, including the stage of the cancer.
In general, when treated at an early stage, more than 90% of patients survive at least 5 years after their diagnosis.
However, only about 40% of colorectal cancer is found at an early stage.
The 5-year survival rate drops considerably once the cancer has spread.
If the patient's colon cancer does not come back (recur) within 5 years, it is considered as cured.
Stage I, II, and III cancers are considered potentially curable.
Stage IV cancer is not curable in most cases.

How to prevent Colorectal Cancer?
-----------------------------------------

Prevention of Colorectal Cancer involve:
1. early and regular screening,
2. lifestyle changes:
Maintain a balanced diet low in animal or saturated fat such as butter, coconut oil, ghee and lard.
Diets high in total fat, protein, calories and meat, and low in calcium are associated with an increased incidence of colorectal cancer.
Increase your intake to at least 2 servings of fruits and vegetables each day. Studies have shown that very low intake of fruits and vegetables is associated with an increased risk of colorectal cancer.
Quit smoking. Cigarette smoke contains many chemicals that promote the development of many types of cancers.
Increase physical activity. Physical activity promotes general health and reduces your risk of colorectal cancer.
Maintain your BMI within the healthy range of 18.5 to 22.9 (kg/m2).

The death rate for colorectal cancer has dropped in the last 15 years.
This may be due to increased awareness and screening by colonoscopy.
Colorectal cancer can almost always be caught in its earliest and most curable stages by colonoscopy.
Almost all men and women age 50 and older should have a colonoscopy.

Other types of colorectal cancer such as lymphoma, carcinoid tumors, melanoma, and sarcomas are rare. The colorectal cancer referred to in this article refers to Colorectal carcinoma.

A Simple Guide to Breast Cancer

A Simple Guide to Breast Cancer
--------------------------------------

What is Breast Cancer?
---------------------------

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. It is the most common type of cancer among women.

How does Breast Cancer Presents?

-----------------------------------------

Breast Cancer occurs as uncontrolled growth of mutated (abnormal) cells from the breast tissues.

It occurs as in 2 main forms:
1.preinvasive cancer:

Preinvasive breast cancer is confined to the breast ducts or lobules and the cancer cells do not have the abilty to spread. It is classified as Stage 0 Breast Cancer (carcinoma-in-situ).

2.invasive cancer:

Invasive Breast Cancer occurs when the cancer cells spread to the surrounding tissues of the breasts and then to the lymph nodes under the armpits.
These cancer cells can also spread to other parts of the body like the lungs, liver and bones.
Invasive breast cancer is classified into 4 stages from Stage 1 to 4 according to severity, stage 4 being the most severe.

What are the Risk factors in Breast Cancer?
----------------------------------------------------

All women are at risk of breast cancer and the risk increases with age.
Main risk factors are:
1.family history of breast cancer,

2 past medical history of breast cancer and ovarian cancer,

3.Menstruating at an early age.

4.late menopause or

5.having your first child after age 30 or never having given birth.

6.Taking hormones such as estrogen and progesterone.

What are the signs of Breast Cancer?
-------------------------------------------

Signs, which may indicate Breast Cancer, are:
1.a painless lump in the breast or armpit

2.abnormal discharge from the nipple

3.changes in the skin over the breast or nipple

4.new retraction (pulling in) of the nipple

5.persistant rash around the nipple

How do you diagnose Breast Cancer?
------------------------------------------

1.Breast Self Examination (BSE)
-----------------------------------
It is very important for every woman above aged 30 years old to learn, and practise BSE regularly once a month, about a week after each menstrual period. Women who no longer have periods should practise BSE on a fixed date each month.

2.Mammography
------------------
1.Women aged 40 - 49 years are encouraged to go for regular mammography every year 2.Women 50 years and above should go every two years.
3.Women who are at higher risk of developing breast cancer should see a doctor for advice. You may need to go for screening earlier and more frequently.
Mammography is a low-dose X-ray of the breast using specially designed X-ray machine.
It is the most effective method to detect very small lumps in the breast even before they can be felt by the hand.

3.Ultrasound of the Breasts
-------------------------------
Ultrasound of the Breasts is used together with mammography in cases where the diagnosis of possible cancer of the breast is not confirmed.
The ultrasound may be able to detect small lumps, which are not detected by mammogram.

4.MRI (magnetic resonance imaging) of the Breasts
----------------------------------------------------------
MRI is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas in the body. With advancement of technology, a MRI of the breasts can detect even more clearly any abnormal lumps or tissues in the breasts.

5.Estrogen and progesterone receptor test:
-----------------------------------------------
A test to measure the amount of estrogen and progesterone (female hormones) receptors in cancer tissue. The test results show whether hormone therapy may stop the cancer from growing.

6.Biopsy:
-----------
The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, the doctor may need to cut out a small piece of the lump.
Four types of biopsies are as follows:
Excisional biopsy: The removal of an entire lump or suspicious tissue.
Incisional biopsy: The removal of part of a lump or suspicious tissue.
Core biopsy: The removal of part of a lump or suspicious tissue using a wide needle.
Needle biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle.

What is the Treatment of Breast Cancer?
-----------------------------------------------

There are different types of treatment for patients with breast cancer.
Four types of standard treatment are used:
1.Surgery
---------
Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells.
Lumpectomy: Breast-conserving surgery to remove a tumor (lump) and a small amount of normal tissue around it.
Partial mastectomy: Surgery to remove the part of the breast that has cancer and some normal tissue around it. This procedure is also called a segmental mastectomy.
Total mastectomy: Surgery to remove the whole breast that has cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after. This is done through a separate incision.
Modified radical mastectomy: Surgery to remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.
Radical mastectomy: Surgery to remove the breast that has cancer, chest wall muscles under the breast, and all of the lymph nodes under the arm. This procedure is sometimes called a Halsted radical mastectomy.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy, chemotherapy, or hormone therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.
If a patient is going to have a mastectomy, breast reconstruction (surgery to rebuild a breast's shape after a mastectomy) may be considered. Breast reconstruction may be done at the time of the mastectomy or at a future time.
2.Radiation therapy
--------=---------------
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
External radiation therapy uses a machine outside the body to send radiation toward the cancer.
Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
3.Chemotherapy
--------------------
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
4.Hormone therapy
-----------------------
Hormone therapy is a cancer treatment that removes female hormones or blocks their action and stops cancer cells from growing.
Examples are tamoxifen and aromaase inhibitors.

Other newer methods are:
Sentinel lymph node biopsy followed by surgery
--------------------------------------------------------
Sentinel lymph node biopsy is the removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. After that biopsy, the surgeon removes the tumor (breast-conserving surgery or mastectomy).
Monoclonal antibodies as adjuvant therapy
---------------------------------------------------
Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory, from a single type of immune system cell. The antibodies attach to the cancer cells, block their growth, or keep them from spreading.
Examples are Trastuzumab (Herceptin) which blocks the effects of the growth factor protein HER2, Tyrosine kinase inhibitors which block signals needed for tumors to grow, Lapatinib which blocks the effects of the HER2 protein and other proteins inside tumor cells.

Treatment of Preinvasive Breast Cancer
------------------------------------------------

Surgery is the main form of treatment for this stage of Cancer.
Either a lumpectomy or a mastectomy can be done.
Women who choose lumpectomy usually have to undergo radiation treatment or radiotherapy.

The type of surgical treatment depends on
1. The size and extent of cancer within the breast
2.the patient's suitability or desire to undergo radiotherapy.

Chemotherapy is not required for cancer detected at such an early stage.

Treatment of Invasive Breast Cancer
-------------------------------------------

Surgery is the main treatment as well in this case.
It involves the removal of the cancer with or without preserving the breast.
In the late stages where the cancer has spread to the other parts of the body, surgical removal of the cancer may be done to reduce the pain.

Chemotherapy is given to treat the cancer that has spread beyond the breast and armpit. It can be given orally or by injection.
The decision to use chemotherapy depends on:
1. The stage of the cancer
2. Type of cancer cells
3. Whether the woman has reached menopause
Chemotherapy may be used before surgery in large cancers to reduce cancer recurrence or to increase the chance of safe breast preservation surgery.

Hormonal therapy is used for hormone responsive cancers to deprive the cancer cells of oestrogen, which is required for such cancers to grow.
It is given in place of chemotherapy or following it.

Radiotherapy uses high-energy rays to kill cancer cells or stop them from growing further. It may be given for a peroid of time after a lumpectomy or after a mastectomy.
It is also given for inoperable cancers.

How is Breast Cancer Recurrence detected?
---------------------------------------------------
After cancer treatment, patients are required to follow up with their doctors at regular intervals especially in the first 5 years after treatment when the risk of recurrence is highest.
This include:
Physical examination of the breasts, underarm, neck.
Peroidic mammograms
Blood tests
Chest x-rays and
Bone scan.
Any complaints of change in surgical areas or other parts of the breasts, swollen lymph glands or bone pains may suggest a recurrence.

What is the Prognosis of Breast Cancer?
-----------------------------------------------
The prognosis (chance of recovery) and treatment options depend on the following:
1.stage of the cancer (whether it is in the breast only or has spread to lymph nodes or other places in the body).
2. type of breast cancer.
3.Estrogen-receptor and progesterone-receptor levels in the tumor tissue.
4.woman's age, general health, and menopausal status (whether a woman is still having menstrual periods).
5.Whether the cancer has just been diagnosed or has recurred.

Finally please note that Breast Cancer can also occur in Men!