Carsinoma Doctor

Posts Tagged ‘Chemotherapy’

Radiation therapy administered high-energy X-rays that can destroy rapidly multiplying cancer cells. It has many uses in lung cancer:

* As primary treatment
* To reduce the size of the tumor before surgery
* After surgery to remove cancer cells that may have formed on the treated area
* To treat lung cancer that has spread to the brain or other body parts

In addition to attacking the tumor, radiation therapy helps relieve some symptoms such as shortness of breath. As initial treatment instead of surgery, radiation therapy can be given alone or in combination with chemotherapy. Today, many patients with small lung cancer that is accessible by an X-ray beam but are not candidates for surgery, received curative doses of radiotherapy. This group may include the elderly, patients with chronic heart failure, and those who receive blood arralar medications that put them at risk of bleeding during surgery. More recently, greater use is being given a new technique called Stereotactic Body Radiotherapy (SBRT). It involves a multitude of small radiation beams focused tracking the lung tumor in conjunction with breathing movements, usually three to five treatments. This treatment delivers high doses of radiation therapy or lung cancer patients for whom surgery is not an option.

Most of the time the radiation was administered with external beam technique, with which a beam of X-rays directly to the tumor. Treatment is given in a series of sessions, or fractions, usually for six weeks. Some studies have obtained good results and fewer side effects when the total dose of radiation is given in more fractions in a shorter time period. For more details see page of external beam radiation therapy. The three-dimensional conformal radiotherapy is a relatively new technique that is based on three-dimensional image of tumor obtained with computed tomography (CT). This image serves as the target for a beam of high-dose radiation that automatically changes shape and size to match the tumor. This method minimizes radiation exposure to surrounding normal lung tissue.

The reactions induced by chemotherapy is due to the effects that drugs have on healthy cells and, although very frequent, it is normal that each person reacts differently. You may not experience any sensations described below, and these vary in degree throughout the treatment. Consult your doctor everything that concerns you. Talk to him.

Most patients often feel tired because of the ‘chemo’, although there who manages to continue with their normal life without the treatment interfere with their work activities, social or family. And thanks to advances, the drugs used in chemotherapy are now becoming more selective, so that kill malignant cells, causing minimal damage to healthy.

It is difficult to predict how each patient will react because there are no homogeneous parameters. It is normal for all the discomfort disappears when the cycle is completed when the cells are an opportunity to recover themselves from the effects of chemotherapeutic drugs.

Chemotherapy involves using drugs to kill cancer cells. There are over 50 different drugs to combat the disease and prevent the growth, multiplication and dissemination of malignant cells.

When they are healthy, they grow and divide in a controlled fashion, but cancer cells are characterized precisely by the uncontrolled growth. Therefore, these agents, which can be used alone or in combination, are intended to block this proliferation chaotic.

The treatment duration, dose, drugs and so on. depend on factors as diverse as cancer, its location, general condition … This is only a brief guide that under no circumstances can replace the doctor, ask him any questions that arise before starting therapy.

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).

The first written information about the treatment of a patient with cancer dates back to 1,600 BC. This is an Egyptian papyrus which tells the first surgery for removal of a solid tumor.

Regarding chemotherapy, the first cytotoxic compound ( ‘poisonous to certain types of cells’) are not just used for medical purposes. Mustard gas was first used as a military weapon during the First World War and later studied in greater depth during the Second.

In 1945, after several soldiers were accidentally exposed to this substance was discovered that white blood cell levels were surprisingly low. This observation led scientists to believe in the ability of this agent to kill cells and therefore began its use as a cancer drug in lymphoma patients, just a variety of disease related to white blood cells.

It was used for intravenous administration instead of gas inhalation. He ran the forties and from that the number and variety of anticancer drugs has changed dramatically today.

Generally breast cancers are classified according to three factors: 1) the site that originated the carcinoma or tumor, 2) the degree of invasion, 3) the appearance of cells seen under a microscope.
Breast cancer is classified into the following types:

• Carcinoma in situ
In situ means “in place.” It is a type of cancer does not invade deep and is considered likely to be cured by simple removal of the tumor. It is located in the ducts of the lobules, has not spread to fatty tissue near the breast or other organs. Not metastasize, do not invade blood vessels or nodes.

There are two types of carcinoma in situ:

- Lobular carcinoma in situ (LCIS): Also called neoplasm (tumor) lobular. It originates in the lobes or lobules of the breast (milk glands manufacturers). Not through the walls of these so I generally do not become invasive cancer. However, there are cases where it can develop into invasive lobular carcinoma.

Types of Breast Cancer
- Ductal carcinoma in situ (DCIS) is also called intraductal carcinoma. It is the most common type of noninvasive breast cancer that exists, in which abnormal cells are present in the lining of a breast duct. In this case the cancer cells spread through the walls into fatty tissue of the breast. Treatment includes surgery or radiation, which are generally favorable to the cure of the disease. However, if not treated early can become invasive.

While lobular carcinoma in situ (LCIS) is only a marker of future cancer, ductal carcinoma in situ (DCIS), is a predictor of invasive cancer in the future.

• ductal carcinoma infiltrating (or invasive)
It originates in the milk-producing glands. May spread to the lymph channels or blood vessels within and distributed to other parts of the body. This is the most common type of tumor in breast cancer.

• lobular carcinoma infiltrating (or invasive)
Also originates in the milk-producing glands and can spread to other parts of the body. It is estimated that between 10 and 15 percent of invasive cancers fall into this classification.

• Medullary carcinoma
Estimated to be responsible for 5 percent of all cases of breast cancer. In it, the cancer cells are clustered at the edges of the tumor cells are the immune system that serve to attack and destroy abnormal cells and other foreign agents such as bacteria or viruses.

• colloid carcinoma.
Consists of cells that produce mucus. In medical terms is called mucinous carcinoma. It belongs to the invasive ductal cancer and has a favorable prognosis to be less likely to spread the cancer invasive ductal or invasive lobular.

• tubular carcinoma.
Tubular carcinoma is a special type of infiltrating ductal carcinoma. Are less likely to spread outside the breast, compared with invasive ductal cancer or invasive lobular. Is responsible for 2% of all cases of breast cancer.

• Inflammatory breast cancer.
It is very common, representing only 1 percent of breast cancers. Symptoms include hot, red skin, with the appearance of an orange peel. The cancer cells block the lymph vessels of the skin, ie it is not a simple inflammation. This cancer is more likely to spread and the prognosis is less encouraging than other types.

What is thyroid cancer?
This disease is the most common tumor of the endocrine system. It has, however, a low incidence, being responsible for 1% of all cancer deaths. Predominates in women (2:1) and its frequency increases with age.

Thyroid cancer is classified into different types, depending on the cells that form. So basically described: papillary carcinoma, follicular, Hurthle cell, medullary, and anaplastic.

These tumors are extremely variable in their behavior, from moderate to fatal aggression.

These tumors are extremely variable in their behavior, from moderate to fatal aggression.

What factors contribute to osteoporosis?
Not clearly known what causes this type of tumor except their relationship with ionizing radiation (radiotherapy). Multiple cases have been detected 10 or 20 years after having received such treatment. Also shuffled a number of other factors that contribute to its genesis:

Thyroid Cancer
The possible association with other thyroid diseases.
The elevation of the TSH that causes a constant stimulation of the thyroid gland.
Areas of endemic goiter.
Predisposing genetic factors.

Papillary carcinoma

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It is the most common thyroid tumor, about 60% of the total. Is the lowest grade of malignancy. Usually occurs in young, predominantly women. In these patients usually identified a history of prior radiotherapy.

The tumor grows slowly and often spreads to lymph adjacent neck adenopathies leading to detectable by palpation in the area. Distant spread is rare.

In general, the individual goes to the doctor when you notice a painless nodule in the anterior neck (thyroid nodule) or to observe swollen glands in the neck.

The doctor then performed, various tests, may find the following findings:

Blood: The thyroid hormones are normal.
Ultrasound of the thyroid: solid nodule, ill-defined, with some liquid inside areas.
Thyroid scintigraphy: generally behaves as a cold nodule, ie after the injection of isotope is objectively low uptake in the thyroid.
Biopsy of the thyroid.

Treatment depends on the size. The smaller ones are treated with partial resection of the gland while large require a total resection (total thyroidectomy) and radioactive iodine (I131).

Is a tumor of low grade malignancy with a 10-year mortality of 5-10%. However, there are groups of patients where the prognosis dims:

Elderly.
Males.
Tumors larger than 4 cm.
Local and distant spread. The regional lymph nodes (near the thyroid) do not worsen the prognosis.
Undifferentiated tumors, ie the most immature.

Follicular Carcinoma
Accounts for 10-15% of all thyroid carcinomas and the second in frequency. Also prevalent in women and occurs at older ages, especially in the elderly. We detected a higher number of cases in areas of endemic goiter. The first symptom is usually the detection of a lump or mass in the thyroid that has grown slowly, is hard and almost always painless. It is not often the existence of nodes involved in areas close to it. In the analysis of blood is no objective alteration of thyroid function and hormones are normal and usually behaves scintigraphy as a cold nodule. The ultrasound is not specific. A biopsy is needed to assess the degree of tumor invasion. It is also considered a tumor of low grade malignancy but a worse prognosis than papillary carcinoma. Distance spread more often through the blood, coming mainly the lungs, bones and liver. Evolution is worse in patients with:

Older than 40-50 years.
A variant of the tumor invading blood vessels, with a mortality of 40% at 10 years.
Tumors larger than 6 cm, although in this case the size is not as important as in the papillary ..
Metastasis.

Cancers of the head and neck cancer include nose and throat, thyroid tumors, mouth cancer, salivary gland cancer and cancer of the larynx (voice box) and upper respiratory tract. These cancers are discussed below.

Cancer of the nose and throat
Cancers that begin in the lining of the nasal cavity and throat are called nasopharyngeal cancers. Have an incidence of approximately 1 in every 100,000 people under 20 years of age in the United States.

Nasopharyngeal cancer occurs in association with infection of Epstein-Barr virus (EBV, for its acronym in English), the virus associated with infectious mononucleosis. This cancer most frequently spreads to lymph nodes in the neck, which can alert the patient, parent or caregiver the presence of this tumor. It can also spread to the nose, mouth and pharynx, causing snoring, nosebleeds, obstruction of the Eustachian tubes, or hearing loss. In addition, it can invade the base of the skull, causing cranial nerve palsy or difficulty with movement in the jaw (lockjaw). Between distant sites to which this cancer can spread include the bones, lungs and liver.
Unusual Cancers of Childhood

The treatment combines the use of surgery, radiotherapy and chemotherapy. This tumor usually has already spread to the bones of the skull and neck lymph nodes at diagnosis and, therefore, the primary role of surgery is to obtain adequate diagnostic material from a biopsy of the lymph nodes or the primary site.

Esthesioneuroblastoma

Esthesioneuroblastoma (olfactory neuroblastoma) is a small tumor, rare, which originates in the olfactory bulb (the organ responsible for the sense of smell) located in front of the brain. Most children have a tumor in the nose or throat at the time of diagnosis. The tumor can spread to the eyes, sinuses, and the front of the brain. Esthesioneuroblastoma occurs most often in children and usually appears during adolescence. It is very rare for the disease spreading to other parts of the body. Generally, treatment for this disease consists of surgery and radiotherapy could also use chemotherapy.

Thyroid Tumors

Thyroid tumors (a gland near the windpipe that produces thyroid hormone, which helps regulate growth and metabolism) are classified as adenomas or carcinomas. Adenomas are benign growths that can cause inflammation of the gland or part of it, which extends on both sides of the neck and can be quite large. Some of these tumors may secrete hormones. The transformation to a malignant carcinoma (cancer) can start in some cells, which can then grow and spread to the lymph nodes in the neck and lungs.

Most thyroid carcinomas occur in girls. Thyroid carcinomas are differentiated tumors, meaning they tend to grow slowly and are not very malignant.

The treatment required for all thyroid tumors is surgery. We recommend total thyroidectomy (surgical removal of complete thyroid) or removal of part of the thyroid gland, depending on the type of tumor. After the operation, should be administered hormone replacement therapy to offset the loss of thyroid hormone. Assessments are needed at intervals of 4 or 6 months to determine whether the disease has spread to the lungs. Thyroid cancer patients have generally, excellent survival with minimal side effects. Even patients whose cancer has spread to the lungs may expect that with the right treatment, not reduce their years of life.

Cancers of the mouth

Mouth cancer is extremely rare in children and adolescents. It occurs mostly in adults over age 50 who used snuff for many years, but can occur in people who have had other tumors of children and have received radiotherapy in this area. There is evidence that oral cancer in younger primarily due to the use of moist snuff by preadolescent males. It has been observed changes in texture, color and shape of the tissues inside the mouth in more than half of teens who use snuff chewing. Precancerous lesions are common among children. Squamous cell carcinoma, which is the most common type of cancer in these sites should be distinguished from benign (not cancerous) of the throat and neck. Other tumors in this region may include ameloblastoma and adamantinoma, rare tumors that may arise in the bones of the jaw.

Salivary gland cancer

The salivary glands are the parts of the mouth and throat that produce saliva. Many of these tumors arise in the parotid gland. About 15 percent of these tumors may arise in the submandibular glands or minor salivary glands, under the tongue or jaw. These tumors most often are benign, but on rare occasions may be malignant (cancerous). The malignant lesions include adenocarcinoma, undifferentiated carcinoma, acinic cell carcinomas and mucoepidermoid carcinoma. These tumors may occur after a person has received radiation therapy for primary leukemia or solid tumors. Complete surgical resection is the preferred treatment whenever possible, with radiotherapy and chemotherapy. The prognosis (outcome) for patients with these tumors is generally good.

Laryngeal Cancer

Benign and especially malignant (cancerous) tumors of the larynx (vocal cords) are very rare. Malignant tumors may be associated with benign tumors such as polyps and papillomas. These tumors can cause hoarseness, difficulty swallowing, and enlarged lymph nodes in the neck. Rhabdomyosarcoma (a malignant tumor of muscle tissue) is the most common malignant tumors of the larynx in the pediatric population. Squamous cell carcinoma of the larynx should be treated with surgery and radiation. The first type of treatment used for these lesions may be the laser surgery.

Papillomatosis of the larynx is a benign overgrowth of tissues lining the larynx. This condition is not cancerous. These tumors can cause hoarseness because of their association with wart-like nodules of the vocal cords can also spread into the lung and larynx cancer.

Chemotherapy drugs are toxic to cancer cells. These drugs are usually given by injection into a vein or directly through a catheter inserted into a larger vein. Often given after surgery to kill small groups of cancer cells that may have been, chemotherapy can cause the tumor to grow less rapidly, and alleviate symptoms in patients who can not be operated. This treatment may be used at all stages of lung cancer and can prolong life even in the elderly if they are in good general health. Some chemotherapy drugs increase the damage caused by radiation to cancer cells. Other drugs keep tumor cells in a stage where they are more susceptible to radiation, or reduce the ability of cancer cells to repair after a course of radiotherapy. There is increasing evidence that a combination of these drugs and radiotherapy is more effective than radiotherapy alone, but there is a risk of serious side effects.

Chemotherapy causes many serious side effects including severe nausea and vomiting, and damage to white blood cells needed to fight infections, however, now there are ways to address some of these effects. Some patients with lung cancer will have to decide whether it is worth suffering side effects and diminished quality of life in order to prolong life a bit more.

Approximately one third of patients with lung cancer are diagnosed with localized disease can be treated by surgical resection. Another third of patients have disease that has spread to lymph nodes. In such cases, radiation therapy used in combination with chemotherapy and sometimes surgery. The last third of patients may have tumors that have already spread to other parts of the body through the bloodstream and usually are treated with chemotherapy and sometimes radiation therapy for relief of symptoms.
* Surgery is the primary treatment for patients with early stage cancer who have good general health. The goal of surgery is to completely eliminate all tumor cells and thus cure the disease. Although a tumor reappears after trying to remove it, often it can be removed with a second operation. Surgery is a possibility although there are multiple tumors or metastases, the tumors are always together on one site that the surgeon has access. Unfortunately, lung cancer tends to occur in smokers over 50 years of age, who often already have lung disease or other serious health conditions which increase the risk of surgery.

The location and size of a lung tumor determine the extent of surgery. Lobectomy, or removal of an entire lung lobe, is an accepted procedure to remove the cancer when the lungs are functioning. The risk of death is 3 to 4 percent, and tends to be higher in older patients. If lung function does not allow a lobectomy, a small cancer and confined within a limited area can be removed with a small portion of surrounding lung tissue. This is called a segmental or wedge resection. Patients lose less pulmonary function since it removes a smaller portion of the lung. The segmental resection is only for early-stage small cancers that are on the verge of lung and carries a mortality rate of 1.4 percent. If it is necessary to remove the entire lung by pneumonectomy, the mortality rate is 5 to 8 percent. Older patients are at greater risk, and is very common for the cancer coming back.

In most cases the patient is not eligible for surgery or can not remove the entire tumor because of their size or location. However, there are several other treatments available that can reduce the size of the tumor to make it easier to remove it, or in some cases completely destroy lung cancer.