Ovarian cancer symptoms: What you need to know

Ovarian cancer has long been called "The Silent Killer", because it usually isn't discovered until its advanced stages.  In 70-75% of cases the cancer has spread to other parts of the abdomen before it is detected.  However, the truth is that early-stage ovarian cancer often does produce symptoms – but they are subtle.

Just How Common Is Ovarian Cancer?

It is relatively rare, accounting for about 3 percent of all cases of cancer in women. In general, your chances of getting ovarian cancer are 1 in 58 (compared to 1 in 7 for breast cancer), but the odds worsen as various risk factors are considered.

Why Should I Worry About Ovarian Cancer?

You shouldn’t worry about it – but you should be aware of it and take the steps to detect it at a stage when the chance of a cure is high. When this cancer is found early and in still in the ovaries, there’s a 90 to 95 percent chance the patient will survive five years. When it is detected at an advanced stage, the five-year survival rate drops to 18 percent.

At What Age Is Ovarian Cancer Most Likely to Be Found?

It is most often found in women between the ages of 40 and 70 – and women between 50 and 59 are in the high-risk group – but it sometimes strikes women in their 20s. In fact, the Julie Merle Epstein Cancer Fund at UConn Health was created to honor the memory of Julie, a woman who died from ovarian cancer at the age of 28.

I Have a Pap Test Each Year. Will It Detect Ovarian Cancer?

No. The Pap test detects cancer of the cervix, not cancer of the ovaries.

What Should I Do to Detect Ovarian Cancer?

The best precaution is to have a complete pelvic exam done every year by a physician who is aware of your family and medical history. It is especially important for your doctor to be aware of any factors that place you at high risk for this disease.

What Are the Risk Factors for Ovarian Cancer?

The most important is a family history of ovarian cancer – a mother, sister, or grandmother who had it. A history of breast or colorectal cancer increases your risk, as does infertility or never having given birth to a living child. The use of birth control pills or having several children is associated with a lower risk for ovarian cancer.

Are There Warning Signals to Watch for?

The problem with ovarian cancer is that many of the symptoms are easily confused with digestive disorders and bladder problems, so the cancer goes unrecognized until it's advanced.

Many women with ovarian cancer realize they were experiencing unexplained symptoms for months, even years, before their cancer was diagnosed. Recently, researchers found that ovarian cancer could be detected using a blood test in combination with a simple screening. Women should check with their doctors if they notice one or more of these symptoms:

·         Pelvic or abdominal pain

·         Increased abdomen size or bloating

·         Feeling constantly full or having difficulty eating

Of course, these symptoms are common to many conditions. But if the symptom is new, and persists over time, talk to your doctor.

Other signs reported by ovarian cancer patients:

·         Abdominal cramping

·         An urgent need to urinate

·         Urinary burning or discharge

·         Indigestion or nausea that persists over a long period of time

·         Frequent episodes of gas

·         Unexplained constipation

·         Unexplained increase in waist size "“ i.e. you can't zip up your jeans

·         Pain during sex

·         Lower back pain

·         Menstrual changes such as more pain during periods or heavier bleeding

·         Lack of energy

Those with a family history of breast or ovarian cancer should be even more vigilant; talk to your doctor about genetic screening and be alert to any new symptoms in the pelvic area.

Services for Women at Higher Risk

Although researchers are trying to find ways to identify “tumor markers” (substances in the blood or urine that may reveal cancer before symptoms develop), there currently is no screening exam to detect this cancer in women without symptoms.

However, women at higher risk can take advantage of frequent screening tests, including transvaginal ultrasound of the ovaries and in some cases, blood tests. 

How Is Ovarian Cancer Diagnosed and Treated?

If cancer is suspected, exploratory surgery may be done so the doctor can see the ovaries and take tissue samples. If tests of the samples reveal cancer, then appropriate surgery is the initial phase of treatment, after which chemotherapy may be used.

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You can reduce your risk of throat cancer by not smoking, not chewing tobacco and limiting alcohol use

Throat cancer refers to cancerous tumors that develop in your throat (pharynx), voice box (larynx) or tonsils.

Your throat is a muscular tube that begins behind your nose and ends in your neck. Your voice box sits just below your throat and is also susceptible to throat cancer. The voice box is made of cartilage and contains the vocal cords that vibrate to make sound when you talk. Throat cancer can also affect the piece of cartilage (epiglottis) that acts as a lid for your windpipe. Tonsil cancer, another form of throat cancer, affects the tonsils, which are located on the back of the throat.

You can reduce your risk of throat cancer by not smoking, not chewing tobacco and limiting alcohol use.

You cannot pick up the signs of cancer quickly enough most of the times. Some cancers are so deceptive that they cannot be detected until the later stages. Cervical cancer for example, is very hard to detect. However, throat cancer symptoms are rather obvious if you remain watchful. We all come under the cancer risk scanner now. So it is both smart and feasible to look out for throat cancer symptoms.

There are many causes of throat cancer. Smoking and chewing tobacco is among the main causes of throat cancer. If you feel that you come in the high risk category for cancer, keep your eyes open for these early throat cancer symptoms.

Difficulty In Swallowing

Difficulty in swallowing is one of the first signs of cancer. Cancer grows as a tumour in your throat. And if you have an additional growth in your throat, it will obstruct the passage of food or even make it difficult to swallow just like that.

Roughness In The Larynx

You must have had a rough feeling in your throat just before you come down with an infection. It is a feeling of discomfort that is hard to ignore. If you have started developing throat cancer, you will feel this roughness 24x7.

Voice Changes

If the cancer is growing around your vocal chords then it will cause obvious voice changes. Even booming baritones can be reduced to feeble whining voices if you have a cancerous growth in your throat. Consult your doctor as soon as you see the first signs of an apparent voice change.

Persistent Cough

When you have a persistent cough that makes your voice hoarse, it is called smoker's cough. Developing a smoker's cough is one of the first throat cancer symptoms. And if you ignore this symptom, you stand the risk of developing cancer at any point of time. Every one who has a smoker's cough does not have cancer. But do you really want to count on getting lucky?

Strange Breathing Sounds

When you breathe, the air passes through your pharynx and then goes on to your trachea. One of the throat cancer symptoms is that you make strange, often whistling hoarse sounds while you breathe.

If you notice any of these throat cancer symptoms, rush to the doctor immediately. There is no antidote for lost time when it comes to treating cancer.

Your treatment options are based on many factors, such as the location and stage of your throat cancer, the type of cells involved, your overall health, and your personal preferences. Discuss the benefits and risks of each of your options with your doctor. Together you can determine what treatments will be most appropriate for you.

Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays, to deliver radiation to the cancer cells, causing them to die. Radiation therapy can come from a large machine outside your body (external beam radiation). Or radiation therapy can come from small radioactive seeds and wires that can be placed inside your body, near your cancer (brachytherapy).

For early-stage throat cancers, radiation therapy may be the only treatment necessary. For more advanced throat cancers, radiation therapy may be combined with chemotherapy or surgery. In very advanced throat cancers, radiation therapy may be used to reduce signs and symptoms and make you more comfortable.

Surgery

The types of surgical procedures you may consider to treat your throat cancer depend on the location and stage of your cancer. Options may include:

·         Surgery for early-stage throat cancer. Throat cancer that is confined to the surface of the throat or the vocal cords may be treated surgically using endoscopy. Your doctor may insert a hollow endoscope into your throat or voice box and then pass special surgical tools or a laser through the scope. Using these tools, your doctor can scrape off, cut out or, in the case of the laser, vaporize very superficial cancers.

·         Surgery to remove all or part of the voice box (laryngectomy). For smaller tumors, your doctor may remove the part of your voice box that is affected by cancer, leaving as much of the voice box as possible. Your doctor may be able to preserve your ability to speak and breathe normally. For larger, more-extensive tumors, it may be necessary to remove your entire voice box. Your windpipe is then attached to a hole (stoma) in your throat to allow you to breathe (tracheotomy). If your entire larynx is removed, you have several options for restoring your speech. You can work with a speech pathologist to learn to speak without your voice box.

·         Surgery to remove all or part of the throat (pharyngectomy). Smaller throat cancers may require removing only part of your throat during surgery. Parts that are removed may be reconstructed in order to allow you to swallow food normally. Surgery to remove your entire throat usually includes removal of your voice box as well. Your doctor may be able to reconstruct your throat to allow you to swallow food.

·         Surgery to remove cancerous lymph nodes (neck dissection). If throat cancer has spread deep within your neck, your doctor may recommend surgery to remove some or all of the lymph nodes to see if they contain cancer cells.

Surgery carries a risk of bleeding and infection. Other possible complications, such as difficulty speaking or swallowing, will depend on the specific procedure you undergo.

Chemotherapy

Chemotherapy uses chemicals to kill cancer cells. Chemotherapy is often used along with radiation therapy in treating throat cancers. Certain chemotherapy drugs make cancer cells more sensitive to radiation therapy. But combining chemotherapy and radiation therapy increases the side effects of both treatments. Discuss with your doctor the side effects you're likely to experience and whether combined treatments will offer benefits that outweigh those effects.

Targeted drug therapy

Targeted drugs treat throat cancer by taking advantage of specific defects in cancer cells that fuel the cells' growth. Cetuximab (Erbitux) is one targeted therapy approved for treating throat cancer in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of throat cancer cells.

Other targeted drugs are being studied in clinical trials. Targeted drugs can be used in combination with chemotherapy or radiation therapy.

Rehabilitation after treatment

Treatment for throat cancer often causes complications that may require working with specialists to regain the ability to swallow, eat solid foods and talk. During and after throat cancer treatment, your doctor may have you seek help for:

·         The care of a surgical opening in your throat (stoma) if you had a tracheotomy

·         Eating difficulties

·         Swallowing difficulties

·         Stiffness and pain in your neck

·         Speech problems

Cyberknife Radiosurgery for Prostate Cancer : Prostate Cancer Treatment in India

The challenge that doctors face in treating prostate tumors with radiation therapy is that the prostate moves unpredictably as air passes through the rectum and as the bladder empties and fills. Minimizing any large movements of the prostate can help reduce unnecessary irradiation of surrounding healthy tissue. The CyberKnife Robotic Radiosurgery System is able to overcome this challenge by continuously identifying the exact location of the prostate and making active corrections for any movement of the prostate throughout the course of the treatment. During treatment, a patient lays still and breathes normally while the CyberKnife zeroes in on a moving target – the prostate – and irradiates it without harming surrounding areas. As a result, the procedure is more comfortable for patients, radiation is delivered more accurately and treatments can be completed in four to five days.

Currently the CyberKnife Radiosurgery System is most frequently used by itself for patients with early stage prostate cancer confined to the prostate or in combination with another therapy, such as external beam radiation for patients with disease that extends beyond the prostate. Depending on the stage of the patient’s prostate cancer the doctor will recommend a treatment plan. 

What does a typical CyberKnife treatment entail?
Prostate cancer treatment with the CyberKnife System involves a team approach, in which several specialists participate. A team may include:

·         a urologist

·         a radiation oncologist

·         a medical physicist

·         a radiation therapist 

·         medical support staff

Once the team is in place, the patient will begin preparations for CyberKnife treatment. As part of their diagnosis, doctors will have measured prostate specific antigen (PSA) levels via a blood test that will be used to help track treatment results. Prior to CyberKnife treatment, patients will be scheduled for a short outpatient procedure in which three to five tiny gold seeds – called fiducial markers – are inserted into the prostate. The fiducials are placed through a needle, which is guided via an ultrasound. Patients may be asked to clean out their rectum with an enema the day of the fiducial placement.

The CyberKnife System uses the fiducials as reference points to identify the exact location of the prostate. Doctors will wait approximately one week after insertion of the fiducials before CyberKnife treatment planning can begin to ensure that fiducial movement has stabilized.

Prior to the treatment, a special custom-fit body cradle will be made. The cradle is made of a soft material that molds to the patient’s body, ensuring that the patient is in the same position for each treatment session and is comfortable during the procedure.

While lying in the cradle, patients will undergo a CT scan. This CT data will be used by the CyberKnife team to determine the exact size, shape and location of the prostate. An MRI scan also may be necessary to fully visualize the prostate and nearby anatomy. Once the imaging is done, the body cradle will be stored and used during CyberKnife treatment.

A treatment plan will be specifically designed by a medical physicist in conjunction with the patient’s doctors. Patients will not need to be present at this time. During treatment planning, CT and/or MRI data will be downloaded into the CyberKnife System’s treatment planning software. The medical team will determine the size of the area being targeted by radiation and the radiation dose, as well as identifying critical structures – such as the bladder and rectum – where radiation should be minimized.

At this time, the CyberKnife System will be able to calculate the optimal radiation delivery plan to treat the prostate. Each patient’s unique treatment plan will take full advantage of the CyberKnife System’s extreme maneuverability, allowing for a safe and accurate prostate cancer treatment. After the treatment plan is developed, patients return to the CyberKnife center for treatment. The treatment is usually delivered in one to five sessions.

For most patients, the CyberKnife treatment is a completely pain-free experience. They may dress comfortably in street clothes, and the CyberKnife center may allow patients to bring music to listen to during the treatment. Patients also may want to bring something to read or listen to during any waiting time, and have a friend or family member with them to provide support before and after treatment.

The CyberKnife System’s computer-controlled robot will move around the patient’s body to various locations from which it will deliver radiation. At each position, the robot will stop. Then, special software will determine precisely where the radiation should be delivered. Nothing will be required of the patient during the treatment, except to relax and lay as still as possible.

Once prostate cancer treatment is complete, most patients quickly return to their daily routines with little interruption to their normal activities. If treatment is being delivered in stages, patients will need to return for additional treatments over the next several days as determined by their doctors.

Advantages of CyberKnife Radio Surgery Over Other Radio surgery Methods

• The CyberKnife system is able to locate tumors within the body without the use of an invasive stereotactic headframe used with other systems. This is much more convenient and less traumatic for patients.
  
• While other forms of radiosurgery can only treat tumors in the head, Cyberknife can treat tumours anywhere in the body- brain, spine, liver, lungs, pancreas, kidney or prostrate.
  
• While other forms of radio surgery treatment techniques need rigid head-frames screwed to the patient's head for controlling movement, which is painful and cumbersome for the patient, CyberKnife does not require such extreme procedures to keep patients in place, and instead relies on sophisticated tracking software, allowing for a much more comfortable and non-invasive treatment.
  
• The CyberKnife System can essentially "paint" the tumor with radiation allowing it to precisely deliver treatment to the tumor alone, sparing surrounding healthy tissue.

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How Do You Know If You Have Liver Cancer? : Liver Cancer Treatment in India

What is liver cancer?

Liver cancer is cancer that starts in the cells of the liver. There are two main types: hepatocellular carcinoma (HCC) and cholangiocarcinoma.

HCC starts from the main cells in the liver (hepatocytes), and is the most common type of primary liver cancer. Cholangiocarcinoma starts in the cells lining the bile duct.

Cancer can also spread to the liver from another part of the body. This is called secondary liver cancer.

Liver cancer symptoms :-

Primary liver cancer usually has no symptoms in the early stages. Symptoms usually appear when the cancer has advanced. Symptoms for secondary cancer in the liver are similar and may include:

         

•        pain in the upper right side of the abdomen
•         weight loss
•        loss of appetite
•         feeling sick (nausea)
•         swelling of the abdomen (ascites)
•        yellowing of the skin and eyes (jaundice).
•     weakness and tiredness (fatigue)

How Do You Know If  You Have Liver Cancer?

Screening for early detection of primary liver cancer is not performed routinely, but it may be considered for people at high risk for the disease. However, studies haven't determined if screening is beneficial for anyone. To diagnose liver cancer, a doctor must rule out other causes of liver dysfunction.

Patients at high risk include patients with a condition called hemochromatosis, chronic hepatitis, and alcoholics.

Additional tests include:

·         Blood tests that measure tumor markers -- the levels of these substances rise in the blood if someone has a particular cancer -- can aid diagnosis. Liver cancers secrete a substance called alpha fetoprotein (AFP) that is normally present in fetuses but goes away at birth. An elevated AFP in adults may indicate liver cancer as it is produced in 70% of liver cancers. Elevated levels of iron may also be a tumor marker. 

·         Imaging with ultrasound is the initial diagnostic test as it can detect tumors as small as one centimeter. High resolution CT scans and contrast MRI scans are used to diagnose and stage these tumors. 

·         A liver biopsy will distinguish a benign tumor from a malignant one. However, depending on the results of other tests, a biopsy might not be required to diagnose cancer.

·         Laparoscopy, using tools and cameras through small incisions, is useful for detecting small tumors, determining the extent of cirrhosis, or obtaining a biopsy, and confirm previous tests, among other things.

What Are the Treatments for Liver Cancer?

Any liver cancer is difficult to cure. Primary liver cancer is rarely detectable early, when it is most treatable. Secondary or metastatic liver cancer is hard to treat because it has already spread. The liver's complex network of blood vessels and bile ducts makes surgery difficult. Most treatment concentrates on making patients feel better and perhaps live longer.

Patients with early-stage tumors that can be removed surgically have the best chance of long-term survival. Unfortunately, most liver cancers are inoperable at the time it's diagnosed, either because the cancer is too advanced or the liver is too diseased to permit surgery. In some patients, chemotherapy is given directly into the liver (chemoembolization) to reduce tumors to a size that may make surgery possible. This may also be done without chemotherapy (bland emoblization) in some cases, using ethanol instead. After surgery, radiation and chemotherapy have shown no advantage in improving survival. Patients in remission must be monitored closely for potential recurrence.

Cryotherapy, or freezing the tumor, and radiofrequency ablation (RFA), using radio waves to destroy the tumor, may be used to treat some cases of liver cancer. Radiation therapy can be given in various ways, but has its limitations due to the liver's low tolerance to radiation. When used, the role of radiation is to alleviate symptoms outside of the liver or to relieve pain within the liver by shrinking the tumor. Radioembolization therapy uses substances to cut off the blood supply to the tumor.

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Combinations of Several Types of Treatments to effectively fight against Brain Cancer

Brain cancer is an abnormal growth of cells in the brain, which result in a collection of cells called a brain tumor. If the abnormal cells were originally brain cells that started to grow uncontrollably, it is a primary brain tumor. If the abnormal cells originated in another part of the body, such as the lung or breast, and were carried to the brain by the blood or other body fluid, then it is considered a metastatic brain tumor. 

Primary brain tumors

There are many types of primary brain tumors, including meningiomas, pituitary adenomas, schwannomas and gliomas, which are divided into astrocytomas, ependymomas, medulloblastomas and oligodendrogliomas. Each primary brain tumor is categorized based on the type of normal brain cell from which they originated and has its own unique characteristics and growth patterns. Gliomas account for 40 percent of all primary brain tumors and it is common for them to spread from the brain to other parts of the body.The most aggressive type of glioma is called glioblastoma multiforme.

Metastatic brain tumors

 The cells that form metastatic brain tumors travel to the brain from other parts of the body through the bloodstream, along nerves or within the fluid surrounding the spinal cord and brain. These cells most commonly originate in tumors within the lung, breast, skin or colon, and are deposited in the brain where they grow into a tumor.

Both primary and metastatic brain tumors can be very dangerous because they can compress sensitive brain tissue and nerves within the head, causing patients to experience symptoms such as vision loss, hearing loss, difficulties with balance, pain or seizures. As these tumors grow larger, they can be life-threatening because they disrupt critical parts of the brain that are responsible for breathing and other basic life functions.

How is Brain Cancer Treated?

The treatment of brain tumors often requires combinations of several types of treatments to effectively fight the disease.

Surgery: 

For solitary tumors that are not near the brain’s most critical structures, such as those involved in vision or regulation of breathing, the most common treatment option is surgery, in which the tumor is cut out through surgery.⁵ Surgery is used for primary brain tumors, such as a GBM, as well as solitary brain metastases and benign tumors. Surgery is often followed by whole brain radiation therapy or partial brain radiation techniques to eliminate any microscopic bits of the tumor. In some cases, malignant brain tumors can be treated in combination with chemotherapy for greater effect.

Radiation therapy: 

If the patient suffers from multiple tumors, as is often the case with metastatic brain cancer, treatment is often whole brain radiation therapy. Whole brain radiation treatment typically requires 20 to 40 sessions over four to six weeks and is used to treat the entire brain, including both the tumor(s) and normal tissue. The normal brain tissue is not as susceptible to small doses of radiation as the tumor cells, so the extended courses of whole brain radiation therapy result in minimal destruction of normal brain cells for the patient.

For patients with a limited number of tumors in their brain, radiosurgery is another option.

Chemotherapy: 

Chemotherapy medication is delivered orally or through an IV. It affects both normal tissue and the cancer cells, so patients may experience side effects, such as severe nausea and vomiting, infections, fatigue and weight loss. Chemotherapy is typically given to a patient in combination with other types of brain cancer treatment. For example, it may be given after whole brain radiation therapy to target both the metastatic tumors in the brain and the tissues outside the brain that originally produced the cancer cells.

Radiosurgery: 

During the last 25 to 30 years, radiosurgery has emerged as an alternative to surgery. Unlike conventional radiation therapy, during which small doses of radiation are delivered over weeks and months, radiosurgery can treat a tumor in one to five sessions by delivering a high dose of radiation with extreme accuracy. During radiosurgery, hundreds of narrow radiation beams are delivered from different angles, all intersecting at the tumor. This treatment allows the tumor to be attacked by a high dose of radiation without damaging surrounding sensitive brain tissue. To be effective and safe, radiosurgery must be accurate. To achieve this accuracy, some radiosurgery devices, such as the Gamma Knife®, require a rigid stereotactic frame be affixed to a patient’s head so the system can pinpoint the exact location of a tumor.

These frames are screwed into a patient’s skull after local anesthesia is given. Many patients find these frames to be uncomfortable and painful. In addition, if multiple treatment sessions are required, the patient may have to be hospitalized with the frame in place for several days until the treatment is complete.

Other radiosurgery devices, such as the CyberKnife Robotic Radiosurgery System, improve on other radiosurgery techniques by eliminating the need for stereotactic frames. As a result, the CyberKnife System enables doctors to achieve a high level of accuracy in a non-invasive manner and allows patients to be treated on an outpatient basis

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