Thehealthtime.com

Diethylstilbestrol
What is diethylstilbestrol?
Diethylstilbestrol (say: “die-eth-el-still-bess-troll”), or DES, is a man-made form of estrogen. Between 1938 and 1971, millions of women in the United States were given DES to prevent them from having a miscarriage or giving birth too early. DES was used in other countries until at least the early 1980s.

In 1971, researchers found that women who were exposed to DES before they were born are more likely to get a certain kind of cancer of the vagina and cervix (called clear cell adenocarcinoma, or CCA). These women are sometimes called “DES daughters.”
Return to top

Has DES caused any other problems?
Yes. Women who took DES during pregnancy have about a 30% higher risk of getting breast cancer. Daughters of women who took DES during pregnancy also may have a higher risk of breast cancer.

Up to one-third of DES daughters have reproductive tract problems. These problems increase their risk of not being able to get pregnant, having a miscarriage or having a baby too early. Even with the increased risk, however, most of these women have no problem getting pregnant and delivering their babies.

The sons of women who took DES during pregnancy (sometimes called “DES sons”) have a higher risk of some reproductive tract problems, such as abnormally small or undescended testicles. However, they seem to have normal fertility.
Return to top

How do I know if I was exposed to DES?
If you were pregnant between 1938 and 1971 and think that you may have taken a prescription medicine during your pregnancy, try to get your medical records from the doctors who took care of you. Remember, DES was used in other countries until the early 1980s.

If you were born between 1938 and 1971, ask your mother if she remembers taking any prescription medicine during her pregnancy.
Return to top

I took DES during pregnancy. What should I do?
Be sure to tell your children that you took DES during your pregnancy and encourage them to tell their doctors.

Although the increase in your risk of getting breast cancer is small, you should also tell your doctor that you took DES during pregnancy. Your doctor will discuss this risk factor with you. He or she will most likely recommend regular breast screenings and medical exams.
Return to top

I am a DES daughter. What special health care needs do I have?
Be sure to tell your family doctor that you were exposed to DES.

If you have never had a pelvic exam, your doctor will want you to have one. Your doctor will check your vagina, uterus, cervix and ovaries for lumps. Your exam should also include a colposcopy (say: “call-poss-kah-pee”). A colposcopy is an exam in which your doctor uses an instrument (called a colposcope) to magnify the view of the tissues in your vagina and cervix.

It is important to have pelvic exams and Pap smears every year. You might have a little trouble getting pregnant, but most DES daughters are usually able to get pregnant and have healthy babies.
Return to top

I am a DES daughter and I’m pregnant. Is there any risk to my baby?
There is a slightly greater risk of infertility and miscarriage in women exposed to DES. However, most DES daughters have healthy babies. Talk with your doctor about your concerns.
Return to top

I am a DES son. What special health care needs do I have?
Tell your family doctor that you were exposed to DES. Have regular prostate exams and do regular self-exams of your testicles. You also should report any urinary or genital problems to your doctor.

Thehealthtime.com

Prostate Cancer Treatment Options
What are some of the treatment options for prostate cancer?
The treatment options for prostate cancer depend in part on your age, your overall health and whether the tumor has spread. For tumors that are still inside the prostate, radiation therapy (using x-rays that kill the cancer cells) and a surgery called radical prostatectomy are common treatment options. “Watchful waiting” is also a treatment option. In this approach, no treatment is given until the tumor gets bigger. Watchful waiting may be the best choice for an older man who has a higher risk of dying from something other than his prostate cancer.

Usually, tumors that have grown beyond the edge of the prostate can’t be cured with either radiation or surgery. They can be treated with hormones that slow the cancer’s growth.

___________________

What is radical prostatectomy?
Radical prostatectomy is a surgery to remove the whole prostate gland and the nearby lymph nodes. After the prostate gland is taken out through an incision, a catheter (a narrow rubber tube) is put through the penis into the bladder to carry urine out of the body until the area heals.

Other kinds of prostate surgery are less invasive and have different risks and recovery rates. Your doctor will help decide which type of surgery is the best option for you. Laparoscopic surgery helps the surgeon see inside your body using a thin tube with a tiny camera attached to it. Small cuts are made near the tumor site, and thin tools are used to remove the tumor and surrounding tissue. Some hospitals also have robots to assist in this kind of surgery. The doctor operates the robot arm from a computer.

Your doctor will talk to you about the kind of anesthesia used during surgery. You may be given general anesthesia, which puts you into a sleep-like state. Or an epidural or spinal anesthesia may be given instead. This kind of anesthesia blocks nerve routes from the spine and numbs the area.

___________________

What are the risks and benefits of radical prostatectomy?
If you’re young and in good health, the short-term risks of this surgery are low. The hospital stay is usually 2 to 3 days, with the catheter left in place for 2 to 3 weeks. You’re usually able to go back to work in about 1 month. You shouldn’t have severe pain with this surgery. Most men regain bladder control a few weeks to several months after the surgery.

The main advantage of surgery is that it offers the most certain treatment. That is, if all of the cancer is removed during surgery, you are probably cured. Also, the surgery provides your doctor with accurate information about how advanced your cancer is, since the nearby lymph nodes are taken out along with the tumor.

Surgery does have risks. The main risks of radical prostatectomy are incontinence (loss of bladder control) and impotence (loss of the ability to get or keep an erection long enough to have sex). Most bladder and impotence problems improve with time.

Fortunately, only a very low percentage of men have severe incontinence after radical prostatectomy. Up to 35% of men have some accidental leakage of urine during heavy lifting, coughing or laughing. The chance of impotence (erectile dysfunction) is lower if the surgeon is able to avoid cutting the nerves. This may not be possible if the tumor is large. Your age and degree of sexual function before the surgery are also important factors. If you’re under 50 years old when you have this surgery, you’re likely to regain sexual function. If you’re older than 70, you’re more likely to lose sexual function. Remember, even if the nerves are cut, feeling in your penis and orgasms remain normal. Only the ability to get a rigid penis for sexual intercourse is lost. However, there are medicines and devices that can help make the penis rigid.

You could lose a lot of blood during this surgery. Before the surgery, you might want to save about 2 units of your own blood in case you need a transfusion.

___________________

What is radiation therapy? What are its risks and benefits?
There are 2 types of radiation therapy. In one type, called external (beam) radiation therapy, radiation is given from a machine like an x-ray machine. In another type — internal radiation therapy — radioactive pellets (called “seeds”) are injected into the prostate gland. This is sometimes called seed therapy or brachytherapy (say: “brake-ee-ther-uh-pee”). Both types have about the same results in curing prostate cancer.

The external beam radiation therapy is usually only takes about 10 minutes, but it is given 5 days a week over 6 to 8 weeks. Some people might find this time-consuming. However, you don’t need any anesthesia for this kind of treatment. The side effects are milder than the side effects that can occur with seed therapy. However, seed therapy can be done with just one hospital visit. For seed therapy, you’ll need to have anesthesia for a few minutes, but you should be able to go home right after the treatment. In seed therapy, higher doses of radiation can be put right into the cancer. You may feel more discomfort after this treatment.

Older studies show that about one half of patients become impotent within 5 years of having radiation therapy but newer forms of radiation may have different outcomes. Many men feel very tired at the end of the treatment period. About 15% to 30% of men who have radiation therapy have side effects like urinary burning, urinary bleeding, frequent urination, rectal bleeding, rectal discomfort or diarrhea during or shortly after the treatment. Erectile dysfunction (impotence) is a common side effect which often gets worse over time. More serious complications are rare. However, a degree of uncertainty goes along with radiation treatment. Since the prostate gland and the lymph nodes are not taken out, your doctor can’t tell the exact size of the tumor. The cancer could come back many years after radiation treatment.

At 10 years after treatment, cure rates are about the same for radiation therapy and radical prostatectomy. Men who have radiation therapy avoid the risks of surgery. There is also no risk of bleeding. You don’t have to stay in the hospital and you’ll recover faster. Daily activities can usually go on during the treatment. Incontinence is extremely rare after radiation therapy. Surgery, however, may give you a better chance of cure over the long term.

___________________

What are the risks and benefits of watchful waiting?
Often, prostate cancers are small and grow slowly. Because many men with a slow-growing tumor have the same life expectancy as men who don’t even have prostate cancer, it may not be necessary to treat very small, very slow-growing prostate tumors. Also, for some men, the side effects of treatment outweigh the benefits. With watchful waiting, you have no treatment, but you see your doctor often. If there’s no sign the cancer is growing, you continue to have no treatment. Hormone therapy can be started if the cancer starts to grow.

It can be hard to tell if a small tumor will grow slowly or quickly. Your doctor will get clues about the way your tumor will grow by checking your prostate-specific antigen (PSA) level with a blood test, examining the biopsy tissue and giving you a rectal exam. The choice of watchful waiting is up to you.

___________________

What is the purpose of hormone therapy? Are there side effects?
The purpose of hormone therapy is to lower the level of male hormones, called androgens, which are produced mostly in the testicles. Androgens, such as testosterone, help the prostate tumor grow. Shots or pills can be given over a period of several months, or the testicles can be surgically removed. Once the testosterone is out of your body, the prostate cancer usually shrinks and new growth slows down. Hormone treatments are often used in combination with other kinds of prostate cancer treatments.

Hormone therapy does have side effects. Some of the more serious side effects include loss of sex drive, weakened bones, erectile dysfunction, fatigue and osteoporosis.

Hormone treatments are also used in patients with cancer that has spread beyond the prostate gland. While prostate cancer that has spread usually responds to 1 or 2 years of hormone therapy, it does not cure the disease and most tumors eventually begin to grow again. Once this happens, the treatment goal is to control symptoms. No current treatment can cure prostate cancer once hormone therapy stops working. Recently however, chemotherapy has been shown to help some people with advanced prostate cancer live longer.

___________________

What happens after prostate cancer treatment?
Talk with your doctor about how frequently you will need follow-up PSA blood tests or other exams.
___________________

Where can I get more information about prostate cancer?
Your family doctor, your oncologist (cancer doctor), the radiotherapist and your urologist can give you information. Your local hospital or cancer center may refer you to a local prostate cancer support group, where you can meet other men who have had this cancer.

Thehealthtime.com

Colorectal Cancer Screening
What is cancer?
The body is made up of many types of cells. Normally, cells grow, divide and then die. Sometimes, cells mutate (change) and begin to grow and divide more quickly than normal cells. Rather than dying, these abnormal cells clump together to form tumors. If these tumors are cancerous (also called malignant tumors), they can invade and kill your body’s healthy tissues. From these tumors, cancer cells can metastasize (spread) and form new tumors in other parts of the body. By contrast, noncancerous tumors (also called benign tumors) do not spread to other parts of the body.
_________________

What is colorectal cancer?
Colon cancer is cancer of the large intestine (called the colon). Rectal cancer is cancer of the rectum (which is the part of the large intestine closest to the anus). These forms of cancer have many common features. They are often referred to together as colorectal cancer.

Colorectal cancer is the second leading cause of cancer deaths in the United States. Many of these deaths happen because the cancers are found too late to be effectively treated. If colorectal cancer is found early enough, it is usually very treatable and not life-threatening.
_________________

What are the signs and symptoms of colorectal cancer?
Most colorectal cancers begin as a polyp (say “pohl-ip”). At first, a polyp is a small, harmless growth in the wall of the colon. However, as a polyp gets larger, it can develop into a cancer that grows and spreads.

See your doctor if you have any of the following warning signs:
•Bleeding from your rectum
•Blood in your stool or in the toilet after you have a bowel movement
•A change in the shape or consistency of your stool (such as diarrhea or constipation lasting several weeks)
•Cramping pain in your lower stomach
•A feeling of discomfort or an urge to have a bowel movement when there is no need to have one
•Weakness or fatigue
•Unintended weight loss
Other conditions can cause these same symptoms. You should see your doctor to find what is causing your symptoms.
_________________

What are screening tests for colorectal cancer?
Screening tests can find polyps or cancers before they are large enough to cause any symptoms. Screening tests are important because early detection means that the cancer can be more effectively treated. Your doctor will choose the tests that are right for you. The following are some screening tests for colorectal cancer:

Digital Rectal Exam. In this exam, your doctor puts his or her gloved finger into your rectum to find any growths. This exam is simple to do and is not painful. However, because this exam can find less than 10% of colorectal cancers, it must be used along with another screening test.

Barium Enema. For this test, you are given an enema (injection of fluid into the rectum) with a liquid that makes your colon show up on an X-ray. Your doctor looks at the X-ray to find abnormal spots in your entire colon. If you have an abnormal spot or if the radiologist detects polyps in your colon, your doctor will probably want you to have colonoscopy.

Fecal Occult Blood Test. This test checks your stool for blood that you can’t see. Your doctor gives you a test kit and instructions to use it at home. Then you return a stool sample to your doctor for testing. If blood is found, another test is done to look for a polyp, cancer or another cause of bleeding. Your doctor will also ask you to not eat certain foods or take certain medicines that may interfere with test results a few days before the test.

Certain foods and medicines can make this test turn out positive, even though you don’t really have blood in your stool. This is called a “false-positive” test. These include some raw vegetables, horseradish, red meat, non-steroidal anti-inflammatory drugs (such as ibuprofen), blood thinners, vitamin C supplements, iron supplements and aspirin. Some medical conditions, like hemorrhoids, can also cause a false-positive test result.

Stool DNA Test. This test checks your stool for cells that are shed by colon cancers or precancerous polyps. Your doctor will give you a test kit with instructions on how to collect a stool sample. Your doctor may also ask you to not eat certain foods or take certain medicines that may interfere with test results a few days before the test. If your test turns out positive, your doctor will probably want you to have a screening test called colonscopy.

Colonoscopy. Before you have this test, you are given a medicine to make you relaxed and sleepy. A thin, flexible tube connected to a video camera is put into your rectum, which allows your doctor to look at your entire colon. The tube can also be used to remove polyps and cancers during the exam. Colonoscopy may be uncomfortable, but it is usually not painful.

Virtual Colonoscopy. This is a new test that uses a computerized tomography (CT) machine to take pictures of your colon. Your doctor can then see all of the images combined in a computer to check for polyps or cancer. If your doctor finds polyps or other abnormalities in your colon, you will need to have a traditional colonscopy to examine them in more detail or to remove them.

Flexible Sigmoidoscopy. In this test, your doctor puts a thin, flexible, hollow tube with a light on the end into your rectum. The tube is connected to a tiny video camera so the doctor can look at the rectum and the lower part of your colon.

This test can be a bit uncomfortable, but it lets your doctor see polyps when they are very small (before they can be found with a fecal occult blood test). Because flexible sigmoidoscopy may miss cancerous polyps that are in the upper part of the colon, some doctors prefer a colonoscopy. Your doctor will discuss these options with you.

_________________

When should I be screened for colorectal cancer?
Colorectal cancer is more common in older people, so doctors usually screen people 50 years of age and older. Some people have risk factors that make them more likely to get colorectal cancer at a young age. Screening should begin earlier in these people.

You should be screened for colorectal cancer at a younger age if:
•You have had colorectal cancer or polyps in the past
•You have a family history of colorectal cancer or polyps
•You have ulcerative colitis or Crohn’s disease
•You have a hereditary colon cancer syndrome
•You eat a high-fat, low-fiber diet
If you are in one of these groups, you may also need to be tested more often than a person who doesn’t have risk factors for colorectal cancer.

Any one of the screening programs (with a digital rectal exam at each screening) may be used every 5 to 10 years, beginning at 50 years of age.
Talk to your family doctor to decide which screening tests you should have and how often you should be screened. If you don’t have any risk factors for colorectal cancer, you will probably have your first screening test around 50 years of age.

Thehealthtime.com

Endometrial Cancer
What is endometrial cancer and what should I watch for?
Endometrial cancer is cancer of the endometrium, which is the lining of the uterus (sometimes called the womb). The most common sign of endometrial cancer is unusual bleeding from your vagina, especially bleeding after menopause.

Endometrial cancer can almost always be treated successfully if it’s caught early. You can increase the chances that endometrial cancer will be found early by telling your doctor about any unusual bleeding.
_______________

Am I at risk for endometrial cancer?
Certain things may put you at greater risk for getting endometrial cancer. One risk factor is age. Endometrial cancer is most common in women who are over 50 years of age.

You may also be at greater risk if you have had high levels of estrogen in your body. Many things can increase your estrogen level. These include being extremely overweight, having high blood pressure or having diabetes.

Using estrogen replacement therapy without taking progestin may also increase the risk for endometrial cancer. For this reason, women who use hormone replacement therapy (HRT) usually take a combination of estrogen and the hormone progestin. While estrogen stimulates growth of the entometrium, progestin seems to protect the lining of the uterus from the estrogen. In fact, using birth control pills that contain both estrogen and progestin during the childbearing years seems to decrease a woman’s risk of endometrial cancer.

Other things that may put you at greater risk for endometrial cancer include having your first period before the age of 12 or going through menopause after the age of 50. Women who have never been pregnant and women who use a medicine called tamoxifen may also be at greater risk.

_______________

How is endometrial cancer diagnosed?
Your doctor will diagnose endometrial cancer by performing one or more of the following procedures:
•Endometrial biopsy is usually done in your doctor’s office. It involves inserting a narrow tube into the uterus through the vagina and removing a small amount of tissue from the uterine wall. This tissue is tested in a lab for cancerous or precancerous cells. The procedure usually takes just a few minutes.
•Dilatation and curettage (D & C) involves dilating (widening) the cervix (the opening of the uterus) and inserting an instrument to scrape or suction the uterine wall and collect tissue. D & C is also an outpatient procedure. It takes about an hour and usually requires general anesthesia (puts you in a sleep-like state).
•Imaging tests are used in patients with certain medical conditions such as severe high blood pressure, obesity, diabetes, or other types of cancer. These patients may not be able to safely have anesthesia. In these patients, imaging tests such as an MRI scan, CT scan, or ultrasound may help diagnose cancer of the uterus.
Your doctor will talk to you about which procedure is right for you.
_______________

What is the treatment for endometrial cancer?
Treatment usually involves removing the uterus, the fallopian tubes and the ovaries. You may also need to take progestin to balance out high levels of estrogen. Sometimes radiation therapy or chemotherapy is also needed. Treatment can be very effective, especially if the cancer is found early.

Thehealthtime.com

Testicular Cancer
What is testicular cancer?
The body is made up of many types of cells. Normally, cells grow, divide and then die. Sometimes, cells mutate (change) and begin to grow and divide more quickly than normal cells. Rather than dying, these abnormal cells clump together to form tumors. If these tumors are cancerous (also called malignant tumors), they can invade and kill your body’s healthy tissues. From these tumors, cancer cells can metastasize (spread) and form new tumors in other parts of the body. By contrast, noncancerous tumors (also called benign tumors) do not spread to other parts of the body.

Testicular cancer begins in one or both of the testicles. The testicles are located in the scrotum, the skin “sack” that hangs beneath the penis. They manufacture male hormones and produce sperm. A normal adult testicle is about the size of a golf ball and is round, smooth and firm.
>>

Who gets testicular cancer?

Male reproductive system Cancer of the testicles is the most common cancer in young men (15 to 34 years old). A man is more likely to get testicular cancer if any of the following are true about him:
•Is white.
•Has a father or brother who has or has had testicular cancer.
•Has a testicle that did not come down into the scrotum (called an undescended testicle). This applies even if surgery was done to remove the testicle or bring it down.
•Has small testicles or testicles that aren’t shaped normally.
•Has Klinefelter’s syndrome (a genetic condition where male infants are born with an extra X chromosome).
>>

What are some signs of testicular cancer?
•A hard, painless lump on the testicle (this is the most common sign)
•Pain or a dull ache in the scrotum
•A scrotum that feels heavy or swollen
•Bigger or more tender “breasts”
Testicular cancer is very treatable if it’s found early. Your doctor can check your testicles during an exam. A self-exam is another good way to check for testicular cancer (see below for self-exam directions). If you find anything unusual during a self-exam (like a lump or swelling), see your doctor right away.
>>

How do I do a testicular self-exam?
The best time to do the exam is during or right after a shower or a bath. The warm water relaxes the skin on your scrotum and makes the exam easier.
•Check your testicles one at a time. Use one or both hands.
•Cup your scrotum with one hand to see if there is any change from the way it feels normally (Picture #1).
•Place your index and middle fingers under one testicle with your thumb on top.
•Gently roll the testicle between your thumb and fingers.
•Feel for any lumps in or on the side of the testicle (Picture #2). Repeat with the other testicle.
•Feel along the epididymis (a soft, tubelike, comma-shaped structure behind the testicle that collects and carries sperm) for swelling (Picture #3).
It’s normal for one testicle to be a little bit bigger than the other. The testicles should be smooth and firm. If you feel any bumps or lumps, visit your doctor right away.
>>

How is testicular cancer treated?
If you have testicular cancer, your doctor will likely suggest that the cancerous testicle be surgically removed. Your doctor may also recommend chemotherapy if your cancer is more severe or the cancer has spread to other parts of the body.

Thehealthtime.com

Definition

Lip cancer is a malignant tumor, or neoplasm, that originates in the surface layer cells of the epithelial tissue in the upper or lower lip.

Description

The upper and lower lips are the well-defined red (often called vermilion) areas that surround the opening to the mouth. They contain muscles and special cells (receptors) that are sensitive to heat and cold and feeling. Largely taken for granted, the lips are important in identifying types of food to the brain and in getting food into the mouth. Lips also play a crucial role in speech.

A malignant tumor, or neoplasm, that originates in the cells of one of the lips is a cancer of the lip. Lip cancer almost always begins in the flat, or squamous, epithelial cells. Epithelial cells form coverings (tissues) for the surfaces of the body. Skin, for example, has an outer layer of epithelial tissue.

If a part of the lip is affected by cancer and must be removed by surgery, there will be significant changes in eating ability and speech function. The more lip tissue removed, the greater the disturbances to the normal patterns of talking and eating.

Demographics

Nine out of ten cases of lip cancer are diagnosed in people over the age of 45. Age, or the aging process, may contribute to the way the cancer develops. As a line of cells gets older, the genetic material in a cell loses some of its ability to repair itself. When the repair system is operating normally, damage to the genetic material, or DNA, caused by ultraviolet light from the sun is quickly weeded out. When the system fails, changes in the genetic material are kept, and they multiply when a cell divides.

If the genetic material cannot repair itself, damage caused by exposure to environmental factors such as sunlight and chemicals can quickly set in motion the uncontrolled growth of cells.

The effects of factors that are known to cause lip cancer, such as smoking and exposure to sunlight, also add up as a person ages. Thus, the combination of a breakdown in the repair system in the genetic material and the considerable periods of time (decades) over which a person is exposed to cancer agents probably causes lip cancers. However, researchers are still investigating how lip cancers start.

Men are at greater risk for lip cancer than women. Depending on where they live, men are two or three times more likely to be diagnosed than women. Fair-skinned people are more likely to get lip cancer than those with dark skin. For reasons not yet understood, people in Asia have a much lower risk of lip cancer than those living on other continents. In many parts of Asia, lip cancer is extremely rare. In North America, nearly 13 out of 100, 000 men will be diagnosed with lip cancer during their lifetime. In Australia, about 13.5 men per 100, 000 will be diagnosed.

The frequency of lip cancer is often lumped together with oral cancer, although lip cancer is probably much more like skin cancer in origin. There are about 30, 000 new diagnoses of mouth and lip cancer in the United States each year.

In some places, such as South Australia, women are experiencing a striking increase in lip cancer diagnoses. There are several theories to explain the trend. Among them, perhaps fewer women regularly wear hats, which offer protection from the sun. Women might also be for-going lipstick, which serves as another barrier to sunlight.

Causes and symptoms

Exposure to sunlight and smoking, particularly pipe smoking, increases the risk of developing lip cancer. However, the way they do so is not understood. Alcohol consumption is tied to oral cancers and may contribute to lip cancer as well.

Much of the evidence about the link between time spent in the sun and lip cancer comes from a look at those who are most likely to be diagnosed. Among them are farmers, golfers, and others who spend long periods of time outdoors.

Lip cancer seems to share some properties with skin cancer in the way it originates. Yet several studies suggest that it takes more than exposure to sun to increase the risk of lip cancer. Viral infection is a risk factor, as is reduced immunity, which is a condition that may be caused by viral infection. A team of researchers in the Netherlands recently reported a link between liver transplants and a higher risk of lip and skin cancer following the transplant. The results are not unexpected. In this procedure, drugs are used to suppress, or lower, the activity of a recipient’s immune system so that a donor organ will be accepted. Thus, the immunity of the organ recipient is low, and lower immunity is linked to lip cancer.

Individuals with acquired immunodeficiency syndrome (AIDS) are at a greater risk for lip cancer. People infected with herpes simplex viruses, papilloma viruses and other viruses may also be at greater risk.

Vitamin deficiency may also be a factor that contributes to lip cancer. The sorts of vitamins found in fruits and vegetables, particularly carotene, the substance the body uses to form vitamins A and C, seem to be important in preventing lip cancer.

Particular symptoms of this cancer include white spots, sores, or lumps on the lip. Pain can also be a symptom, particularly pain in a lymph node near the affected part of the lip. This is a troubling symptom, since it indicates that the cancer has metastasized (spread) beyond the lip.

Diagnosis

Dentists frequently identify a suspicious spot, sore, or lump on the lip. A good dental exam includes an examination of the lips and the mouth. X ray and biopsy, the taking of a tissue sample for analysis, can be used to determine whether or not cancer is present.

Because spots and sores on the lips can be short-lived, people should not be alarmed by every change that appears. However, when there is a change that occurs and stays, it should be investigated. If the next scheduled dental visit is several months away, a special appointment with the dentist or a physician should be made. Dentists should tell their patients, particularly older ones, how to undertake a regular self-exam of the lips between check-ups.

Treatment team

A physician who specializes in oncology, the study and treatment of cancer, will probably take the lead on treatment. A surgeon will remove the cancer. Not all oncologists are surgeons, so it is likely that the team will include a medical oncologist, who coordinates treatment, as well as a surgical oncologist, who performs the surgery.

Because surgery on the lip can interfere with eating and talking, most teams include a nutritionist and a speech pathologist. Scars and alterations of facial features can produce changes in body image, and a social worker may participate in the team to help a patient cope with such changes. It is possible that a dentist or oral surgeon will also play a role. Nurses who administer chemotherapy and monitor the status of patients will be involved, as will radiation technicians and a radiation oncologist. If reconstruction of a lip is necessary because of the amount of tissue removed or the size of a scar, a plastic surgeon will be added to the team.

Clinical staging, treatments, and prognosis

The ability to see a suspicious area on the lips and to detect lip cancer early combine to form the staging process. (One inch equals 2.5 centimeters.)

•Stage I: The cancer is less than one inch in diameter and has not spread.
•Stage II: The cancer is up to approximately two inches in diameter and has not spread.
•Stage III: The cancer is either larger than two inches or has spread to a lymph node on the side of the neck that matches the primary location of the lip cancer. The lymph node is enlarged, but not much more than an inch.
•Stage IV: One or more of several things can occur. There may be a spread of cancer to the mouth or to the areas around the lip, more than one lymph node with cancer, or metastasis (spread) to other parts of the body.
The outlook for recovery from lip cancer is very good if it is diagnosed early. For stage I and stage II cancers, surgery to remove the cancer or radiation treatment of the affected area is sometimes all that is required to produce a cure. Decisions about which method to use depend on many factors, but the size of the tumor and the tolerance a patient has for radiation or chemotherapy are particularly important. The larger the tumor, the more urgent is its removal. Smaller tumors can be treated with radiation or other methods in an effort to shrink them before surgery. In some cases, surgery might be avoided. For stage III cancer with lymph node involvement, the cancerous lymph nodes are also removed.

Chemotherapy may be used at any stage, but it is particularly important for stage IV cancer. In some cases, chemotherapy is used before surgery, just as radiation is, to try to eliminate the cancer without cutting, or at least to make it smaller before it is cut out (excised). After surgery, radiation therapy and chemotherapy are both used to treat patients with stage IV lip cancer, sometimes in combination.

There are many new and promising types of treatment for lip cancer. For example, heat kills some cancer cells, and a treatment known as hyperthermia uses heat to eliminate cancer in some patients.

Because lip cancers are well-studied and often successfully treated, the best practices for dealing with the cancer, or a suspected cancer, are specific. In the case of how to extract and study tissue to determine whether a suspicious growth is malignant (biopsy), size is an extremely useful guide.

It is possible to take tissue from a suspected lip cancer for examination, or biopsy, by simply piercing and extracting tissue with a large, hollow needle. The technique is called a punch biopsy. However, the method is not recommended for any tumor that is thicker than about one-sixteenth of an inch. For thicker tumors, a tissue sample is better taken by cutting into the tumor, that is, making an incision.

The success with identifying lip cancer early and eliminating it means that it is not a big killer. Only 4 in 2.5 million people die from lip cancer each year, or about 112 individuals in the entire U.S. population. In contrast, cancers in the oral cavity, including on the tongue, cause more than 8, 000 deaths in the U.S. each year.

Alternative and complementary therapies
Because there seems to be some link between a chronic absence of vitamins A and C in the diet and lip cancer, some complementary therapies promote taking massive amounts of the vitamins, or megavitamins. The value of such therapy has not been demonstrated. In order to avoid possible side effects or harmful interactions with standard cancer treatment, patients should always notify their treatment team of any over-the-counter or herbal remedies that they are taking.

Coping with cancer treatment

The doctor and patient should discuss the need for a way to communicate if speech is impaired after surgery. A pad and pencil may be all that is needed for a short interval. If there will be a long period of speech difficulty, patients should be ready with additional means, such as TYY phone service.

A change in appearance after the removal of a lip cancer can lead to concerns about body image, and social interaction may suffer. A support group can help. Discussions with a social worker, loved ones, or other patients who have undergone similar treatment can be of major benefit.

If a significant portion of lip is removed, speech therapy may be necessary to relearn how to make certain sounds. Scars and alterations of the lips usually can be reduced or hidden entirely with the techniques available from plastic surgery, so any alteration in appearance because of lip cancer is typically transient.

Reconstruction of the lip will help with appearance, but it might not make it easier to talk, especially if muscle tissue is removed during the surgery to eliminate the cancer. In many cases, the reconstruction process actually damages more muscle and sensory tissue. New methods of reconstructive surgery are being developed to avoid such an outcome.

Appetite may be affected before, during and after treatment. Before treatment, the presence of a tumor can interfere with the tasting of food, and food might not seem as appealing as it once did. During treatment, particularly radiation treatment, the area of the lips and mouth might be sore and make eating difficult. After treatment, a loss of sensation in the part of the lip affected can reduce appetite. A nutritionist can help with supplements for those who experience significant weight loss and who do not have an appetite (anorexia).

Clinical trials

The Cancer Information Service at the National Institutes of Health offers information about clinical trials that are looking for volunteers. The service can be reached at or (800) 422-6237.

Prevention

The best prevention is to stay out of the sun and avoid tobacco and alcohol. Eating plenty of fruits and vegetables is a good measure. Even though the importance of fruits and vegetables is not proven to prevent lip cancer, overall fruits and vegetables are demonstrated cancer-fighters. Any precaution that is taken against contracting human immunodeficiency virus (HIV), which causes AIDS, is also likely to reduce the chance of developing lip cancer.

Special concerns

Certain diseases can mimic a possible lip cancer. They must be ruled out if a suspicious spot is found. This is particularly true in areas where diseases that cause lesions, or sores, on the lips are found. One such disease is histoplasmosis capsulatum, which is caused by a fungus. It sometimes produces an ulcer, or lesion, on the lip that leads to suspicion of lip cancer.

Sometimes lip cancer cannot be cured. It may keep recurring. It may also metastasize, particularly to the lungs. But overall, lip cancer is considered highly curable. Talking openly with the physician in charge of care is important in order for the patient to understand the course of the disease and be prepared to make decisions.

See Also Oropharyngeal cancer

Resources
PERIODICALS
Brennan, P., et al. “Secondary Primary Neoplasms Following Non-Hodgkin’s Lymphoma in New South Wales, Australia.” British Journal of Cancer 82 (April 2000):1344-7.

Haagsma, E.B., et al. “Increased Cancer Risk After Liver Transplantation: a Population-based Study.” Journal of Hepatology 34 (January 2001): 84-91.

ORGANIZATIONS
Support for People with Oral and Head and Neck Cancer (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053.(800) 377-0928. .

Diane M. Calabrese

QUESTIONS TO ASK THE DOCTOR

•Is this cancer curable?
•What is the stage of the cancer?
•What is the likelihood the cancer will recur?
•Is there a clinical trial in which I should participate?

Biopsy

—A procedure in which a tissue sample is taken from the body for examination.

Epithelial tissue

—The collection of cells that form coverings for the surfaces of the body.

Immunity

—Ability to resist the effects of agents, such as bacteria and viruses, that cause disease.

Lymph node

—A concentration of lymphatic tissue and part of the lymphatic system that collects fluid from around the cells and returns it to the blood vessels, and helps with the immune response.

Squamous cells

—Flat epithelial cells, which usually make up the outer layer of epithelial tissue, the layer farthest away from the surface the epithelium covers.

thehealthtime.com

Simple Precautions Prevent Cancer

Nearly half of all cancer deaths are preventable.

That remarkable news comes with an equally stunning corollary — the key to success doesn’t rest with some undiscovered therapies or treatments. Much of cancer’s toll can be reduced with simple precautions, such as lifestyle changes and routine screenings.

But somehow that message isn’t getting through to enough people.

“We can’t beg people to change their behavior, to make the lifestyle changes that we know will reduce cancer risk,” said Carolyn “Bo” Aldige, president of the Cancer Research and Prevention Foundation, in Alexandria, Va.

The biggest threat, of course, is smoking. “You’d have to live on another planet not to know smoking causes cancer,” Aldige said.

Smoking is the single most preventable cause of death in U.S. society. Tobacco causes nearly one in five deaths in the United States, killing about 438,000 Americans each year, according to the American Cancer Society.

Yet, about 45 million adults still smoke — about 23 percent of men and 19 percent of women.

Need more proof that much of cancer’s misery is self-inflicted?

Experts estimate that about one in three of the 564,830 deaths from all forms of cancer this year will be related to poor nutrition, inactivity, overweight and obesity.

Research has shown that “excess calories cause the mutations that start genes going down the pathways that cause cells to divide out of control, and that’s what cancer is,” Aldige said. “If everybody today magically had the appropriate body mass index, we’d start seeing a lot less colorectal, breast, and prostate cancer,” she said.

But there’s a highly effective second line of defense against each of these cancers and many others — screenings. Doctors can test for these cancers, as well as testicular, cervical and other kinds of malignancies, and often catch them before they’ve gone too far. And taking the tests usually requires little time and causes only minimal discomfort.

Eventually, there will even be screenings for lung cancer, probably in the form of “spiral CT” scanning, using special equipment to obtain multiple cross-sectional images of the organs and tissues of the chest, Aldige said.

Then there’s melanoma, the deadly skin cancer that’s on the rise. An estimated 62,190 new cases of the disease will be diagnosed in the United States this year, and 7,910 people will die of it, according to the American Cancer Society.

But melanoma is highly curable if it’s caught in its early stages. The best way to do that: Check your own skin about once a month and become familiar with the pattern of moles, freckles, and other marks so you’ll spot any changes. And a skin exam should be part of a routine cancer checkup by a doctor or qualified health professional.

Many people know that too much sun causes skin cancer, and they use sun block to protect themselves. But not many know that you need some sun every day — about 15 to 20 minutes’ worth, especially younger people, for vitamin D. The trick is to go out before 10 a.m. and after 4 p.m. during warm weather months, Aldige said.

Vitamins play an important role in cancer prevention as well, she said, and eating properly and taking recommended supplements can help.

Yet, the overall problem isn’t just one of people refusing to do what’s good for them, said Dr. Ahmedin Jemal, program director of cancer occurrence at the American Cancer Society.

“It is access to care,” he said. “Recently, the federal government has made access to breast and cervical cancer screenings available to women. But a large percentage of the population is uninsured, and it is a question of access and care,” he said.

“We cannot completely prevent cancer,” Jemal added, “but we can substantially improve by doing the right thing.”

More articles on Preventing Cancer

thehealthtime.com

Cancer of the uterus

What is cancer of the uterus?
The uterus (womb) is a muscular organ within the pelvis. It has a cavity in the middle which is lined with tissue called the endometrium. Until the menopause, the endometrium builds up every month and is passed during a woman’s period.

Cancer of the uterus may develop if there are changes in the cells of endometrium during the last few years before the menopause or in the years just after. Cancer of the uterus should not be confused with cervical cancer, which is an entirely different condition.

What causes cancer of the uterus?
It is still uncertain what makes the mucous membrane grow and become malignant (cancerous). Some risk factors for the development of this cancer exist including being overweight.

Having children tends to reduce a woman’s risk of this disease. Correctly prescribed hormone replacement therapy (HRT) does not cause cancer of the uterus.

Cancer of the uterus is rarely seen in women under 40 and is far more common in women over 60.

What are the symptoms of cancer of the uterus?
This will vary according to whether or not the woman is still having periods. If she is still having periods then the cancer may make her periods more irregular or heavier. If her periods have stopped, then any bleeding from the vagina is abnormal and cancer of the womb needs to be considered as a possibility.

Any woman past the menopause should consult her doctor immediately if she has sudden and unexpected vaginal bleeding. The fact that cancer of the uterus often develops very slowly should not lead any woman to take any unexpected bleeding lightly.

How is cancer of the uterus diagnosed?
In order to diagnose cancer of the uterus, a gynaecologist may wish to perform one of a number of investigations. These include taking a biopsy from the lining of the womb, passing a tiny telescope through the neck of the womb (hysteroscopy) or an ultrasound scan of the pelvis (transvaginal ultrasound).

How is cancer of the uterus treated?
Approximately 90 per cent of women with cancer of the uterus are treated with hysterectomy – surgical removal of the womb and ovaries. The five-year survival rates following surgery are over 70 per cent.

Sometimes surgical treatment is supplemented with radiotherapy. Radiotherapy alone may be used in advanced cases, or cases of recurrent disease, or where surgery is not appropriate.

There is no reliable evidence that chemotherapy or hormone treatment is effective for cancer of the uterus, however, more research is being carried out in this area.

Prognosis
Because cancer of the womb grows slowly and women are alerted to a problem by abnormal bleeding from the vagina, most cancers are detected and treated at an early stage.

Cure rates following surgery are very high.

__________________

The Symptoms of Uterine Cancer

Uterine cancer, also known as endometrial cancer, is common in post-menopausal women. Usually the first sign that something is amiss is the appearance of abnormal vaginal bleeding, which is found in over 90 percent of the women diagnosed with the disease.

Significance
Uterine cancer is the most common female reproductive cancer in the United States, affecting over 40,000 women annually. The five-year survival rate is 83 percent and increases to 95 percent when caught in its early stages.
Risk Factors
Most cases of uterine cancer occur in women between the ages of 55 and 74. White women are twice as likely to contract the disease as black women, but black women are more likely to die from it. Obesity, periods before age 12 or after age 50, tamoxifen use, high blood pressure and diabetes also increase risk.
Symptoms
Besides abnormal vaginal bleeding, symptoms may include heavy menstrual bleeding between periods, watery white or pink vaginal discharge, lower abdominal or pelvic pain, pain during intercourse and trouble urinating.
Causes
Scientists believe that exposure to estrogen is a primary contributing factor. The presence of estrogen without the tempering effects of progesterone during menopause causes the uncontrollable growth of endometrial cells.
Treatment
Treatment usually involves a hysterectomy, although hormone therapy and radiation may be used.
Screening
An endometrial biopsy is recommended for high-risk cases.

thehealthtime.com

Lymphoma: an ignored cancer Largely ignored general public, the lymphomas set up a group of cancers of the lymphatic system. Striking each year more than 11.000 French, they are classified according to the type of cancer cells and their speed of evolution in particular. Discover essence on these diseases.

A cancer of the lymphatic system

The lymphoma touches each year 11.000 French and is responsible of more than 5.000 deaths. This cancer of the lymphatic system is presented in two different forms: the lymphomas non-hodgkiniens and the disease of Hodgkin. Essence on these ignored pathologies.

Lymphomas in figures

We diagnoses in France 11.000 new cases of lymphomas each year. The lymphomas represent by order frequency of cancers the 6th rank. Some figures make it possible to better apprehend the reality of this ignored cancer.

Treatments of the lymphoma

There exist several treatments vis-a-vis the lymphomas according to the type of cancer, of its stage of advance, the general health condition of the patient… Each case is single. The point with the pr. Gilles Rooms of the service of hematology of the CHU of Lyon.

Graft marrow: multiple indications

The Clerc’s Offices of marrow make it possible to treat a cancer and bring a real hope, when the traditional assumption of responsibility is insufficiently effective. Various methods make it possible to reconstitute the osseous marrow of a patient.

To live with a lymphoma

Created in 2006, France Lymphoma Hope intends to fight against the lack of information on the lymphoma. It is the first national association of patients reached of this disease. Its president Guy Bouguet says some to us more.

thehealthtime.com

Zoom on the cancer of the thyroid
Since the middle of the years 1970, the cancer of thyroid doesn’t cease increasing in France. We counts each year more than 3.800 new cases, mainly of the woman. Which are the reasons of this evolution? Does the accident of Tchernobyl have an influence? … Symptoms with the treatments while passing by the risk factors, discover essence on this ignored cancer.

The cancer of thyroid in figures
The cancer of thyroid is increasingly frequent, but the mortality which is associated for him is in fall. Which are the causes of this evolution? The answer appears difficult to bring… Discover some brief replies.

Risk factors of cancer of the thyroid
Why a person will be victim of a cancer of thyroid and the other not? Medicine pains a little to identify the causes of such an injustice. But some risk factors were updated. Discover them with the pr. Jean-Louis Wémeau, president of the Group Seeks on the Thyroid.

Which examinations for the thyroid?
There exist many very precise examinations to detect and diagnose the diseases of the thyroid: clinical observation, palpation of the neck, proportionings of the thyroid, technical hormones of medical imagery… The point with Doctissimo.

A well controlled treatment
We distinguishes three great types of treatment of the cancer of the thyroid: surgery, radioactive iodine, the hormonotherapie. But it is well the surgery which constitutes to it principal assumption of responsibility. It owes éradiquer the tumour but also to prevent that cancer is not propagated. The point with the pr. Jean Louis Peix of the Hospital of Southern Lyon.

Which are the true consequences of Tchernobyl?
In 1986, the accident of the power station of Tchernobyl recalled to the world the dangers nuclear power. But the bond between this pollution and the increase in cancers of thyroid are still not established. A new official report draws up a first assessment 20 years after the catastrophe.

Surgery of thyroid, which complications?
Results of inquire Doctissimo

Nodules, cancers, goitre, hyperthyroïdie… As many pathologies of thyroid gland being able to require an operation. If the surgery makes it possible to correct an imbalance or to treat a pathology, it involves sometimes complications. An exclusive investigation on line made it possible to better appreciate them. Discover its results with lighting of Professor Peix, surgeon of thyroid at Southern the Lyon hospital.

best the source remains… the meat. Can one be vegetarian and preserve sufficient contributions? Certain fruit and vegetables can they decrease the risk of deficiencies? How to avoid weakens? To read to keep a ferric constitution!