Cancer Treatment & Information

What are the symptoms of Pancreatic Cancer?

The main symptoms of pancreatic cancer include the following:

• Pain in the abdomen, the back, or both  
• Weight loss, often associated with the following:
  • Loss of appetite (anorexia)
  • Bloating
  • Diarrhea or fatty bowel movements that float in water (steatorrhea)
  • Rarely may present with new diabetes in a person with weight loss and nausea 
• Jaundice (yellowing of the skin)

The symptoms of pancreatic cancer are generally vague and can easily be attributed to other less serious and more common conditions. This lack of specific symptoms explains the high number of people who have a more advanced stage of disease when pancreatic cancer is discovered.

How is Pancreatic Cancer diagnosed?

To diagnose pancreatic cancer, the doctor does a complete physical exam and asks about the patient’s personal and family medical history. In addition to checking general signs of health (temperature, pulse, blood pressure, and so on), the doctor usually orders blood, urine, and stool tests. The doctor may also ask for a “barium swallow,” or “upper GI series.” For this test, the patient drinks a barium solution before x-rays of the upper digestive system are taken. The barium shows an outline of the pancreas on the x-rays.

Other tests may be ordered, such as:

• An angiogram, a special x-ray of blood vessels.
• CT scans, x-rays that give detailed pictures of a cross- section of the pancreas. These pictures are created by a computer.
• Transabdominal ultrasound to view the pancreas. In this procedure, an instrument that sends out high-frequency sound waves, which cannot be heard, is passed over the abdomen. The sound waves echo off the pancreas. The echoes form a picture on a screen that looks like a television.
• ERCP (endoscopic retrograde cholangiopancreatogram), is a special x-ray of the common bile duct. For this test, a long, flexible tube (endoscope) is passed down the patient’s throat through the stomach and into the small intestine. A dye is injected into the common bile duct, and x-rays are taken. The doctor can also look through the endoscope and take tissue samples.
• Endoscopic ultrasound is a relatively new procedure that can be used to diagnose pancreatic cancer. For the procedure, an endoscope is passed in the same way as for ERCP; however, on the end of the endoscope is an ultrasound probe which scans the pancreas for cancers. Because the ultrasound probe is closer to the pancreas than with transabdominal ultrasound, it is possible to identify small cancers within the pancreas. The cancers also can be biopsied through the endoscope.

A biopsy is the only sure way for the doctor to know whether cancer is present. In a biopsy, the doctor removes some tissue from the pancreas. It is examined under a microscope by a pathologist, who checks for cancer cells.

One way to remove tissue is with a long needle that is passed through the skin into the pancreas. This is called a needle biopsy. Doctors use x-rays or ultrasound to guide the placement of the needle. Another type of biopsy is a brush biopsy. This is done during the ERCP. The doctor inserts a very small brush through the endoscope into the bile duct to rub off cells to examine under a microscope.

Sometimes an operation called a laparotomy may be needed. During this operation, the doctor can look at organs in the abdomen and can remove tissue. The laparotomy helps the doctor determine the stage, or extent, of the disease. Knowing the stage helps the doctor plan treatment.Tissue samples that are obtained with one kind of biopsy may not give a clear diagnosis, and the biopsy may need to be repeated using a different method.

What are the symptoms of Ovarian Cancer?

Early ovarian cancer may not cause obvious symptoms. But, as the cancer grows, symptoms may include:

• Pressure or pain in the abdomen, pelvis, back, or legs
• A swollen or bloated abdomen
• Nausea, indigestion, gas, constipation, or diarrhea
• Feeling very tired all the time

Less common symptoms include:

• Shortness of breath
• Feeling the need to urinate often
• Unusual vaginal bleeding (heavy periods, or bleeding after menopause)

Most often these symptoms are not due to cancer, but only a doctor can tell for sure. Any woman with these symptoms should tell her doctor.

How is Ovarian Cancer diagnosed?

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history. You may have one or more of the following tests. Your doctor can explain more about each test:

• Physical exam: Your doctor checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.
• Pelvic exam: Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells. The Pap test detects cervical cancer. The Pap test is not used to diagnose ovarian cancer.
• Blood tests: Your doctor may order blood tests. The lab may check the level of several substances, including CA-125. CA-125 is a substance found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman’s response to ovarian cancer treatment and for detecting its return after treatment.
• Ultrasound: The ultrasound device uses sound waves that people cannot hear. The device aims sound waves at organs inside the pelvis. The waves bounce off the organs. A computer creates a picture from the echoes. The picture may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
• Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen. Surgery is usually needed to diagnose ovarian cancer. To learn more about surgery, see the “Treatment” section.

Although most women have a laparotomy for diagnosis, some women have a procedure known as laparoscopy. The doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.

A pathologist uses a microscope to look for cancer cells in the tissue or fluid. If ovarian cancer cells are found, the pathologist describes the grade of the cells. Grades 1, 2, and 3 describe how abnormal the cancer cells look. Grade 1 cancer cells are not as likely as to grow and spread as grade 3 cells.

What are the symptoms of Mesothelioma Cancer?

About 15% of Mesothelioma cases are found in the early stages, before the cancer has spread to nearby lymph nodes or elsewhere. The 5 year survival rate for people with Mesothelioma is 50% if there is no evidence of cancer in lymph nodes at the time of surgery. Unfortunately, in most cases, the spread of cancer has already occurred even if not detected by current medical tests. When all Mesothelioma stages are considered together, the 5 year survival rate is only about 14%. Many early Mesothelioma are diagnosed incidentally - they are found as a result of tests that are done for an unrelated medical condition. Although Mesothelioma does not cause any symptoms until it has spread too far to be cured, symptoms do occur in some patients with early Mesothelioma . Prompt attention to symptoms, leading to early diagnosis and treatment can result in a cure for some patients. For others, prompt attention to symptoms can improve the likelihood that treatment can extend their life and relieve many of their symptoms.

Common signs and symptoms of Mesothelioma include:

• A cough that does not go away
• Chest pain, often aggravated by deep breathing
• Hoarseness
• Weight loss and loss of appetite
• Bloody or rust-colored sputum (spit or phlegm)
• Shortness of breath
• Fever without a known reason
• Recurring infections such as bronchitis and pneumonia
• New onset of wheezing
• When Mesothelioma spreads to distant organs, it may cause:
• Bone pain
• Neurologic changes (such as weakness or numbness of a limb, dizziness)
• Jaundice (yellow coloring of the skin and eyes)
• Masses near the surface of the body, due to cancer spreading to the skin or to lymph nodes (collection of immune system cells) in the neck or above the collarbone.

A. Pleural Mesothelioma Symptoms
Some of the symptoms of pleural mesothelioma (mesothelioma cancer of the lung lining) include:

• pain in the lower back or the side of the chest
• shortness of breath
• a persistent cough
• difficulty swallowing food
• fever and sweating
• fatigue
• weight loss.

These symptoms are also common to many minor ailments and, therefore, may not cause a doctor to suspect mesothelioma.

Pleural Effusion-fluid in the Lungs. One of the most common and specific symptoms of pleural mesothelioma is the accumulation of fluid between the lungs and chest cavity. This generally causes shortness of breath, and requires a doctor to drain the fluid, called fine-needle aspiration, to make breathing easier and relieve chest pain. This symptom is more unique to mesothelioma, making it more likely that you may have the disease.

B. Peritoneal Mesothelioma Symptoms
Symptoms of peritoneal mesothelioma (abdominal mesothelioma - mesothelioma of the lining of the stomach) include:

•  stomach pain
• nausea and vomiting
• weight loss.

Like pleural mesothelioma, these symptoms are also common to many minor ailments and, therefore, may not cause a doctor to suspect mesothelioma.

How is Mesothelioma Cancer diagnosed?

Mesothelioma is diagnosed by pathological examination from a biopsy. Tissue is removed, placed under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid build-up around the lungs (pleural effusions), shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an x-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:

• Thoracoscopy - For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital with a local anesthetic or painkiller. If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.
• Peritoneoscopy - For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.
• Biopsy - If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.

What are the symptoms of Lymphoma Cancer?

The most common sign of both Hodgkin’s disease (HD) and non-Hodgkin’s lymphoma (NHL) is a painless swelling in one or more of the lymph nodes of the neck, collarbone region, armpits, or groin. But it is important to remember that most lymph node swelling - especially in children - is caused by an infection, not by lymphoma. Affected lymph nodes usually return to normal size within a few weeks or months after an infection has cleared. Physicians often observe swollen lymph nodes during this time to see if they change in size following antibiotic treatment. However, if a lymph node(s) is larger than one inch in size (>1 in), and if there are other suspicious symptoms, the physician may choose to perform an immediate biopsy to rule out or confirm a diagnosis of cancer.

If HD or NHL involves lymphatic tissue within the abdomen the belly may become swollen, and even resemble pregnancy in some female patients. Fluid may build up within the abdominal cavity, and swelling near the intestines may block the normal passage of feces. Such blockage may cause sensations of abdominal pressure or pain.

Other symptoms include:

• Chest Pain
• Trachea
• General Symptoms
• B Symptoms

Chest Pain
If lymphoma involves the lymphatic tissue of the thymus, the gland located in front of the heart, it may cause chest pain. In addition, an enlarged thymus may press on nearby structures such as the trachea (windpipe) or superior vena cava (SVC), the large vein that carries blood from the head and arms back to the heart.

Trachea
Pressure on the trachea can lead to coughing, fatigue, shortness of breath, and other respiratory difficulties. Pressure on the superior vena cava may produce SVC syndrome, a swelling of the head and arms. SVC syndrome involving the brain can be fatal and must be treated immediately. But enlarged lymphatic tissue in the chest cavity generally tends to displace - rather than press upon or encase- adjacent structures. Therefore, compromised breathing and SVC syndrome are relatively uncommon signs of lymphoma.

General Symptoms
As lymphomas progress and cancerous lymphocytes spread beyond the lymphatic system, the body loses its ability to fight infections. The generalized symptoms that develop may be confused with influenza, other infections, such as infectious mononucleosis (”mono”), tuberculosis (TB), or other cancers. In particular, people with HD or NHL may experience:

• fever
• drenching night sweats
• weight loss
• fatigue
• appetite loss
• red patches on the skin
• severely itchy skin, often affecting the legs/feet

The itching associated with Hodgkin’s disease is much more severe than that caused by dry skin. In some cases, patients may actually scratch through the skin with their fingernails in attempts to get some relief. The night sweats caused by HD or NHL may be so extreme that they completely soak the individual’s sheets and blankets.

Some oncologists refer to these generalized symptoms as B symptoms. Unfortunately, B symptoms are related to an increased cancer “burden” - more cancerous tissue - in many patients and, therefore, indicate a worse prognosis, or outcome.

How is Lymphoma Cancer diagnosed?

The fact is that most people with lymphoma (e.g., up to 75% of HD patients) experience no classic symptoms. Often, lymphomas are diagnosed because of abnormalities found on chest x-rays or other imaging studies that are performed for nonspecific complaints.

If lymphoma is suspected, the physician will want to obtain a full medical history to uncover any relevant symptoms or risk factors. A complete physical examination will supply other clues about possible infection, health problems, or signs of lymphoma. The physician will pay particular attention to the size, location, tenderness, and consistency (firmness) of swollen lymph nodes, and will examine other lymphatic sites for possible disease.

Once the physician suspects that a patient has Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL), he or she will want to perform a biopsy of an enlarged lymph node, that us, remove a small amount of tissue for examination. A pathologist (disease diagnosis specialist) will evaluate the size and shape of the sampled tissue under a microscope. In particular, the pathologist will look for Reed-Sternberg (R-S) cells, which confirm a diagnosis of Hodgkin’s disease.

Types of Biopsy

Several types of biopsy are available:

• Fine Needle Aspiration (FNA) biopsy uses a very thin, hollow needle that is attached to a syringe. If the enlarged lymph node is palpable (can be felt) and near the skin’s surface, the needle is inserted into the swollen lump. It is then pushed back and forth to free some cells, which are aspirated (drawn up) into the syringe and are smeared on a glass slide for analysis.If the suspicious nodes or tissues are deep within the body (e.g., abdominal nodes, thymus), the needle may be guided while it is viewed on a CT (computed tomography) scan.FNA can distinguish noncancerous conditions, like infections, from NHLs or other cancers. FNA also is useful for staging, or determining the extent, of disease, and for monitoring recurrence, or return of cancer. But, because of small sample sizes and lack of information about lymph node structure, FNA often is inadequate for the initial diagnosis of HD or NHL. In such cases, larger tissue samples are obtained by surgical biopsy.
• Large Needle/Core Biopsy uses a large-bore needle to obtain a small tissue sample for analysis. Core biopsy has limited role in the diagnosis of lymphoma and is reserved for those patients who are unable to tolerate an invasive surgical procedure. Both FNA and core biopsy procedures may be guided by CT, ultrasound, or other imaging techniques.
• Surgical Biopsy refers to both incisional (cutting into) and excisional (cutting away) procedures. If a tumor mass is large and only a tiny piece of it is removed for examination, the procedure is called an incisional biopsy. Incisional biopsy has, in large part, been replaced by needle biopsy; needle biopsy is less time-consuming and less prone to infection and it produces less scarring.If the tumor mass is small and it is completely removed by biopsy, the procedure is called an excisional biopsy. Excisional biopsy usually is performed if a physician suspects that a lump is not cancerous (benign). Local anesthesia is used if the node is located near the skin’s surface and the child or adult is cooperative; however, deeper nodes (e.g., in the chest or abdomen) require general anesthesia.

Biopsy samples usually are sent to a laboratory for a number of additional tests, such as immunocytochemistry, flow cytometry, and cytogenetic studies. These tests, which also are used in diagnosing leukemia, rely on changes in cell-specific antibodies, the immune system chemicals that are directed against foreign substances, and genetic material to help identify specific types of lymphoma.

Imaging Studies

After reviewed the findings from preliminary x-rays, the physician may want to conduct additional imaging studies. Computed tomography (CT or CAT scan), a computer-assisted x-ray that produces cross-sectional images of the body, and magnetic resonance imaging (MRI scan), a technique that uses electromagnets and radio waves to create computer-generated pictures of the internal organs, are particularly useful for detecting enlarged lymph nodes or lymphoma-related abnormalities of the spleen or other organs.

A newer imaging test, called CT/PET fusion imaging, combines the technology of CT scan with the technology of PET (positive emission tomography) scan. PET scans involve injecting a sugar-based radiopharmaceutical, which travels through the body and collects in organs and tissues. The PET scan is used to detect cancer cells in the body and the CT scan provides detailed images that can determine the location and size of the cancer. When the results of these tests are “fused” (brought together), the images provide more complete diagnostic information.

In addition, the physician may request a lymphangiogram, a form of x-ray in which pictures are made of the lymphatic system. The patient is injected with a special dye that helps to highlight the lymph nodes and their vessels. Imaging studies also are significant tools for the staging of HD and NHL.

Bone Marrow Tests

If lymphoma has been diagnosed, the physician may want to sample the bone marrow to assist with cancer staging, that is, determining the extent of disease. The bone marrow is sampled by a technique known as bone marrow aspiration. During this procedure, a thin, hollow needle with a syringe attachment is used to aspirate (suction up) a teaspoon-sized sample of liquid bone marrow from the back of the hip bone. A larger needle then is employed to obtain a bone marrow biopsy (core biopsy), which removes roughly a 1/16 inch cylindrical piece of bone marrow from the hip site.

After the bone marrow samples are obtained, they are examined by many physician specialists, including a pathologist (disease diagnosis specialist), hematologist (blood specialist), and oncologist (cancer specialist). In the past, biopsy of both hip bones was standard procedure, but it now typical to perform the procedure on only one side.

Lumbar Puncture

Lumbar puncture, also known as a spinal tap, is a procedure in which a thin needle is inserted through the lumbar (lower) backbone, below the level of the spinal cord. Cerebrospinal fluid (CSF) is withdrawn through the needle, and is then analyzed for the presence of lymphoma cells. This test is performed to see whether lymphoma has spread to the central nervous system.

What are the symptoms of Leukemia?

Like all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells collect, patients with leukemia may have a number of symptoms.

Common symptoms of leukemia:

• Fevers or night sweats
• Frequent infections
• Feeling weak or tired
• Headache
• Bleeding and bruising easily (bleeding gums, purplish patches in the skin, or tiny red spots under the skin)
• Pain in the bones or joints
• Swelling or discomfort in the abdomen (from an enlarged spleen)
• Swollen lymph nodes, especially in the neck or armpit
• Weight loss

Such symptoms are not sure signs of leukemia. An infection or another problem also could cause these symptoms. Anyone with these symptoms should see a doctor as soon as possible. Only a doctor can diagnose and treat the problem.

In the early stages of chronic leukemia, the leukemia cells function almost normally. Symptoms may not appear for a long time. Doctors often find chronic leukemia during a routine checkup—before there are any symptoms. When symptoms do appear, they generally are mild at first and get worse gradually.

In acute leukemia, symptoms appear and get worse quickly. People with this disease go to their doctor because they feel sick. Other symptoms of acute leukemia are vomiting, confusion, loss of muscle control, and seizures. Leukemia cells also can collect in the testicles and cause swelling. Also, some patients develop sores in the eyes or on the skin. Leukemia also can affect the digestive tract, kidneys, lungs, or other parts of the body.

How is Leukemia diagnosed?

If a person has symptoms that suggest leukemia, the doctor may do a physical exam and ask about the patient’s personal and family medical history. The doctor also may order laboratory tests, especially blood tests.

The exams and tests may include the following:

• Physical exam—The doctor checks for swelling of the lymph nodes, spleen, and liver.
• Blood tests—The lab checks the level of blood cells. Leukemia causes a very high level of white blood cells. It also causes low levels of platelets and hemoglobin, which is found inside red blood cells. The lab also may check the blood for signs that leukemia has affected the liver and kidneys.
• Biopsy—The doctor removes some bone marrow from the hipbone or another large bone. A pathologist examines the sample under a microscope. The removal of tissue to look for cancer cells is called a biopsy. A biopsy is the only sure way to know whether leukemia cells are in the bone marrow.

There are two ways the doctor can obtain bone marrow. Some patients will have both procedures:

• Bone marrow aspiration: The doctor uses a needle to remove samples of bone marrow.
• Bone marrow biopsy: The doctor uses a very thick needle to remove a small piece of bone and bone marrow.

Local anesthesia helps to make the patient more comfortable.

• Cytogenetics—The lab looks at the chromosomes of cells from samples of peripheral blood, bone marrow, or lymph nodes.
• Spinal tap—The doctor removes some of the cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). The doctor uses a long, thin needle to remove fluid from the spinal column. The procedure takes about 30 minutes and is performed with local anesthesia. The patient must lie flat for several hours afterward to keep from getting a headache. The lab checks the fluid for leukemia cells or other signs of problems.
• Chest x-ray—The x-ray can reveal signs of disease in the chest.

What are the symptoms of Colorectal Cancer?

Cancer of the colon and rectum can exhibit itself in several ways. If you have any of these symptoms, seek immediate medical help.
You may notice bleeding from your rectum or blood mixed with your stool.

• People commonly attribute all rectal bleeding to hemorrhoids, thus preventing early diagnosis owing to lack of concern over “bleeding hemorrhoids.”
• Rectal bleeding may be hidden and chronic and may show up as an iron deficiency anemia.
• It may be associated with fatigue and pale skin.
• It usually, but not always, can be detected through a fecal occult (hidden) blood test, in which samples of stool are submitted to a lab for detection of blood.

If the tumor gets large enough, it may completely or partially block your colon. You may notice the following symptoms of bowel obstruction:

• Abdominal distension: Your belly sticks out more than it did before without weight gain.
• Abdominal pain: This is rare in colon cancer. One cause is tearing (perforation) of the bowel. Leaking of bowel contents into the pelvis can cause inflammation (peritonitis) and infection.
• Unexplained, persistent nausea or vomiting
• Unexplained weight loss
• Change in frequency or character of stool (bowel movements)
• Small-caliber (narrow) or ribbon-like stools
• Sensation of incomplete evacuation after a bowel movement
• Rectal pain: Pain rarely occurs with colon cancer and usually indicates a bulky tumor in the rectum that may invade surrounding tissue.

Studies suggest that the average duration of symptoms (from onset to diagnosis) is 14 weeks. There is no association between overall duration of symptoms and the stage of your tumor.

How is Colorectal Cancer diagnosed?

Colon and rectal cancers are diagnosed using the screening tests mentioned below. These tests are used to detect precancerous polyps or cancer at a colon cancer stage early enough for removal and cure. Digital Rectal Examination or DRE is used to detect tumors in the lower intestine, the rectum and the prostate. A lubricated-gloved finger is inserted into the patient’s rectum by a doctor. The doctor feels for lumps or other abnormalities. Less than 10% of colon cancers can be evaluated this way.

Because blood in the stool or feces is not always visible to the naked eye, the fecal occult blood test (FOBT) is used to detect this hidden (occult) blood. The patient supplies up to six stool specimens in a specially prepared package. The stool is smeared on chemically treated paper, which will turn blue if blood is present.

When FOBT or DRE show signs of cancer, several techniques are available to help the physician visualize the colon. These include colonoscopy, sigmoidoscopy, and double-contrast barium enema. Sigmoidoscopies are limited. This imaging technique only views the rectum and the left side of the colon. Colonoscopy and barium enemas allow the physician to view the entire large intestine.

Both flexible sigmoidoscopy and colonoscopy are invasive procedures that involve moving a fiber optic tube through the rectum and colon to view the intestinal walls. The tube contains a tiny camera that transmits the image to a video screen. The use of an ultrasound (sound wave) scanner can enhance viewing quality. During either sigmoidoscopy or colonoscopy, the physician is able to remove polyps or other abnormalities revealed by the procedures.

Colonoscopy is the most accurate testing method and can reduce cancer incidence by up to 90%. It is indicated for anyone with an increased risk for colorectal cancer, including those with a personal or family history of the disease. For about a day before the procedure the patient eats nothing and drinks a laxative solution that cleans out the colon. Air may be introduced into the intestine to widen it and allow the tube to navigate curves.

Other diagnostic tests include genetic screening, stool DNA testing and virtual colonoscopy.

Virtual Colonoscopy is an experimental technique that provides a three-dimensional image of the colon without using the invasive instruments used in the standard colonoscopy. The procedure itself involves pumping air into the colon and scanning the intestine using computed tomography (CT). It is very safe and takes only about 10 minutes. Follow up colonoscopy is needed if suspicious tissue is found.

There is also another exciting development in imaging of the digestive tract. Cancer research has yielded a small, pill-sized, video camera that can be swallowed. As it winds its way through the digestive tract, the camera beams data to a receiver worn by the patient. The camera is not a replacement for colonoscopy. More testing is needed to determine its value.

What are the symptoms of Cervical Cancer?

Precancerous changes and early cancers of the cervix generally do not cause pain or other symptoms. It is important not to wait to feel pain before seeing a doctor.

When the disease gets worse, women may notice one or more of these symptoms:

• Abnormal vaginal bleeding
  • Bleeding that occurs between regular menstrual periods
  • Bleeding after sexual intercourse, douching, or a pelvic exam
  • Menstrual periods that last longer and are heavier than before
  • Bleeding after menopause
• Increased vaginal discharge
• Pelvic pain
• Pain during sexual intercourse

Infections or other health problems may also cause these symptoms. Only a doctor can tell for sure. A woman with any of these symptoms should tell her doctor so that problems can be diagnosed and treated as early as possible.

How is Cervical Cancer diagnosed?

If a woman has a symptom or Pap test results that suggest precancerous cells or cancer of the cervix, her doctor will suggest other procedures to make a diagnosis.

These may include:

• Colposcopy: The doctor uses a colposcope to look at the cervix. The colposcope combines a bright light with a magnifying lens to make tissue easier to see. It is not inserted into the vagina. A colposcopy is usually done in the doctor’s office or clinic.
• Biopsy: The doctor removes tissue to look for precancerous cells or cancer cells. Most women have their biopsy in the doctor’s office with local anesthesia. A pathologist checks the tissue with a microscope.
  • Punch biopsy: The doctor uses a sharp, hollow device to pinch off small samples of cervical tissue.
  • LEEP: The doctor uses an electric wire loop to slice off a thin, round piece of tissue.
  • Endocervical curettage: The doctor uses a curette (a small, spoon-shaped instrument) to scrape a small sample of tissue from the cervical canal. Some doctors may use a thin, soft brush instead of a curette.
  • Conization: The doctor removes a cone-shaped sample of tissue. A conization, or cone biopsy, lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix. The doctor may do this test in the hospital under general anesthesia. Conization also may be used to remove a precancerous area.

Removing tissue from the cervix may cause some bleeding or other discharge. The area usually heals quickly. Women may also feel some pain similar to menstrual cramps. Medicine can relieve this discomfort.

During my personal journey through cancer, now over thirteen years ago, I made an interesting emotional observation. This observation led me to coin a term I call “a sick mentality”. For anyone who has even been very sick and/or fought a deadly illness or disease such as cancer you will identify with either having or fighting this mentality. It starts with accepting that you are not in perfect health and that, in itself, is not bad. In fact, for simple life preservation, many times it is imperative that you change things about your lifestyle, actions and attitudes.

However, after those changes have been made if is important that you do not get a “sick mentality”. By that I mean that all you think about, talk about….every action you take is based on an inner attitude of “I am a sick person”. Our minds work in such a way that the more we tell ourselves we are sick we actually spiral down mentally and emotionally which then may cause us to spiral down more physically. It will become a vicious spiral unless steps are taken to stop it.

One of the best ways to help keep the spiral from starting - or to stop it and start it moving the opposite direction is to take action regarding how you take care of yourself and how you look. I firmly believe that looking your best is a cancer treatment.

I know you don’t feel good during the cancer journey and that it is more of a challenge physically to put yourself together, especially if your body has changed due to surgery. You will find, though, that if you get up each morning and get dressed (even if you are not going anywhere) it does something to your psyche. You do not have to dress up or even dress in street clothes. Just pulling on a pair of comfy pull-on pants and a soft top that are color coordinated is a good start. When you stay in your bedclothes you tend to feel lazy and sloppy. That affects how you walk and hold yourself. You need to be standing up straight and talking steps not shuffling if you physically capable of doing that. On a day when you are going somewhere, like the doctors office or perhaps you need to work even though you are ill be sure to think about wearing something that is a bit fitted and in a color that complements your complexion. These two things alone will make you feel a bit more perky and pretty.

Your skin care and makeup regimen also need to morph with you during this time…but that does not mean doing nothing because you don’t feel like it. This is a sure way to make yourself feel worse with that “sick mentality” spiral. You need to be doing basic skin care and putting your face on daily. A simple makeup regimen of an organic mineral foundation in a sun-kissed color combined with a moisturizing colored lip gloss and a bit or mascara only takes a couple of minutes to apply. If you are on a chemotherapy that causes hair loss there are a few more steps you can add for days you need to look a bit more professional or dressed up. There are several companies that offer eyebrow stencils and there is even a company called NuBrow that sells eyebrow prosthetics! These prosthetic eyebrows can be dyed to match your natural hair color and will last up to six weeks of daily applications. A simple dot and smear technique to give the illusion of eyelashes is easy to learn or you can have false eyelashes professionally applied. (Please do not apply them yourself unless you have been doing it already for years. Your eyes are especially susceptible to infection during treatment, It is not worth taking the risk. You will love the dot and smear method as an alternative.)

More than perhaps any other time in your life you will want to adopt a KISS attitude…”keep it simple sister”. Just remember simple does not equal doing nothing. This is a time to explore your options and have some fun doing it. So much is being dictated for you but this is something you can take control of. Looking your best really is cancers silent treatment. source

A stressful life may make it tougher to fight the virus which causes the majority of cervical cancer cases, say scientists. HPV is a sexually transmitted infection - but only a small percentage of women who catch it develop cancer. US researchers, writing in the journal Annals of Behavioural Medicine, said that stressed women had a weaker immune response to the virus. But the study did not prove that stress was the root cause of the problem.

It is already known that the way the body’s immune system reacts when confronted with HPV - short for human papillomavirus - can determine whether the infection causes more serious problems. Many women appear able to “clear” the virus from their bodies, while in others it can cause a persistent infection which raises the risk of the abnormal cell changes which can eventually lead to cancer.

The latest study, carried out at the Fox Chase Cancer Center in Philadelphia, looked for reasons why, in some women, the immune system is unable to clear the virus. Their small study asked 78 women who had had abnormal smear tests to fill in a questionnaire about their day-to-day stresses over the previous month, and any major events such as bereavements or divorce over a longer period.

Then the ability of their immune system to respond to HPV16 - the most common variety of the virus linked to cervical cancer - was measured. Similar tests were carried out on 28 women who had not received an abnormal smear test, and the results compared. The researchers found that the immune response was poorer among women who reported higher levels of day-to-day stress. However, there was no correlation between immune response and the number of major events.

No cause

Dr Carolyn Fang, who led the study, said: “Women with higher levels of perceived stress were more likely to have an impaired immune response to HPV16. “That means that women who report feeling more stressed could be at greater risk of developing cervical cancer because their immune system can’t fight off one of the most common viruses that cause it.”

The researchers admitted, however, that the design of the study meant that it was impossible to look for proof that stress actually caused the immune response, rather than just accompanied it. A spokesman for Cancer Research UK said that more research would be needed to prove the link. “We already know that an effective immune response against certain forms of HPV can guard against cervical cancer - this knowledge helped to spearhead the development of cervical cancer vaccines targeting this virus.

“This small study does not provide conclusive evidence that a stressful life directly suppresses the immune system and increases the risk of cervical cancer. “More work would be needed before we know if there is a relationship between stress levels and the ability to fight HPV infection.”

What are the symptoms of Breast Cancer?

Knowing the signs and symptoms of breast cancer may help save your life. When the disease is discovered early, you have more treatment options and a better chance for a cure.

Most breast lumps aren’t cancerous. Yet the most common sign of breast cancer for both men and women is a lump or thickening in the breast. Often, the lump is painless. Other potential signs of breast cancer include:

• A spontaneous clear or bloody discharge from your nipple, often associated with a breast lump
• Retraction or indentation of your nipple
• A change in the size or contours of your breast
• Any flattening or indentation of the skin over your breast
• Redness or pitting of the skin over your breast, like the skin of an orange

A number of conditions other than breast cancer can cause your breasts to change in size or feel. Breast tissue changes naturally during pregnancy and your menstrual cycle. Other possible causes of noncancerous (benign) breast changes include fibrocystic changes, cysts, fibroadenomas, infection or injury.

If you find a lump or other change in your breast — even if a recent mammogram was normal — see your doctor for evaluation. If you haven’t yet gone through menopause, you may want to wait through one menstrual cycle before seeing your doctor. If the change hasn’t gone away after a month, have it evaluated promptly.

How is Breast Cancer diagnosed?

If you have a symptom or screening test result that suggests cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history. You may have a physical exam. Your doctor also may order a mammogram or other imaging procedure. These tests make pictures of tissues inside the breast. After the tests, your doctor may decide no other exams are needed. Your doctor may suggest that you have a follow-up exam later on. Or you may need to have a biopsy to look for cancer cells.

Breast self-examination

Breast self-examination is an option beginning at age 20. By becoming proficient at breast self-examination and familiar with the usual appearance and feel of your breasts, you may be able to detect early signs of cancer. Learn how your breasts typically look and feel and watch for changes. If you detect a change, promptly bring it to your doctor’s attention. Have your doctor review your examination technique if you’d like input or you have questions.

Clinical breast exam

Unless you have a family history of cancer or other factors that place you at high risk, the American Cancer Society recommends having clinical breast exams once every three years until age 40. After that, the American Cancer Society recommends having a yearly clinical exam.

During this exam, your doctor examines your breasts for lumps or other changes. He or she may be able to feel lumps you miss when you examine your own breasts and will also check for enlarged lymph nodes in your armpit (axilla).

Mammogram

A mammogram, which uses a series of X-ray images of your breast tissue, is currently the best imaging technique for detecting tumors before you or your doctor can feel them. For that reason, the American Cancer Society has long recommended screening mammography for all women over 40.

Two types of mammograms include:

• Screening mammograms. Screening mammograms are performed on a regular basis — about once a year — to check your breast tissue for any changes since your last mammogram.
• Diagnostic mammograms. Your doctor may recommend a diagnostic mammogram to evaluate a breast change detected by you or your doctor. During a diagnostic mammogram, the radiologist performing the exam can take additional views to evaluate the area of concern more closely.

Yet mammograms aren’t perfect. A certain percentage of breast cancers — sometimes even lumps you can feel — don’t show up on X-rays (false-negative result). The rate is higher for women in their 40s. That’s because women of this age and younger tend to have denser breasts, making it more difficult to distinguish abnormal from normal tissue.

At other times, mammograms may indicate a problem when none exists (false-positive result). This can lead to unnecessary biopsies, to fear and anxiety, and to increased health care costs. The skill and experience of the radiologist reading the mammogram also have a significant effect on the accuracy of the test results. In spite of these drawbacks, however, most experts agree mammography is the most reliable screening test for most women.

During a mammogram, your breasts are compressed between plastic plates while a radiology technician takes the X-rays. The whole procedure should take less than 30 minutes. You may find mammography somewhat uncomfortable. If you have too much discomfort, inform the technician. If you have tender breasts, schedule your mammogram for a time after your menstrual period. Avoiding caffeine for two days before the test may help reduce breast tenderness.

Also available at some mammography centers is a soft, single-use, foam pad that can be placed on the surface of the compression plates of the mammography machine, making the test less uncomfortable. The pad doesn’t interfere with the image quality of the mammogram. If possible, try to schedule your mammogram around the same time as your annual clinical exam. That way the radiologist can specifically look at any changes your doctor may discover. Most important, don’t let a lack of health insurance keep you from having regular mammograms. Many state health departments and Planned Parenthood clinics offer low-cost or free screenings.

Other tests

Computer-aided detection (CAD). In traditional mammography, your X-rays are reviewed by a radiologist, whose skill and experience play a large part in determining the accuracy of the test results. In CAD, a computer scans your mammogram after a radiologist has reviewed it. CAD identifies highly suspicious areas on the mammogram, allowing the radiologist to focus on specific spots, but many of these areas may later prove to be normal. Still, using mammography and CAD together may increase the cancer detection rate.

Digital mammography. In this procedure, an electronic process is used to collect and display X-ray images on a computer screen. This allows your radiologist to alter contrast and darkness, making it easier to identify subtle differences in tissue. In addition, digital images can be transmitted electronically, so women who live in remote areas can have their mammograms read by an expert who is based elsewhere. Digital mammography has been found to be most helpful in evaluating dense breast tissue in women in their 40s.

Magnetic resonance imaging (MRI). This technique uses a magnet and radio waves to take pictures of the interior of your breast. Although not used for routine screening, MRI can reveal tumors that are too small to detect through physical exams or are difficult to see on conventional mammograms. MRI doesn’t take the place of mammograms, but rather is performed as an additional (adjunct) study of the breast.

MRI isn’t recommended for routine screening on women at average risk because it has a high rate of false-positive results, leading to unnecessary anxiety and biopsies. It’s also expensive, not readily available and requires interpretation by an experienced radiologist. However, the American Cancer Society now recommends annual screening MRI for women with a lifetime breast cancer risk of 20 percent or higher, women who received chest radiation between ages 10 and 30, and women with a strong family history of breast and ovarian cancers.

Recent recommendations propose that women with newly diagnosed breast cancer in one breast have a one-time MRI done. MRI can detect breast tumors in the opposite (contralateral) breast missed by mammograms. The test can also detect additional lesions in the affected breast. However, whether finding early tumors in this situation improves treatment outcomes — and deaths from breast cancer — is still unknown.

Breast ultrasound (ultrasonography). Your doctor may use this technique to evaluate an abnormality seen on a mammogram or found during a clinical exam. Ultrasound uses sound waves to produce images of structures deep within the body. Because it doesn’t use X-rays, ultrasound is a safe diagnostic tool that can help determine whether an area of concern is a cyst or solid tissue. But breast ultrasound isn’t used for routine screening because it has a high rate of false-positive results — finding problems where none exist.

Experimental procedures

Ductal lavage. In this procedure, your doctor inserts a tiny, flexible tube (catheter) into the lining of a duct in your breast — the site where most cancers originate — and withdraws a sample of cells. The cells are then examined for precancerous changes that might eventually lead to disease. These changes may show up long before tumors can be detected on a mammogram. But because ductal lavage is a new and invasive procedure, many unknowns remain, including the rate of false-negative results, the exact location in the breast of abnormal cells and whether those cells will necessarily lead to cancer. Clinical trials are being conducted to help find the answers to these questions. In the meantime, ductal lavage isn’t recommended as a screening tool.

Molecular breast imaging (MBI). This experimental technique tracks the movement of a radioactive isotope injected into the bloodstream and taken up by breast tissue, particularly tumors. In preliminary studies, MBI found small tumors that both mammography and ultrasound missed. It’s not yet clear how any abnormal findings from MBI could be biopsied, but this is an area of study. Besides requiring some radiation, this imaging method also involves slight compression of the breast. This imaging technique is being studied in women with dense breast tissue and women at high risk of breast cancer. Depending on study results, MBI would most likely become an adjunct to — but not a replacement for — mammography.

Diagnostic procedures

Unlike screening tests, diagnostic procedures help to further characterize breast abnormalities found by some other means, such as by feeling a breast lump or seeing a spot on a mammogram or MRI. These tests help your doctor determine the need for a biopsy and also may be used to help guide a biopsy.

Ultrasound

Ultrasound uses sound waves to create an image of your breast on a computer screen. By analyzing this image, your doctor may be able to tell whether a lump is a cyst or a solid mass. Cysts, which are sacs of fluid, usually aren’t cancerous, although your doctor may recommend draining the cyst. If the cyst appears very typical and disappears completely with removal of the fluid, then observation is the only follow-up necessary. If the cyst appears complex, doesn’t disappear completely when the fluid is drained or contains bloody fluid, a biopsy is necessary to determine whether cancer is present.

Biopsy

A biopsy — a small sample of tissue removed for analysis in the laboratory — is the only test that can tell if cancer is present. Biopsies can provide important information about an unusual breast change and help determine whether surgery is needed and if so, the type of surgery required. Types of biopsies include:

Fine-needle aspiration biopsy. Your doctor uses a thin, hollow needle to withdraw tissue from the lump. He or she then sends the tissue to a lab for microscopic analysis. The procedure takes about 30 minutes and is similar to drawing blood. A similar procedure — fine-needle aspiration — is typically performed to remove the fluid from a painful cyst, but it can also help distinguish a cyst from a solid mass.

Core needle biopsy. A radiologist or surgeon uses a hollow needle to remove tissue samples from a breast lump. As many as 15 samples, each about the size of a grain of rice, may be taken then sent to a pathologist to be analyzed for malignant cells. The advantage of a core needle biopsy is that it removes more tissue for analysis. Sometimes your radiologist or surgeon may use ultrasound to help guide the placement of the needle. 

Stereotactic biopsy. This technique is used to sample and evaluate an area of concern, such as microcalcification, that can be seen on a mammogram but that cannot be felt or seen on an ultrasound. During the procedure, a radiologist takes a core needle biopsy, using your mammogram as a guide. Stereotactic biopsy usually takes about an hour and is performed using local anesthesia.

Wire localization. Your doctor may recommend this technique when a worrisome lump is seen on a mammogram but can’t be felt or evaluated with a stereotactic biopsy. Using your mammogram as a guide, a thin wire is placed in your breast and the tip guided to the lump. Wire localization is usually performed right before a surgical biopsy and is a way to guide the surgeon to the area to be removed and tested.

Surgical biopsy. This remains one of the most accurate methods for determining whether a breast change is cancerous. During this procedure, your surgeon removes all or part of a breast lump. In general, a small lump will be completely removed (excisional biopsy). If the lump is large, only a sample will be taken (incisional biopsy). The biopsy is generally performed on an outpatient basis in a clinic or hospital.

Estrogen and progesterone receptor tests

Malignant cells removed in a biopsy can be tested for the presence of hormone receptors. If the cancer cells have receptors for estrogen or progesterone or both, your doctor may recommend treatment with a drug such as tamoxifen, which prevents estrogen from binding to these sites.

Staging tests

Staging tests determine the size and location of your cancer and whether it has spread. They also help with treatment planning. Cancer is staged using the numbers 0 through IV. Stage 0 cancers are also called noninvasive, or in situ (in one place), cancers. Although they don’t have the ability to invade normal breast tissue or spread to other parts of your body, it’s important to have them removed because they eventually can become invasive cancers.

Stage I to IV cancers are invasive tumors that have the ability to invade normal breast tissue or spread to other areas. A stage I cancer is small and well localized and has a high cure rate. But the higher the stage number, the lower the chances of cure. By stage IV, the cancer has spread beyond your breast to other organs, such as your bones, lungs or liver. Although it’s not possible to cure cancer at this stage, it may still respond well to various treatments, which could effectively shrink and control the cancer for an extended period of time.

Genetic tests

If you have a strong family history of breast cancer or other cancers, blood tests may help identify defective BRCA or other genes that are being passed through the family. These tests are often inconclusive and should only be done in select cases after a thorough evaluation with a genetic counselor. Unless you are at high risk of hereditary breast or ovarian cancers, genetic testing usually isn’t recommended.

In general, testing is beneficial only if the results will help you make a decision about how you might best reduce your breast or other cancer risk. Options range from lifestyle changes and closer screening and therapy with medications such as tamoxifen to extreme measures such as preventive (prophylactic) bilateral mastectomy and removal of your ovaries (oophorectomy).