The wall of the bladder is lined with cells called transitional cells and
squamous cells. More than 90% of bladder cancers begin in the transitional
cells. This type of bladder cancer is called transitional cell carcinoma.
About 8 % of bladder cancer patients have squamous cell carcinomas. Cancer
that is only in cells in the lining of the bladder is called superficial
bladder cancer. Cancer that begins as a superficial tumor may grow through
the lining and into the muscular wall of the bladder. This is known as
invasive cancer. Invasive cancer may extend through the bladder wall.
The cause of bladder cancer is unknown, although there are many risk factors
that increase a person’s chance of developing the disease. Some
of these risk factors are age, tobacco usage, occupation, infections,
previous treatment with cytoxan or arsenic, race, being a man, family
history, and personal history of bladder cancer. Some of the common symptoms
of bladder cancer can include: blood in urine, pain during urination,
frequent urination, or feeling the need to urinate without results. People
with these symptoms may see their family doctor or a urologist, who specializes
in diseases of the urinary system.
Upon a doctor visit with a urologist the patient may have one or more
of the following tests: physical exam, urine tests, intravenous pyelogram,
and cystoscopy. During a cystoscopy the doctor may remove sample tissue,
called a biopsy to be sent to a pathologist for diagnosis. Staging is
sometimes done at the time of diagnosis, or sometimes additional tests
such as, CT scan, MRI, sonogram, intravenous pyelogram, bone scan, or
chest x-ray may need to be done. Sometimes staging is not done till surgery.
Once staging is complete the doctor may refer you to doctor who specializes
in treating cancer. Treatment generally begins within a few weeks after
diagnosis. Treatment may consist of surgery, chemotherapy, radiation therapy,
or biological therapy. A treatment plan that is best for you will be decided
upon by you and your healthcare team.
Bone cancer is a cancerous tumor of the bone that destroys normal bone
tissue. Not all bone tumors are cancerous. Noncancerous bone tumors are
more common than malignant ones. Both types of bone tumors may grow and
compress healthy bone tissue, but noncancerous tumors do not spread, or
destroy bone tissue, and are rarely a threat to life.
Cancerous tumors that begin in bone tissue are called primary bone cancer.
Cancer that spreads to the bones from other parts of the body, such as
the breast, lung, or prostate is called metastatic cancer, and is named
for the organ or tissue in which it began. Primary bone cancer is far
less common than cancer that spreads to the bones. Common types of primary
bone cancer are osteosarcoma, chondrosarcoma, and The Ewing Sarcoma Family
Osteosarcoma is a cancer of the bone that usually affects the large bones
of the arm or leg. It occurs most commonly in young people and affects
more males than females. Sarcoma is cancer of the bone, cartilage, fat,
muscle, blood vessels, or other connective or supportive tissue. The cause
of bone cancer is not exactly known but factors that contribute to developing
tumors are high-dose external radiation therapy, treatment with certain
anticancer drugs, and heredity.
The most common symptom of bone cancer is pain, but not all bone cancers
cause pain. Swelling can also be seen with bone cancer. To help diagnose
bone cancer the doctor will ask your personal and family medical history.
He or she will also perform a physical exam and order lab and diagnostic
testing that may include x-rays, bone scan, CT scan, MRI , PET scan, and
biopsy. A biopsy is used to remove a tissue sample from the bone tumor
to determine if cancer is present. This tissue is then sent to a pathologist
to determine if it is cancer or not. Treatment options depend on the type,
size, location, and stage of the tumor, as well as age and person’s
health. Once diagnosis is confirmed the doctor will go over treatment
options with you. Treatment options include surgery, chemotherapy, radiation
therapy, and cryosurgery. A treatment plan that is best for you will then
be decided upon by you and your physician.
Brain cancer is the growth of abnormal cells in the tissues of the brain.
Brain tumors can be benign or malignant. Brain tumors are grouped by grade.
The grade of the tumor refers to the way the cells look under a microscope.
Cells from low grade tumors (grade 1 and 2) look more normal and generally
grow more slowly than cells from high grade tumors (grades 3 and 4). Over
time a low grade tumor may become a high grade tumor. There are many types
of primary brain tumors. Tumors are named according to the type of cells
or the part of the brain in which they begin.
Most primary tumors begin in glial cells. This type of tumor is called
a glioma. Among adults, the most common types of tumors are; 1. astrocytomas
which arise from star-shaped glial cells called astrocytes. It can be
any grade and most often occurs in the cerebrum. 2. Meningioma is a tumor
that arises in the meninges. It can be grades 1, 2, or 3. It is usually
benign and grows slowly. 3. Oligodendroglioma which the tumor that arises
from cells that make the fatty substance that covers and protects nerves.
It usually occurs in the cerebrum. It’s most common in middle-aged
adults. It can be grade 2 or 3.
No one knows the exact cause of brain tumors. Researchers are studying
whether people with certain risk factors are more likely than others to
develop a brain tumor. Studies have found the following as risk factors
for brain tumors: ionizing radiation and family history. Symptoms of a
brain tumor depend on tumor size, type, and location. Symptoms may be
caused when a tumor presses on a nerve or harms a part of the brain. They
also may be caused when a tumor blocks the fluid that flows through and
around the brain, or when the brain swells because of the buildup of fluid.
The most common symptoms of brain tumors are headaches, nausea and vomiting,
changes in speech, vision, or hearing, problems balancing or walking,
changes in mood, personality, or ability to concentrate, problems with
memory, muscle jerking, or twitching, and numbness or tingling in the
arms or legs.
If you have symptoms that exhibit a brain tumor your doctor will give
you a physical exam and ask about your personal and family health history.
Additional tests including neurologic exam, MRI, CT scan, angiogram, spinal
tap, and biopsy may be done also. A biopsy is the removal of tissue to
look for tumor cells. Biopsies are done by a surgeon and sent to a pathologist
to evaluate the tissue under a microscope for diagnosis and grade. Once
testing is complete, treatment options are discussed with the patient.
Brain cancer treatment options include surgery, chemotherapy, and radiation
therapy. The choice of treatment depends on the type and grade of brain
tumor, its location in the brain, its size, and your age and general health.
A treatment plan that is best for you will then be decided upon by you
and your physician.
Occurring in both men and women, breast cancer forms in tissues of the
breast, usually the ducts and lobules. Each breast is divided into 15-20
sections called lobes. Lobes contain many smaller lobules. Lobules contain
groups of tiny glands that can produce milk. The breasts also contain
lymph vessels, which carry a clear fluid called lymph. The lymph vessels
lead to small, round organs called lymph nodes. Groups of lymph nodes
are found near the breast in the axilla, above the collarbone, in the
chest behind the breastbone, and in many other parts of the body.
No one knows the exact cause of breast cancer, although there are many
risk factors that may increase a person’s chance of developing the
disease. Some of the risk factors are age, personal history of breast
cancer, family history, certain breast changes, genetic alterations, reproductive
and menstrual history, race, radiation therapy to chest, breast density,
taking diethylstilbestrol, being obese after menopause, physical inactivity,
and, use of alcoholic beverages. A woman should talk with her health care
provider about personal risk of getting breast cancer and screenings available
to detect breast cancer. Screenings available to detect breast cancer
before any symptoms would arise are: mammogram, clinical breast exam,
and breast self-exam. Symptoms that women should watch for are a change
in how the breast or nipple feels, a change in how the breast or nipple
looks, and nipple discharge.
If a woman has a breast change, her doctor must determine whether it is
due to breast cancer or some other cause. Additional tests that are performed
to determine this are clinical breast exam, diagnostic mammography, ultrasound,
MRI, and/or biopsy. Often, tissue must be removed from the breast to help
the physician determine if cancer is present. If the diagnosis is cancer,
the physician needs to know the stage of the disease to determine treatment
plan. Staging may involve x-rays and labs and often the extent of the
cancer is not known until after surgery to remove the tumor in the breast
and the lymph nodes under the arm. Once the testing is complete and staging
is done, your physician will discuss all available treatment options consisting
of surgery, radiation therapy, chemotherapy, hormonal therapy, and biological therapy.
A treatment plan that is best for you will then be decided upon by you
and your healthcare team.
The organ connecting the uterus and vagina is called the cervix, and cervical
cancer forms in its tissues. It is usually slow-growing cancer that may
not have symptoms but can be found with regular pap tests. Cervical cancer
is almost always caused by human papillomavirus infection. Early detection
is very important in cervical cancer. If all women had pelvic exams and
Pap tests regularly, most precancerous conditions would be detected and
treated before cancer develops. With this, most invasive cancers could
be prevented and any invasive cancer that does occur would likely be found
at an early, curable stage.
Precancerous changes that may occur do not usually cause pain, so, therefore,
are often not detected unless a woman has a pelvic exam and a pap test.
Symptoms usually do not appear until abnormal cervical cells become cancerous
and invade nearby tissue. When this happens the most common symptom is
abnormal bleeding. Menstrual bleeding may last longer and be heavier than
usual. Bleeding after menopause and increased vaginal discharge is another
symptom of cervical cancer. The pap test and pelvic exam allow the doctor
to detect abnormal changes in the cervix. If the exam suggests something
other than infection, other tests will be done to find out what the problem
is. One of the most common tests is colposcopy in which they use a colposcope
to look closely at the cervix. During this procedure, the doctor may remove
a small amount of cervical tissue to be examined by a pathologist. Removing
tissue may cause some bleeding or discharge, but healing usually occurs
quickly. Some pain similar to menstrual cramping may also be experienced.
In some cases, it is not clear whether an abnormal pap test is caused
by problems in the cervix or in the endometrium. If this should arise,
the doctor may do a D and C (dilatation and curettage) to scrape tissue
from the lining of the uterus as well as the cervical canal to determine
where the problem is. Treatment for precancerous lesions depends on whether
the lesion is low or high grade if the woman wants to have children in
the future, age and general health, and the preference of the woman and
her doctor. Some of these options are cryosurgery, cauterization, or laser
surgery to destroy the abnormal area without harming nearby healthy tissue.
The choice of treatment for cervical cancer depends on the location and
size of the tumor, the stage of the disease, a woman’s age, and
general health. Staging is then done to determine if cancer has spread
and if so to what parts. Blood tests, urine tests, CT scan, intravenous
pyelogram, ultrasound, and MRI are usually done as well as a thorough
pelvic exam in the operating room with the patient under anesthesia. Some
of the procedures done are called cystoscopy and proctosigmoidoscopy.
Once staging is complete your physician will go over all available treatment
options for the diagnosis which include surgery, radiation therapy, chemotherapy,
and biological therapy. A treatment plan will then be decided upon by
you and your healthcare team.
Most colon cancers are adenocarcinomas (cancers that begin in cells that
make and release mucus and other fluids) and form in the tissues of the
colon. The rectum is the last several inches of the largest intestine
closest to the anus, and it is in these tissues that rectal cancer may
form. Cancers that affect either of these organs may also be called colorectal cancer.
The exact causes of colorectal cancer are not known, however, there are
several risk factors that increase a persons chance of developing colorectal
cancer. These are age, diet, polyps, personal medical history, family
medical history, and ulcerative colitis. Research shows that colorectal
cancer develops gradually from benign polyps. Early detection and removal
of polyps may help to prevent colorectal cancer. Research has also shown
that changes in certain genes raise the risk of colorectal cancer. People
who have increased risk factors should ask their doctors when to begin
checking for colorectal cancer through testing. Some of these tests are
a fecal occult blood test, sigmoidoscopy, colonoscopy, double contrast
barium enema, and digital rectal exam.
Signs and symptoms of colorectal cancer include, change in bowel habits,
diarrhea, constipation, and feeling that bowel does not empty completely.
Other symptoms include blood in the stool, stools that are narrower than
usual, abdominal discomfort, weight loss, constant tiredness, and vomiting.
To find the cause of the symptoms the physician will evaluate your medical
history, perform a physical exam, and order diagnostic tests. Some of
the tests include: x-rays, sigmoidoscopy, colonoscopy, polypectomy, and
biopsy. A biopsy is removing a sample of tissue to be sent to lab for
a pathologist to look at under a microscope to be used to determine diagnosis.
Once diagnosis is determined the doctor will want to know the stage or
extent of the disease. Additional tests may be ordered to determine this.
Treatment of colorectal cancer depends on the size, location, and extent
of the tumor, as well as patient’s general health. Patients are
often treated by a team of specialists, including a gastroenterologist,
surgeon, medical oncologist, and radiation oncologist. Several different
types of treatment options can be used and are sometimes combined. These
include surgery, chemotherapy, radiation therapy, biological therapy,
and clinical trials. After diagnosis, a treatment plan that is best for
you will then be decided upon by you and your healthcare team.
Cancer that begins in the esophagus is divided into two major types, squamous
cell carcinoma and adenocarcinoma. Squamous cell carcinomas are present
in squamous cells that line the esophagus. They usually occur in the upper
and middle part of the esophagus. Adenocarcinomas usually develop in the
glandular tissue in the lower part of the esophagus. Treatment is similar
for both types.
The exact causes of esophageal cancer is not known, but the following
risk factors can increase the risk of developing cancer of the esophagus.
These risk factors are: age, sex, tobacco use, alcohol use, Barrett’s
esophagus, and medical history. Early esophageal cancer usually does not
cause symptoms. However, as the cancer grows, symptoms may include: difficult
or painful swallowing, severe weight loss, pain in the throat or back,
behind the breastbone or between the shoulder blades, hoarseness or chronic
cough, vomiting, and coughing up blood.
Testing is done to help find the cause of symptoms, and may include a
barium swallow or an endoscopy. If an abnormal area is found during an
endoscopy the doctor can collect cells and tissue in a procedure called
a biopsy. The biopsy can show cancer, tissue changes that may lead to
cancer, or other conditions. If the diagnosis is esophageal cancer the
next step is to determine the stage of the disease to see if it has spread
to any other parts of the body. Some tests used to determine this are,
CT scan, bone scan, and bronchoscopy.
Treatment options depend on size, location, and extent of the tumor, and
the general health of the patient. Patients are often treated by a team
of specialists, which may include a gastroenterologist, surgeon, medical
oncologist, and radiation oncologist. Treatment options available for
esophageal cancer are surgery, radiation therapy, chemotherapy, laser
therapy, and photodynamic therapy. After diagnosis, a treatment plan that
is best for you will be decided upon by you and your physician.
The exact cause of gastric cancer, which forms in tissues lining the stomach,
is unknown, but there are certain risk factors that may contribute to
why one person develops the disease and another does not. Risk factors
for gastric cancer are: age, sex, race, diet, helicobacter pylori infection,
smoking, certain health problems, and family history.
Early stomach cancer often does not cause clear symptoms, but as the cancer
grows the most common symptoms are discomfort in the stomach area, feeling
full or bloated after a small meal, nausea and vomiting, and weight loss.
If you have some of the above symptoms that suggest stomach cancer your
doctor may refer you to a gastroenterologist, who specializes in diagnosing
and treating digestive problems. The physician will obtain your personal
and family health history. Additional blood or other lab tests may be
done along with a physical exam, upper GI series that consists of x-rays
of your esophagus and stomach, endoscopy, and biopsy. Through a biopsy
the tissue is sent to a pathologist to check the tissue for cancer cells.
Once diagnosis of gastric cancer is confirmed the doctor needs to know
the extent or stage of the disease. Additional tests may be ordered to
check this. Blood tests, chest x-rays, CT scan, endoscopic ultrasound,
or laparoscopy may be used to determine stage. Treatment options depend
mainly on the size and place of the tumor, the stage of disease, and your
general health. Treatment may involve surgery, chemotherapy, or radiation
therapy. After diagnosis, a treatment plan that is best for you will be
decided up on by you and your physician.
Head & Neck Cancer
Cancer that arises in the head or neck region (in the nasal cavity, sinuses,
lips, mouth, salivary glands, throat, or larynx). Head and neck cancers
account for approximately 3 to 5% of all cancers in the United States.
These cancers are more common in men and people over 50. 85% of head and
neck cancers are linked to tobacco use. People who use both tobacco and
alcohol are at greater risk for developing these cancers.
Certain risk factors for head and neck cancer include:
- Oral cavity: Sun exposure; possibly human papillomavirus infection
- Salivary glands: Radiation to the head and neck
- Paranasal sinuses and nasal cavity: Certain industrial exposures, such
as wood or nickel dust inhalation
- Nasopharynx: Asian/Chinese ancestry, Epstein-Barr virus infection, occupational
exposure to wood dust and consumption of certain preservatives or salted foods
- Oropharynx: Poor oral hygiene, human papilomavirus infection, and use of
mouthwash that has a high alcohol content are possible risk factors
- Hypopharynx: Pummer-Vinson syndrome, a rare disorder that results from
iron and other nutritional deficiencies.
- Larynx: Exposure to airborne particles of asbestos
Symptoms that have been associated with this type of cancer include a lump
or sore that does not heal, a sore throat that doesn’t go away,
difficulty swallowing, and change or hoarseness in the voice. To find
the cause of the symptoms a doctor evaluates your medical history, performs
a physical exam, and orders diagnostic tests. Tests may include endoscopy,
lab tests, x-rays, CT scan, MRI, PET scan, and a biopsy to remove tissue
from suspicious area for a pathologist to examine to determine diagnosis.
If the diagnosis is cancer the doctor will then need to know the stage
or extent of the disease to see if it has spread. This may involve x-rays,
lab tests, and examination under anesthesia in the operating room.
Once diagnosis and stage are confirmed your doctor will go over treatment
options with you. The treatment plan depends on the location of the tumor,
the stage of the cancer and the person’s age and general health.
Treatment options consist of surgery, radiation therapy, and chemotherapy.
A plan that is best for you will then be decided upon by you and your
Hodgkin’s Lymphoma is a cancer of the immune system that is marked
by the presence of a type of cell called the Reed-Sternberg cell. The
two major types of Hodgkin’s lymphoma are classical Hodgkin’s
lymphoma and nodular lymphocyte-predominant Hodgkin’s lymphoma.
Hodgkin’s lymphoma begins in cells of the immune system. The lymphatic
system is part of the immune system and includes the lymph vessels, lymph,
and lymph nodes. Since lymphatic tissue is in many parts of the body,
Hodgkin’s lymphoma can start almost anywhere. Usually, it’s
first found in a lymph node above the diaphragm, but may also be found
in a group of lymph nodes.
Hodgkin’s lymphoma begins when a lymphocyte becomes abnormal. The
abnormal cell divides to make copies of itself. Hodgkin’s lymphoma
cells are called Reed-Sternberg cells. These cells don’t protect
the body from infections or other diseases, and also don’t die when
they should. The lymph node that contains the Reed-Sternberg cells becomes
enlarged, and the abnormal cells can spread throughout the body.
It is unknown why one person develops this and another does not, but there
are certain risk factors that increase the chance that a person will develop
the disease. These include certain viruses, weakened immune system, age
and family history. Hodgkin’s lymphoma can cause many symptoms also.
Symptoms consist of swollen lymph nodes in the neck, underarms, or groin,
becoming more sensitive to the effects of alcohol, having painful lymph
nodes after drinking alcohol, weight loss for no known reason, fever that
does not go away, soaking night sweats, itchy skin, coughing, trouble
breathing, chest pain, and weakness and tiredness that don’t go away.
Upon visiting with your physician about your symptoms you may also have
a physical exam, blood tests, chest x-rays, and biopsy. A biopsy is the
only sure way to diagnosis Hodgkin’s lymphoma and is done by removal
of entire lymph node or part of lymph node. A pathologist checks the tissue
under microscope for Hodgkin’s lymphoma cells. This helps determine
the type of Hodgkin’s lymphoma either classical Hodgkin’s
lymphoma which most people have that show Reed-Sternberg cells. The nodular
lymphocyte-predominant Hodgkin’s lymphoma is rare and the abnormal
cell is called a popcorn cell.
In order to come up with the best treatment plan the doctor needs to know
the stage of the disease. To find out what parts of the body are affected
by the disease additional testing may need to be done involving CT scan,
MRI, PET scan, and bone marrow biopsy may be done. Upon final test results
a treatment plan will be determined by you and your healthcare team and
will be determined mainly on the type of your Hodgkin’s lymphoma,
its stage, whether you have a mass or tumor that is more than 4 inches
wide, age, and if you’ve had weight loss, drenching night sweats,
or fever. People with Hodgkin’s lymphoma may be treated with chemotherapy,
radiation therapy, or both which will be discussed to you by your healthcare
Cancer that starts in blood-forming tissues such as the bone marrow and
causes large numbers of blood cells to be produced and enter the blood
stream is called leukemia. In leukemia, the bone marrow makes abnormal
white blood cells. The abnormal cells are leukemia cells and like normal
blood cells, leukemia cells don’t die when they should. They may
crowd out normal white blood cells, red blood cells, and platelets, making
it hard for normal blood cells to do their work.
Types of leukemia can be grouped based on how quickly the disease develops
and gets worse. Leukemia is either chronic in which the disease usually
gets worse slowly, and the leukemia cells can still do some of the work
of normal white blood cells. Leukemia can also be acute in which the disease
gets worse quickly and the leukemia cells can’t do any of the work
of normal white blood cells. The types of leukemia can also be grouped
based on the type of white blood cell that is affected. The four common
types are chronic lymphocytic leukemia (CML), chronic myeloid leukemia
(CLL), acute lymphocytic leukemia (ALL), and acute myeloid leukemia (AML).
No one knows the exact cause of leukemia but there are certain risk factors
that increase the chance that a person will get this disease. Risk factors
include being exposed to high levels of radiation, atomic bomb explosions,
smoking, benzene, chemotherapy, down syndrome and certain other inherited
diseases, myelodysplastic syndrome and certain other blood disorders,
human T-cell leukemia virus type 1, and family history of leukemia.
The symptoms of leukemia depend on the number of leukemia cells and where
these cells collect in the body. With chronic leukemia people may not
have symptoms and the doctor may find the disease during a routine blood
test. With acute leukemia people usually go to the doctor because they
feel sick. Common symptoms of chronic or acute leukemia may include swollen
lymph nodes that usually don’t hurt, fevers or night sweats, frequent
infections, feeling weak or tired, bleeding and bruising easily, swelling
or discomfort in the abdomen, weight loss for no known reason, and pain
in the bone or joints.
During your appointment with a physician a personal and family medical
history will be taken. Additional tests include blood tests, physical
exam, cytogenetics, spinal tap, chest x-ray, and bone marrow biopsy. A
bone marrow biopsy is the only sure way to know if there are leukemia
cells in you bone marrow. During the biopsy a small amount of bone marrow
is removed for a pathologist to examine under a microscope to check for
leukemia cells. When final test results are received the doctor will discuss
treatment options consisting of watchful waiting, chemotherapy, targeted
therapy, biological therapy, radiation therapy, and stem cell transplant.
The choice of the treatment depends mainly on the type of leukemia, age,
and if leukemia cells were found in your cerebrospinal fluid. Your doctor
can describe your treatment choices, expected results, and possible side
effects. Together you and your healthcare team will develop a treatment
plan to meet your needs.
Lung cancer forms in tissues of the lung, usually in the cells lining air
passages. The two main types are small cell lung cancer and non-small
cell lung cancer. These types are diagnosed based on how the cells look
under a microscope. Each type of lung cancer grows and spreads in different
ways and is treated differently. Non-small cell lung cancer is more common,
and generally grows and spreads more slowly. Non-small cell cancer is
divided into three main types and are named for the type of cells in which
the cancer develops. These three types are squamous cell carcinoma, adenocarcinoma,
and large cell carcinoma. Small cell lung cancer, sometimes referred to
as oat cell cancer, is less common than non-small cell lung cancer. This
cancer grows more quickly and is likely to spread to other organs of the body.
There are several causes of lung cancer, most related to the use of tobacco,
including cigarettes, cigars and pipes, environmental tobacco smoke, radon,
asbestos, pollution, lung diseases, and personal history. Some of the
common symptoms of lung cancer include cough that doesn’t go away
and gets worse over time, constant chest pain, coughing up blood, shortness
of breath, wheezing, hoarseness, repeated problems with pneumonia or bronchitis,
swelling of the neck and face, loss of appetite or weight loss, and fatigue.
During your doctor appointment a family history of cancer will be taken
along with, your medical history, smoking history, and exposure to environmental
and occupational substances. A physical exam is performed as well as a
chest x-ray and sputum cytology to detect lung cancer. To confirm the
diagnosis the doctor must examine tissue from the lung and this is done
through a biopsy. Tissue can be obtained through bronchoscopy, needle
aspiration, thoracentesis, or thoracotomy. The tissue is then examined
under a microscope by a pathologist for diagnosis.
If the diagnosis is cancer the doctor will next need to know the stage
of the disease to help plan treatment. Tests used for staging include
CT scan, MRI, radionuclide scanning, bone scan, and mediastinoscopy. Planning
for treatment depends on the type of lung cancer non-small cell versus
small cell, the size, location and extent of tumor, as well as general
health of the patient. Treatment options available are surgery, chemotherapy,
radiation therapy, photodynamic therapy, and clinical trials. Together
you and your healthcare team will answer your questions and develop a
treatment plan to best meet your needs.
Melanoma is a form of cancer that begins in melanocytes (cells that make
the pigment melanin). It may begin in a mole, but can also begin in other
pigmented tissues, such as in the eye or in the intestines. Melanoma is
the most serious type of cancer of the skin. Melanoma occurs when melanocytes
(produce melanin, the pigment that gives skin it natural color) become
malignant. Most pigment cells are in the skin therefore when melanoma
starts in the skin, the disease is called cutaneous melanoma. Melanoma
may also occur in the eye (ocular melanoma or intraocular melanoma).
Chances of developing melanoma increase with age and can occur on any
skin surface. In men it is often found on the trunk or head and neck and
in women it often develops in the lower legs. If developed in dark-skinned
people it tends to occur under the fingernails or toenails, or on palms
or soles. The exact cause of melanoma is not known although there are
certain risk factors that may contribute to people developing melanoma.
Some of them are dysplastic nevi, many ordinary moles, fair skin, personal
history of melanoma or skin cancer, family history of melanoma, weakened
immune system, severe blistering sunburns, and ultraviolet radiation.
Most time the first sign of melanoma is the change in the size, shape,
color or feel of an existing mole. Most melanomas have a black or blue-black
area and some early stage melanomas may be found when an existing mole
changes slightly for example, when a new black area forms. Other symptoms
like newly formed fine scales and itching in a mole also are common symptoms
of early melanoma. In advanced melanoma, the texture of the mole may change
leaving the mole hard or lumpy. Melanomas may feel different than regular
moles. More advanced moles may itch, ooze, or bleed also, but melanomas
usually don’t cause pain.
A skin examination is often part of a routine checkup by a health care
provider. Upon skin exam if the doctor sees a suspicious spot on the skin
that he thinks is melanoma, the patient will need a biopsy. During a biopsy
the doctor tries to remove all the suspicious looking growth then the
tissue is sent to a pathologist to examine under a microscope to look
for cancer cells. If the diagnosis is melanoma, the doctor then needs
to know the stage of the disease before planning treatment. To stage the
doctor may need to remove nearby lymph nodes to check for cancer cells,
and may also order chest x-ray, blood tests, and scans to help facilitate
this process. If melanoma is diagnosed early and treated when the tumor
is thin and has not deeply invaded the skin a cure is possible. However,
if melanoma is not removed in its early stage, cancer cells may grow downward
from the skin surface and invade healthy tissue. If this happens the disease
often spreads to other parts of the body making the disease difficult
Melanoma patients are often treated by a team consisting of a dermatologist,
surgeon, medical oncologist, radiation oncologist, and plastic surgeon.
Treatment choices such as surgery, chemotherapy, biological therapy, or
radiation therapy are discussed with the patient after staging is complete.
The doctor and patient work together to develop a plan to best fit the
A type of cancer that begins in plasma cells, multiple myeloma may also
be called Kahler disease, myelomatosis, and plasma cell myeloma. Plasma
cells are white blood cells that make antibodies. Antibodies are part
of the immune system that works with other parts of the immune system
to help protect the body from germs and other harmful substances.
Like other cancers, myeloma begins when a plasma cell becomes abnormal.
Over time myeloma cells collect in the bone marrow. They may damage the
solid part of the bone. When myeloma cells collect in several of your
bones, the disease is called multiple myeloma. Myeloma cells make antibodies
called M proteins and others proteins that can collect in the blood, urine,
No one knows the exact cause of multiple myeloma, but research has shown
that certain risk factors increase the chance of developing the disease.
Some of these are age 65 and over, race, being a man, personal history
of monoclonal gammopathy of undertermined significance, and family history
of multiple myeloma. Symptoms associated with multiple myeloma include
bone pain, usually in the back and ribs, broken bones, usually in the
spine, feeling weak and very tired, feeling very thirsty, frequent infections
and fevers, weight loss, nausea or constipation, and frequent urination.
Multiple myeloma can sometimes be found after a routine blood test, but
it is suspected more often after an x-ray for a broken bone. To help evaluate
for multiple myeloma your doctor may ask you about your personal and family
medical history and do a physical exam. Additional tests may include blood
tests, urine tests, x-rays, and a biopsy to evaluate to see if there are
myeloma cells in your bone marrow. After the biopsy tissue from the biopsy
is sent to a pathologist to review under a microscope to determine if
the diagnosis is multiple myeloma. If diagnosis is confirmed that you
may need additional blood tests, CT scan, and MRI to determine the extent
or stage of the disease and best treatment plan.
With multiple myeloma there are many treatment options. These include
watchful waiting, chemotherapy, and stem cell transplant. If bone disease
is involved radiation therapy is also sometimes involved. The choice of
treatment depends on how advanced the disease is and symptoms that accompany
it. A treatment plan that is best for you will be decided upon by you
and your healthcare team.
Myelodysplastic Syndromes (MDS)
Myelodysplastic syndromes, or MDS, is a group of diseases in which the
bone marrow does not make enough healthy blood cells. Also called preleukemia
and smoldering leukemia. When you have MDS, your bone marrow doesn’t
totally stop working, it still makes blood cells. It makes fewer cells,
and the cells it does make don’t always work right.
The cause of MDS is unknown in about 70-80 out of 100 people who have
it. In the other 20-30 people who have MDS, it may be caused by treatment
for another disease. MDS is more common in smokers and is more common
in people who have spent time around or worked with chemicals like benzene.
It is also more common in those 60 years or older and is rare in young people.
Some of the symptoms of MDS are fatigue, weakness, shortness of breath,
bruising easily, bleeding for no reason, and frequent infections. Symptoms
of MDS can be managed by blood transfusions, antibiotics to help or control
infection and growth factors that help healthy or normal cells make more cells.
Tests that are done to determine if you have MDS are blood tests and bone
marrow biopsy. Once diagnosis is confirmed the doctor will go over treatment
options with you. Options for treatment may consist of demethylating agents
to help bone marrow make blood cells normally, immunosuppressive drug
therapy to help make blood cells more slowly, chemotherapy, bone marrow
transplant, and/or stem cell transplant. A treatment plan that is best
for you will be decided upon by you and your healthcare team.
Non-Hodgkin’s lymphoma can be any of a large group of cancers of
the lymphocytes (white blood cells). It is a cancer that begins in cells
of the immune system, which fights infections and other diseases and is
composed of the lymphatic system which includes the following: lymph vessels,
lymph, and lymph nodes. Since lymphatic tissue is in many parts of the
body, lymphoma can start almost anywhere, but it’s first found in
a lymph node. Non-Hodgkin’s Lymphoma begins when a lymphocyte (usually
a B cell) becomes abnormal. There are several risk factors that can increase
the chance that a person will develop this disease. Some of them are weakened
immune system, certain infections, and age.
Symptoms associated with Non-Hodgkin’s Lymphoma are swollen, painless
lymph nodes in the neck, armpits, or groin, unexplained weight loss, fever,
soaking night sweats, coughing, trouble breathing, chest pain, weakness
and tiredness that don’t go away, pain, swelling, or a feeling of
fullness in the abdomen.
If you have swollen lymph nodes or other symptoms that suggest lymphoma
your physician will perform a series of tests. He may start with a personal
and family history and do a physical exam as well as some blood tests.
A chest x-ray may be ordered to check for swollen lymph nodes or other
signs of disease as well as a biopsy of a lymph node to confirm diagnosis.
After the biopsy is performed a pathologist reviews the tissue sample
and identifies the type of lymphoma found. The most common types of Non-Hodgkin’s
Lymphoma are diffuse large b-cell lymphoma and follicular lymphoma. Lymphomas
may also be grouped by how quickly they are likely to grow also. Indolent
or low-grade lymphomas grow slowly. They tend to cause few symptoms. Aggressive
also called intermediate-grade and high-grade lymphomas grow and spread
more quickly. They tend to cause severe symptoms. Over time may indolent
lymphomas become aggressive lymphomas.
In order for your doctor to make a plan of care he needs to know the stage
and extent of the disease. Staging may involve some of the following tests;
bone marrow biopsy, CT scan, MRI, ultrasound, spinal tap, and PET scan.
The stage is based on where lymphoma cells are found and how many areas
of the body are affected. After all testing is complete your physician
will go over treatment options with you. Treatment options for Non-Hodgkin’s
Lymphoma consist of chemotherapy, biological therapy, radiation therapy,
or watching the disease since no symptoms are noticed at this time. A
treatment plan that is best for you will be decided upon by you and your
Most ovarian cancers are either ovarian epithelial carcinomas (cancer that
begins in the cells on the surface of the ovary) or malignant germ cell
tumors (cancer that begins in egg cells). Ovarian cancer cells can break
away from the ovary and spread to other tissues and organs in a process
called shedding. When ovarian cancer sheds, it tends to form new tumors
on the peritoneum or the large membrane that lines the abdomen and on
the diaphragm. Ovarian cancer cells can also enter the blood stream or
lymphatic system and travel and form new tumors in other parts of the body.
The exact causes of ovarian cancer is not known, however there are certain
risk factors that increase the chance of developing the disease. These
are family history, age, if you’ve had children, personal history,
fertility drugs, talc use, and hormone replacement therapy. About 1 in
every 57 women in the United States develop ovarian cancer. Most women
are over 50, but it can also affect younger women. Studies have now shown
that breastfeeding and taking birth control pills may decrease a woman’s
chance of developing ovarian cancer. Also women who have had a tubal ligation
or hysterectomy are at lower risk. Evidence also shows that reducing the
amount of fat in the diet may lower the risk of developing ovarian cancer.
Ovarian cancer can be hard to detect early. The sooner it is found and
treated, the better a woman’s chance for recovery. Many times women
with ovarian cancer have no symptoms or just mild symptoms until the disease
is in an advanced stage. Some of the symptoms of ovarian cancer may include
general abdominal discomfort and/or pain, nausea, diarrhea, constipation,
frequent urination, loss of appetite, feeling of fullness even after a
light meal, weight gain or loss with no known reason, and abnormal bleeding
from the vagina.
Scientists are studying ways to detect ovarian cancer before symptoms
develop. They are exploring the usefulness of measuring the level of CA-125,
a substance called a tumor marker which is often found in higher-than-normal
amounts in the blood of women with ovarian cancer. They are also evaluating
transvaginal ultrasounds to help detect the disease early.
To help find the cause of the symptoms a doctor will evaluate your medical
history and also perform a physical exam. Tests used to help diagnose
ovarian cancer include pelvic exam, ultrasound, CA-125, lower GI series,
CT scan, and biopsy. A biopsy is removing some of the tissue to be examined
under a microscope by a pathologist for diagnosis. If the diagnosis is
ovarian cancer the doctor will want to learn the extent or stage of the
disease to see if the cancer has spread to other parts of the body. This
may involve surgery, x-rays, other imaging procedures, and lab tests.
Treatment depends on the stage of the disease and general health of the
patient. Patients are often treated by a team of specialists including
gynecologic oncologist, medical oncologist, and radiation oncologist.
Some treatment options are surgery, chemotherapy, radiation therapy, and
clinical trials. A treatment plan that is best for you will be decided
by you and your healthcare team.
Also called exocrine cancer, pancreatic cancer is a disease in which malignant
cells are found in the tissues of the pancreas. Most pancreatic cancers
begin in the ducts that carry pancreatic juices.
The exact cause of pancreatic cancer is not known, but research has shown
that people with certain risk factors are more likely than others to develop
pancreatic cancer. These risk factors are age, smoking, diabetes, being
male, being African American, family history, and chronic pancreatitis.
Other studies have shown that exposure to certain chemicals in the workplace
or a diet high in fat may increase the chance of getting pancreatic cancer.
Early pancreatic cancer often does not cause symptoms and is often called
silent disease. As the cancer grows the symptoms may include pain in the
upper abdomen or upper back, yellow skin and eyes, dark urine, weakness,
loss of appetite, nausea and vomiting, and weight loss. If a patient has
symptoms that suggest pancreatic cancer the physician will ask about the
patient’s medical history, perform a physical exam, and order lab
tests. Other tests that may be done consist of CT scan, ultrasound, endoscopic
retrograde cholangiopancreatography, percutaneous transhepatic cholangiography,
and biopsy. The biopsy is used to remove tissue from the tumor for a pathologist
to look under a microscope for cancer cells to confirm diagnosis.
When pancreatic cancer is diagnosed the doctor needs to know the extent
or stage of the disease to help plan treatment so additional tests may
be ordered. Such tests may include blood tests, CT scan, ultrasound, laparoscopy,
or angiography. Tests results help your physician decide which treatment
is appropriate for you. Cancer of the pancreas is very hard to control
with current treatments so for this reason many doctors encourage patients
to consider taking part in a clinical trial. Other treatment options for
pancreatic cancer are radiation therapy, chemotherapy, and surgery. A
treatment plan that is best for you will be decided upon by you and your
The prostate is a gland in the male reproductive system found below the
bladder and in front of the rectum. No one knows the exact cause of prostate
cancer; however, research has shown that men with certain risk factors
are more likely than others to develop prostate cancer. Some of the risk
factors are age 65 and over, family history, race, certain prostate changes,
and certain genetic changes.
A man who develops prostate cancer may not have any symptoms, but for
men who do, the common symptoms include urinary problems, including not
being able to pass urine, hard time starting or stopping the urine flow,
needing to urinate often, especially at night, weak flow of urine, urine
flow that starts and stops, and pain or burning during urination. Other
symptoms include difficulty having an erection, blood in the urine or
semen, and frequent pain in the lower back, hips, or upper thighs. Your
doctor can check for prostate cancer before you have any symptoms by asking
about you personal and family medical history. You’ll have a physical
exam, digital rectal exam, and blood test for prostate-specific antigen
to help detect any presence of prostate cancer.
If the digital rectal exam and PSA test detect a problem in the prostate
your doctor may suggest other tests to make the diagnosis. These may include
other lab tests, transrectal ultrasound, and transrectal biopsy. A biopsy
is removal of tissues to look for cancer cells. It is the only sure way
to diagnosis prostate cancer. Tissue is removed from areas of the prostate
and sent to the lab for a pathologist to check the sample for cancer cells.
If cancer is found the pathologist studies tissue samples to report the
grade of the tumor. The grade tells how much the tumor tissue differs
from normal prostate tissue and suggests how fast the tumor is likely
to grow. Tumors with higher grades tend to grow faster than those with
lower grades. They are also more likely to spread. Doctors use tumor grading
along with your age and other factors to suggest treatment options.
If the biopsy shows that you have cancer, your doctor needs to learn the
extent or stage of the disease to help you choose the best treatment.
Staging is done to find out whether the tumor has invaded nearby tissues
and has spread. Some additional tests that may be done to help determine
this are bone scan, CT scan, and MRI. Once testing is complete treatment
options will be gone over with you. Treatment depends mainly on your age,
the grade of the tumor, the number of biopsy tissue samples that contain
cancer cells, the stage of the cancer, your symptoms, and your general
health. Treatment options for prostate cancer are active surveillance,
or watching, surgery, radiation therapy, hormone therapy, and chemotherapy.
Cancer that forms in the tissues of the kidneys is called renal cancer.
Kidney cancer includes renal cell carcinoma (cancer that forms in the
lining of very small tubes in the kidney that filter the blood and removes
waste products) and renal pelvis carcinoma (cancer that forms in the center
of the kidney where urine collects).
Kidney cancer develops most often in people over 40, but no one knows
the exact causes of this disease. Research has shown that people with
certain risk factors are more likely than others to develop kidney cancer.
Some of the risk factors are smoking, obesity, high blood pressure, long-term
dialysis, Von Hippel-Lindau syndrome, occupation, and gender.
Symptoms of kidney cancer can include blood in the urine, pain in the
side that does not go away, a lump or mass in the side of the abdomen,
weight loss, fever, and feeling very tired or having a general feeling
of poor health.
If a patient has symptoms that suggest kidney cancer the doctor will perform
some tests. These include physical exam, urine tests, blood tests, intravenous
pyelogram, CT scan, ultrasound, biopsy, and surgery. A biopsy is done
to get a sample of tissue from the kidney to be sent to the pathologist
to look for cancer cells and determine diagnosis. The doctor also needs
to know the extent of the disease or stage to help plan the best treatment.
Staging may involve testing such as ultrasound, CT scan, and MRI. After
testing is complete your doctor will go over treatment options with you.
These include surgery, arterial embolization, radiation therapy, biological
therapy, or chemotherapy.
There are several types of skin cancer. Skin cancer that forms in melanocytes
(skin cells that make pigment) is called melanoma. Skin cancer that forms
in basal cells (small, round cells in the base of the outer layer of skin)
is called basal cell carcinoma. Skin cancer that forms in squamous cells
(flat cells that form the surface of the skin) is called squamous cell
carcinoma. Skin cancer that forms in neuroendocrine cells (cells that
release hormones in response to signals from the nervous system) is called
neuroendocrine carcinoma of the skin. Most skin cancers form in older
people on parts of the body exposed to the sun or in people who have weakened
The two most common types of skin cancer are basal cell cancer and squamous
cell cancer. These cancers usually form on the head, face, neck, hands,
and arms. These areas are exposed to the sun, but skin cancer can occur
anywhere. Basal cell skin cancer grows slowly. It usually occurs on areas
of the skin that have been in the sun. It is most common on the face.
Basal cell cancer rarely spreads to other parts of the body. Squamous
cell skin cancer also occurs on parts of the skin that have been in the
sun, but it also may be in places that are not in the sun. Squamous cell
cancer sometimes spreads to lymph nodes and organs inside the body.
Research has shown that people with certain risk factors are more likely
than others to develop skin cancer. Some of these risk factors are ultraviolet
radiation, scars or burns on the skin, infection, exposure to arsenic,
chronic skin inflammation or skin ulcers, diseases that make the skin
sensitive to the sun, radiation therapy, medical conditions or drugs that
suppress the immune system, personal history of one or more skin cancers,
and family history of skin cancer. The best way to prevent skin cancer
is to protect yourself from the sun and use sunscreen lotions.
If found and treated early most basal cell and squamous cell skin cancers
can be cured. Changes on the skin are the most common signs of skin cancer.
This may consist of a new growth, a sore that doesn’t heal, or a
change in an old growth. Skin changes to watch for are small, smooth,
shiny, pale, or waxy lump; firm, red lump; sore or lump that bleeds or
develops a crust or a scab; flat red spot that is rough, dry, or scaly
and may become itchy or tender; red or brown patch that is rough and scaly.
Sometimes skin cancer is painful, but usually is not.
If you notice changes on the skin the doctor must find out whether it
is due to skin cancer or something else. The doctor will remove all or
part of the area that does not look normal by a procedure called a biopsy.
This will then be sent to a lab for a pathologist to check for skin cancer.
A biopsy is the only sure way to diagnose skin cancer. If the biopsy shows
you have cancer, the doctor will then need to know the extent or stage
of the disease. The stage is determined by the size of the growth, how
deeply it has grown beneath the top layer of the skin, and whether it
has spread to nearby lymph nodes or to other parts of the body. Once diagnosis
and staging is done your doctor will go over treatment options with you.
Sometimes all of the cancer is removed during the biopsy and no additional
treatment is needed. Treatment for the disease depends on the type and
stage of the disease, the size and place of the growth, and your general
health and medical history. Treatment options include surgery, topical
chemotherapy, photodynamic therapy, or radiation therapy.
Testicular cancer forms in tissues of the testis (one of two egg-shaped
glands inside the scrotum that make sperm and male hormones). It usually
occurs in young or middle-aged men. Two main types of testicular cancer
are seminomas, or cancers that grow slowly and are sensitive to radiation
therapy and make up about 30% of all testicular cancers. The other type
of testicular cancer is nonseminomas or different cell types that grow
more quickly than seminomas. Nonseminomas include choriocarcinoma, embryonal
carcinoma, teratoma, and yolk sac tumors.
The cause of testicular cancer is unknown however; there are several factors
that increase a man’s chance of developing testicular cancer. These
are undescended testicle, abnormal testicular development, Klinefelter
syndrome, and history of testicular cancer. Most testicular cancers are
often found by men themselves.
Doctors generally examine the testicles during routine physical exams
also. Some of the symptoms of testicular are painless lump or swelling
in either testicle, any enlargement of a testicle or change in the way
it feels, a feeling of heaviness in the scrotum, a dull ache in the lower
abdomen or the groin, a sudden collection of fluid in scrotum, and pain
or discomfort in a testicle or in the scrotum.
If any of these symptoms appear you should see your doctor and he will
evaluate your general health as well as perform a physical exam, ultrasound,
and lab tests. If a tumor is suspected the doctor will order a biopsy
which involves surgery to remove the testicle. If only one testicle remains,
a small incision is made to get tissue from the testicle. Once sample
tissue is obtained it is sent to the lab for a pathologist to review under
a microscope to determine diagnosis. If the diagnosis is testicular cancer
the stage or extent of the disease will have to be determined to plan
appropriate treatment for the patient.
Most men with testicular cancer can be cured with surgery, radiation therapy,
and/or chemotherapy. Seminomas and nonseminomas grow and spread differently,
and each type may need different treatment. Treatment also depends on
the stage of the cancer, patient’s age, and general health.
The thyroid is an organ at the base of the throat that makes hormones that
help control heart rate, blood pressure, body temperature, and weight.
Four main types of thyroid cancer are papillary, follicular, medullary,
and anaplastic thyroid cancer. The four types are based on how the cancer
cells look under a microscope.
Papillary and follicular thyroid cancers account for 80-90% of all thyroid
cancers. Both types begin in the follicular cells of the thyroid. Most
of this type tends to grow slowly and if detected early, most can be treated
Medullary thyroid cancer accounts for 5-10% of thyroid cancer cases and
it arises in C cells not follicular cells. Medullary thyroid cancer is
easier to control if it is found and treated before it spreads to other
parts of the body. Anaplastic cancer is least common with only 1-2% of
cases. It arises in follicular cells and the cells are highly abnormal
and difficult to recognize. This type of cancer is usually very hard to
control because the cancer cells tend to grow and spread very quickly.
The exact cause of thyroid cancer is unknown however; certain risk factors
are more likely to contribute to thyroid cancer in one individual versus
another. The risk factors associated with an increased chance of developing
thyroid cancer are radiation, family history, being female, age, race,
and not enough iodine in the diet. Early thyroid cancer does not cause
symptoms. As cancer grows symptoms may include a lump or nodule in the
front of the neck near the Adam’s apple, hoarseness or difficulty
speaking in a normal voice, swollen lymph nodes, especially in the neck,
difficulty swallowing or breathing or pain in the throat or neck. If a
person has symptoms that suggest thyroid cancer the doctor may perform
a physical exam and ask about the patient’s personal and family
medical history. Lab tests and imaging including ultrasound, radionuclide
scanning, and a biopsy may also be performed. A biopsy is the removal
of tissue to look for cancer cells and is the only sure way to know whether
a nodule is cancerous. The tissue is examined under a microscope by a
pathologist for diagnosis.
If the diagnosis is thyroid cancer, the doctor then needs to know the
extent or stage of the disease. Additional testing including ultrasound,
MRI, CT scan, and radiounuclide scan may be done to see whether the cancer
has spread to the lymph nodes or other areas within the neck. After testing
and staging are complete treatment options are discussed. Treatment options
are surgery, radioactive iodine therapy, hormone treatment, external radiation
therapy, and chemotherapy.
Two types of uterine cancer are endometrial cancer (cancer that begins
in cells lining the uterus) and uterine sarcoma (a rare cancer that begins
in muscle or other tissues in the uterus). No one knows the exact causes
of uterine cancer however; there are certain risk factors that make it
more likely for one woman to get the disease over another. Risk factors
include age, endometrial hyperplasia, hormone replacement therapy, obesity,
tamoxifen use, race, and colorectal cancer.
Uterine cancer usually occurs after menopause, but it may also occur around
the time menopause begins. Some of the symptoms seen with uterine cancer
are unusual vaginal bleeding or discharge, difficult or painful urination,
pain during intercourse, and pain in the pelvic area. If a woman has symptoms
that may suggest uterine cancer her doctor may check lab and urine tests
and do a pelvic exam, pap test, transvaginal ultrasound, and a biopsy
to remove tissue from the uterine lining to confirm diagnosis.
Once diagnosis is determined the doctor needs to know the extent or stage
of the disease to plan the best treatment. Staging is a careful attempt
to find out whether the cancer has spread, and if so to what parts of
the body. Additional tests to determine stage may be blood and urine tests,
x-rays, CT scan, ultrasound test, MRI, sigmoidoscopy, or colonoscopy.
In most cases, the most reliable way to stage uterine cancer is to remove
the uterus so the pathologist can examine it for any signs of cancer.
Once staging is complete treatment options are gone over with you. Treatment
options consist of surgery, radiation therapy, and hormonal therapy.