Wednesday, 13 May 2015

Knowledge about Cancer

Types of Cancer:

  1. HEAD & NECK CANCERS WITH EYE CANCER
  2. LUNG CANCER
  3. Esophagus Cancer
  4. Cancer Of Stomach
  5. Breast Cancer
  6. Liver Cancer
  7. Pancreas Cancer
  8. Colo-Rectal Cancer
  9. Rectum Cancer
  10. Anal Cancer
  11. Kidney Cancer
  12. Urinary Bladder Cancer
  13. Prostate Cancer
  14. Penile Cancer
  15. Testicular Cancer
  16. Cancer Of Uterine Cervix
  17. Cancer Of Uterine Body
  18. Ovarian Cancer
  19. Brain Cancer
  20. Thyroid Cancer
  21. Osteosarcoma (Bone Cancer)
  22. Children Specific Cancer
  23. Skin Cancer
  24. Lymphoma
  25. Blood Cancer-Leukemia

HEAD & NECK CANCERS WITH EYE CANCER:

(1) Overview
(a) Oral cavity and oropharyngeal cancer
(b) Hypopharynx cancer
(c) Larynx cancer
(d) Nasopharynx cancer
(e) Salivary glands cancer
(f) Nasal cavity and Paranasal sinus cancer

Eye cancer (Retinoblastoma):


(1) Overview
(2) Symptoms
(3) Risk factors
(4) Diagnosis as per modern science
(5) Staging


Section I – Head & neck cancers

(a) Oral Cavity cancer

(1) Overview

The oral cavity includes the lips, the inside lining and the cheeks (buccal mucosa), the teeth, the gums, the front two thirds of the tongue, the floor of the mouth below the tongue, the bony roof of the mouth (hard palate), and the area behind the wisdom teeth (retromolar trigone).
Oropharyngeal cancer developes in the part of the throat just behind the mouth, called the oropharynx. The oropharynx begins where the oral cavity ends. It also includes the base of the tongue (the back third of the tongue), the soft palate, the tonsils and the tonsillar pillars, and the back wall of the throat (the posterior pharyngeal wall).
The oral cavity and oropharynx are useful in breathing, talking, eating, chewing and swalling. Minor salivary glands located throughout the oral cavity and oropharynx make saliva that keeps the mouth moist and helps digest food.
The oral cavity and oropharynx contain several types of tissue and each of these tissues contain several types of cells. Different cancers can develop from each kind of cell.
More than 90% of cancers of the oral cavity and oropharynx are squamous cell carcinomas, also called squamous cell cancers. Squamous cells are flat scale like cells that normally form the lining of the oral cavity and oropharynx. Squamous cell cancer begins as a collection of abnormal squamous cells. The earliest form of squamous cell cancer is called carcinoma in situ, meaning that the cancer cells are present only in the lining layer of cells called the epithelium. Invasive squamous cell cancer means that the cancer cells have spread beyond this layer into deeper layers of the oral cavity or oropharynx.

(2) Symptoms 

(i) A sore in the mouth that does not heal.
(ii) Persistent pain.
(iii) Persistent lump or thickening in the cheek.
(iv) Persistent white or red patch on the gums, tongue, tonsil, or lining of the mouth.
(v) Difficulty chewing or swallowing.
(vi) Difficulty moving the jaw or tongue.
(vii) Numbness of the tongue or in other areas of the mouth.
(viii) Swelling of the jaw.
(ix) Loosening of the teeth without any apparent reason, voice change.
(x) Lump or mass in the neck, weight loss, bad breath. 

(3) Risk factors 

(a) Tobacco – Almost 90% of people with oral cavity and orophayngeal cancer use tobacco, and the risk of developing these cancers increases with the amount used.
(b) Alcohol – Drinking alcohol strongly increases a smoker’s risk of developing oral cavity and oropharyngeal cancer. It is found predominantly in alcohol users.
(c) Ultraviolet light – Majority of patients with lip cancer have outdoor occupation associated with prolonged exposure to sunlight.
(d) Irritation – Long time irritation to the lining of the mouth is a risk factor for oral cancer. The major source for this in India being tobacco.
(e) Human Papilomavirus – Papilomavirus are a suspected source of oral cancers, like in cervix, vagina, vulva and penis.
(f) Immune system suppression – People undergoing immunosuppressive drugs to treat certain immune system diseases, or to prevent rejection of transplanted organs, are at an increased risk of oral cancer. 

(4) Diagnosis as per modern science: - 

(I) Complete medical history.
(II) Complete Head & Neck examination including nasopharyngoscopy, Pharyngoscopy, and laryngoscopy.
(III) Ex-foliative cytology.
(IV) Incisional biopsy.
(V) Fine needle biopsy.
(VI) Imaging tests including chest X-ray, CT scan, MRI. 

(5) Staging:- 

(i) Stage 0 – The cancer is in situ. It has not yet penetrated to a deeper layer of oral or orophayngeal tissue and has not spread to lymph-nodes or distant sites.
(ii) Stage 1 – The tumor is 2cms or smaller and has not spread to lymph nodes or distant sites.
(iii) Stage 2 – The tumor is larger than 2 cms., but smaller tha 4 cms., and has not spread to lymph nodes or distant sites.
(iv) Stage 3 – The tumor is larger than stage 2 and has spread to one lymph node.
(v) Stage 4 – The tumor can be larger than 6 cms and has spread to lymph nodes and to distant sites.

(b) Hypopharynx Cancer: - 

(1) Overview: -
                     Hypopharynx is the end part of the throat or the pharynx. This is a 5 inch long hollow tube extending from behind the nose and going down to become part of the oesophagus. Air and food pass through pharynx from the way on to the trachea or the oesophagus respectively.
In the cancer that originates from the hypopharynx, the cancer cells are mostly squamous cells, which are flat and scaly cells. A small portion of cancer could also be lymphomas, i.e., non-hodgekin’s lymphoma.
Hypopharyngeal cancer usually spreads through the lymphatic system. And the cancerous cells are carried along by the lymphs, which are colourless fluid containing cells that help fight infections and disease.

(2) Symptoms: - 

(I) A sore in the throat that will nor soothe.
(II) Difficulty and pain while chewing and swallowing.
(III) A change in the voice or pain in the ear.

(3) Risk factors: - 

(i) Tobacco use
(ii) Tobacco chewing as is common in many south asean countries.
(iii) Chronic usage of alcohol.

(4) Diagnosis as per modern science: -

(i) Direct laryngoscopy.
(ii) Biopsy
(iii) Barium swallow to detect spread in the oesophagus and digestive organs.

(5) Staging: -

(a) Stage 1 – The disease is only in one part of the hypopharynx and has not spread to the lymph nodes in the area.
(b) Stage 2 – It has spread to more than one part of the hypopharynx or has spread to tissues adjacent to the hypopharynx but has not grown into the larynx. Has not spread to the lymph nodes.
(c) Stage 3 – The disease has spread to nearby organs and the lymphatic system.
(d) Stage 4 – The cancer has spread to the distant organs of the body. 

(c) Laryngeal cancer: -

(1) Overview: -

The larynx is a two inch long organ in the neck. The larynx in used by humans to talk, breathe or swallow. It is made of cartridge. The main cartiledge which forms the front of the larynx is also called as adam’s apple.
Just behind the trachea and the larynx in the neck lies the food pipe or the oesophagus, which carries the food from the mouth to the stomach. The opening of the oesophagus and the larynx are adjascent to each other in the throat.
When we swallow food, a small flap called the epiglottis moves down to cover the larynx in order to prevent the food from going down the wrong passage and into the lungs.
The other important anatomical areas of the larynx are,
(i) The glottis, which is where the vocal cords are.
(ii) The supraglottis, which is the area above the vocal cords.
(iii) The subglottis, which is the area which connects the larynx to the trachea.
Cancer of the larynx, can develop in any other region of the larynx, the glottis, the supraglottis, or the subglottis. The cancer can also go outside the larynx into lymph nodes or lymph glands in the neck.
Through lymphnodes laryngeal cancer can spread to other parts of the throat and neck, the lungs, and to the back of the tongue, and other distant parts of the body such as the bones and the brain. 

(2) Symptoms: -

(i) Majority of cancers originate from the vocal cords. These are painless tumors, which almost always cause a change in the voice or hoarsness.
(ii) The tumors which are located in the supraglottis cause a feeling of a lump or a sore throat or earache.
(iii) Tumors below the vocal cords are very rare, but they make it hard to breathe and produce noisy difficult breathing.
(iv) A cough which refuses to goaway, or the feeling of a lump in the throat are early warning signs of cancer of the larynx.
(v) As the tumors keep progressing, it causes weight loss, pain, bad breath, and frequent choking upon food.
(vi) In some cases tumor can grow so big that it may become impossible for the patient to swallow. 

(3) Risk factors: -

(i) Gender & age – It is most often seen in people aged above 55 years and it is seen more commonly in men than in women.
(ii) Smoking and chewing tobacco is a very potent risk for developing laryngeal cancer.
(iii) Alcohol – Alcohol combined with tobacco is a high risk factor for causing laryngeal cancer.
(iv) Asbestos – Asbestos workers also run a great risk of getting cancer of the larynx. 

(4) Diagnosis as per modern science: -

(i) Indirect laryngoscopy – Which comprises of a small, long handled mirror being used to check the larynx and the vocal cords indirectly to look for abnormal areas. The test is painless.
(ii) Direct laryngoscopy – It is a more specific investigation in which a self-lit or indirectly lit metallic tube is inserted into the patient’s nose or mouth. This tube is also called a laryngoscope. As the tube descends down the throat, the doctor can look at areas that cannot be seen with the simple mirror used in indirect laryngoscopy.
(iii) Biopsy – If the doctor doctor notices any abnormalities he perfoms biopsy, which is the removal of a small piece of representative tissue. This tissue piece is then examined to find the presence of cancer cells.
Usually cancer cells of larynx are squamous cell carcinomas. Squamous cells are cells lining the epiglottis, the vocal cords, and other parts of the larynx and they are flat, scale like cells. 

(5) Staging: -

Stage I – There is no of spread to lymph nodes the tumor is smaller than 2cms.
Stage II – The tunmor involves more than 1 subsites of the larynx, or is 2 to 3 cms. in size.
Stage III – The cancer has spread to lymph nodes but size not larger than 3 cms., on the same side of the neck as primary tumor.
Stage IVa – There is spread to 1 lymph node, size is about 3 to 6 cms., on the same side of the neck as primary tumor.
 Stage  IVb – There is spread to lymph nodes on both sides of the neck, the tumor may be larger than 6 cms.
Stage  IVc – There is spread to lymph nodes and the tumor is larger than 6 cms, with evidence of distant metastasis. 

(d) Nasopharynx cancer: -
(1) Overview: -

The nasopharynx is the area in the back of the nose towards the base of the skull. The nasopharynx is a box like organ about 1.5 inches in size. It lies just above the soft palate, behind the entrance into the nasal passages. It tends to spread very rapidly. The nasopharynx contains several types of cells. Different cancers can develop in each type of cell.

Three types of cancerous tumors are recognized in the nsopharynx.
(a) Keratinizing squamous cell carcinoma.
(b) Non—keratinizing squamous cell carcinoma.
(c) Undifferentiated carcinoma.

Lymphomas can also be found in the nasopharynx. They are cancers of immune system cells called lymphocytes. 

(2) Symptoms: -

Some patients with nasopharynx cancer have no symptoms at all. Most of the patients have a lump or tumor mass in the neck area when the cancer is diagnosed. Other symptoms may present as follows.
(i) Loss of hearing.
(ii) Nasal blockage or stuffiness.
(iii) Painful nose-bleeds.
(iv) Difficulty opening the mouth.
(v) Blurred or double vision. 

(3) Risk factors: -

(i) Diet – Nasopharynx cancer is commonly seen in people having high salt content fish and meat diet.
(ii) Virus infections – Infection with EBV virus can cause mononucleosis, leading to cancer of the nasopharynx.
(iii) Tobacco and alcohol – People habituated to chewing tobacco, or smoking with alcohol intake are at a very high risk of developing nasopharynx cancer.
(iv) Genetic factors – It is found that people with certain tissue types are at a higher risk of developing nasopharynx cancer. 

(4) Diagnosis as per modern science: -

(a) X-Ray
(b) C-T Scan
(c) MRI
(d) Blood Tests
(e) Fine needle Biopsy 

(5) Staging & Grading: -

Stage 0 – Cancer is in-situ, has not penetrated to deeper levels of tissues, and has not spread to lymph nodes or distant sites.

Stage I – Tumor is only in the nasopharynx and has not spread to lymph nodes or other organs.

Stage II – The tumor has spread to soft tissues of the nasal cavity and the oropharynx and has not spread to lymph nodes or distant sites.

Stage III – The tumor has spread to soft tissues of the nasal cavity and the oropharynx and to lymph nodes, not larger than 6 cm, on both sides of the neck but not to distant sites.

Stage IV – The tumor is larger than 6 cm, has spread to lymph nodes and distant sites. 

(e) Salivary Glands tumor: -

(1) Overview: -

These are glands that produce saliva, saliva  is a fluid which keeps the mouth moist. It also moistens and softens food during the act of chewing and has a minimal digestive action on food components as well.
The salivary glands are chiefly arranged in three groups
(i) The parotid glands are the largest, placed just in front of the ear.
(ii) The submandibular glads are placed just beneath the jaws, protruding partially into the top of the neck.
(iii) The sublingual glands are arranged on both sides of the floor of the mouth.
(iv) There are several monor salivary glands as well, scattered randomly in the mouth and other parts of the upper gastrointestinal tract.
Most of the salivary gland tumors are non-cancerous, however few tumors can be cancerous. Cancers arising from salivay glands are of several types. 

(2) Symptoms: -

(i) A mass or lump in the face, neck, or mouth
(ii) Pain in one place in the face, neck, or mouth
(iii) A newly noticed difference between the size and/or shape of the left and right sides of the face or neck
(iv) Numbness in part of the face, noticeable  weakness of the muscles on one side of the face. 

(3) Risk factors: -

(i) Radiation exposure – Industrial exposure to certain radioactive elements increases risk levels of salivary glands tumor.
(ii) Diet – Diets rich in animal fats, but low in fruits and vegetables may leads to salivary glads tumors.
(iii) Tobacco & Alcohol – Chewing and smoking of tobacco combined with alcohol greatly increases the risk of salivary glands tumors.
(iv) Hereditary factor – Certain inherited genetic factors are responsible for causing salivary gland tumors. 

(4) Diagnosis as per modern science: -

(i) X – Ray
(ii) C-T Scan
(iii) MRI
(iv) Biopsy
(v) Fine needle aspiration 

(5) Staging: -

Stage I – The cancer is not more than 4 cm in diameter and has not spread into the surrounding tissue or to the lymph nodes in the region.

Stage II – The cancer is more than 4 cm and has spread into the surrouding tissues including the skin, soft tissues, bone or nerve near the glands, but there is no spread to the neighbouring lymph nodes.

Stage III – There is spread to nearby lymph node.

Stage IV – The cancer is any size and has spread to more than one lymph nodes on the same side of the neck, or on both sides. Has spread to distant organs. 

(f) Nasal cavity & Paranasal sinus cancer: - 
(1) overview: -

 The nose opens into the nasal passageway, or cavity. This cavity runs along the top of the palate, and turns downward to join the passage from the mouth to the throat.Paranasal sinus means in the vicinity of the sinus area. They are cavities of small tunnels. The nasal cavity and paranasal sinuses help filter, warm, and humidify the air we breathe. They also provide resonanace to the voice, lighten the skull, and provide a bony frame work for the face and eyes.The nasal cavity ans paranasal sinuses are lined by a layer of mucos producing tissue called mucosa. The mucosa has multiple types of cells including.Squamous epithelial cells, which are lining cells and form the majority of the mucosa.Glandular cells, such as minor salivary glands etc. which produce mucus and other fluids.Nerve cells which are responsible for sensation and the sense of smell in the nose.Infection fighting cells which are part of the immune system, blood vessel cells, and other supporting cells All of these cells that make up the mucos can become cancerpus.Squamous cell carcinoma is the most common type.Adenocarcinoma – Cancer of the glandular cells.Malignant lymphomas – Cancer arising out of lymph or immune system cells.Malignant melanoma – Cancer of pigment or skin color containing cells.Papilomas – Wart like growths that are not cancer, but have a potential to become cancerous.Esthesioneuroblastomas – These are derived from the olfactory nerves, the cells that govern the sense of smell. 

(2) Symptoms: -

- Persistent or progressive nasal congestion and stuffiness.
- Pain above or below the eyes.
- One sided nasal obstruction
- Nasal bleeds and nasal drainage in the back of the nose and throat.
- Pus drainage from the nose
- Decresed sense of smell and numbness or pain inparts of the face.
- Groeth or tumor in the face
- Bulging of the eyes or loss of vision. 

(3) Risk factors: -

(a) Occupational hazards – Occupational exposure to dust of wood, textiles, and leather inhaled, and also flour.
Other material may include glues, formaldehyde, solvents used in furniture and shoe production, nickel and chromium dust, radium.
(b) Smoking – Smoking is a risk factor for nasal cavity cancer, as well as for cancers of other organs.
(c) Family history – Genetic inheritance is a factor for causing nasal and paranasal sinus cancers. 

(4) Diagnosis as per modern science: -
  • X-Ray
  • Computed tomography
  • Magnetic resonance imaging
  • Biopsy. 

(5) Staging: -

Stage I – The cancer is limited to sinus mucosa and has not spread.

Stage II – The cancer has affected or destroyed some of the bones of the maxillary sinuses, but has not spread beyond that.

Stage III – The cancer has grown through the back of the sinus. The cancer has reached the tissues of the cheek, the eye socket, or the ethmoid sinus in front of the maxillary sinus. The cancer may not have spread to the lymphatic system or to distant organs.

Stage IV – In this stage the cancer has spread to one or more lymph nodes, is larger than 3 cms, spread to distant organs.

Eye cancer (Retinoblastoma):



(1) Overview: -

The ratina is a lining of nervous tissues located at the back of the two eyes. It is a photosensitive layer, that is, it is responsible for sensing light and forming images.
Cancer of the ratin is called retinoblastoma. It can occur at any age. It can apprear in any one of the eye, or both the eyes. Usually, the tumor is confined to the eye socket without spreading to the adjascent tissues.
Retinoblastoma has a tendency to be hereditary. This type of cancer often is seen in children. 

(2) Symptoms: -

Usually the tumor id quite evident, with the patient having a white or discolured bulging tumor in one or both eyes, which may have no vision at all. 

(3) Risk factors: -

(1) Age – Eye cancer predominantly found in children and is rarely seen inadults.
(2) Genetic factors – About half the cases of retinoblastoma are hereditary. The other half may occur due to other reasons. Hereditary retinoblastoma tends to affect both the eyes whereas the sporadic ones usually ocuurs only in one eye. 

(4) Diagnosis as per modern science: -

As per modern science diagnosis may involve CT Scan, MRI, Sonography of the abdomen, Bone scan, Biopsy etc. 

(5) Staging: -

(a) Intraoccular retinoblastoma – Cancer is restricted to one or both eyes and has not spred to adjascent or distant tissues.
(b) Extraoccular retinoblastoma – Cancer has spread beyond the eyes, either in adjascent tissues or to distant organs.
(c) Recurrant retinoblastoma – This is a disease which has recurred after the initial therapy is completed. It may have occurred in the eye or in any other part of the body.

LUNG CANCER:


(1) Overview
(2) Types of lung cancers
(3) Symptoms of lung cancer
(4) Risk factors
(5) Diagnosis as per modern science
(6) Staging and Grading

(1) Overview:-

              The lungs are two sponges like organs in the chest cavity. The right lung is divided into 3 sections, called lobes. Left lung has two lobes. It is smaller to accommodate the heart. Air with the breath goes into the lungs through trachea (wind pipe). The trachea divides into tubes called the bronchi, which divides further into smaller branches called the bronchioles. At the end of the bronchioles are tiny air sacks known as alveoli. Many tiny blood vessels run through the alveoli absorbing oxygen from the inhaled air into the blood stream and releasing carbon dioxide. Taking in oxygen and releasing carbon dioxide are the two main functions of the lung. A lining called pleura surrounds the lungs. This slippery lining protects the lungs and help them slide back and forth as they expand and contract, during breathing. Most lung cancers start in the lining of the bronchi, frequently in the periphery of the lungs. Lung cancers are thought to develop over a period of many years. First, there may be areas of precancerous changes in the lungs. These changes do not form a mass or tumor, or cannot be seen or x-ray, and do not cause any symptoms. Lung cancer is most frequently seen in industrialized nations. This cancer is found in both sexes. This cancer was not as widely spread as it is today 100 years ago, now it is one of the major cancers affecting people. It is found mostly in people above 40 years of age.

(2) Types of lung cancers:-

There are two major types of lung cancers:

(1) Small cell lung cancer – About 15 to 20% of all lung cancers are small cell lung cancers, named for the small round cells that make up these cancers. Small cell lung cancer tends to spread widely through the body. This is important because ir means that treatment must include drugs to destroy the wide spread disease. The cancer cells can multiply quickly, form large tumors, and spread to lymph nodes and other organs such as the bones, brain, adrenal glands, and liver. This type of cancer also starts in the bronchi near the centre of the chest. Small cell lung cancer is almost always caused by smoking.

(2) Non-small cell lung cancer – The majority of lung cancers are non-small cell type. There are three sub types of this cancer. The cells in these types differ in size, shape and chemical make-up.

(a) Squamous cell carcinoma – About 25-30% of all lung cancers are of this type. They are associated with a history of smoking.

(b) Adeno carcinoma – This type of cancer accounts for about 40-45% of all lung cancers. It is usually found in the outer region of the lung.

(c) Large cell carcinoma – This type of lung cancer accounts for about 10 to 15% of all lung cancers. It may appear in any part of the lung, and it tends to grow and spread very quickly. 

(3) Symptoms: -


Lung cancer produces symptoms at a very late stage of development, till it has spread very far.

(a) A cough that does not go away – 75% of patients complain of coughing at initial stage. If coughing persists more than three weeks x-rays should be taken. Smokers, who have chronic bronchitis, should remain more alert and should do periodic screening.

(b) Chest pain – Often aggravated by deep breathing, coughing and even laughing.

(c) Bloody or rust coloured sputum – Blood or pus in sputum could indicate lung cancer, timely screening helps early diagnosis. If a major vein or artey is affected by cancer, sudden burst can cause immediate danger to the patient’s life.

(d) Weight loss and loss of appetite – Any unexplained weight loss or loss of appetite is a sign to be taken seriously.

(e) Shortness of breath and hoarseness of speech – As cancer spreads in lungs the capacity of the lungs to breathe air diminishes, thus causing shortness of breath frequently, speech also changes.

(f) Recurring infections – Infections of pneumonia and bronchitis, which are uncured even after a lot of treatment may indicate lung cancer.

When the cancer has spread to other parts of the body the symptoms may present in the following manner.

(i) Bone pain.
(ii) Neurological changes such as weakness or numbness of limbs, dizziness, or recent onset of a seizure.
(iii) Jaundice yellow coloring of the skin and the eyes.
(iv) Masses near the surface of the body, due to cancer spreading to the skin or to the lymph nodes in the neck, or above the collarbone.

These symptoms could be the first warning signs of a lung cancer. Many of these symptoms can result from other causes or from non-cancerous diseases of the lungs, or heart, and other organs.

(i) Horner’s syndrome – Cancer of the upper part of the lungs may damage a nerve that passes from the upper chest into neck. These are at times also called pancost tumors. Their most common symptom is severe shoulder pain. Horner’s syndrome is the medical name for the group of symptoms consisting of drooping or weakness of one eyelid, reduced or absent perspiration on the same side of face, and a smaller pupil on that side of the face.

(ii) Paraneoplasic syndrome – Some lung cancers may produce hormones like or other substances that enter the blood stram and causes problems with distant tissues and organs, even though the cancer has not spread to those tissues or organs. These problems are called paraneoplasic syndromes. Sometimes these syndromes may be the first symptoms of early lung cancer. Because these symptoms affect other organs, patients and their doctors may suspect at first that disease other than lung cancer caused them. Patients with small cell lung cancer and those with non-small cell lung cancer often have different paraneoplastic syndromes. The most common paraneoplastic syndrome associated with small cell lung cancer.

(iii) SIADH – ( Syndrome of inappropriate antidiuretic hormones ) causes salt levels of the blood to become very low. Symptoms of SIADH include fatigue, loss of appetite, muscle weakness or cramps, nausea, vomiting, restlessness, and confusion. Without treatment, severe cases may lead to seizure and coma.

(iv) Production of  substances that cause blood clots to form – most of these clots interrupt blood flow to the limbs, lungs, brain, or their internal organs.

(v) Unexplained loss of balance and unsteadiness in arms and legs movement (cerebeller degeneration ) – The most common paraneoplastic syndrome caused by non-small cell cancer are. 1- Hypercalcemia (sometimes painful) of certain bones, especially those in fingertips. The medical term for this is hypertrophy osteoarthropy. 2- Production of substances that activates the clotting system, leading to blood clots. 3- Excess breast growth in men. The medical term for this condition is gynecomastia.

(vi) Easinophelis – Easinophil counts if are excess in blood it may indicate lung cancer.

(vii) Neuromyipathies – The patient feels swelling of muscle tissues and general weakness of the muscles. Sense of touch is lost in some parts of the body. When all treatments fail lung x-ray sometimes reveals the spread of lung cancer. As cancer is treated successfully these symptoms disappear.

(viii) Myesthenia gravis – This disorder can also be caused due to lung cancer. Where muscle activity is lost due to weakness. If eyelids are affected one loses control of movement of them, eyes get closed inadvertently. If throat muscles get affected breathing becomes difficult, chewing and swallowing of food also becomes difficult.

(ix) These are some of the common complaints of patients affected with lung cancer.
  • General weakness in the body.
  • Diminished strength and skin glow.
  • Clubbing of nails.
  • Irregular breathing.
  • Neck tumors are seen.
  • Enlargement of liver.
  • Joint pains in the body.
  • Bone fracture without any visible cause.

(4) Risk factors: - 

(i) Tobacco smoking – Tobacco is the most common risk factor for lung cancer. In the past lung cancer was not so common as it is today. Phenomenal increase in smoking due to mass production and marketing of cigarettes has increased the instances of lung cancer drastically. Smoling is equally dangerous even if smoke is inhaled indirectly i.e. passively. Even after the smoker has stopped smoking, the damaged lung tissues take 10 to 15 years to return to normal condition. Even after that period the risk reduction is only third of what it would be if the person had not stopped smoking.

(ii) Asbestos – Exposure to asbestos fibres is an important risk factor for lung cancer. And if a person is smoking and also is exposed to asbestos inhalation, the risk of lung cancer is 50 times higher than that of any other person. Both smokers and non-smokers exposed to asbestos have a great risk of developing lung cancer that starts from pleura. This cancer is called mesothelioma.

(iii) Radiation exposure – When uranium breaks down naturally it produces radon, a radio-active gas that is not dangerous outdoors, but indoors it can be very dangerous if inhaled directly.

(iv) Cancer causing agents in the workplace – Radioactive ores such as uranium, inhaled chemicals or minerals such as arsenic, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, and chloromethylether, fuel fumes from gasoline etc., exhaust fumes inhalation. In cotton industry fine dust particles of cotton entering the lungs through breathing can cause cancer. Workers in stone mines face the danger of inhaling stone dust. This gets settled in the lungs ultimately resulting in cancer. People working in farms are exposed to minute dust particles and pollen from plants which causes lung cancer in the long run.

(v) Radiation therapy – People exposed to radiation therapy for chest are at high risk for lung cancer. The most at risk are women being treated for breast cancer.

(vi) Mineral exposure – Talc mineral contains asbestos amd exposure to talc dust increases the risk of lung cancer. Also minerals like silicosis and berylliosis also have a higher risk of lung cancer.

(vii) Family history, diet and air pollution have a major role to play in the developed of lung cancer. 

(5) Diagnosis as per modern science: -

  • X-ray
  • CT scan
  • MRI
  • Sputum cytology
  • Radiologically occult cancer – This type of cancer is detected in other biological tests, but X-ray fails to detect this cancer.
  • Lung profusion scan – With the help of this scan the physician can determine the spread of this cancer. 

(6) Staging and Grading: -

Stage 0:- The cancer is found only in the layer of cells lining the air passages. It has not
invaded other lung tissues nor spread to lymph nodes or distant sites.

Stage IA:- The cancer is no larger than 3 centimeters, has not spread to the membranes that surround the lungs, does not affect the main branches of the bronchi and has not spread to lymph nodes or distant sites.

Stage IB:- The cancer is larger than 3 cm, or involves a main bronchus, but is not near the carina or it has spread to the pleura or the cancer is partially clogging the airways. It has not spread to lymph nodes or distant sites.

Stage IIA:- The cancer is no larger than 3 centimeters, has not spread to the membranes that surround the lungs, does not affect the main branches of the bronchi. It has spread to nearby or hilar lymph nodes, but not to distant sites.

Stage IIB:- The cancer is larger than 3 cm, or involves a main bronchus, but is not near the carina or it has spread to the pleura or the cancer is partially clogging the airways. It has spread to nearby lymph nodes, but not to distant sites, it has spread to the chest wall or the diaphragm, the mediastinal pleura, or membranes surrounding the heart, or it invades a main bronchus and is close to the carina or it has grown into the airways enough to cause an entire lung to collapse or to cause pneumonia in the entire lung. It has not spread to lymph nodes or distant sites.

Stage IIIA:- The cancer can be any size, or involves a main bronchus, but is not near the carina or it has spread to the pleura or the cancer is partially clogging the airways. It hasspread to nodes in the middle of the chest (mediastinum), but not to distant sites.

Stage IIIB:- The cancer can be of any size. It has spread to lymph nodes around the collarbone on either side, or to hilar or mediastinal lymph nodes on the side opposite
the cancerous lung, it has spread to the mediastinum, the heart, the windpipe (trachea), the esophagus (tube connecting the throat to the stomach).

Stage IV:- The cancer has spread to distant sites.

Esophagus Cancer:



(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Metastasis
(5) Diagnosis as per modern science
(6) Staging


(1) Overview: -

    The esophagus connects the mouth to the stomach and carries food into the stomach. The esophagus is 10 to 13 inches in length. Adult person’s esophagus under normal circumstances is three quarters of an inch at it’s smallest point.

     The wall of the esophagus consists of several layers. Cancers of esophagus start from its inner layer and grows outward. The inner layer of the esophagus is called mucosa, which consists of mainly two parts, the epithelium and the lamina propria. The epithelium forms the lining of the esophagus and is made from cells called squamous cells. The lamina propria is a thin layer of connective tissue right under the epithelium.

     There is a thin layer of muscle tissue under the mucosa called the muscularis mucosa. The next layer is sub-mucosa. Some parts of the esophagus have mucus-secreting glands in this layer. The layer under the sub-mucosa is a thick band of muscle called muscularis propria. This layer of muscle contracts in a coordinated, rhythmic way to force food along the esophagus from the throat to the stomach. The outermost layer of the esophagus is formed by connective tissues. It is called adventitia.
The upper part of the esophagus has a special area of muscles at its beginning that relaxes to open the esophagus when it senses food or liquid coming towards it. This muscle is called the upper esophageal sphincter. The lower part of the esophagus that connects to the stomach is called the gastroesophageal junction, or GE junction. There is a special area of muscle near the GE junction called the lower esophageal sphincter. The lower esophageal sphincter controls the movement of food from the esophagus into the stomach and it keeps the stomach’s acids and digestive enzymes out of the esophagus.

     There are two main types of esophagus cancer. Squamous cell carcinoma, and adenocarcinoma. Since the entire esophagus is normally lined with squamous cells, squamous cell carcinoma can occur anywhere along the length of the esophagus.
Adenocarcinoma starts in glandular tissues, which normally does not cover the esophagus. Before an adenocarcinoma can develop, glandular cells must replace an area of squamous cells as in baret’s esophagus. 

(2) Risk factors: -

(a) Age: - The incidence of esophageal cancer, or rate of occurrence, increases with age and peaks around age 70-80 years old. Nearly 80% of people diagnosed are between ages, 55 and 85.

(b) Gender: - Compared with women, men have a 3 fold higher rate of esophagus cancer.

(c) Race: - Some tribes in Africa drink locally prepared beer which contains Nitrosamine, a well known carcinogen, which results in a very high rate of cancer.

(d) Tobacco & Alcohol: - The use of tobacco products along with drinking alcohol increases the chances of developing esophageal cancer.

(e) Obesity: - Being overweight is a definite risk factor for developing esophageal cancer, the risk of this cancer is increased by 50% in overweight people.

(f) Baret’s esophagus: - Is a condition caused due to reflux of stomach acids into the lower esophagus. The symptom that may occur is heartburn. Baret’s esophagus is a high risk factor for developing adenocarcinoma type cancer.

(g) Gastroesophageal reflux disease: - Long term GERD can increase the person’s risk of developing esophageal cancer.

(h) Diets: - Diets lacking in fruits, vegetables, minerals and vitamins, may increase the risk of esophageal cancer. Certain dietary habits specific to geographic location may lead to esophageal cancer.

(i) Occupational Exposure: - Industrial workers exposed to carcinogenic chemicals have a very high risk of developing cancer.

(j) Chemical ingestion: - Accidental chemical ingestion in childhood can lead to esophagus cancer in adulthood.

(k) Achalasia: - In this disease, the lower esophageal sphincter does not relax properly to allow food/liquid to pass into the stomach. The cause of this disease is probably a defect of nerve cells in the lower esophagus that keeps the lower esophagus sphincter from relaxing and thus makes it difficult to swallow. The esophagus above this narrowing becomes dilated and retains food. A small percentage of Achalasia patients do develop esophagus cancer.

(l) Tylosis: - Tylosis causes excess growth of the top layer of skin on the palm of the hands and soles of the feet. People with this condition have a very high risk of developing esophagus cancer. 

(3) Signs & Symptoms: -

(a) Dysphagia:- The most common symptom of esophagus cancer is difficulty swallowing, or Dysphagia, with the sensation of food getting stuck in the throat or chest. The opening of the esophagus is narrowed by the tumor causing this symptom.

(b) Pain: - In some cases patients can have mild chest pain or discomfort, a slight pressure sensation, or burning. Painful swallowing is usually a late sign of a large cancer blocking the opening of the esophagus. This pain can occur a few seconds after swallowing food or liquid as it reaches the tumor and cannot pass it.

(c) Weight loss: - About half of patients with esophagus cancer complain of unintended weight loss. This happens because they cannot swallow enough food and nutrition to maintain their weight. Early in the disease, this may go unnoticed. Cancer can also cause a decreased appetite and can affect a person’s metabolism.

Some of the most common symptoms of Esophagus cancer:-
(i) Dysphagia
(ii) Significant weight loss without dieting.
(iii) Avoidance of solid food because of pain, when the patient swallows.
(iv) Hiccups and Dysphagia together. 

(4) Metastasis: -

Esophagus cancer when detected has spread rapidly inside to distant organs in most of the patients. This cancer spreads directly to trachea, lungs, pleura, throat, stomach and digestive organs. This cancer more predominantly spreads through the lymphatic system faster than though blood. 

(5) Diagnosis as per modern science

(i) Barium swallow or upper GI tract X rays.
(ii) Upper endoscopy.
(iii) Computed tomography.
(iv) Endoscopic ultrasound.
(v) Bronchoscopy. 

(6) Staging: -

(a) Stage 0: - Is called carcinoma in situ, the cancer is still in very early stage and is found only in the first layer of cells lining the esophagus and has not reached the inner membrane, which is the first layer of mucosal lining.

(b) Stage I: - Cancer is found in only a small part of the esophagus and has not spread to adjacent tissues, lymph nodes, or other organs.

(c) Stage II: - Cancer is found in a large segment of the esophagus and has spread to all sides of the esophagus, and may have spread to the local lymph nodes. But it has not spread to adjacent organs.

(d) Stage III: - Cancer has spread to the lymph nodes near the esophagus and also to the tissues and organs near the esophagus but has not shown any signs of distant spread.

(e) Stage IV: - Cancer has spread to distant parts of the body. 

Cancer of Stomach:


(1) Overview
(2) Risk factors
(3) Sign & Symptoms
(4) Diagnosis as per modern science
(5) Staging

(1) Overview: -
                The stomach is a sack like organ that holds food and begins the digestive process by secreting gastric juices. The food and gastric juice are mixed and then emptied into the first part of the small intestine called the duodenum.The stomach is divided into five sections. The upper portion (closest to the esophagus) is the proximal stomach. Some cells of this area of the stomach produce acid and pepsin ( a digestive enzyme), the ingredients of the gastric juice that helps digest food. The lower portion is the distal stomach. This area includes the antrum, where the food is mixed with gastric juices, and the pylorus, which acts as a valve to control emptying of the stomach contents into the small intestine. Other organs next to the stomach include the colon, liver, spleen, small intestine, and pancreas.
                    The stomach has five layers. The innermost layer is called mucosa, in mucosa stomach acid and the digestive enzymes are made. Next layer is called submucosa. Submucosa is surrounded by muscularis, a layer of muscle that moves and mixes the stomach contents.
                      The next two layers, the submucosa and outermost serosa act as wrapping layers for the stomach. Most stomach cancers start in the mucosa. Stomach cancers develop slowly over many years. Stomach cancers can spread or metastasize, in different ways. They can grow through the walls of the stomach and eventually grow into the nearby organs. They can also spread to the lymph nodes. Of cancer spreads to the lymph nodes the chances of cure also becomes less. In later stages the stomach cancer will travel through the blood stream and form metastasis in organs such as liver, lungs, and bones. Even if it has spread to other organs it is still called stomach cancer. 

                    Majority of stomach cancers are adenocarcinoma. They develop from the epithelial cells that form the epithelial cells that form the innermost lining of the stomach’s mucosa.

The other less frequently occurring cancers of the stomach are.
(a) Lymphoma
(b) Gastrointestinal stromal tumors
(c) Carcinoid tumors 

(2) Risk factors: - 


(i) Age: - Most cases of stomach cancers can occur in people over age 55.

(ii) Gender: - Men have double the risk of developing stomach cancer as compared to women.

(iii) Family history: - People who have a first degree relative who has had stomach cancer are at an increased risk for stomach cancer.

(iv) Diet: - Consuming foods preserved with preservatives can increase the risk of developing stomach cancer. Eating fresh fruits and vegetables can reduce the risk of developing stomach cancer.

(v) Bacteria: - A type of bacteria called H-pylori, which causes stomach inflammation and ulcers, may increase the risk of stomach cancers. However most people infected with this disease never develop stomach cancer.

(vi) Previous surgery or health conditions: - People who have had stomach surgery or pernicious anemia (severe decrease in red blood cells) or achlorhydria (absence of hydrochloric acid in the gastric juices) which helps digest food have an increased risk of stomach cancers.

(vii) Occupational exposure: - Exposure to certain dusts and fumes may increase the risk of developing stomach cancer.

(viii) Obesity: - Excess body weight increases the risk for stomach cancer. 

(3) Signs & Symptoms: - 

(i) Indigestion or heartburn
(ii) Pain or discomfort in the abdomen
(iii) Nausea and vomiting
(iv) Diarrhea or constipation.
(v) Bloating of the stomach after meals
(vi) Loss of appetite
(vii) Weakness and fatigue
(viii) Vomiting blood or having blood in the stool
(ix) Unintended weight loss
These symptoms can also be caused by many other illnesses, such as a stomach virus or an ulcer. People with these symptoms should get a thorough check-up. 

(4) Diagnosis as per modern science: - 

(a) Upper endoscopy
(b) Imaging studies
(c) Barium swallow
(d) Endoscopy
(e) Computed tomography
(f) Magnetic resonance imaging
(g) X-Ray 

(5) Staging: -  

Stage 0: - Carcinoma in situ. Cancer cells are limited to the mucosa (innermost layer of the stomach) and have not invaded deeper layers of the stomach.

Stage I: - Tumor invades underneath the mucosa, into the lamina propria or submucosa.

Stage II: - Tumor invades the muscle layer below the mucosa and lamina propria, or tumor invades the subserosa (layer between the muscle layer and serosa)

Stage III: - Tumor perforates the serosa but does not invade any adjacent organs.

Stage IV: - Tumor perforates the serosa and invades an adjacent organ or other structures such as major blood vessels. 

Liver Cancer:



(1) Overview
(2) Symptoms
(3) Risk factors
(4) Metastasis
(5) Diagnosis as per modern science
(6) Staging and grading
  
(1) Overview :- 
The liver is a very important organ in the human body. It is placed under right ribs just under the right lung. The most important function of the liver is to convert food into energy and filtering and storing blood. The liver plays a pivotal role in the detoxification of blood, i.e. removal of toxins produced in the body due to metabolic activity of the body. The liver receives blood from two sources, the hepatic artery supplies the liver with blood from the heart that is rich in oxygen and the portal vein carries nutrient rich blood from the digestive organs. Liver also produces clotting agents necessary for clotting the blood when the body is injured. It secrets bile into the intestines, to help absorb nutrients. The liver is made up of several different types of cells. This is why there are several types of malignant (cancerous) and benign (non-cancerous) tumors that can form in the liver. 

Benign tumors :- 

(i) Hemangioma – The most common type of benign tumor of the liver, starts in blood vessles. Because most hemangiomas of the liver cause no symptoms, they do not need treatment. Some however may need to be surgically removed. 

(ii) Hepatic adenomas – These are benign tumors of hepatocytes (the main type of liver cell). Most cause no symptoms and do not need treatment. However, some eventually cause symptoms, such as abdominal pain, a mass in the abdomen, or blood loss. Because there is a risk that the tumor could rupture, and a small risk that it would eventually develop into liver cancer, most experts usually recommend surgical removal if possible. 

(iii) Focal nodular hyperplasia – This is a tumor growth of several cell types. Although FNH tumors are benign, it can be difficult to tell them apart from true liver cancers, and they sometimes are surgically removed when diagnosis is unclear. 

Malignant tumors: - 

(i) Hepatocellular carcinoma :- It is the most common form of liver cancer occurring. It is on numerous occasions called hepatoma because it comes from the hepatocytes. It accounts for about 75% of primary liver cancers. 

(ii) Cholangeocarcinomas :- This accounts for 10 to 20% of primary liver cancers. These are also called intrahepatic (starting with the liver) Cholangeocarcinomas. These cancer starts in the small bile ducts within the liver. 

(iii) Angiosarcomas and hemangiosarcomas: - These are rare cancers that begin in the blood vessles of the liver. Exposure to various chemicals such as vinyl chlorides or thorium oxide, and radioactive elements like radium or poisons like arsenic are known to cause these types of cancers. Angiosarcomas grow rapidly, by the time they are detected the growth is too large to be surgically removed. 

(iv) Hepatoblastoma: - This is a very rare kind of cancer that developes in children, usually up to five years of age. If detected early this cancer is highly treatable.  

(2) Symptoms: - 
   Signs and symptoms in liver cancers are not present until the last stage when cancer has spread. Many signs and symptoms are relatively non-specific, they can be caused by other cancers or non-cancerous diseases. However the following symptoms may require attention. 

(i) Unexplained, unintentional weight loss. 

(ii) Anorexia – persistent lack of appetite. 

(iii) Liver enlargement or a mass that can be felt in the area of liver. 

(iv) Persistent abdominal pain. 

(v) Jaundice. 

(vi) Hyperglycemia – Some liver hormones may cause hyperglycemia ( high blood calcium levels). This can lead to weakness. 

(vii) Hypoglycemia – Low blood sugar levels, which can lead to fainting. 

(viii) Gynecomastia – Enlargement of breasts in men, and shrinking of testis. 

(ix) Aseitis – Water retention in the abdominal area. Many patients are seen with these symptoms.  

(3) Risk factors 


(i) Gender – Hepatocellular carcinoma is predominantly more common in males than in females.

(ii) Chronic viral hepatitis – Chronic (long term) infection with hepatitis B virus or Hepatitis C virus is an important liver cancer risk factor. These infections are responsible for making liver cancer the most common type of cancer in the world. 

(iii) Cirrhosis – Cirrhosis is the result of scar tissue formation in the liver. This can often lead to cancer. Most liver cirrhosis occurs in people who abuse alcohol. But, Hepatitis B and C are also major causes of liver cirrhosis. Another cause is excessive iron in liver. 

(iv) Tobacco use – A link has been established between tobacco use and liver cancer. Combined with alcohol tobacco is very potent in causing cancer. 

(v) Inherited metabolic diseases – Certain metabolic diseases can also lead to cirrhosis. People with hemochromatosis, absorb too much iron from their food. They are more likely to develop cirrhosis because of the high levels of iron in their liver. 

(vi) Aflatoxins – These cancer causing substances are produced by a fungus that contaminates crops. Long term exposure may cause Hepatocellular carcinoma. 

(vii) Arsenic – Chronic exposure to drinking water contaminated with naturally occurring arsenic such as that from wells, increases the risk of liver cancer.  

(4) Metastasis: - 
               Mostly when cancer is found in the liver, it did not start there but spread, or metastasized from a cancer that developed in the other organs of the body such as pancreas, colon, stomach, breast, or lung, and metastasized to the liver. These tumors are named after their primary site of occurrences and are further known as metastasis. For example, cancer that started in the lung and spread to the liver is called metastatic lung cancer with spread to the liver.  

(5) Diagnosis: - 

The following methods are used by modern science in the diagnsis of liver cancer. 
(i) Ultrasound
(ii) Computed tomography (CT)
(iii) Magnetic resonance imaging (MRI)
(iv) Angiography
(v) Leproscopy
(vi) Biopsy
(vii) Alpha-fetoprotein blood test.  

6.Staging: - 

Stage 1 – The tumor may be small or large but has not affected blood vessles.

Stage 2 – There may be many tumors of large size but blood vessles are not yet affected.

Stage 3-a – There are several tumors, and at least one is larger than 5 cms. And a tumor invades a branch of major liver blood vessles. (Portal vein or Hepatic vein)

Stage 3-b – A tumor invades a nearby organ or a tumor has penetrated the lining of the liver.

Stage 3-c – The cancer has invaded nearby lymph nodes.

Stage 4 – The cancer has spread to other parts of the body. 

Pancreas Cancer:



(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging

(1) Overview: -

Pancreas is a secreting gland placed right behind the stomach. It is about 6 inches long but less than 2 inches wide, and extends horizontally across the abdomen.
The pancreas contains two separate glands, the exocrine and endocrine glands. Exocrine glands releases substances into the ducts, the endocrine gland releases substances into the blood-stream. More than 95% of the cells in the pancreas are exocrine glands and ducts. The exocrine glands produce pancreatic juices, which contains enzymes that help digest fats, proteins, and carbohydrates in the food. The exocrine ducts carry this pancreatic juice to the common bile duct and eventually to the small intestine.
A small percentage of the cells in the pancreas are endocrine cells. These cells are arranged in small clusters called islets. The islets release 2 hormones, insulin and glucogen. Insulin is important in reducing the amount of sugar in the blood while glucogen increases it.

(2) Risk factors: -  

Age: - Almost 70% of patients with pancreas cancer are above 65 years of age.

Gender: - Men are more likely to develop cancer of the pancreas as compared to women.

Tobacco and Alcohol: - The risk of developing pancreas cancer increases with the intake combination of tobacco and alcohol.

Diet: - Diet with high fat content may increase the risk of developing pancreas cancer. Fruits and vegetables have an effect of reducing the risk.

Diabetes Mellitus: - Pancreatic cancer is more common in people with this disease.

Chronic Pancreatitis: - This is a long term inflammation of the pancreas. This condition is associated with an increased risk of Pancreatitis cancer.

Occupational exposure: - Heavy exposure to certain pesticides, dyes and chemicals related to gasoline may increase the risk of developing cancer of the pancreas.

Family history: - An inherited tendency to develop this cancer may be a factor in a large no. of cases.

Stomach problems: - Infection of the stomach with the ulcer causing bacteria H-Pylori increases the risk of pancreatic cancer. 

(3) Signs and symptoms: -  
  • Jaundice
  • Pain
  • Weight loss
  • Digestive problems
  • Gallbladder enlargement
  • Diabetes mellitus
  • Blood clots or fatty tissue abnormalities 

(4) Diagnosis as per modern science 

(i) CT scan
(ii) Positron emission tomography
(iii) Ultrasonography
(iv) Magnetic resonance Imaging
(v) Endoscopy
(vi) Several Blood Tests
(vii) Biopsy 

(5) Staging: -  

Stage I: - The tumor is confined to the pancreas and is less than 2cms in size. It has not spread to nearby lymph nodes or distant sites.

Stage II: - The tumor is either confined to the pancreas or growing outside the pancreas but not into large blood vessels. It has spread to nearby lymph nodes but not to distant sites.

Stage III: - The tumor is growing outside the pancreas into large blood vessels. It may or may not have spread to lymph nodes. It has not spread to other organs.

Stage IV: - The cancer has spread to distant sites. 



Colo-Rectal Cancer:



(1) Overview
(2) Risk Factors
(3) Signs and Symptoms
(4) Diagnosis as per modern science
(5) Staging 

(1) Overview: -  

           Colorectal cancer is a term used to refer to cancer that develops in the colon or the rectum. The colon and rectum are parts of the digestive system.The first and major part of the large bowel, i.e. the colon, continues to absorb water and mineral nutrients from the food matter and serves as a storage place for waste matter. The waste matter left after this process is feces and goes into the rectum, the final 6 inches of the large bowel. From here it passes out of the body through the anus. 

The colon has four sections

(a) The first section is called the ascending colon
(b) The second section is called transverse colon.
(c) The third colon is called descending colon.
(d) The fourth part is called the sigmoid colon. The sigmoid colon joins the rectum, which in turn joins the anus, or the opening where waste matter passes out of the body. 

              The walls of each of these sections of the colon and the rectum have several layers of tissue. Colorectal cancer starts in the innermost layer and can grow through some or all of the other layers. In most people Colo-rectal cancers develop slowly over a period of several years. Before the symptoms can be felt. 
             
             A vast majority of colo-rectal cancers are adenocarcinoma. These are cancers of the glandular cells that line the inside layer of the wall of the colon and rectum.
Carcinoid tumors develop from specialized hormone producing cells of the intestine.
Gastrointestinal stromal tumors develop from specialized cells in the walls of the colon called the ‘interstitial cells of the cajal’.

          Some tumors are benign, others are malignant (cancerous). Although these cancers can be found anywhere in the gastrointestinal tract, they are unusual in the colon.
Lymphomas are cancers of the immune system cells that typically develop in lymph nodes but also may start in the colon and rectum or other organs. 

(2) Risk factors: - 

(a) A family history of colorectal cancer
(b) Ethnic background
(c) A personal history of colo-rectal polyps
(d) Chronic inflammatory bowel disease
(e) Ageing
(f)  Non-vegetarian diet
(g) Sedentary life-style
(h) Obesity
(i) Diabetes
(j) Smoking
(k) Alcohol intake
(l) disorderly lifestyle 

(3) Signs & Symptoms 

A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days.

A feeling that you need to have a bowel movement that is not relived by doing so.

Rectal bleeding or blood in the stool.

Cramping or steady abdominal pain.

Weakness and fatigue. 

(4) Diagnosis as per modern science: - 

(i) Medical history and physical exam.
(ii) Sigmoidoscopy, barium enema, colonoscopy.
(iii) Blood tests
(iv) Biopsy
(v) Ultrasound
(vi) CT scan
(vii) MRI 


(5) Staging: -

Stage 0: - The cancer is in the earliest stage. It has not spread beyond the inner layer (mucosa) of the colon or rectum. This stage is also known as carcinoma in situ or intramucosal carcinoma.

Stage 1: - The cancer has grown through the mucosa into the submucosa or it may also have grown into the muscularis propria, but it has not spread into nearby lymph nodes or distant sites.

Stage 2: - The cancer has grown through the wall of the colon or rectum into other nearby tissues 
or organs. It has not yet spread to the nearby lymph nodes or distant sites.

Stage 3: - The cancer has grown through the walls of the colon or rectum or into other nearby tissues or organs and has spread to nearby lymph nodes.

Stage 4: - The cancer has spread to distant organs such as liver, lung, peritoneum, or ovary. 

Rectum Cancer:


(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging

(1) Overview: - 

      The rectum is part of the body’s digestive system. The digestive system removes and processes nutrients, vitamins, minerals, carbohydrates, fats, proteins, and water from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach and the small and large intestines. The first 6 feet of the large intestine are called the large bowel or colon. The last 6 inches are the rectum and the anal canal. The anal canal ends at the anus, the opening of the large intestine to the outside of the body. 

(2) Risk factors: - 

(i) Age 50 years or above.
(ii) A family history of cancer of the colon or rectum
(iii) A personal history of cancer of the colon, rectum, ovary, endometrium or breast.
(iv) A history of ulcerative colitis (Ulcers in the lining of the large intestine or crohn’s disease.)
(v) Certain hereditary conditions such as familial adenomatous polyposis and hereditary non-polyposis colon cancers. 

(3) Signs and symptoms: - 

(a) A change in bowel habits
(b) Blood (either bright red or very dark) in the stool
(c) Diarrhea, constipation, or feeling that the bowel does not empty completely
(d) Stools that are narrower than usual
(e) General abdominal discomforts, frequent gas, pains, bloating, fullness, or cramps.
(f) Weight loss with no known reasons
(g) Constant tiredness
(h) Vomiting 

(4) Diagnosis as per modern science: - 

Fecal occult test
Digital rectal exam
Barium enema
Sigmoidoscopy
Colonoscopy
Biopsy 

(5) Staging: -  

Stage 0: - A very early cancer involving only the innermost lining of the colorectum

Stage I: - The cancer involves a little more of the inner wall of the colorectum 

Stage II: - The cancer has spread outside the rectum to nearby tissue, but it has not gone into the lymph nodes (small, bean-shaped structures found throughout the body that filter substances in a fluid called lymph and help fight infection and disease).

Stage III: -in  stage III, cancer has spread to nearby lymph nodes, but it has not spread to other parts of the body

Stage IV: - In stage IV, cancer has spread to other parts of the body, such as the liver, lungs, or ovaries. 

Anal Cancer:


(1) Overview
(2) Risk factors
(3) Signs and symptoms
(4) Diagnosis as per modern science
(5) Staging 

(1) Overview: -  

Anal cancer occurs in the anus. The anus is the end of the large intestine that opens to allow the passage of feces during a bowel movement. Other parts of the large bowel includes the colon the longest part of the large intestine and the rectum. The anus is about one and a half inch long.
The anus contains several types of tissues and each of these tissues contain several types of cells. The epithelium on the outside of the anus contains flat cells known as squamous cells. 

Types of anal cancers 

(a) Squamous cell carcinomas: - Squamous cell carcinomas are the most common type of anal cancer. They account for most anal cancers. These tumors come from squamous cells of the epithelium that lines the anal margin and most of the anal canal. In its earliest stage, squamous cell carcinoma is known as carcinoma in situ. The cancerous cells of CIS are limited to the epithelium and have not spread into any other tissues. Cells of invasive squamous cell carcinomas have already spread beyond the epithelium and are therefore no longer considered in situ.

(b) Cloacogenic carcinomas: - This is a subclass of the squamous cell cancers.Approximately 30% of anal tumors develop in the transitional zone. Another word for this zone is the cloaca. Some tumors that form here are known as Cloacogenic carcinomas.

(c) Adenocarcinoma: - A small number of anal cancers are known as adenocarcinoma. (Adeno means gland) Adenocarcinomas can develop in glands located under the anal epithelium that release their secretions into the anal canal. They can also arise in apocrine glands (a type of sweat gland of the perianal skin).

(d) Basal cell Carcinoma: - Basal cell carcinomas are a type of skin cancer that can develop from the perianal skin. These tumors are rare in occurrence in anal cancers.

(e) Malignant melanoma: - Melanoma type of cancer is common on parts of the body that are exposed to the sun. however a small minority of skin cancers are of melanoma type developing from cells in the skin that produce brown pigment called melanin. 

(2) Risk factors: - 

Age: - Most cases of the disease are diagnosed in people between the ages of 50 and 80.

Human Papiloma virus: - The same virus responsible for cervical cancer is also responsible for Anal cancer.

Smoking: - Use of tobacco and smoking increases the risk of developing anal cancer.

Fistulas: - Long-term problems in the anal area, such as fistulas, can increase the chances of developing the disease. 

(3) Signs & Symptoms: - 

(a) Pain in the anal area.
(b) Straining during bowel movement.
(c) Anal itching.
(d) Change in bowel habits such as more frequent or less frequent movements.
(e) Change in the diameter of stool.
(f) Abnormal discharge from the Anus.
(g) Swollen lymph nodes in the anal or groin areas. 

(4) Diagnosis as per modern science: - 

(i) Endoscopy.
(ii) Anoscopy.
(iii) Fine needle aspiration biopsy.
(iv) CT Scan
(v) MRI. 

(5) Staging: -  

Stage 0: - Stage 0 is very early cancer that exists only in the top layer of anal epithelium.

Stage I: - The cancer has spread beyond the top layer of anal tissue but it is less than 2 cms. in size.

Stage II: - The cancer is larger than 2 cms. but it has not spread to nearby organs or lymph nodes.

Stage III: - The cancer has grown into nearby organs such as the vagina or the bladder and has spread to lymph nodes around the rectum.


Stage IV: - Cancer can be any size and may or may not have spread to lymph nodes but has spread to organs in other parts of the body. 


Kidney Cancer:


(1)   Overview
(2)   Symptoms
(3)   Risk factors
(4)   Diagnosis as per modern science
(5)   Spread or metastasis 

Overview :-
                   The kidneys are reddish brown organs about the size of a small fist located above the waist to either side of the spine. They are closer to the back then to the front. In kidney cancer, cells grow uncontrollably and form tumors.Kidneys filter blood and remove impurities, excess minerals and salts, and surplus water. These organs also produce hormones to help control blood pressure, red blood cell production, and other functions. Although people have two kidneys, each works independently. The human body can function with less than one complete kidney. With dialysis, a mechanized filtering process, it is possible to live without kidneys.

Types of kidney cancers 

(i)   Renal cell carcinoma
Renal cell carcinoma is the most common type of kidney cancer. It accounts for more than 90% malignant kidney tumors.
Further divided renal cell carcinomas are of main five types.
(a)    Clear cell
(b)   Papillary
(c)    Chromophobe
(d)   Collecting duct
(e)    Classified
Clear cell carcinomas consist of about 80% of all renal cell carcinomas.

(ii)               Transitional cell carcinomas
                     About 5 to 10 % of all kidney tumors are transitional cell carcinomas, also known as urothelial carcinomas. Transitional cell carcinoma begins in the area of the kidney where urine collects before being funneled to the bladder. This type of kidney cancer is similar to bladder cancer and is treated like bladder cancer.
(iii)             Wilms tumour :-
                     About 5 to 6% of all kidney cancers are wilms tumors. This type of cancer is almost always found in children and is extremely rare among adults.
(iv)             Renal sarcoma :-
                   Renal sarcomas are a very rare type of kidney cancer that begins with the kidney’s collective tissues.
(v)               Benign tumours :-
                  Some type of kidney tumors do not usually spread to other parts of the body, although they can still grow and cause problems. These include renal cell adenomas, renal oncocytomas, and angiomyolipomas.

(2)   Symptoms :-

(i)                 Blood in urine
(ii)               Low back pain on one side
(iii)             A mass or lump in the abdomen
(iv)             Fatigue
(v)               Weight loss
(vi)             Fever that is not associated with a cold, flu, or other infection and that does not go away after a few weeks.
(vii)           Swelling of ankles and legs.


(3)   Risk factors :-

(i)                 Smoking:-
Cigarette smoking is one of the major causes of kidney cancer.
(ii)               Gender :-
Kidney cancer occurs two or three times more often in men than it does in women.
(iii)             Age :-
Kidney cancer is primarily a disease of adults and is usually diagnosed between the ages 50 & 70.
(iv)             Diet and weight :-
Research has consistently demonstrated a link between kidney cancer and obesity caused by a high fat diet.
(v)               Hypertension :-
A connection has been made between high blood pressure and kidney cancer in men.
(vi)      Overuse of certain medications:-
Some medicines such as diuretics and analgesic pain killers have also been linked to kidney cancer.
(vii)      Exposure to chemicals:-
Some studies have shown a connection between kidney cancer and exposure to the metallic element cadmium. Working with products such as batteries, paints, or welding materials, may also increase risk; this risk is especially strong for smokers exposed to cadmium.
(viii)         Sedentary lifestyle :-
Several studies have found that inactive people are more likely to develop kidney cancer than, people who exercise regularly.
(ix)             Genetic and hereditary risk factors :-
Some people inherit a tendency to develop a certain type of cancer. Hereditary kidney cancer can be caused by unknown hereditary factors.
(x)               Von-hippen-lindau disease :-
People with this condition often develop several kinds of tumors. Between 25% to 45% of these people develop renal carcinoma. They may also have benign blood vessel tumors hemangioblastomas  in the eyes, brain and spinal cord, cystic (fluid-filled) growths in their pancreas and other organs, and a type of adrenal gland tumor called pheochromocytoma. These tumors can cause various symptoms, so unfortunately there are no symptoms that are specified for this disease.

(4)   Diagnosis as per modern medical science:-
Imaging tests
(i)                 CT SCAN (Computed tomography)
(ii)               MRI (Magnetic resonance imaging)
(iii)             Ultrasonography
(iv)             Angiography
(v)               Chest x-ray
(vi)             Bone scan

Lab Tests
(i)                 Urine analysis
(ii)               Blood tests
(iii)             Fine needle aspiration biopsy

(5) Spread (Metastasis) :-

Stage 1 – The cancer is confined to the kidney
Stage 2 – The cancer has broken through the kidney capsule and spread into the fatty tissue immediately around the kidney and / or into the adrenal gland immediately above the kidney.
 Stage 3 – The cancer has spread farther into nearby lymph nodes and / or blood vessels.
Stage 4 – The cancer has grown into a nearby organ or spread through the blood stream to other organs, lungs, liver or bone.

Urinary Bladder Cancer:



(1) Overview
(2)  Risk factors
(3) Signs and Symptoms
(4) Diagnosis as per modern science
(5) Staging 

(1) Overview: - 
The bladder is a hollow organ in the lower part of the abdomen; it is shaped like a small balloon and has a muscular wall that stores urine until it is passed out of the body. Urine is the liquid waste that is made by the kidneys when they clean the blood. The urine passes from the two kidneys into the bladder through two tubes called ureters. When the bladder is emptied during urination, the urine goes from the bladder to the outside of the body through another tube called the urethra.


Types of Bladder cancers

(1) Transitional cell carcinoma or urothelial carcinoma.
        Sub-types of urothelial carcinoma.

        (i) Non-Invasive urothelial tumors: - These tumors are limited to the bladder only.
       (ii) Invasive urothelial tumors: - The cancer may have spread from the urothelium to the deeper layers of the bladder.
       (iii) Papillary urothelial tumors.

(2) Squamous cell carcinoma: - Cancer that begins in squamous cells, which are thin, flat cells that may form in the bladder after long-term infection or irritation.
(3) Adenocarcinoma: - Cancer that begins in the glandular cells. Glandular cells in the lining of the bladder produce and release fluids such as mucus.
(4) Cancer that is confined to the lining of the bladder is called superficial bladder cancer. Cancer that begins in the transitional cells may spread through the lining of the bladder and invade the muscle wall of the bladder or spread to nearby organs and lymph nodes this is called invasive bladder cancer. 

(2) Risk factors: -

(a) Smoking
(b) Occupational exposure: - Exposure to certain chemicals at work, such as rubber, certain dyes used in textiles, paint and certain chemicals in hairdressing and perfume industry.
(c) A diet in fried meats and fat.
(d) Age factor.
(e) Being male.
(f) Race.
(g) Bladder infection and inflammation for long duration.

(3) Signs and Symptoms: -  

(i) Blood in the urine.
(ii) Frequent urination, or feeling the need to urinate without being able to do so.
(iii) Pain during urination.
(iv) Lower back pain. 

(4) Diagnosis as per modern science: -

(a) CT scan
(b) Urine analysis
(c) Internal examination of vagina and rectum.
(d) Intravenous pyelogram.
(e) Cytoscopy.
(f) Biopsy.
(g) Urine cytology. 

(5) Staging: -

(i) Stage 0: - The cancer is non-invasive papillary carcinoma. It has not grown into the muscles or connective tissues of the bladder wall or spread to lymph nodes or distant sites.
(ii) Stage I: - The cancer has grown to the connective tissues under the layer of the bladder wall. The cancer has not spread to lymph nodes or to distant sites.
(iii) Stage II: - The cancer has spread to the thick muscle layer of the bladder wall, but, it has not passed completely through the muscles to reach the layer of fatty tissues that surrounds the bladder. The cancer has not spread to lymph nodes or to distant sites.
(iv) Stage III: - The cancer has grown completely through the bladder into the layers of fatty tissues that surrounds the bladder. It may have spread into prostate, uterus, or vagina. The cancer has not spread to lymph nodes or to distant sites.
(v) Stage IV: - The cancer has spread through the bladder wall to the pelvic or abdominal wall and/or has spread to lymph nodes and/or distant sites, such as bones, liver or lungs. 

Prostate Cancer:



(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per Ayurveda
(5) Staging 

(1) Overview: -

The prostate is a gland in the male reproductive system. Located just below the bladder (the organ that collects and empties urine), and in front of the rectum. It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder. The prostate gland produces fluid that makes up part of the semen.
Prostate cancer is found mainly in elder men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause difficulty in urination or can interfere with sexual function. The condition is called benign prostatatic hyperplasia, although it is not cancer, surgery may be required to remove it. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be similar to symptoms for prostate cancer.
Although several cell types are found in the prostate, almost 99% of prostate cancers develop from the glandular cells. Glandular cells make the seminal fluid that is secreted by the prostate. The medical term for a cancer that starts in glandular cells is Adenocarcinoma. Because other types of prostate cancer are so rare.
Most prostate cancers grow slowly. Some prostate cancers, however can grow and spread quickly. 

(2) Risk factors: - 

(a) Age: - The chances of having prostate cancer increases after age 50. Majority of prostate cancers are diagnosed in men above 65 years of age.
(b) Race: - Prostate cancer is found more widely in African-American men. Prostate cancer occurs less frequently in Asian men as compared to European or white men.
(c) Family history: - Hereditary factors play a role in the development of prostate cancer.
(d) Diet: - Men having high fat diets are more likely to develop prostate cancer.
  
(3) Signs and Symptoms: -  

(i) Weak or interrupted flow of urine.
(ii) Frequent urination.
(iii) Difficulty urinating.
(iv) Pain or burning during urination.
(v) Blood in the urine or semen.
(vi) Nagging pain in the back, hips or pelvis.
(vii) Painful ejaculation. 

(4) Diagnosis as per modern science: -

(a) Digital rectal exam.
(b) Prostate specific antigen tests.
(c) Trans rectal ultrasound.
(d) Biopsy.
(e) CT Scan.
(f) MRI. 

(5) Staging: - 

(i) Stage I: - The cancer is still confined to the prostate and has not spread to lymph nodes or elsewhere in the body.
(ii) Stage II: - The cancer is still within the prostate and not spread to the lymph nodes or elsewhere in the body. It can be felt on digital rectal exam or seen on transrectal ultrasound.
(iii) Stage III: - The cancer has begun to spread outside the prostate and may have spread to the seminal vesicles, but it has not spread to the lymph nodes.
(iv) Stage IV: - It has spread to other, more distant sites in the body.

Penile Cancer:



(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging

(1) Overview: -

The penis is the external male genital organ. Inside the penis is the urethra, the tube through which urine and semen exit the body. The head of the penis is called the gland.
Inside the penis are 3 chambers that contain a soft, spongy network of blood vessels. Two of these cylinders shaped chambers known as the corpora cavernosa, lie on either side of the upper part of the penis. The third lies below them and is known as the corpus spongiosum. This chamber widens at its end to form the gland. The corpus spongiosum surrounds the urethra, a tube that caries urine from the bladder through the penis. This opening at the end of the urethra is called the meatus. 

Type of cancers of the penis: -

(i) Epidermoid carcinoma: - 90 to 95% of penile cancers develop from flat skin cells called squamous cells. Penile tumors tend to grow slowly. When found at an early stage, these tumors can be cured. Most Squamous cell penile cancers develop in the penis foreskin, or glans penis
.
(ii) Verrucous carcinoma: - It is a rarely occurring form of squamous cell cancer that can occur on the male or female genitals, skin, mouth, larynx and anus.

(iii) Adenocarcinoma: - Is a rare type of penile cancer, can develop from sweat glands in the skin of the penis. The cancer cells at first spread within the skin, but they may eventually, invade underneath the skin and spread to lymph nodes.

(iv) Melanoma: - A small percentage of penile cancers develop from pigment producing skin cells called melanocytes. Cancers of these cells are called melanomas. These cancers grow and spread rapidly.

(v) Basal cell penile cancers: - Basal cell cancers represent less than 2% of penile cancers. They are slowly growing tumors that rarely spread to other parts of the body.
(vi) Sarcomas: - A small percentage of penile cancers are sarcomas, cancers that develop from the blood vessels, smooth muscles, and other connective tissue cells of the penis. 

(2) Risk factors: -

(a) Human papiloma virus infection: - It is the most avoidable risk factor for penile cancer.

(b) Smoking and alcohol: - Tobacco use and alcohol usage greatly increases the risk of developing penile cancer.

(c) Smegma: -Oily secretions from the skin, dead skin cells and bacteria can accumulate under the foreskin. The result is a thick, substance called Smegma. The resulting inflammation and irritation can cause cancer.

(d) Treatment of psoriasis: - Men who have psoriasis and have been treated with a combination of psoralean and ultraviolet light have a high risk of developing penile cancer.

(e) Age: - Majority of penile cancer cases are above 55-60 years of age. 

(3) Signs and Symptoms: -
  • ·    A growth or ulcer on the penis, especially on the glans or foreskin.
  • ·        Changes in color on the penis.
  • ·        Skin thickening on the penis.
  • ·        Persistent discharge with foul odor beneath the foreskin.
  • ·        Blood coming from the tip of the penis or under the skin.
  • ·        Unexplained pain in the penis.
  • ·        Growing marks or lesions beneath the foreskin or on the body of the penis.
  • ·        Reddish rashes beneath the foreskin.
  • ·        Swollen groin lymph nodes.
  • ·        Irregular swelling at the end of the penis. 


(4) Diagnosis as per modern science: -

(i) Biopsy
     (a) Fine needle aspiration
     (b) Sentinel node biopsy
(ii) CT scan
(iii) MRI
(iv) Ultrasound
(v) X-Rays 

(5) Staging: -

(a) Stage I: - Cancer cells are found only on the surface of the glans (the head of the penis) and on the foreskin (the loose skin that covers the head of the penis).
(b) Stage II: - Cancer cells are found in the deeper tissues of the glands and have spread to the shaft of the penis (the long, slender cylinders of tissue inside the penis that contains spongy tissue and expands to produce erections.
(c) Stage III: - Cancer cells are found in the penis and have spread to nearby lymph nodes in the groin.
(d) Stage IV: - Cancer cells are found throughout the penis and the lymph nodes in the groin and/or have spread to other parts of the body.

Testicular Cancer:


(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging

(1) Overview: -
The testicles are a part of male reproductive system. These two egg shaped organs in adult males, are contained within a sac of skin called the scrotum, which hangs beneath the base of the penis.
The testicles manufacture the male hormones, most of which is testosterone. They also produce sperm. Sperm cells are carried from the testicles by the vas deferens to the seminal vesicles, where they are mixed with fluid produced by the prostate glands. During ejaculation, sperm cells, seminal vesicle fluid, and prostate fluid enter the urethra, the tube in the centre of the penis through which both urine and semen are passed.
Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and non-seminomas. These 2 types grow and spread differently and are treated differently. Non-seminomas tend to grow and spread more quickly than seminomas.

 Testicular cancer is more common in men 25 to 35 years old.  

(2) Risk factors: -

(a) Having had an Un-descended testicle.
(b) Having had abnormal development of the testicle.
(c) Having Klinefelter’s syndrome (a genetic disorder in males caused by having an extra X-chromosome). Males with this disorder may have larger than normal breasts, a lack of facial and body hair, and small testicles.
(d) Age. 

(3) Signs and symptoms: -

(i) A painful lump or swelling in either testicle.
(ii) A change in how the testicle feels.
(iii) A dull ache in the lower abdomen or groin.
(iv) A sudden built up of fluid in the scrotum.
(v) Pain or discomfort in a testicle or in the scrotum. 

(4) Diagnosis as per modern science: -

(a) Physical exam and history: - An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles will be examined to check for lumps, swelling, or pain. A history of the patient's health habits and past illnesses and treatments will also be taken.

(b) Ultrasound: - Procedures in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

(c) Serum tumor marker test: - A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers.

The following 3 tumor markers are used to detect testicular cancer:
 Alpha-fetoprotein (AFP).
Beta-human chorionic gonadotropin
Lactate dehydrogenase (LDH).

(d)  Radical inguinal orchiectomy and biopsy: -A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.

(5) Staging: -

Stage 0: - (Carcinoma in situ) Preinvasive germ cell cancer.
Stage I: - No spread to lymph nodes or distant organs, and blood tests are normal.
Stage II: - Cancer has spread to regional lymph nodes but not to lymph nodes in other parts of the body or to distant organs.

     (i) Nonbulky stage II: - Spread to lymph nodes behind the abdominal cavity (retroperitoneal lymph nodes), and lymph nodes are not larger than 5cms.
       (ii) Bulky stage II: - Cancer has spread to 1 or more retroperitoneal lymph nodes, and they are larger than 5cms.

Stage III: - Cancer has spread to distant lymph nodes and/or to distant organs, such as the lungs or liver.
       (i) Non-bulky stage III: - Metastasis are limited to lymph nodes and lungs, and no mass is larger than 2 cms.
      (ii) Bulky Stage III: - There are large metastasis and lymph node metastases are larger than 2 cm. and/or cancer has spread to other organs, such as the liver or brain.

Cancer of Uterine Cervix:


(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging


(1) Overview: -
Cervical cancer starts in a woman's cervix, the lower, narrow part of the uterus. The uterus holds the growing fetus during pregnancy. The cervix connects the lower part of the uterus to the vagina and, with the vagina, forms the birth canal.
Cervical cancer develops when normal cells on the surface of the cervix begin to grow uncontrollably, and eventually form a mass of cells called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous).
This phase of the disease is called dysplasia (an abnormal growth of cells). The precancerous tissue needs to be removed to keep cancer from developing.
 If the precancerous cells change into true cancer cells and spread deeper into the cervix or to other tissues and organs, the disease is then called cervical cancer.
Cervical cancers are divided into two main types, named for the type of cell where the cancer started.
  • Squamous cell carcinomas, which make up about 85% to 90% of all cervical cancers
  • Adenocarcinoma, which make up 10% to 15% of all cervical cancers

 (2) Risk factors: -
The following factors can raise a person's risk of developing cervical cancer:

(a) Human papillomavirus (HPV) infection: -
The most important risk factor for cervical cancer is infection with HPV. HPV is passed from one person to another during sexual intercourse. Factors that raise the risk of being infected with HPV include becoming sexually active at an early age, having many sexual partners (or having sex with a man who has had many partners), and having sex with a man who has penile warts.

(b) Human immunodeficiency virus (HIV) infection: -
Infection with HIV, the virus that causes acquired immune deficiency syndrome (AIDS), is also a risk factor for cervical cancer. When a woman is infected with HIV, her immune system is less able to fight off early cancers. Women whose immune systems have been suppressed by corticosteroid medications, kidney transplantations, or therapy for other cancers or AIDS are also at greater risk.

(c) Herpes: -
Women who have genital herpes are at greater risk for developing cervical cancer.

(d) Smoking: -
Women who smoke are about twice as likely to develop cervical cancer as women who do not smoke.

(e) Age: -
The risk goes up between the late teens and mid-30s. Women over 40 remain at risk and need to continue having regular Pap tests.


(f) Race: - Cervical cancer is more common among blacks, Hispanics, and American Indians.

(g) Exposure to diethylstilbestrol: -
Women whose mothers were given this drug during pregnancy to prevent miscarriage are also at increased risk for cervical cancer. DES was given for this purpose from about 1940-1970.

(3) Signs & Symptoms: -

(i) Blood spots or light bleeding between or following periods
(ii) Menstrual bleeding that is longer and heavier than usual
(iii) Bleeding after intercourse, douching, or a pelvic examination
(iv) Pain during intercourse
(v) Bleeding after menopause
(vi) Increased vaginal discharge

(4) Diagnosis as per modern science: -

(i) Pap smear: - A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called a Pap test.

(ii) Colposcopy: - A procedure to look inside the vagina and cervix for abnormal areas. A colposcope (a thin, lighted tube) is inserted through the vagina into the cervix. Tissue samples may be taken for biopsy.

(iii) Biopsy: - If abnormal cells are found in a Pap smear, the doctor may do a biopsy. A sample of tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. A biopsy that removes only a small amount of tissue is usually done in the doctor’s office. A woman may need to go to a hospital for a cervical cone biopsy (removal of a larger, cone-shaped sample of cervical tissue).

(iv) Pelvic exam: -An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor inserts one or two lubricated, gloved fingers of one hand into the vagina and the other hand is placed over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.

(v) Endocervical curettage: -A procedure to collect cells or tissue from the cervical canal using a curette (spoon-shaped instrument). Tissue samples may be taken for biopsy. This procedure is sometimes done at the same time as a colposcopy.

(5) Staging: - 

(1) Stage 0: - (Carcinoma in Situ) In stage 0, cancer is found only in the first layer of cells lining the cervix and has not invaded the deeper tissues of the cervix. Stage 0 is also called carcinoma in situ.

(2)Stage I: -In stage I, cancer is found in the cervix only. Stage I is divided into stages IA and IB, based on the amount of cancer that is found.

                   Stage IA: A very small amount of cancer that can only be seen with a microscope is found in the tissues of the cervix. The cancer is not deeper than 5 millimeters and not wider than 7 millimeters.

             Stage IB: In stage IB, cancer is still within the cervix and either:
·        Can only be seen with a microscope and is deeper than 5 millimeters or wider than 7 millimeters; or
·        Can be seen without a microscope and may be larger than 4 centimeters.

(3) Stage II: - In stage II, cancer has spread beyond the cervix but not to the pelvic wall (the tissues that line the part of the body between the hips). Stage II is divided into stages IIA and IIB, based on how far the cancer has spread.
#       Stage IIA: Cancer has spread beyond the cervix to the upper two thirds of the vagina but not to tissues around the uterus.
#       Stage IIB: Cancer has spread beyond the cervix to the upper two thirds of the vagina and to the tissues around the uterus.

(4) Stage III: -
In stage III, cancer has spread to the lower third of the vagina and may have spread to the pelvic wall and nearby lymph nodes. Stage III is divided into stages IIIA and IIIB, based on how far the cancer has spread.
#       Stage IIIA: Cancer has spread to the lower third of the vagina but not to the pelvic wall.
#       Stage IIIB: Cancer has spread to the pelvic wall and/or the tumor has become large enough to block the ureters (the tubes that connect the kidneys to the bladder). This blockage can cause the kidneys to enlarge or stop working. Cancer cells may also have spread to lymph nodes in the pelvis.

(5) Stage IV: -
In stage IV, cancer has spread to the bladder, rectum, or other parts of the body. Stage IV is divided into stages IVA and IVB, based on where the cancer is found.
#         Stage IVA: Cancer has spread to the bladder or rectal wall and may have spread to lymph nodes in the pelvis.
#          Stage IVB: Cancer has spread beyond the pelvis and pelvic lymph nodes to other places in the body, such as the abdomen, liver, intestinal tract, or lungs.

Cancer of Uterine Body:



(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis
(5) Staging

(1) Overview: - 

Uterine cancer (also known as endometrial cancer) is the most common cancer of the female reproductive system. The uterus is hollow and shaped like a pear and located in a woman's pelvis between her bladder and rectum. The uterus is also known as the womb, where a baby grows when a woman is pregnant. It has three sections: the cervix (the narrow, lower section), the corpus (the broad, middle section), and the fundus (the dome-shaped top section). The inside of the uterus (the wall) has two layers of tissue: endometrium (an inner layer), and myometrium (the outer layer), which is muscle tissue.

          Every month during a woman's childbearing years, the lining of the uterus grows and thickens in preparation for pregnancy. If the woman does not get pregnant, this lining, which is bloody and thick, passes out of her body through her vagina during menstruation. This process continues until menopause.

         Uterine cancer begins when cells in the uterus begin to change, grow uncontrollably, and eventually form a tumor. Tumors can be benign (noncancerous) or malignant (cancerous). Noncancerous conditions of the uterus include fibroids (benign tumors in the muscle of the uterus), endometriosis (endometrial tissue on the outside of the uterus or other organs), and endometrial hyperplasia (an increased number of cells in the uterine lining).

There are two types of uterine cancer.

Adenocarcinoma: -
This type of cancer makes up more than 95% of uterine cancers. It develops from cells in the lining of the uterus, the endometrium. This cancer is also commonly called endometrial cancer.

Sarcoma: -
This form of uterine cancer develops in the uterine muscle, the myometrium. Sarcomas account for only 2% to 4% of uterine cancers.
 

(2) Risk factors: - 

Age: - Uterine cancer most often occurs in women over age 50; the average age is 60.

Ethnicity: -
White women are more likely to develop uterine cancer than black women.

Genetics: -
Uterine cancer may run in families where colon cancer is hereditary.

Other health conditions: - Women may be at increased risk for uterine cancer if they have had endometrial hyperplasia (an increased number of cells in the uterine lining) or if they have diabetes.

Other cancers: -
Women who have had breast, colon, or ovarian cancers are at increased risk for uterine cancer.

Tamoxifen: -
Women taking the drug tamoxifen to prevent or treat breast cancer are at increased risk for developing uterine cancer. However, the benefits of tamoxifen may outweigh the risk of developing uterine cancer, so women should discuss the benefits and risks of tamoxifen with their doctor.

Radiation therapy: -
Women who have had prior radiation treatment in the pelvic area for another cancer are at increased risk for uterine cancer.

Diet: -
Women who eat a diet high in animal fat are at increased risk for uterine cancer.


Estrogen: - Exposure to estrogen and/or an imbalance of estrogen is relevant to many of the following risk factors:
- Women who started having their periods before age 12 and/or go through menopause later in life.
- Women who take hormone replacement therapy after menopause, especially if they are only taking estrogen (estrogen with progesterone poses a lower risk).
- Women who have never had children

Obesity: - Fatty tissue in overweight women produces additional estrogen, which can increase the risk of uterine cancer. 

(3) Signs & Symptoms: -

The most likely time for uterine cancer to occur is after menopause. The most common symptom of uterine cancer is abnormal vaginal bleeding, ranging from watery and blood-streaked flow to a flow that contains more blood. Vaginal bleeding during menopause is not normal and, therefore, always a sign of some problem.
·        Unusual vaginal bleeding, spotting or discharge
·        Difficulty or pain when urinating
·        Pain during intercourse
·        Pain in the pelvic area, the lower part of the abdomen between the hip bones

(4) Diagnosis as per modern science: -

  1. Physical exam and history: - An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  2. Pelvic exam: - An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor inserts one or two lubricated, gloved fingers of one hand into the vagina and the other hand is placed over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
  3. Pap test: - A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called a Pap smear. Because uterine sarcoma begins inside the uterus, this cancer may not show up on the Pap test.
  4. Dilatation and curettage: - A surgical procedure to remove samples of tissue or the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. Tissue samples may be taken for biopsy. This procedure is also called a D&C.
  5. Endometrial biopsy: - The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells.

(5) Staging: -
Stage I: - In stage I, cancer is found in the uterus only.

Stage II: - In stage II, cancer has spread from the uterus to the cervix.

Stage III: -  In stage III, cancer has spread beyond the uterus and cervix, but has not spread beyond the pelvis.

Stage IV: - In stage IV, cancer has spread beyond the pelvis. Cancer has spread to the bladder and/or bowel wall, including lymph nodes in the abdomen and/or groin.

Ovarian Cancer


(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Stages

(1) Overview: -
Ovarian cancer begins in the woman's ovaries, the glands containing the germ cells or eggs. The ovaries are part of a woman's reproductive system and are located on each side of the uterus. They are almond-shaped and are about one and a half inches long. Every month, during ovulation, an egg is released from an ovary and moves to the uterus through a system called the fallopian tube. Ovaries are the primary source of women's sex hormones, estrogen and progesterone. These hormones influence breast growth, body shape, and body hair, and regulate the menstrual cycle and pregnancy. During menopause, the ovaries stop releasing eggs and producing sex hormones.

         Ovarian cancer begins when cells in the ovary begin to change, grow uncontrollably, and eventually form a tumor. Tumors can be benign (noncancerous) or malignant (cancerous). Ovarian cysts, which form on the surface of the ovary are not cancerous.

There are three types of ovarian cancer.


Epithelial carcinoma: - Epithelial tumors make up 85% to 90% of ovarian cancers. They begin in cells on the outer surface of the ovary. Because they are difficult to diagnose, 70% of ovarian cancers are not found until the disease has reached an advanced stage and moved from the ovaries into another part of the body, most commonly the abdomen.

Germ cell tumors: -
This uncommon type of ovarian cancer develops in the egg-producing cells of the ovaries.

Stromal tumors: -
This rare form of ovarian cancer develops in the connective tissue cells that hold the ovaries together and produce female hormones. 

(2) Risk factors: - 
(a) Age: - Risk of developing ovarian cancer increases with age. The disease most often occurs in women over age 50.

(b) Family history: -
Ovarian cancer risk increases for women who have a first-degree relative (mother, daughter, sister) who has had ovarian cancer. The risk is increased when two or more such relatives have had the disease.  
(c) Genetics: - A mutation in the BRCA1 or BRCA2 gene is associated with increased risk of ovarian cancer. Women with the condition of hereditary nonpolyposis colon cancer also have an increased risk of developing ovarian cancer.

(d) Ethnicity: - Women of North American, Northern European, or Jewish heritage are at increased risk for ovarian cancer.

(e) Reproductive history: - Women, who have never had children, have unexplained infertility, have not taken birth control pills, or had their first child after the ages of 30 are at increased risk for ovarian cancer. Also, women who started menstruation before age 12 and/or go through menopause later in life are at increased risk for ovarian cancer.

(f) Hormones: -
Women who have taken estrogen-only hormone replacement therapy after menopause are at higher risk for ovarian cancer. Fertility drugs may be associated with a higher risk of ovarian cancer.

(3) Signs & Symptoms: -

(i) Abdominal or pelvic discomfort or pain.
(ii) Persistent indigestion, gas, nausea, diarrhea, or constipation.
(iii) Frequent or urgent need to urinate.
(iv) Abdominal or pelvic pressure, swelling, or bloating.
(v) Loss of appetite, feeling of fullness even after a light meal.
(vi) Unexplained weight loss or gain, especially in the abdominal area.
(vii) Abnormal bleeding from the vagina.
(viii) Pain during intercourse.
(ix) Constant tiredness, lower back pain.


(4) Diagnosis as per modern science: - 
·        Pelvic Exam
·        Ultrasound
·        Ca 125 Assessment
·        Barium enema
·        Intravenous pyelogram
·        Ct Scan
·        Biopsy

(5) Stages: - 
(a) Stage I: - In Stage I The Cancer is found in one or both of the ovaries and has not spread.
(b) Stage II: - In stage II, cancer is found in one or both ovaries and has spread into other areas of the pelvis.
(c) Stage III: - In stage III, cancer is found in one or both ovaries and has spread to other parts of the abdomen.
(d) Stage IV: - In stage IV, cancer is found in one or both ovaries and has metastasized beyond the abdomen to other parts of the body. Cancer is found in the tissues of the liver.

Brain Cancer:




(1) Overview
(2) Risk Factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging 

(1) Overview: -
The brain and spinal column make up the central nervous system (CNS), where all vital functions of the body are controlled. When tumors arise in the CNS, they are especially problematic because a person's thought processes and movements can be affected. Also, these tumors can be difficult to treat because the tissues surrounding the tumor may be vital to functioning.

Anatomy of the brain: -

The cerebrum, the largest part of the brain, contains two cerebral hemispheres and is divided into four lobes where discrete functions occur.
  • The frontal lobe, which controls reasoning, emotions, problem-solving, and parts of speech and movement
  • The parietal lobe, which controls the sensations of touch, pressure, pain, temperature, and parts of speech
  • The temporal lobe, which controls memory, sense of hearing, and parts of speech
  • The occipital lobe, which controls vision
The cerebellum, or "little brain," is located beneath the cerebrum. The cerebellum is the back part of the brain responsible for coordination and balance.

The brain stem, which is the lowest portion of the brain and connects to the spinal cord, controls involuntary functions essential for life, such as the beating of the heart and breathing.

The meninges are the membranes that surround and protect the brain and spinal cord. There are three meningeal layers, called the dura mater, arachnoid, and pia mater.

Types of brain tumors: -

Gliomas: -
 Gliomas as a group are considered the most common type of brain tumor. A glioma is a tumor that grows from a glial cell, which is a supportive cell in the brain. There are two types of supportive cells: astrocytes and oligodendrocytes. Therefore, most gliomas are called either astrocytoma or oligodendroglioma, or a mixture of both. Gliomas are graded (how much the tumor appears like normal brain tissue) from I to IV based on their degree of aggressiveness. A grade I glioma is a benign tumor, while grades II through IV are tumors with an increasing degree of aggressiveness and are therefore considered increasingly malignant in potential.

Types of gliomas:
·        Astrocytoma is the most common type of glioma. Astrocytomas begin in cells called astrocytes in the cerebrum or cerebellum. Glioblastoma multiforme (also called grade IV astrocytoma) is a very aggressive form of astrocytoma.
·        Oligodendroglioma is a tumor that develops from cells called oligodendrocytes. These cells are responsible for producing the myelin that surrounds nerves.
·          Brain stem gliomas begin in the glial cells in the brain stem.
·          Ependymomas, which begin in the ependyma (the cells that line the passageways in the brain where cerebrospinal fluid is made and stored.
·          Mixed tumors, which are composed of more than one of the glial cell types.

Non-glioma tumors: -
·        Non-glioma tumors begin in other types of cells in the CNS, and are described as either benign (noncancerous) or malignant (cancerous).
·        Meningioma is the most common primary non-glioma brain tumor. It begins in the meninges surrounding the brain and spinal column and is most often benign. Meningioma can cause significant symptoms if it grows and presses on the brain or spinal cord.
·        Acoustic schwannoma (also called acoustic neuroma) is a rare tumor that begins in the vestibular nerve and is normally benign.
·        Craniopharyngioma is a benign tumor that begins near the pituitary gland. These tumors are rare.
·        Medulloblastoma, which begins in granular cells in the cerebellum, is most common in children and is most often malignant.
·        Primary CNS lymphoma is a form of lymphoma (cancer that begins in the lymphatic system) that starts in the brain.
·        The pineal and pituitary glands, located near the base of the brain, are the location of about a small no. of all brain tumors.

 (2) Risk Factors: -
Age: - Children and older adults are two groups most likely to be diagnosed with brain tumors.

Gender: -
 Men are generally more likely than women to develop gliomas, while women are more likely to be affected by meningiomas.

Home/occupational exposures: -
 Occupational exposures to solvents, pesticides, oil products, rubber, or vinyl chloride may increase the risk of developing a brain tumor, although there is no scientific evidence to date. Black hair dye has also been researched as a potential cause of brain tumors, although the data remains inconclusive at this time.

Some genetic conditions: -
 Some genetic conditions, such as von Hippel-Lindau disease, Turcot syndrome, or neurofibromatosis, increase the risk of developing a brain tumor. 

Exposure to infections, viruses, and allergens: -
 Infection with the Epstein-Barr virus increases the risk of CNS lymphoma. Several types of other viruses have been shown to cause brain tumors in experimental animal studies; however, more data is needed in order to determine if exposure to infections, other viruses, or allergens affect brain tumor risk.

Electromagnetic fields: -
 Electromagnetic fields, such as energy from power lines or from cell phone use, may or may not increase the risk of developing a brain tumor.

Ethnicity: -
 In the United States, whites have higher rates of gliomas but lower rates of meningioma than blacks. The rate of malignant brain tumors in Japan is less than half the rate of Northern Europe.

Ionizing radiation: -
 Treatment with ionizing radiation (including x-rays) has shown, in some cases, to be a risk factor for brain tumors.

 (3) Signs and Symptoms: -
  •  Headaches, which may be severe and may worsen with activity or in the early morning.
  • Seizures
  • Personality or memory changes
  • Nausea or vomiting
  • Vision changes such as blurred vision                               
  •   Symptoms specific to the location of the tumor includes
  • Pressure or headache near the tumor
  • Loss of balance and difficulty with fine motor skills
  • Changes in judgment, including loss of initiative, sluggishness, and muscle weakness or paralysis (Frontal lobe of the cerebellum)
  • Partial or complete loss of vision (occipital lobe of the cerebellum)
  • Changes in speech, hearing, memory, or emotional state including aggressiveness and problems understanding or retrieving words (temporal lobe of the cerebellum)
  • Altered perception of touch or pressure, arm or leg weakness on one side of the body, confusion with left and right sides of the body (parietal lobe of the cerebellum)
  • Inability to look upward (pineal tumor)
  • Lactation, altered menstrual periods, and growth in hands and feet in adults (pituitary tumor)
(4) Diagnosis as per modern science: -
(a) Imaging tests
·        Magnetic resonance Imaging
·        Magnetic Resonance Spectroscopy
·        Computerized Tomography
·        Positron emission tomography
·        Myelogram
(b) Neurological hearing and vision tests.
(c) Blood tests
(d) Lumbar puncture
(e) Electroencelography
(f) Cerebral arteriogram
(g) Stereotactic biopsy
(h) Evoked potentials
 (5) Staging: -
Malignant (cancerous) tumors of the brain and spinal cord (the central nervous system [CNS]) differ in several important ways from tumors in other parts of the body. In the rest of the body, the most deadly aspect of a malignant tumor is its ability to spread throughout the body. In contrast, tumors starting in the brain or spinal cord can spread to other parts of the CNS, but they almost never spread to other organs. The dangerous aspect of these tumors is that they can interfere with essential, normal functions of the brain.

Thyroid Cancer:


(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging 

(1) Overview: -

Thyroid cancer is a disease in which cancer cells are found in the tissues of the thyroid gland. the thyroid gland is at the base of the throat. It has two lobes, one on the right side and one on the left. The thyroid gland makes important hormones and helps the body function normally.
There are four main types of thyroid cancer
  1. papillary
  2. follicular
  3. medullary
  4. anaplastic
Some types of thyroid cancer grow faster than others. The prognosis is better for patients younger than 40 years who have cancer that has not spread beyond the thyroid.
The genes in our cells carry the hereditary information from our parents. An abnormal gene has been found in patients with some forms of thyroid cancer. If medullary thyroid cancer is found, the patient may have been born with a certain abnormal gene which may have led to the cancer. Family members may have also inherited this abnormal gene. Tests have been developed to determine who has the genetic defect long before any cancer appears. It is important that the patient and his or her family members see a doctor about tests that will show if the abnormal gene is present.

(2) Risk factors: -

Certain factors may increase the risk of developing thyroid cancer.
  1. Thyroid cancer occurs more often in people between the ages of 25 and 65 years.

  1. People who have been exposed to radiation or received radiation treatments to the head and neck during infancy or childhood have a greater chance of developing thyroid cancer. The cancer may occur as early as 5 years after exposure or may occur 20 or more years later.

  1. People who have had goiter (enlarged thyroid) or a family history of thyroid disease have an increased risk of developing thyroid cancer.

  1. Thyroid cancer is more common in women than in men.

  1. Asian people have an increased risk of developing thyroid cancer.

(3) Signs & Symptoms: -

  • A lump in the front of the neck, near the Adam's apple
  • Hoarseness
  • Swollen glands in the neck
  • Difficulty swallowing
  • Difficulty breathing
  • Pain in the throat or neck
  • A cough that persists and is not caused by a cold
(These symptoms may be caused by thyroid cancer, or they may indicate another less serious condition, such as an infection, benign goiter, or other problem.)

(4) Diagnosis as per modern science: -
a)      Fine needle aspiration biopsy
b)      Thyroid scan
c)      Ultrasound
d)     Computed tomography
e)      MRI
f)       Blood tests

(5) Staging: -
  
(i) Stage I: - The cancer is less than 2 cm and has not spread to lymph nodes or distant sites.

(ii) Stage II: - The cancer is 2 to 4 cm. and has not spread to lymph nodes or distant sites.

(iii) Stage III: - The cancer is larger than 4 cm or has grown slightly outside the thyroid and has not spread to lymph nodes or distant sites; or it is any size and has spread to local neck nodes but not to distant sites.

(iv) Stage IV: - Tumor of any size and has grown beyond the thyroid gland to invade nearby tissues of the neck and has spread to lymph nodes in the upper chest, tumor has grown either back to the spine or into nearby large blood vessels, it has spread to distant sites.


Osteosarcoma (Bone Cancer):


(1) Overview
(2)  Risk factors
(3)  Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging

(1) Overview: -  

               Bone is the supporting framework of the body. The bone is a hollow structure. The outer layer of the bone consists of a network of fibrous tissues also called matrix, on which calcium salts are deposited. At each end of the bone is a zone of cartilage, a softer form of bone like tissue. Cartilage consists of a fibrous tissue matrix mixed with a gel-like substance. Unlike bone, cartilage does not contain calcium. Cartilage acts as cushion between bones and, together with ligaments and some other tissues, forms the joints between bones. 
               The outside of the bone is covered with a fibrous tissue called periosteum. The bone contains 2 types of cells. The osteoclast is the cell responsible for forming the bone, and the osteoclast is the cell responsible for dissolving the bone. Bone marrow is the soft tissue inside the hollow bones. The marrow of some bones consists of only fatty tissues. The marrow of other bones is a mixture of flat cells and blood-forming cells. These blood forming cells produce red blood cells, white blood cells, and blood platelets. There are some other cells in the marrow such as plasma cells, fibroblasts, and reticuloendothelial cells. 


Primary bone cancers:-

Most bone cancers are called sarcomas. Sarcomas are cancers that mostly develop from bone, cartilage, muscles, fibrous tissue, fatty tissue, or nerve tissue. 

(1) Osteosarcoma: - Osteosarcoma is the tumor of the bone itself; it is the most common bone cancer. It is more common in younger people. Males are more likely to be affected. 

(2) Chondrosarcoma: - This is a cancer of cartilage cells. The risk of this type of cancer rises with age. 

(3) Ewing’s tumor: - E-wing’s tumor usually develops in bones, and a very small percentage arises in other tissues or organs. Ewing’s tumors of the bone forms in the cavity of the bone. This cancer is primarily seen in children and younger people. 

(4) Chordoma: - This type of bone cancer usually occurs in the base of the skull and bones of the spine.

(2) Risk factors: -

(a) Inherited genes
(b) Paget’s disease
(c) Multiple exostoses (overgrowth of bone tissue)
(d) Multiple osteochondromus (benign bone tumors)
(e) Multiple enchondromas (benign cartilage tumors)
(f) Radiation
(g) Bone marrow transplantation
(h) Injuries

(3) Signs and symptoms of bone cancer: -

(A) Pain: - Pain in the affected bone is the most common complaint
(B) Swelling: - Swelling in the affected area
(C) Fractures
(D) Generalized symptoms: - If the cancer has spread it can cause many symptoms in other organs.

(4) Diagnosis as per modern science: -

(a) X-Rays
(b) Computed tomography
(c) Magnetic resonance Imaging
(d) Radionuclide bone scan
(e) Positron emission tomography
(f) Biopsy

(5) Staging: -

(i) Stage I: - The tumor is low grade, and is small in size and has not spread.
(ii) Stage II: - The tumor is high grade and larger, and it has not spread.
(iii) Stage III: - The tumor is of any grade but it has not spread.

(iv) Stage IV: - The cancer has spread to the lymph nodes and to distant sites also, other than lung. 


Children Specific Cancer:



(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science 

(1) Overview: -

The following type of cancers are usually seen in children
 (a) Acute Lymphoblastic Leukemia: - (ALL) It is the most common childhood malignancy and accounts for about 30% of all childhood cancers.
(b) Wilm’s tumor: - Is a cancer that may affect one or both kidneys. It is most often found in children 2 to 3 years of age.
(c)  Neuroblastoma: - Is the most common extra cranial (outside of the brain) solid tumor in children and most often diagnosed during the first year of life. This tumor can appear anywhere but usually occurs in the abdomen as a swelling.
(d) Retinoblastoma: - Is a cancer of the eye, it occurs in about 5% of children cancer cases.
(e) Rhabdomyosarcoma: - Is the most common soft tissue sarcoma in children.
(f) Central nervous system: - (Brain & Spinal cord) Cancers are the second most common cancers in children. Most brain cancers of children involve the cerebellum or brain stem.
(g) Osteosarcoma: - Osteosarcoma is cancer that begins in the bone.
(h) Non-Hodgkin’s lymphoma and Hodgkin’s lymphoma: - Are cancers that begin in the lymphatic system.

(2) Risk factors: -

             Modern science is yet unsure as the exact causes of childhood cancers. A small percentage of cancers can be linked to Down syndrome, other inherited abnormalities, and some to radiation treatment. Environmental causes are suspected as a potential cause of childhood cancers.

(3) Signs & Symptoms: -

 Symptoms of cancer often look like other common childhood illnesses.
(i) Unexplained and untreatable weight loss.
(ii) Headaches and vomiting early in the morning.
(iii) Mass or lump in the abdomen, neck, chest, pelvis, or armpits.
(iv) Excessive bleeding or development of rashes.
(v) Constant infections.
(vi) Uncommon appearance of the pupil of the eye.
(vii) Vomiting and vomiting without nausea.
(viii) Weakness tiredness and paleness.
(ix) Eye or vision changes that occur suddenly.
(x) Persistent fevers of unknown origin.
  
(4) Diagnosis as per modern science: -
  
(a) Blood tests
(b) C.T. Scan
(c) Magnetic resonance Imaging
(d) Ultrasound
(e) Biopsy
(f) Bone marrow aspiration

(g) Lumbar puncture


Skin Cancer:


(1) Overview
(2) Risk factors
(3) Signs & Symptoms
(4) Diagnosis as per modern science
(5) Staging

(1) Overview: -

Skin cancer is the most common of all cancers. Reducing exposure to ultraviolet light from sun’s radiation can prevent most skin cancers. Skin cancer if detected early is treatable.
The skin, the body’s largest organ protects against infection and injury and helps regulate body temperature. The skin also stores water and fat and produces vitamin D. Skin is made up of two main layers. The epidermis (outer layer of the skin) and the dermis (inner layer of the skin).

 Types of Skin Cancers: -

There are three main types of skin cancers
(a) Squamous cell carcinoma: - Most of the epidermis is made up of flat, scale like cells squamous cells. Cancer of these cells is called Squamous cell carcinoma. It usually arises from sun exposure, but can appear on skin that has been burned, damaged by chemicals, or exposed to x-rays.
(b) Basal cell carcinomas: - Cells in the lower epidermis are round cells known as basal cells. A great majority of skin cancers develop from this type of cells that have been exposed to the sun and is called basal cell carcinoma. Basal cell carcinoma most often forms on the head & neck.
(c) Melanoma: - Where the epidermis meets the dermis, there are scattered cells called melanocytes, which produces, the melanin that gives skin color. Melanoma starts in melanocytes, and it is the most serious of the three cancer types. 
Squamous cell carcinoma and basal cell carcinoma are known as non-melanoma skin cancers. 

(2) Risk Factors: -

(i) Exposure to UV Radiation.

(ii) Fair Skin: - Less pigment in skin means poorer protection against UV radiation. Those who burn easily by exposure to sunlight are more likely to develop skin cancer.

(iii) Gender: - Rate of skin cancer in white people has increased in recent years.

(iv) Age: - Most basal cell and Squamous cell cancers appear after age 50, but may appear earlier in individual with sun-damaged skin.

(v) Individual History: - People with weakened immune system or those who use certain medications such as immunosuppressive drugs, certain steroids and drugs that makes the skin sensitive to light, are at a higher risk for developing skin cancer, particularly Squamous cell cancers.

(vi) Precancerous condition: - Two types of lesions known as actinic keratoses, characterized by rough, red or scaly skin, or Brown’s disease which is common in people exposed to sun. Such conditions can lead to Squamous cell cancers.

(vii) Viral infections: - People infected with a specific type of Human Papiloma Virus (HPV) are at increased risk for developing Squamous cell carcinoma, particularly if their immune system becomes suppressed. 

(3) Signs & Symptoms of non-melanoma skin cancers: -

(a) An open sore that bleeds, oozes, or crusts, and remains open for several weeks.
(b) A Reddish raised patch, or irritated area that may crust or itch, and rarely hurts.
(c) A shiny pink, red or white pearly or translucent bump.
(d) A pink growth with an elevated border and crusted central indentation.
(e) A scar-like, white yellow or waxy area, often poorly defined.
(f) An elevated growth with a rough surface and a central depression. 

(4) Diagnosis as per modern science: -

(i) Skin biopsy
(ii) Shave biopsy
(iii) Punch biopsy
(iv) Incisional and excisional biopsy
(v) Lymph node biopsy
(vi) Fine needle aspiration biopsy
(vii) Surgical lymph node biopsy 

(5) Staging: -

Stage 0: - Squamous cell carcinoma in situ, also called Bowen’s disease.
Stage I: - The cancer is small and has not spread to lymph nodes or other organs.
 Stage II: - The cancer is large and has not spread to lymph nodes or other organs.
Stage III: - The cancer has spread to tissues beneath the skin, such as muscles, bones, or cartilage, and or it has spread to regional lymph nodes.
Stage IV: - The cancer is very large size, and it has spread to lymph nodes. It has spread to other organs such as the lungs or brain.


 Lymphoma:



(1) Overview
(2) Risk Factors
(3) Signs & Symptoms
(4) Diagnosis as per Modern science 

(1) Overview: -  
Adult Hodgkin's lymphoma is a disease in which malignant (cancer) cells form in the lymph system.
Adult Hodgkin's lymphoma is a type of cancer that develops in the lymph system, part of the body's immune system.
The lymph system is made up of the following:
·        Lymph: -
Colorless, watery fluid that travels through the lymph system and carries white blood cells called lymphocytes. Lymphocytes protect the body against infections and the growth of tumors.

·        Lymph vessels: -
 A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.
·        Lymph nodes: -
Small, bean-shaped structures that filter substances in lymph and help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.
·        Spleen: -
An organ that produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach.
·        Thymus: -
 An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.
·        Tonsils: -
Two small masses of lymph tissue at the back of the throat. The tonsils produce lymphocytes.
·        Bone marrow: -
The soft, spongy tissue in the center of large bones. Bone marrow produces white blood cells, red blood cells, and platelets.
Because lymph tissue is found throughout the body, Hodgkin's lymphoma can begin in almost any part of the body and spread to almost any tissue or organ in the body.
Lymphomas are divided into 2 general types: Hodgkin's lymphoma and non-Hodgkin's lymphoma.
There are 5 different types of Hodgkin's lymphoma. These 5 types are based on the way they look under a microscope.

·        Nodular sclerosing Hodgkin's lymphoma.
·        Mixed cellularity Hodgkin's lymphoma.
·        Lymphocyte depletion Hodgkin's lymphoma.
·        Lymphocyte-rich classical Hodgkin's lymphoma.
·        Nodular lymphocyte-predominant Hodgkin's lymphoma.

(2) Risk Factors: -

·        Being in young or late adulthood.
·        Being male.
·        Being infected with the Epstein-Barr virus.
·        Having a first-degree relative (parent, brother, or sister) with Hodgkin's lymphoma.



















No comments:

Post a Comment