What Is Breast Cancer?

Breast cancer is a tumor that has become malignant - it has developed from the breast cells. A 'malignant' tumor can spread to other parts of the body - it may also invade surrounding tissue. When it spreads around the body, we call it 'metastasis'.

A woman's breast consists of lobules. Lobules are milk-producing glands. The breast is also full of ducts - milk passages that connect the lobules to the nipple. There is also fatty and connective tissue surrounding the ducts and lobules - this is called stroma.

The most common breast cancers start in the cells around the ducts. Others can start in the cells that line the lobules. A smaller number of breast cancers can start in other parts of the breast.

The human body has two ways of moving fluid about. One is through the blood stream, which carries plasma, red and white blood cells and platelets. Lymphatic vessels carry tissue fluid, waste products and infection fighting cells (immune system cells). Immune system cells are located in the lymph nodes - the nodes are shaped like a bean.

It is common for cancer cells to grow in the lymph nodes. They get there via the lymphatic vessels.

The lymphatic system of the breasts connect to the lymph nodes in three areas: Under the arm (axillary lymph node), in the chest (internal mammary node) and by the collarbone (supra or infraclavicular node).

Doctors guess that if cancer cells are in the lymphatic system, they are most likely to be in the bloodstream and will spread to other organs in the body. It is very hard to test for breast cancer cells in the bloodstream.

If breast cancer cells have got to the nodes under the arm (axillary), it will most likely swell. Whether or not it has swollen there, will decide what type of treatment a patient should have. If cancer cells are found in more lymph nodes, then the likelihood of it turning up in different parts of the body is greater. However, there is no hard and fast rule here. Women have had swellings in many nodes and did not develop metastases, while some women with no swellings in their nodes did.

What is the treatment for anal cancer?

Treatment for anal cancer will depend on various factors, including how big the tumor is, whether or not it has spread, where it is, and the general health of the patient. If the tumor is small it can be removed surgically, and that's it.

The type of surgery a patient will require depends on the size and position of the tumor.

Resection - this removes a small tumor and some surrounding tissue. This type of surgery can only be carried out if the anal sphincter is not sacrificed. Patients who undergo a resection do not have their ability to pass a bowel movement affected.

Abdominoperineal resection - the anus, rectum and a section of the bowel are surgically removed. The patient will need a colostomy - the end of the bowel is brought out onto the skin on the surface of the abdomen. A bag is placed over the stoma - the opening of the bowel - and collects the stools (feces) outside the patient's body. Although this sounds shocking, people with colostomies can lead normal lives, play sports and have active sex lives.

In most cases, the patient will probably have to undergo chemotherapy and/or radiotherapy.

Chemotherapy and radiotherapy

Radiotherapy combined with chemotherapy treatments (chemoradiation) are commonly used to destroy the anal cancer cells. Treatments are either given simultaneously or consecutively. This combined therapy approach has led to a much higher percentage of patients with an intact anal sphincter - survival and cure rates are good.

Chemotherapy uses cytotoxic drugs (antineoplastics) - cytotoxic drugs prevent the cancer cells from dividing. They are administered either by injection or orally.

Radiotherapy uses high-energy rays that destroy the cancer cells. This can be given by an external beam or internally (brachytherapy).

Stages of cancer of the lip and oral cavity

Stages of mouth cancer and lip cancer are indicated using Roman numerals from I to IV, with I being the smallest and IV the largest or most advanced.

* Stage I - the tumor is under 1 inch in diameter (2 cm) and has not reached nearby lymph nodes.

* Stage II - the tumor is over 1 inch in diameter (2 cm) but less than 2 inches (4 cm) and has not reached nearby lymph nodes.

* Stage III - any of the three possibilities below:
o The tumor is over 2 inches (4 cm) in diameter.
o The tumor has spread to just one nearby lymph node on the same side of the neck as the tumor.
o The cancer in the lymph node is no more than 3cm.

* Stage IV - any of the possibilities below:
o The cancer has reached tissues around the oral cavity and lip. Nearby lymph nodes may or may not contain cancer.
o The cancer has spread to 2 or more lymph nodes on the same side of the neck as the tumor.
o The cancer has spread to lymph nodes on the other side of the neck.
o Lymph nodes on either side have a tumor that measures over 6 cm.
o The cancer has spread further, to other parts of the body.

The TNM staging method

This is another method of staging mouth cancers. T describes the tumor, N describes the lymph node(s), and M describes metastasis (distant spread). X means there is no data to make an assessment.

* TX - not possible to assess primary tumor.
* T0 - there is no evidence of a primary tumor.
* Tis - carcinoma in situ (cancer only in the place where it began; it has not spread).
* T1 - tumor 2 cm maximum measurement in greatest dimension.
* T2 - tumor over 2 cm and 4 cm maximum in greatest dimension.
* T3 - tumor over 4 cm in greatest dimension. In the case of lip cancer, tumor invades adjacent structures, such as cortical bone, deep muscle of tongue, maxillary sinus, and skin.
* T4 - In the cases of oral cavity cancer, tumor invades adjacent structures, such as cortical bone, deep muscle of tongue, maxillary sinus, and skin.

* NX - nearby lymph nodes cannot be assessed.
* N0 - nearby lymph nodes have no cancer.
* N1 - cancer in one nearby lymph node on same side of neck. Maximum 3 cm in greatest dimension.
* N2
o N2a - cancer has spread to one lymph node on same side of neck, no more than 6 cm in greatest dimension.
o N2b - Cancer has spread to 2 or more lymph nodes; none are greater than 6 cm in greatest dimension.
o N2c - Cancer has spread to lymph nodes on either side of the neck, or both sides of the neck, no bigger than 6 cm in greatest dimension.
* N3 - cancer has spread to a lymph node and is over 6 cm in greatest dimension.

* MX - distant metastasis (spread) cannot be assessed.
* M0 - no distant metastasis.
* M1 - distant metastasis.

Therefore if a patient is described as T2N1M0, it means:

There is a primary tumor between 2 cm and 4 cm, it has spread (metastasized) to one single lymph node on one side, that node is less than 3 cm in size, there is no distant metastasis.

What causes oral cancer

Cancer starts when the structure of the DNA (deoxyribonucleic acid) alters - a genetic mutation. DNA provides the cells with a basic set of instructions, much like a computer program for life. The instructions tell cells when to grow, reproduce, and die, among other things. When there is a genetic mutation cells grow in an uncontrollable manner, eventually producing a lump (tumor).

If the cancer is left untreated it grows and eventually spreads to other parts of the body, usually through the lymphatic system - a series of nodes (glands) that exist throughout the body. The lymph glands produce many of the cells of our immune system. As soon as the cancer reaches the lymphatic system it can spread anywhere in the body and invade bones, blood and organs. The cancer cells continue reproducing uncontrollably, gradually occupying more and more space.

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.

With time, oral cancer may spread firstly to other parts of the mouth, then the head and neck, and eventually to other parts of the body. Mouth cancers typically start in the squamous cells (flat, thin cells) than line the lips and the inside of the mouth - they are referred to as squamous cell carcinomas.

Although we know what the risk factors are, experts are not sure what cause the mutations in squamous cells that eventually lead to mouth cancer.

What is the treatment for ovarian cancer?

Treatment for ovarian cancer consists of surgery, chemotherapy, a combination of surgery with chemotherapy, and sometimes radiotherapy. The kind of treatment depends on many factors, including the type of ovarian cancer, its stage and grade, as well as the general health of the patient.
Some studies have indicated that specialized hospitals tend to have better survival rates for ovarian cancer patients, compared to general hospitals

Surgery

The surgical removal of the cancer is performed in the vast majority of ovarian cancer cases, and is often the first treatment the patient will undergo.

Unless the ovarian cancer is very low grade, the patient will require an extensive operation that includes the removal of both ovaries, the fallopian tubes, the uterus, nearby lymph nodes, and the omentum (a fold of fatty abdominal tissue). Cancer often spreads into the omentum. In most cases the operation will be carried out by a gynecologic oncologist surgeon - a specialist in surgery for women with cancer of the reproductive organs. This operation, sometimes referred to as a total hysterectomy, will mean that the woman will begin her menopause immediately. Recent research by Canadian scientists found that premature removal of the ovaries increases the risk of lung cancer.

If the cancer is confined to just one of the ovaries the surgeon may just remove the affected ovary and the adjoining fallopian tube. The woman will have a chance of being able to conceive. If both ovaries are removed it will not be possible to conceive.

Surgery for ovarian cancer will require a hospital stay of up to two weeks, plus a recovery period of at least six weeks when the patient gets back home.

Chemotherapy

Chemotherapy is the use of chemicals (medication) to treat any disease - more specifically in this text, it refers to the destruction of cancer cells. Cytotoxic medication prevents cancer cells from dividing and growing. When health care professionals talk about chemotherapy today, they generally tend to refer more to cytotoxic medication than others. Chemotherapy for ovarian cancer, as well as most other cancers, is used to target cancer cells that surgery cannot or did not remove.

Patients will typically receive a combination of carboplatin (Paraplatin) and paclitaxel (Taxol) intravenously (injected into the bloodstream). As it is injected into the bloodstream it can target cancer cells in the reproductive system, as well as any cancer cells that may have reached elsewhere in the body.

Treatment usually involves 6 to 12 chemotherapy sessions which will be given three to four weeks apart so that the body has time to recover. One session usually consists of a 3-hour gradual injection of the medicine into the body; sometimes it may be extended to 24 hours. Extended injections require an overnight stay in hospital.

Radiotherapy

Radiation is not the mainstay of ovarian cancer treatment - it is not generally considered effective for ovarian cancer. It may be used if there are small traces of cancer in the reproductive system, or to treat the symptoms of advanced cancer. External radiotherapy may be used to clear traces of cancer left after chemotherapy, while internal radiotherapy may be used for advanced cancer. Radiotherapy may cause the following symptoms; some symptoms may not appear until a long time after treatment is over:

The 4 stages of ovarian cancer

Ovarian cancer is classified into four stages, with stage 4 being the most advanced.

• Stage 1 - the cancer is confined to one or both ovaries. This is subdivided into three groups:
  
  
  • Stage 1a - the cancer is confined to just one ovary (contained inside it).
  • Stage 1b - the cancer is confined to both ovaries (contained inside them).
  • Stage 1c - either 1a or 1b, but there is come cancer on the surface of one or both ovaries, cancer cells are found in fluid extracted from inside the abdomen during surgery, or the ovary bursts during or before surgery.


• Stage 2 - the cancer has spread to the uterus, fallopian tubes or some other areas in the pelvis (tummy area). This is subdivided into 3 groups:
  
  
  • 2a - the cancer has spread into the uterus (womb) or the fallopian tubes.
  • 2b - the cancer has spread into other tissues in the pelvis, such as the rectum or bladder.
  • 2c - 2a and 2b, and there is cancer on the surface of one or both ovaries, or cancer cells are identified in fluid extracted from inside the abdomen during surgery, or the ovary bursts during or before surgery.


• Stage 3 - the cancer has spread into the peritoneum (the lining of the abdomen), or to the lymph nodes in the upper abdomen, groin or behind the uterus. Most ovarian cancers are diagnosed at this stage. This stage is divided into three subgroups:
  
  
  • 3a - an examination with a microscope of tissue taken from the peritoneum (lining of the abdomen) or the omentum (fatty layer over the top of the intestines) detects cancer cells.
  • 3b - tumor growths are identified in the peritoneum 2cm or smaller.
  • 3c - tumor growths larger than 2cm are identified in the peritoneum. Cancer is found in the lymph nodes in the groin, behind the womb or the upper abdomen.


• Stage 4 - the cancer has spread beyond the abdomen to other parts of the body, including such organs as the lungs or the liver. If cancer is just found on the surface of the liver, but not inside it, it is still stage 3.

Three main types of ovarian cancers (tumors)

Epithelial ovarian cancer is by far the most common form of ovarian cancer. Germ cell and stromal ovarian cancers are much less common. Ovarian cancer can also result from a cancer somewhere else in the body that has spread:

• Epithelial ovarian cancer (epithelial ovarian tumors) - derived from cells on the surface of the ovary. It occurs mainly in adults.


• Germ cell ovarian cancer (germ cell ovarian tumors) - derived from the egg-producing cells within the body of the ovary. This rare type of cancer more commonly affects children and teenage girls.


• Stromal ovarian ovarian (sex cord stromal tumors) - develops within the cells that hold the ovaries together.


• Cancers from other organs in the body can spread to the ovaries - metastatic cancers - a metastatic cancer is one that spreads from where it first arose as a primary tumor to other locations in the body.

What are the symptoms of lung cancer?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Lung cancer symptoms may take years before appearing, usually after the disease is in an advanced stage.

Many symptoms of lung cancer affect the chest and air passages. These include:

• Persistent or intense coughing
• Pain in the chest shoulder, or back from coughing
• Changes in color of the mucus that is coughed up from the lower airways (sputum)
• Difficulty breathing and swallowing
• Hoarseness of the voice
• Harsh sounds while breathing (stridor)
• Chronic bronchitis or pneumonia
• Coughing up blood, or blood in the sputum

If the lung cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and broken. It is also possible for the cancer to infect the adrenal glands resulting in hormone level changes.

As lung cancer cells spread and use more of the body's energy, it is possible to present symptoms that may also be associated with many other ailments. These include:

• Fever
• Fatigue
• Unexplained weight loss
• Pain in joints or bones
• Problems with brain function and memory
• Swelling in the neck or face
• General weakness
• Bleeding and blood clots