Carsinoma Doctor

Archive for 2010

Cervical cancer is a common type of cancer in women, and is a disease in which cells are cancerous (malignant) in the tissues of the cervix.

The uterus is the hollow organ, inverted pear-shaped, where a fetus grows. The neck or uterine cervix is an opening that connects the uterus to the vagina (birth canal).

Cervical cancer begins to grow slowly. Before they are cancer cells in the cervix, normal tissues of the cervix go through a process known as dysplasia, in which abnormal cells begin to appear. A Papanicolaou cytology usually find these pre-malignant cells. Later, cancer cells start to grow and spread more deeply into the cervix and surrounding areas.

Since there are usually no symptoms associated with cervical cancer usually involves a series of tests to diagnose:

*Papanicolaou cytology: is carried out using a piece of cotton, a brush or a small wooden spatula to gently scrape the outside of the cervix to collect cells. The patient may feel some pressure, which in some cases accompanied by pain.
*Biopsy. If abnormal cells are found, the doctor will remove a sample of tissue from the cervix and observed under a microscope for the presence of cancer cells. To perform a biopsy only takes a small amount of tissue can be done in the doctor’s office. Sometimes you need to extract a biopsy sample cone-shaped, larger (cone), for which it may be necessary to go to hospital.

The prognosis (chance of recovery) and choice of treatment depend on the stage of the cancer (if only in the cervix or has spread to other places) and general health status.

Treatment depends on the stage of the cancer. If the cancer is confined to the outermost layer of the cervix (carcinoma in situ), often can be removed completely removing the cancer of the cervix with a scalpel or electrosurgical excision. This treatment has the advantage of not altering the ability to bear children. But since cancer may recur, doctors advise women to have checks and Pap every 3 months during the first year and every 6 months from now. If a woman has a carcinoma in situ and do not want children, we recommend the removal of the uterus (hysterectomy).

If the cancer is in a more advanced stage, it is necessary to perform a hysterectomy plus removal of adjacent structures (radical hysterectomy) and lymph nodes. The ovaries, if they are normal and functioning properly, are not removed when women are young. Radiation therapy is very effective for the treatment of advanced cervical cancer has not spread beyond the pelvic region. Although it causes little or no immediate problem, it can cause irritation in the rectum and vagina. Injuries to the bladder and rectum can occur even later, and ovaries, in general, cease to function.

When cancer has spread beyond the pelvis, sometimes one must resort to the chemotherapy. However, only effective in 25 to 30 percent of cases treated and the effects are usually temporary.

The Pap can detect accurately and inexpensively as much as 90 percent of cervical cancers, even before symptoms appear. Consequently, the number of deaths from this disease has been reduced by over 50 percent. It is recommended that women get their first Pap smear when they start to be sexually active or after age 18 and repeat it on once a year. If results are normal for 3 consecutive years, then the test can be spaced and do it every 2 or 3 years if you do not change the habit of life. If all women had the Pap regularly, could be eliminated deaths from this cancer. However, nearly 40 percent of women in developed countries are tested regularly.

If you find a lump, ulcer or other suspicious training on the cervix during a pelvic examination, or if Pap results indicate an anomaly or cancer, must perform a biopsy (removing a tissue sample for examination under a microscope .) The tissue sample is taken during a colposcopy, which uses a viewing tube with a magnifying lens (colposcope) to examine the neck of the uterus carefully and choose the place of the biopsy. There are two types of biopsies: the punch biopsy, which removes a tiny portion of the cervix that is selected visually with the colposcope, and endocervical curettage, in which tissue is scraped from the cervical canal visually inaccessible. Both procedures are a bit painful and cause a little bleeding, but together usually provide enough tissue for the pathologist to establish a diagnosis. If it is not clear, it makes a cone, which removes a major portion of tissue. Usually, this biopsy is done by loop electrosurgical excision in one’s own doctor’s office.

Once the diagnosis is established, it must decide the size and exact location of the cancer (ie, staging is done.) The process begins with a physical examination of the pelvis and various tests (cystoscopy, chest radiography, IVP, sigmoidoscopy) to determine if cervical cancer has spread to other surrounding structures or distant parts of the body. It also can perform other tests such as CT scan, a barium enema and X-rays of bones and liver, depending on the characteristics of each case.

Although there are still many mysteries surrounding the cancer is well known that there are other genetic factors that are related to the appearance of tumors: by case, is known about the close ties between the lung and larynx cancer and smoking.

The diet also plays a major role in this field: in food can be substances that encourage tumor growth or, conversely, preventing it. Regarding the former, we can mention, for example, aflatoxins produced by molds, which although not a problem for public health control of food long did involve risk.

Also, be aware that the products may contain polycyclic smoked or benzopyrenes that could become cancerous if their use is very common in here to advise limiting intake of such foods.

Other evidence has shown that a diet low in fiber but high consumption of animal proteins and fats, also influenced the development of cancer of the colon and intestines, or tumors in the breast and uterus would also be linked to diet rich in lipids and obesity.

However, just as some food compounds would be “pro cancer”, exit others, by contrast, protect against cancer: fruits, vegetables are more allied food group, and thanks to antioxidant compounds protect against the harmful effects of free radicals and, consequently, also against cancer.

So remember to eat your five servings of fruits and vegetables to prevent cancer also. Also, in your daily diet includes high fiber foods such as legumes and cereals. Conversely, limit your consumption of foods rich in animal fat, smoked, salted and cured, and alcoholic beverages.

Surgery is usually the first treatment carried out. Often, radiation is added to complete the treatment.
This is major surgery, so that hospitalization is necessary for a variable time according to the patient (it is usually one to two weeks). It will also require general anesthesia.

The incision for the surgery has to be wide, above the navel and horizontal.

Before the intervention, it is necessary to study preoperative called (blood and clotting, electrocardiogram and chest radiograph).

Prior to surgery the patient should be informed about the technique to use, risks and possible complications and sequelae and side effects. You must then sign a paper in which he gives his consent.

The most common technique employed is the removal of the entire uterus, along with surrounding tissue, part of the vagina and lymph. Sometimes, if the tumor is more advanced, the ovaries are removed, what is known as a hysterectomy.

There are other types of surgery and cryosurgery, which involves removing the tumor by freezing, laser surgery, which uses a beam of intense light to kill cancer cells, the cone, which consists in extracting a piece of cloth into a cone shape of the place where the tumor for a biopsy or to treat early stage cancer, the loop electrosurgical excision, which used an electrical current and exenteration in the case the cancer has spread and is necessary to remove the lower colon, rectum or bladder, so it is likely that after this the patient may need plastic surgery to form an artificial vagina.
For young women with early lesions and willing to have children, the uterus can be preserved by limited resections. In these cases it is very often necessary to make revisions.

Often after surgery, radiation therapy adds to lessen the chances that the disease may reappear in the area of intervention.

Like almost all surgery, it will also have impacts and adverse effects. Upon awakening from anesthesia, the patient will feel pain in the area and will have to be moving slowly recovering when the pain is mild. Should be kept clean the wound. This will be done by medical personnel while not removed the points, and once that is done, the patient should continue to be especially careful with that issue. An important point to full recovery is the resumption of sexual activity, an issue that is important to discuss with your gynecologist.

TREATMENT
There are treatments for all cancer patients with small cell lung. Used three kinds of cancer treatment, surgery (limited stage), radiation (for the primary tumor and metastases) and chemotherapy (in all phases of extension)

LIMITED STAGE
1. Chemotherapy and radiotherapy in the chest with or without prophylactic cranial irradiation
2. Chemotherapy with or without prophylactic cranial irradiation.
3. Surgery followed by chemotherapy with or without prophylactic cranial irradiation.

EXTENSIVE STAGE
1. Chemotherapy and radiotherapy in the chest with or without prophylactic cranial irradiation
2. Chemotherapy with or without prophylactic cranial irradiation.
3. Radiotherapy of metastases (brain, bones)

RECURRENT STAGE
1. Radiation therapy to reduce pain
2. There are clinical trials of new drugs.

After confirming the diagnosis of cervical cancer and tests conducted to know in what stage the cancer, we must determine the most appropriate treatment to cure. Your doctor will recommend and explain the treatment options depending on the case and once the patient has received sufficient information with your doctor will take a decision.

The treatment of this cancer is, like most tumors, multidisciplinary. That is, different specialties work together to combine therapies and give the patient the best chance of cure.

To this it follows a protocol, a treatment plan based on scientific expertise for the treatment of this tumor. These protocols are established according to the age of the patient, the stage when the disease is found and the wishes of the patient. Besides this, we must consider whether there are other diseases that may hinder the realization of some kind of treatment.

The most frequently used treatments for cervical cancer are surgery (removing the cancer in an operation), radiation (high energy radiation to kill cancer cells) and chemotherapy (drugs to kill cancer cells).

It is a disease in which cells are cancerous (malignant) in the tissues of the lung. This appears lung cancer in smokers or former smokers.

SYMPTOMS
Cough may appear different from the usual or chest pain does not go away, noise in breathing, shortness of breath (dyspnea), spitting up blood, hoarseness, or swelling of the face and neck. The prognosis and choice of treatment depend on the extent to which stage the cancer, tumor size, or type of lung cancer.

STAGE EXTENSION
Staging is a classification that is performed after appropriate studies to define the extent of cancer (cancer cells) by the lung, or areas near the body.

Thus we can distinguish the following stages as cancer cells are found in:

Limited stage: cells appear only in one lung and nearby lymph nodes.
Extensive stage: Cancer cells have spread outside the lung to other tissues in the chest or other body parts.
Recurrent Stage: When cells appear again after receiving treatment.

In the level cervical cancer can distinguish the following phases or stages depending on tumor size or the area that reaches:

Stage 0
In stage 0 (called carcinoma in situ or preinvasive carcinoma) cells are found in the innermost lining of the cervix, is very superficial, limited to the mucosal cells. These abnormal cells may become cancer and spread into nearby normal tissue.

Stage I
In stage I, cancer has formed and is found only in the cervix. Stage I is divided into stages IA and IB, according to the amount of cancer that is found.
Stage IA: it detects a very small amount of cancer in tissues of the cervix that can only be seen under a microscope. Stage IA is divided into two more stages according to tumor size.
Stage IB: In stage IB, cancer can only be seen with a microscope and is more than 5 millimeters deep or is larger than 7 mm wide, or it can be seen without a microscope. The cancer can be seen without a microscope is divided into two stages according to tumor size.

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) or to the lower third of the vagina and / or the lateral ligaments (parametrium). Stage II is divided into two stages according to 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 the tissues surrounding the uterus.

Stage III
In stage III, cancer has spread to the lower third of the vagina, affects nearby lymph nodes or tissues lso side reaches the cervix to reach the pelvic wall or may have caused the kidney to stop working. 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 or the tumor is large enough to block the ureters (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.

Stage IV
In stage IV, cancer has spread to the bladder, rectum or other body parts, with lymph. Stage IV is divided into stages IVA and IVB, depending on where the cancer.
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 including the abdomen, liver, intestinal tract or lungs.