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CANCER

Cancer, or malignancy, is a group of diseases, wherein cells continuously divide without stopping and spread to other parts of the body.  Normally, the body grow and divide cells that is essential for it, but as it gets older, these cells become damaged and die, and is eventually replaced by new cells.  In cancer, this process is distupted and may cause the cells to divide uncontrollably, and the old cells to be retained.  These extra cells form growths called the tumors.  However, a tumor can be benign, which does not spread or invade surrounding tissues or organs; or it can be malignant.  There are more than 100 Types & Symptoms, and each type is named for the organ or tissue where it is formed.  According to the 2015 Cancer Statistics of the American Cancer Society, the leading causes of cancer deaths in the US for both men and women are the following: lung cancer, breast cancer, prostate cancer, colorectal cancer, ovarian cancer and liver cancer.

Treatment for cancer depends on the type of cancer and how advance the cancer is.  Talking to an oncologist, and discussing all the treatment options, can help the patient decide on a treatment that is suitable for him or her.

Lung Cancer

The most common cause of lung cancer is smoking.  To prevent this, one must avoid the risk factors such as: cigarette, cigar and pipe smoking; and secondahand smoke (from smokers and from cars).  Stopping cigarette smoking before the age of 40, avoids more than 90% of lung cancer risk related to tobacco.

What are the symptoms of Lung Cancer?

A patient with Lung Cancer may manifest with the following:

  • Longstanding cough that may or may not be accompanied by blood in sputum, known as hemoptysis.
  • Weight loss
  • Headache, fever, night sweats, several episodes of loss of consciousness, seizure, and weakness in the arms and legs
  • Growth of the tumor in the passageway of air may lead to difficulty breathing, and may manifest with wheezing, a high-pitched whistling sound made while breathing.
  • Chest pain may also be present depending on the location of blocked air passages.
  • Enlarged or painful lymph nodes

 

Breast Cancer

Breast cancer is the most common tumor in women.  Risk of Breast cancer may be increased by the following: estrogen replacement therapy on menopausal women, therapeutic radiation before age 30, and when patient’s mother or sister had breast cancer.   Male breast cancer is not uncommon and must be taken seriously.  Women are encouraged to perform monthly breast examination, and undergo mammograms beginning at age 40.  To reduce the risk of breast cancer, Tamoxifen is taken for  5 years.

What Are the Symptoms of Breast Cancer?

As a tumor develops, you may note the following signs:

  • A lump in the breast or underarm that persists after your menstrual cycle. These are associated with breast cancer and are usually painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before they can be seen or felt.
  • Swelling or pain in the armpit.
  • A noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt.
  • Any change in the size, contour, texture, or temperature of the breast. A reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.
  • A change in the nipple, such as a nipple retraction, dimpling, itching, a burning sensation, or ulceration. A scaly rash of the nipple is symptomatic of Paget’s disease, which may be associated with an underlying breast cancer.
  • Unusual discharge from the nipple that may be clear or bloody
  • A marble-like area under the skin.

 

Prostate Cancer

Prostate cancer is comparable to the normal prostate hyperplasia or enlargement that begins by age 45 years in men.  On the other hand, growth of the prostate gland originates in the periphery in prostate cancer, and is detectable by rectal exam as one or more nodules in the gland, that is hard in consistency and irregular in shape.

What Are the Symptoms of Prostate Cancer?

Similar to the normal Prostate Hyperplasia, prostate cancer may manifest as:

  • A frequent need to urinate, especially at night
  • Difficulty starting or stopping a stream of urine
  • A weak or interrupted urinary stream
  • Leaking of urine when laughing or coughing
  • Inability to urinate standing up
  • A painful or burning sensation during urination or ejaculation
  • Dull, deep pain or stiffness in the pelvis, lower back, ribs, or upper thighs; pain in the bones of those areas
  • Weight loss and loss of appetite, nausea, vomiting, or suddenly feeling tired
  • Swelling of the lower extremities
  • Weakness or paralysis in the lower limbs, often with constipation

 

Colorectal Cancer

Colon cancer and cancer of the rectum can begin as a small polyp, detectable through regular screening, such as fecal occult blood test and colonoscopy. Factors that may increase the chance of colorectal cancer are the following: family history of colon or rectum cancer, hereditary conditions such as familial adenomatous polyposis (FAP) and hereditary nonpolyposis coloc cancer (HNPCC, Lynch Syndrome), history of ulcerative colitis or Crohn’s disease, history of ovarian, endometrial, or breast cancer, and history or polyps in colon or rectum. Early signs of colon cancer include a change in bowel habits or bleeding,

What Are the Symptoms of Colorectal Cancer?

The most likely warning signs include:

  • Changes in bowel movements, including persistent constipation or diarrhea, a feeling of not being able to empty the bowel completely, an urgency to move the bowels, rectal pain, or rectal bleeding
  • Blood in or on stool
  • Stools that are narrower than usual, or “pencil stools”
  • Black-colored stool
  • Frequent gas pains, bloating, fullnes or cramps in the abdomen
  • Unexplained weight loss, loss of appetite, and suddenly feeling tired

 

Ovarian Cancer

Cancer of the ovaries usually begins with cancer of the fallopian tube, the tube that connects the ovaries to the uterus; or the peritoneal spaces, the tissue that surrounds the abdomen and the organs in it, then spreads to the ovaries.  These cancers are detected at an advanced stage because these may not cause signs or symptoms and there are no good screening tests for them.  Risk is decreased by pregnancy and oral contraceptives.

What are the symptoms of ovarian cancer:

In some cases, ovarian cancer may cause early symptoms. The most common symptoms of ovarian cancer include:

  • Frequent bloating.
  • Pain in your belly or pelvis.
  • Weight gain
  • Urinary problems, such as an urgent need to urinate or urinating more often than usual.
  • Feeling tired
  • Indigestion
  • Back pain
  • Menstrual cycle changes.

If you have one or more of these symptoms that lasts for a long time, talk with your gynecologist.  However, these symptoms are also common in some women who does not have ovarian cancer.

 

Liver Cancer

Liver Cancer or Hepatocellular cancer has several risk factors, but it is commonly associated with long-term Hepatitis B or C infections, and chronic alcoholic consumption.

What are the symptoms of Liver Cancer?

Liver Cancer may not be detected early because it may be asymptomatic.  The symptoms common to Liver Cancer are the following:

  • Abdominal pain
  • Abdominal fullness
  • Weight loss
  • Weakness
  • Swelling
  • Jaundice or yellowish pigmentation of the skin and sclera

DIAGNOSIS

The earlier cancer is diagnosed and treated, the better the chance of its being cured. Some Types & Symptoms — such as those of the skin, breast, mouth, testicles, prostate, and rectum — may be detected by routine self-exam or other screening measures before the symptoms become serious. Most cases of cancer are detected and diagnosed after a tumor can be felt or when other symptoms develop. In a few cases, cancer is diagnosed incidentally as a result of evaluating or treating other medical conditions.

Cancer Diagnosis & Medication begins with a thorough physical exam and a complete medical history. Laboratory studies of blood, urine, and stool can detect abnormalities that may indicate cancer. When a tumor is suspected, imaging tests such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and fiber-optic endoscopy examinations help doctors determine the cancer’s location and size. To confirm the Diagnosis & Medication of most cancers , a biopsy needs to be performed in which a tissue sample is removed from the suspected tumor and studied under a microscope to check for cancer cells.

If the Diagnosis & Medication is positive (cancer is present), other tests are performed to provide specific information about the cancer. This essential follow-up phase of Diagnosis & Medication is called staging. The most important thing doctors need to know is whether cancer has spread from one area of the body to another. If the initial Diagnosis & Medication is negative for cancer and symptoms persist, further tests may be needed. If the biopsy is positive for cancer, be sure to seek a confirming opinion by a doctor who specializes in cancer treatment before any treatment is started.

 

RECOMMENDED MEDICATIONS

Treatment depends on the stage of Cancer and ranges from chemotherapy by taking medications, biologic therapy by immunotherapy and gene therapy, resection or the removal of tumors or affected organs, and radiotherapy.

Chemotherapy is called a systemic treatment because the medicines enter your bloodstream, travel through your body, and kill cancer cells both inside and outside the lung area. Some chemotherapy drugs are taken by mouth (orally), while others are injected into a vein (intravenous, or IV).

 

Lung Cancer-Medications

Lung Cancer Treatment consist of resection of affected part of the lung, chemotherapy and radiation therapy.  Chemotherapeutic drugs along with radiation therapy can possibly cure lung cancer. Other medicines may be used to help alleviate pain.

Chemotherapy

Chemotherapy can help control the growth and spread of the cancer, but its cure is still subjective. It also may be used to treat more advanced stages of non-small cell lung cancer.  Type of chemotherapeutic agent depends on the stage of the cancer and the type of lung cancer, whether it is small cell lung cancer, non-small cell lung cancer or adenocarcinoma lung cancer.

Small cell lung cancer usually require a more rigorous treatment with combination chemotherapy, meaning there are several chemotherapeutic drugs given to the patient.  In non-small cell carcinoma, since it is usually localized in a specific area of the lung, resection is advised in early stages of the cancer, then a single chemotherapy drug is given.  In adenocarcinoma lung cancer, a single chemotherapy drug is given.

Some of the more common chemotherapy medicines used for lung cancer include the following:

  • Bevacizumab
  • Carboplatin
  • Cisplatin
  • Crizotinib
  • Docetaxel
  • Paclitaxel
  • Erlotinib
  • Etoposide
  • Gemcitabine
  • Irinotecan
  • Pemetrexed
  • Vinorelbine

Most chemotherapy causes some side effects. Your doctor may prescribe medicines to control nausea or vomiting.

You may be concerned about losing your hair from cancer treatment. Not all chemotherapy medicines cause hair loss, and some people have only mild thinning that is noticeable only to them. Talk to your doctor about whether hair loss is an expected side effect of the medicines you will receive.

Medicines for pain

Pain is one of the main concerns of people who have cancer. But cancer pain can almost always be controlled with medicines and other options. Medicines used for cancer pain include Non-Steroidal anti-inflammatory drugs  such as aspirin, prescribed medicines, such as hydrocodone or morphine.  Corticosteroids such as dexamethasone can be beneficial in bone pain.

 

Breast Cancer-Medications

In the early stages of Breast cancer, excision, removal of a part of the breast or mastectomy, removal of the whole breast is done.  Then radiation therapy follows excision to prevent further growth of the tumor.  In the invasive type of breast cancer, chemotherapy is added after the first two method.  Hormonal therapy and targeted therapy are other treatment options for breast cancer.

Medicine choices

Chemotherapy.

Chemotherapy is used in early-stage invasive breast cancer to get rid of cancer cells that may be left behind after surgery to reduce the risk of cancer coming back; and in advanced stage cancer to destroy or damage the cancer cells as much as possible. Commonly used medicines include:

  • Capecitabine
  • Gemcitabine
  • Cyclophosphamide
  • Docetaxel
  • Paclitaxel
  • Doxorubicin
  • Epirubicin
  • Vinorelbine
  • Vincristine
  • Paraplatin

Hormone therapy.  Hormonal therapy works by lowering the estrogen amount in the body, and by blocking the action of estrogen on breast cancer cells.  This method can only be effective in hormone receptor-positive breast cancer, or those found to be affected by the hormones.  Medicines for hormone therapy include:

  • aromatase inhibitors (anastrozole, letrozole, and exemestane)
  • selective estrogen receptor modultor (tamoxifen, raloxifene, toremifene),
  • estrogen receptor downregulators (fulvestrant)

Targeted therapy.   This treatment act by focusing on specific characteristics of cancer cells, such as the protein which allows the cancer cell to grow.  This may include:

  • mTOR (mammalian target of rapamycin) inhibitor that works against hormone-receptor-positive breast cancer (e.g. everolimus)
  • Bevacizumab that blocks the growth of any new blood vessels that cancer cells depend on
  • Trastuzumab against HER2- positive breast cancer by blocking the ability of the cancer cells to receive signals
  • Cyclin-dependent kinase 4/6 inhibitor (e.g. palbociclib)

Other medicines that may be used include corticosteroids for cancer that has spread to the brain or spinal cord and bisphosphonates for cancer that has spread to the bones.

Opiate pain relievers are the most common medicines used to treat cancer pain.

 

Prostate Cancer-Medications

Hormones are medicines that can affect the growth of prostate cancer cells. Hormone therapy is sometimes used with radiation treatment or surgery to help make sure that all cancer cells are destroyed.

Hormone therapy cannot cure prostate cancer. But it will usually shrink the tumor and slow the rate of cancer growth, sometimes for years. Taking a hormone-therapy medicine lowers your level of testosterone and other male hormones. Another way to lower male hormones is by having surgery to remove the testicles, called an orchiectomy.

 

Colorectal Cancer-Medications

Chemotherapy is the use of medicines to control the cancer’s growth or relieve symptoms. Often the medicines are given through a needle in your vein. Your blood vessels carry the medicines through your body. Sometimes the medicines are available as pills. And sometimes they are given as a shot, or injection.

Several medicines are used to treat colorectal cancer. There are also several medicines available for treating side effects.

Medicine choices

A combination of drugs often works better than a single drug in treating colorectal cancer. The most commonly used drugs are:

  • Fluorouracil (5-FU) combined with leucovorin
  • Oxaliplatin
  • Capecitabine
  • Irinotecan

Hair loss can be a common side effect with some types of chemotherapy. But hair loss usually isn’t a side effect of these drugs.

 

Ovarian Cancer-Medications

Chemotherapy is used to shrink ovarian cancer and slow cancer growth. Chemotherapy is recommended for most women after the initial surgery for ovarian cancer. But sometimes chemotherapy is given to shrink the cancer before surgery. The number of cycles of treatment will depend on the stage of your disease.

Chemotherapy medicines for ovarian cancer may be taken by mouth, injected into a vein (IV), or given through a thin tube into the body (intraperitoneal, or IP). Sometimes treatments may be combined to give women both IV and IP chemotherapy.

Medicine choices

Some of the chemotherapy medicines used for ovarian cancer include:

Other medicines that may be used include:

Treatment of ovarian cancer with chemotherapy can cause nausea and vomiting. To help relieve nausea, your doctor will prescribe medicines you can take with your treatments and when you get home.

 

Liver Cancer- Medications

Treatment for Liver Cancer may include the resection of a part of the Liver.  Radiation therapy can cure small tumors.  Sorafenib, a targeted therapy, that acts by preventing the growth of new blood vessels.  Chemotherapy is not as helpful in Liver Cancer, because it resists most of the chemotherapeutic drugs, except for Doxorubicin, 5-fluorouracil, and cisplatin.

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