What are Uterine Cancer Symptoms and Signs?

The most common symptom of uterine cancer is abnormal vaginal bleeding. It may start as a watery, blood-streaked flow that gradually contains more blood. After menopause, any vaginal bleeding is abnormal.

These are common symptoms of uterine cancer:

• Abnormal vaginal bleeding, spotting, or discharge
• Pain or difficulty when emptying the bladder
• Pain during sex
• Pain in the pelvic area

These symptoms may be caused by uterine cancer or by other health problems. Women with these symptoms should tell their doctor so that any problem can be diagnosed and treated as early as possible.

How is a diagnosis of uterine cancer determined?

You may have a physical exam and blood tests. Also, you may have one or more of the following tests:If you have symptoms that suggest uterine cancer, your doctor will try to find out what's causing the problems.

• Pelvic exam: Your doctor can check your uterus, vagina, and nearby tissues for any lumps or changes in shape or size. The doctor can see your vagina and cervix in this way, and can feel for changes in the shape of your uterus and ovaries with a pelvic exam.
• Ultrasound: An ultrasound device uses sound waves that can't be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside the pelvis. The echoes create a picture of your uterus and nearby tissues. The picture can show a uterine tumor. For a better view of the uterus, the device may be inserted into the vagina (transvaginal ultrasound).
• Biopsy: The removal of tissue to look for cancer cells is a biopsy. A thin tube is inserted through the vagina into your uterus. Your doctor uses gentle scraping and suction to remove samples of tissue. A pathologist examines the tissue under a microscope to check for cancer cells. In most cases, a biopsy is the only sure way to tell whether cancer is present.

You may want to ask the doctor these questions before having a biopsy:

• Why do I need a biopsy?
• How long will it take? Will I be awake? Will it hurt?
• What is the chance of infection or bleeding after the biopsy? Are there any other risks?
• How soon will I know the results? How do I get a copy of the pathology report?
• If I do have cancer, who will talk with me about treatment? When?

What are Treatment Options for Uterine Cancer

Treatment options for people with uterine cancer are surgery, radiation therapy, chemotherapy, and hormone therapy. You may receive more than one type of treatment.

The treatment that's right for you depends mainly on the following:

• Whether the tumor has invaded the muscle layer of the uterus
• Whether the tumor has invaded tissues outside the uterus
• Whether the tumor has spread to other parts of the body
• The grade of the tumor
• Your age and general health
  
  
  
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Pancreatic Cancer early Detection and Treatment in India

What is Pancreatic Cancer?

The cancer that grows inside the pancreas is known as pancreatic cancer. Pancreas is the gland that is about 6 inches long that makes hormones including the enzymes responsible for controlling blood sugar and also helps in digesting food. The development of pancreatic cancer starts when the cells inside the pancreas grow out of control. This cancer may metastasize or spread top surrounding organs and lymph nodes such as lungs and liver.

The Pancreas

The pancreas is a long leaf shaped organ, almost resembling a flattened obelisk. The broad end is called the head, the tapering point called the tail and the intervening part called the neck and body. It lies transversely in front of the spine in the abdomen. The head end is situated on the right side and the tail on the left, touching the spleen. The common bile duct runs through the head, on its way from the liver to the intestines. The pancreas produces a plethora of digestive enzymes which are secreted into the gut. In addition, it produces the hormone insulin, the lack of which causes diabetes mellitus.

The most common cancer that arises in the pancreas is the adenocarcinoma, which carries the worst prognosis. The main risk factors are smoking, excessive alcohol consumption, obesity and diabetes mellitus. There is also a strong relation to chronic pancreatitis and a family history of cancer. Hence this cancer can be guarded against by lifestyle modifications, such as cessation of smoking, change in drinking habits, regular exercise and a healthy lifestyle.

Signs and Symptoms

The initial signs and symptoms of this disease are very nonspecific and emulate everyday troubles like indigestion and acidity. However, cancer of the pancreatic head announces itself comparatively early by blocking the common bile duct and thus causing jaundice, which is initially painless. Hence any painless jaundice should be immediately investigated with an abdominal ultrasound. Cancer of the other parts of the pancreas do not cause jaundice and are consequently diagnosed even later. They usually cause severe abdominal pain spreading to the back, weight loss, vomiting and onset diabetes.

Diagnosis

Diagnosis is done by imaging, such as CT scan, MRI, CT guided fine needle biopsy (FNAC) and a blood  test to detect a specific protein called CA 19.9, the level of which is elevated in pancreatic cancer. It is not always possible to do preoperative biopsy or FNAC successfully, and it frequently happens that the surgeon decides to operate on clinical and radiological suspicion alone. During the operation, a frozen section biopsy is used to confirm the disease.

Upon diagnosis, the fate of the affected person hinges on whether the cancer is limited to the pancreas and, if so, whether it can be surgically removed. Like most other solid cancers, surgery is the keystone to the treatment of this cancer. If the cancer has spread to other distant organs such as the liver, it is in the incurable stage and the average survival of these patients is 6 to 9 months from diagnosis. Anticancer chemotherapy drugs can be used to ameliorate the painful symptoms, but it does not increase survival at this stage. If the cancerous tumour is not limited to the pancreas but has extended to involve surrounding vital structures, then it is inoperable, which means it cannot be surgically removed.

If the tumour is limited to the pancreas and is operable, then surgery carries the best chance of cure. The operation varies according to where the tumour is located. If it is in the head of the pancreas, then the surgery is called a Whipple procedure (pancreaticoduodenectomy).

If the tumour is in the mid-part or body of pancreas, it is rarely operable, but sometimes a total pancreatectomy or removal of whole pancreas can be done. For cancers in the tail of the pancreas, a distal pancreatectomy operation with removal of the spleen is done.  Thus it is apparent that treatment options for this disease are limited, even when detected relatively early. Research is ongoing to find better options. As of now, it appears that prevention is better than cure, and therein lays the importance of a healthy lifestyle.

Treatment ofPancreatic Cancer

 There are different types of surgeries that help in removing the pancreatic cancer. These surgeries are further categorized into-

    • Curative that helps in treating the cancer by   removing it 
    • Palliative that helps in easing the symptoms 

·       Curative Surgeries :

o  Pancreaticoduodenectomy : This is considered as the most common surgery for removing a pancreatic tumor. This surgery is also termed as Whipple procedure that removes –

§ Part of the common bile duct

§ Head of the pancreas

§ Gallbladder

§ Duodenum

§ Body of the pancreas

§ Lymph nodes close to the pancreas

§ Part of the stomach

§ A small part of the jejunum

o  Total Pancreatectomy : This procedure involves the removal of the spleen and the complete pancreas.

o  Distal Pancreatectomy : This procedure involves the removal of a part of the body of the pancreas and tail of the pancreas. It also removes the spleen. This procedure is more commonly used with islet cell tumors.

·       Palliative Surgeries :

o  Gastric Bypass : When the stomach has been blocked by the cancer then it is sewn with the small intestine. This process allows a patient to eat normally.

o  Stent Placement : In order to avoid blockage, the insertion of the metal tubes is done that helps in keeping the bile duct open.

o  Biliary Bypass : A small surgical cut is made in the bile duct or gallbladder that is then sewed to the small intestine. This surgical procedure is helpful when the tumor has blocked small intestine and has caused bile to accumulate in the gallbladder. Pain is also relieved by the means of this procedure.

·       Laparoscopy : The minimally invasive surgical techniques of laparoscopy are normally used directly before a scheduled pancreatic resection to determine if a more invasive operation is the best course of action. Since metastases can sometimes be missed on CT, MRI or other imaging studies, laparoscopy is a reliable way to check for metastasis to other organs. If metastases are found and the surgeon decides an operation is not the best course of action, then the patient will have a shorter recovery time compared to that of a major surgery and will be in better shape to receive alternate forms of treatment.

·       Radiotherapy :It destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Unlike chemotherapy which is a systemic treatment, radiation therapy is a local treatment meant to destroy only tumor cells. During the treatment, a beam of radiation is directed through the abdomen to the cancerous area. The radiation is similar to that used for diagnostic X-rays, only in a higher dose.

·       Chemotherapy :Chemotherapy uses drugs to help kill cancer cells. Chemotherapy can be injected into a vein or taken orally. Chemotherapy can also be combined with radiation therapy (chemoradiation). Chemoradiation is typically used to treat cancer that has spread beyond the pancreas, but only to nearby organs and not to distant regions of the body. This combination may also be used after surgery to reduce the risk of recurrence of pancreatic cancer.

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Ovarian Cancer has been called the "silent killer" !!!

Historically, ovarian cancer has been called the "silent killer" because symptoms often become apparent only when the cancer has spread and is harder to treat.

                           

However, recent medical studies show symptoms often do exist for ovarian cancer, even in its early stages. The most common include bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and urinary symptoms, such as the need to go urgently or frequently.

Trouble is, these symptoms are relatively common and associated with a number of different health problems, from irritable bowel syndrome to urinary tract infections. They are more likely to be due to other, less serious problems.

But if you have these symptoms almost daily for more than a few weeks, report them to your health care professional right away.

When ovarian cancer is found early, while it is still confined to the ovary, about 93% of patients live longer than 5 years after diagnosis. Unfortunately, only about 20% of ovarian cancers are found at this early stage.

See a doctor if you have persistent symptoms like the ones described above, and get regular women’s health exams. While most early ovarian tumors are difficult for even the most skilled doctor to feel during a pelvic exam, an exam may help identify other cancers or gynecologic conditions. Women should discuss the need for these exams with their doctor.

In addition to paying attention to symptoms and getting regular exams, there are steps women can take to protect themselves from ovarian cancer:

  Know your family history. About 10% to 15% of ovarian cancers result from an inherited genetic tendency to develop the disease. Have candid conversations with your relatives about the health problems that run in your family (especially breast, ovarian, and colon cancers), and discuss your family history with your doctor. You may need closer follow-up, depending on your situation. 

  Eat a healthy diet to help control weight, since being very overweight (obese) may raise ovarian cancer rise. Eat at least 5 servings of fruits and vegetables every day, as well as several servings of whole grain foods from plant sources such as breads, cereals, grain products, rice, pasta, or beans. Limit the intake of red meat and processed meats. 

Get regular physical activity as another way to help control your weight.

Limit alcohol consumption to no more than 1 drink per day. Alcohol use is linked to an increased risk of a certain type of ovarian cancer. 

Diagnosis of Ovarian Cancer

·    Exploratory Surgery : This surgery is performed for confirming the diagnosis of ovarian cancer.

·    Ultrasound : High-frequency sound waves are produced in order to get precise images of the structures inside the body.

·    Blood Tests : CA 125 blood test is performed for those women who are suspected of having ovarian cancer or previously had ovarian cancer. This blood test helps in detecting a protein antigen that can be found at abnormally high levels in the blood serum of those women who have ovarian cancer.

·    Positron Emission Tomographic Scan (PET) : This test helps in defining those areas that altered blood supply and also helps in identifying cancer.

·    Upper G.I. and Lower G.I. Scopy : It helps in ruling out the primary cancer present in G.I. tract.

·    CT scan : This helps in generating two dimensional images of the body that may show whether the cancer has spread.

·    Mammography : Metastatic tumors can be ruled out with this test.

·    Magnetic Resonance Imaging (MRI) : Magnetic energy is used for generating highly detailed images of the anatomy such as tumors.

Advanced Ovarian Cancer Treatment in India Surgery

Three types of surgeries are involved in treating ovarian cancer such as :–

·    Laparoscopy : Gynaeoncologist perform laparotomy through a large abdominal incision, most often removing your ovaries, uterus, fallopian tubes, nearby lymph glands, a fold of fatty tissue called the omentum and as much of the tumor as possible.

·    Frozen Section Tissue Analysis : The rapid analysis of the tissue is done under a microscope. The nature of the tumor is determined as whether it is cancerous or non-cancerous that also helps surgeons to perform a suitable procedure during the first surgery.

·    Laparotomy : This procedure is used by making a large abdominal incision. This incision is done for removing uterus, ovaries, Fallopian tubes surrounding lymph glands, omentum (a fold of fatty tissue) and tumor. Cytoreductive or debulking surgery is another name for this surgery.

Chemotherapy

After surgery, you'll most likely be treated with chemotherapy - drugs designed to kill any remaining cancer cells. Chemotherapy may also be used as the initial treatment in some women with advanced ovarian cancer. Chemotherapy drugs can be administered in a vein (intravenously) or injected directly into the abdominal cavity, or both methods of administering the drugs can be used. Chemotherapy drugs can be given alone or in combination.

Radiation therapy

Radiation therapy uses high-energy beams to kill cancer cells. The use of radiation therapy to treat ovarian cancer has declined in recent years, but Gyneconcologist use it in certain cases, such as when patient have a recurrence of cancer at the original site or if she can't tolerate chemotherapy. Gyneconcologist may use whole abdominal radiation to treat ovarian cancer that remains or recurs in the abdomen.

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The causes of acute leukaemia are uncertain, but known risk factors include ...

Cancer occurs when there is uncontrolled abnormal cell growth and development. It disturbs the normal life span of cells wherein they are formed, mature, carry out their intended function, die, and are replaced by new cells which are constantly regenerated in the body to maintain normal cellular function. Cancer represents the disturbance of this process.

Leukaemia is cancer of the white blood cells. The symptoms of leukaemia include:

* Breathlessness

* Having repeated infections over a short space of time

* Pale skin

* Tiredness

In acute leukaemia, the condition progresses at a rapid and aggressive pace, and treatment needs to be administered immediately.

Bone marrow

Bone marrow is a spongy material that is found inside the bones, and it produces all of the blood cells. It also produces vital cells called stem cells that can create other specialised cells that carry out essential functions. These specialised cells are of three types:

* Red blood cells which carry oxygen around the body

* White blood cells which help fight infection

* Platelets which help stop bleeding

Acute leukaemia prevents the affected bone marrow from producing stem cells that mature into adult blood cells. Instead it releases numerous immature blood cells called blast cells. The immature white blood cells begin to rapidly disrupt the normal balance of cells in the blood, limiting the presence of red blood cells or platelet cells in the body. This can lead to tiredness and other

symptoms of anaemia, and also increase risk of excessive bleeding. The patient also becomes more vulnerable to infection as the white blood cells are not properly formed and thus ineffective in

fighting bacteria and viruses.

Types of acute leukaemia

There are two main types of white blood cells classified according to the type of white blood cells that are affected by cancer:

* Lymphocytes which are mostly used to fight viral infections

* Myeloid cells which fight bacterial infections defend the body against parasites and prevent the spread of tissue damage

The two main types of acute leukaemia are:

* Acute lymphoblastic leukaemia, which is cancer of the lymphocytes

* Acute myeloid leukaemia, which is cancer of the myeloid cells

Acute myeloid leukaemia

It is more common in older people, especially when over 50 years of age, and more common in males than females, though it is not clear why. The causes of acute leukaemia are uncertain, but known risk factors include:

* Exposure to high levels of radiation

* Exposure to benzene, a chemical that is used in manufacturing and is also found in cigarettes

The lack of healthy blood cells in the blood supply causes most of the symptoms of acute leukaemia, which usually begin slowly before rapidly escalating in severity as the number of blast cells in the blood increases.

Outlook

The outlook for people with AML depends on the sub-type of AML, with some subtypes being more challenging to treat than others. The cure rate thus varies, and some sub-types have a 75 per cent cure rate, while others have a 20 per cent cure rate. The outlook also favours younger people as compared to older people. The treatment usually includes a combination of chemotherapy and radiation, or a bone marrow transplant in some cases.

Acute lymphoblastic leukaemia

ALL is the most common type of cancer found in children, though it is uncommon on an overall basis. Approximately one in every 2,000 children will develop ALL. The majority of cases develop in the age group of two to five year olds, and 85 per cent develop in children below the age of 15.

Outlook

The outlook for children with ALL is optimistic, as almost all of them will achieve a remission from their symptoms. 85 per cent of children will be completely cured, whereas only 40 per cent of adults will be completely cured.

Treatment

Treatment for AML involves two stages:

* Induction: The aim of the initial stage of treatment is to kill the leukaemia cells in the bone marrow, restore the blood to proper working order and resolve any symptoms that may be present.

* Consolidation: This stage aims to kill any remaining leukaemia cells that may be present in the central nervous system.

Treatment for ALL involves three stages:

* Induction

* Consolidation

* Maintenance, which involves taking regular doses of chemotherapy tablets to prevent the leukaemia returning. This seems to be the most effective stage.

Other treatments

The other treatments that are used in some circumstances are:

* Radiotherapy

* Stem cell transplant

* Targeted therapies

New directions

The treatment of hematologic malignancies is rapidly changing, and primary therapy for leukaemia has advanced steadily over the past years. Biologic advances have led to a better understanding of drug resistance and the emergence of various targeted therapies, which have revolutionised the way in which leukaemia’s are treated. Some of these offer patients more treatment options with less toxicity.

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How Cancer Treatments Affect Fertility?

What is Male Infertility?

When a couple fails to conceive after repeated attempts, it is termed as infertility. Several studies have concluded that most infertility problems arise in men.

Male infertility is a condition where a man is not able to produce healthy sperms that are made in hundreds of microscopic tubes. There is no definite reason or cause for male infertility, but any major physical or mental stress can hamper the sperm count. So far, there are several different factors that affect the sperm count in men and cause male infertility. One of the most common causes is a low sperm count.  It has been indentified that almost 90 percent of male infertility cases happen due to poor or low sperm count. Such sperm abnormalities could be permanent or temporary. Temporary low sperm count happens due to some chemical exposure and lifestyle changes.

Cancer Connected to Infertility:

In the recent studies, it has been noted that people suffering from any type of cancer are prone to infertility problems. Cancer patients who have undergone treatments such as chemotherapy and radiation therapy usually become infertile. Chemo sessions are known to hamper sperm quality and quantity, resulting in infertility. If a man is suffering from testicular cancer, then the chances of infertility are higher.

How Cancer Treatments Affect Fertility:

It is important to understand how cancer treatments like chemotherapy and radiation therapy affect fertility (sperm count). Reproductive organs such as testicles and adrenal glands release hormones that stimulate and control fertility in men. Infertility happens when one of these organs get damaged by chemo sessions or cancer treatment.

Under radiation therapy, if the target area of the radiation is close to the testicle area then there are chances that after the therapy the treated person may experience a low sperm count. Such radiations slow down sperm production. Radiation can also cause permanent infertility.

In case a person is planning to go for a bone marrow transplant, prior to that he has to undergo full body radiation therapy which usually causes permanent infertility. Sometimes, radiation damages parts of the brain that help control hormone production. Surgeries to treat prostate or bladder cancer also affect men’s semen. They also cut the pathway for sperm cells to be included in the semen.

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