Pulmonary metastatic soft tissue sarcoma curable with surgical excision
Reuters Health Posting Date: January 19, 2007
Last Updated: 2007-01-19 14:13:32 -0400 (Reuters Health) NEW YORK (Reuters Health) - Resection of soft tissue sarcoma metastatic to the lungs can be accomplished with very low morbidity and mortality, surgeons in Germany report, and may in fact be curative. Although pulmonary soft tissue sarcomas (STS) resection is a common procedure, lead author Dr. Alexander Rehders and his associates note in the Archives of Surgery for January, agreement as to which patients make the best candidates has yet to be established. Their current results suggest that "it seems worthwhile to operate on every patient with lung metastasis unless serious comorbidity or technically unresectable metastatic disease is present." At University Hospital in Hamburg-Eppendorf, all patients with operable lung STS metastasis undergo radical surgery with curative intent. The only exceptions are failure of the primary tumor to regress at least partially after 6 months of chemotherapy, extensive involvement of the mediastinum or chest wall, unresectable lung disease or metastatic disease outside the lung, other comorbidities, or insufficient pulmonary function. Between 1991 and 2002, 61 of 121 patients at their institution who developed pulmonary metastasis of STS underwent sternotomy or anterior lateral thoracotomy for metastasectomy, including wedge resection or lobectomy. There were no cases of perioperative mortality. Nine patients experienced transient alveolar leakage requiring pleural drainage, three had wound infections, and three experienced hypoventilation. Otherwise, there were no major complications. After a mean follow-up of 60 months, survival time averaged 33 months (range 2 to 125 months), the authors report. The 5-year survival rate was 25%. None of the common risk factors assessed - age, gender, tumor grade, number of metastatic lesions, bilateral involvement, histologic type, site of primary tumor, and interval before STS metastasis was diagnosed - had any significant effect on survival. Dr. Rehders and his associates report that six patients underwent repeat STS excisions, and that these patients were among the 13 who lived the longest. Arch Surg 2007;142:70-75. Copyright ? 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
Aug 1, 2007
cancer information
beating cancer with nutrition
"I'm sorry, but you have cancer." These words from a doctor introduce fear into the heart of any patient.
The good news is that supportive nutrition therapy can significantly increase cancer patients' quality and length of life and improve their chances for a complete remission. Better yet, a healthy lifestyle that includes a wholesome diet, sufficient exercise, positive attitude and toxin avoidance can prevent up to 90 percent of cancers.
Now for the bad news. Conventional medicine does not have a high success rate with the disease. By the turn of this century, cancer will become the leading cause of death in America. During the past 26 years, NCI spent $37 billion in research with a resulting increase in cancer incidence and deaths. Clearly, medicine cannot produce a "magic bullet" to cure cancer while patients go on living on soft drinks, pollutants and stress.
On December 23, 1971, President Richard M. Nixon confidently declared a "war on cancer" and promised a cure by the 1976 Bicentennial. However, as late as 1991, a group of 60 noted physicians and scientists called a press conference and made the following statement: "The cancer establishment confuses the public with repeated claims that we are winning the war on cancer. ... Our ability to treat and cure most cancers has not materially improved." this article, I will briefly explore the reasons for failure in combating cancer and give rational directions to improve outcomes for the 2.5 million cancer patients being treated in America today.
Developing A Strategy
In early research, the techniques of surgery, radiation and chemotherapy looked like the best approaches to cancer. The goal was to cut away, burn and poison the abnormal cells. While such therapies can temporarily reduce tumor burden, they do not cure cancer. Only by changing the underlying cause of the disease can a cancer patient expect to return to health.
Doctors now know that eliminating cancer begins with changing the conditions that support tumor growth, not just applying cytotoxic therapies to kill cancer cells. Here's an analogy: Fungus grows on the bark of a tree due to the favorable conditions of heat, moisture and darkness. You can cut, burn and poison a fungus all you want, but as long as favorable conditions persist, it will flourish. Similarly, cancer develops in a human when conditions are right. Documented factors that favor tumor formation include toxic burden, immune suppression, malnutrition, mental depression and elevated blood glucose. More speculative causative factors include reduced pH, dysbiosis (abnormal bacteria in the gut), hypothyroidism, insufficient gland and organ output (i.e., insufficient DHEA, enzymes and hydrochloric acid) and parasites. Unless we correct these cancer inducers, cytotoxic therapies are doomed to failure.
The best way to correct the problem is through therapeutic use of nutrients. But, as a word of caution, while nutrition should be an integral component of every cancer patient's treatment program, nutrition therapy alone is probably insufficient for most advanced cancers. The reasons for using therapeutic nutrition in cancer treatment are numerous and include the following:
* Malnutrition: Undernourishing your body can have devastating, even fatal consequences. In fact, more than 40 percent of cancer patients die from malnutrition, not the cancer itself.2 Cancer induces a metabolic abnormality akin to getting your car stuck on ice--the wheels spin and the engine guzzles gas, but you don't go anywhere. Yet, cancer patients often eat less food than they did before their illness began. One reason is that tumors induce a hypermetabolic state and secrete a substance called cachectin that suppresses appetite. Chemo and radiation therapy can also cause anorexia and alone are sufficient biological stressors to induce malnutrition.3 Because cancer patients need more calories than healthy people, they eventually waste away, a condition called cachexia. Weight loss increases the mortality rate for most types of cancer, while also lowering the positive response to chemotherapy.4 In addition to proper eating, nutrient-dense "shakes," canned nutritional formulas, protein powders, hydrazine sulfate, enzymes, DNA loading and other therapies can reverse the weight loss that consumes far too many cancer patients. If cancer patients lose 10 percent or more of their body weight after cancer diagnosis, all other nutrition strategies are irrelevant until this problem is addressed. A word of caution: Do not fill up a fragile stomach with vitamin pills when nutrient-dense foods are more important.
tropic of cancer
Tropic of Cancer, parallel of latitude at 23°30' north of the equator; it is the northern boundary of the tropics. This parallel marks the farthest point north at which the sun can be seen directly overhead at noon; north of the parallel the sun appears less than 90° from the southern horizon at any day of the year. The sun reaches its vertical position over the Tropic of Cancer at about June 22, the summer solstice in the Northern Hemisphere. When the Tropic of Cancer was named, the sun was in the constellation Cancer at the time of the summer solstice.
Where is it?
All of us who have looked at a map have noticed a little dotted line called the Tropic of Cancer. In fact, here in Mazatlan, this little dotted is less than 15 miles north of us. But what is it, and what if anything does it have to do with Cancer? The answer is both simple and complicated. The simple answer is that the Tropic of Cancer is 23.5 degrees north latitude. So what? The real answer is a bit more complicated, and very interesting.
Some History Back in the old days, before television, cellular phones, and the internet, people who had a lot of free time on their hands used to look up at the stars and the sky. They noticed a bunch of remarkable things. One of the things they noticed was that the sun and the stars did not appear in the same place at the same time every day. In the northern hemisphere, from winter until summer, the sun gradually rose higher and higher in the sky each day, while from the summer until winter, the opposite happened. By carefully measuring how high the sun rose at mid day, they discovered that around June 21 (in our current calendar, but that is another story) the sun got as high as it was ever going to get, and that around December 21 the sun stayer lower in the sky than on any other day. To make matters worse, how high and how low the sun gets depends on where you live. For the folks living near the equator, on June 21 the sun was up in the northern sky, their day was long and hot, but things cooled off at night, while for the folks living up near the north pole, the sun was to the south and moved in a small circle. In fact they were in the middle of 6 months of constant daylight. Something funny is clearly going on.
sign of cancer
What Are Symptoms and Signs? A symptom is an indication of disease, illness, injury, or that something is not right in the body. Symptoms are felt or noticed by a person, but may not easily be noticed by anyone else. For example, chills, weakness, achiness, shortness of breath, and a cough are possible symptoms of pneumonia. A sign is also an indication that something is not right in the body. But signs are defined as observations made by a doctor, nurse, or other health care professional. Fever, rapid breathing rate, and abnormal breathing sounds heard through a stethoscope are possible signs of pneumonia. The presence of one symptom or sign may not give enough information to suggest a cause. For example, a rash in a child could be a symptom of a number of things including poison ivy, an infectious disease like measles, an infection limited to the skin, or a food allergy. But if the rash is seen along with other signs and symptoms like a high fever, chills, achiness, and a sore throat, then a doctor can get a better picture of the illness. In many cases, a patient's signs and symptoms do not provide enough clues by themselves to determine the cause of an illness, and medical tests such as x-rays, blood tests, or a biopsy may be needed. How Does Cancer Produce Signs and Symptoms? Cancer is a group of diseases that may cause almost any sign or symptom. The signs and symptoms will depend on where the cancer is, the size of the cancer, and how much it affects the surrounding organs or structures. If a cancer spreads (metastasizes), then symptoms may appear in different parts of the body. As a cancer grows, it begins to push on nearby organs, blood vessels, and nerves. This pressure creates some of the signs and symptoms of cancer. If the cancer is in a critical area, such as certain parts of the brain, even the smallest tumor can produce early symptoms. Sometimes, however, cancers form in places where there may be no symptoms until the cancer has grown quite large. Pancreas cancers, for example, do not usually grow large enough to be felt from the outside of the body. Some pancreatic cancers do not produce symptoms until they begin to grow around nearby nerves, causing a backache. Others grow around the bile duct, which blocks the flow of bile and leads to a yellowing of the skin known as jaundice. By the time a pancreatic cancer causes these signs or symptoms, it has usually reached an advanced stage. A cancer may also cause symptoms such as fever, fatigue, or weight loss. This may be caused by cancer cells using up much of the body抯 energy supply or releasing substances that change the body抯 metabolism. Or the cancer may cause the immune system to react in ways that produce these symptoms. Sometimes, cancer cells release substances into the bloodstream that cause symptoms not usually thought to result from cancers. For example, some cancers of the pancreas can release substances which cause blood clots to develop in veins of the legs. Some lung cancers make hormone-like substances that affect blood calcium levels, affecting nerves and muscles and causing weakness and dizziness. How Are Signs and Symptoms Helpful? Treatment is most successful when cancer is found as early as possible. Finding cancer early usually means it can be treated while it is still small and is less likely to have spread to other parts of the body. This often means a better chance for a cure, especially if initial treatment is to be surgery. A good example of the importance of detecting cancer early is melanoma skin cancer. It is easily removed if it has not yet grown deeply into the skin, and the 5-year survival rate (percentage of people living at least 5 years after diagnosis) at this stage is nearly 100%. But once melanoma has spread to other parts of the body the survival rate drops dramatically. Sometimes people ignore symptoms either because they do not recognize the symptoms as being significant or because they are frightened by what they might mean and don抰 want to seek medical help. General symptoms, such as fatigue, are more likely to have a cause other than cancer and can seem unimportant, especially if they have an obvious cause or are only temporary. In a similar way, a person may reason that a more specific symptom like a breast mass is probably a cyst that will go away by itself. But neither of these symptoms should be discounted or overlooked, especially if they have been present for a long period of time or are getting worse. Most likely, any symptoms you may have will not be caused by cancer, but it抯 important to have them checked out by your doctor, just in case. If cancer is not the cause, your doctor can help figure out what is and treat it, if needed. In some cases it is possible to detect some cancers before symptoms occur. The American Cancer Society and other health groups encourage the early detection of certain cancers before symptoms occur by recommending a cancer-related checkup and specific tests for people who do not have any symptoms. For more information on early detection tests, see our document, "American Cancer Society Guidelines for the Early Detection of Cancer." Keep in mind, however, that these recommended tests do not diminish the importance of reporting any symptoms to your doctor. General Cancer Signs and Symptoms It is important to know what some of the general (non-specific) signs and symptoms of cancer are. They include unexplained weight loss, fever, fatigue, pain, and changes in the skin. Of course, it抯 important to remember that having any of these does not necessarily mean that cancer is present -- there are many other conditions that can cause these signs and symptoms as well. Unexplained weight loss: Most people with cancer will lose weight at some time with their disease. An unexplained (unintentional) weight loss of 10 pounds or more may be the first sign of cancer, particularly cancers of the pancreas, stomach, esophagus, or lung. Fever: Fever is very common with cancer, but is more often seen in advanced disease. Almost all patients with cancer will have fever at some time, particularly if the cancer or its treatment affects the immune system and reduces resistance to infection. Less often, fever may be an early sign of cancer, such as with leukemia or lymphoma. Fatigue: Fatigue may be a significant symptom as cancer progresses. It may occur early, however, in cancers such as with leukemia or if the cancer is causing a chronic loss of blood, as in some colon or stomach cancers. Pain: Pain may be an early symptom with some cancers, such as bone cancers or testicular cancer. Most often, however, pain is a symptom of advanced disease. Skin changes: In addition to cancers of the skin (see next section), some internal cancers can produce visible skin signs such as darkening (hyperpigmentation), yellowing (jaundice), reddening (erythema), itching, or excessive hair growth.
Jul 31, 2007
Type Of Cancer
The list of common cancer types includes cancers that are diagnosed with the greatest frequency in the United States. Cancer incidence statistics from the American Cancer Society and other resources were used to create the list. To qualify as a common cancer, the estimated annual incidence for 2007 had to be 30,000 cases or more.
The most common type of cancer on the list is non-melanoma skin cancer, with more than 1,000,000 new cases expected in the United States in 2007. Non-melanoma skin cancers represent about half of all cancers diagnosed in this country.
The cancer on the list with the lowest incidence is thyroid cancer. The estimated number of new cases of thyroid cancer for 2007 is 33,550.
Because colon and rectal cancers are often referred to as "colorectal cancers," these two cancer types were combined for the list. For 2007, the estimated number of new cases of colon cancer is 112,340, and the estimated number of new cases of rectal cancer is 41,420.
Kidney cancers can be divided into two major groups, renal parenchyma cancers and renal pelvis cancers. Approximately 85 percent of kidney cancers develop in the renal parenchyma, and nearly all of these cancers are renal cell cancers. The estimated number of new cases of renal cell cancer for 2007 is 43,512.
Leukemia as a cancer type includes acute lymphoblastic (or lymphoid) leukemia, chronic lymphocytic leukemia, acute myeloid leukemia, chronic myelogenous (or myeloid) leukemia, and other forms of leukemia. It is estimated that more than 44,000 new cases of leukemia will be diagnosed in the United States in 2007, with chronic lymphocytic leukemia being the most common type (approximately 15,000 new cases).
The following table gives the estimated numbers of new cases and deaths for each common cancer type:
Cancer Type Estimated New Cases Estimated Deaths
Bladder 67,160 13,750
Breast (Female -- Male) 178,480 -- 2,030 40,460 -- 450
Colon and Rectal (Combined) 153,760 52,180
Endometrial 39,080 7,400
Kidney (Renal Cell) Cancer 43,512 10,957
Leukemia (All) 44,240 21,790
Lung (Including Bronchus) 213,380 160,390
Melanoma 59,940 8,110
Non-Hodgkin's Lymphoma 63,190 18,660
Pancreatic 37,170 33,370
Prostate 218,890 27,050
Skin (Non-melanoma) >1,000,000 <2,000
Thyroid 33,550 1,530
Ovarian Cancer Symptom
INTRODUCTION
Recurrent ovarian cancer and its treatment can cause an array of symptoms and side effects. The challenge for you and your health care team is to proactively prevent, manage, and control the extent to which your quality of life is affected by these side effects. It can be helpful to think about what is important to you in your life as you discuss your treatment goals with your physician. Many women find that the use of conventional medicine combined with emotional support and mind-body practices provides the greatest sense of relief and control in coping with the adverse affects of cancer treatment.
There are several other issues to consider when living with ovarian cancer. Many women desire to “take back” control of their lives after the ovarian cancer diagnosis is made. Some women feel as if control is incrementally removed from the very onset of the disease. By becoming knowledgeable about the disease and treatment options, you can begin to regain control and maintain an active partnership with your health care team. You can also take control by making specific choices about how to care for yourself physically, emotionally, and spiritually throughout treatment and beyond. For example, maintaining wellness through good nutrition is very important. Although treatment may alter your desire for food, alter taste and smell, or cause nausea and vomiting, eating a diet high in protein and carbohydrates is essential to restoring balance and health because of damage caused by the cancer and the treatment.Physical activity is equally important to your physical and emotional well-being. Simple exercise such as walking can increase your appetite and improve your nutritional status, cause improved breathing patterns that aid adequate oxygenation of tissues, and stimulate the release of hormones in the brain that arouse feelings of euphoria (happiness) and reduce distress. Physical exercise does not need to be strenuous to be beneficial. Your health care team can help you design an exercise plan that is appropriate for your situation.
prostate cancer
The prostate (pros-tate) is a gland found only in men. The prostate is about the size of a walnut. It is just below the bladder and in front of the rectum. The tube that carries urine (the urethra) runs through the prostate. The prostate contains cells that make some of the seminal fluid. This fluid protects and nourishes the sperm.
Male hormones cause the prostate gland to develop in the fetus. The prostate keeps on growing as a boy grows to manhood. If male hormone levels are low, the prostate gland will not grow to full size. In older men, though, the part of the prostate around the urethra often keeps on growing. This causes BPH (benign prostatic hyperplasia) which can result in problems with urinating.
Most of the time, prostate cancer grows slowly. Autopsy studies show that many older men who died of other diseases also had prostate cancer that neither they nor their doctor were aware of. But sometimes prostate cancer can grow and spread quickly. Even with the latest methods, it is hard to tell which prostate cancers will grow slowly and which will grow quickly.
Some doctors believe that prostate cancer begins with very small changes in the size and shape of the prostate gland cells. These changes are known as PIN (prostatic intraepithelial neoplasia). These changes can be either low-grade (almost normal) or high-grade (abnormal).
If you have had a prostate biopsy that showed high-grade PIN, there is a greater chance that there are cancer cells in your prostate. For this reason, you will be watched carefully and may need another biopsy.
Introduction to Prostate Cancer Kit
Being diagnosed with prostate cancer can be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the life of the man diagnosed, but also the lives of his family members in significant ways for many years to come.
To help men and women know where to begin, the Prostate Cancer Foundation created an Introduction to Prostate Cancer Kit, which features Conversation Tips, a series of pointers and questions that can be used to start a conversation about prostate cancer. In addition, the Kit includes the An Introduction to Prostate Cancer guide, a list of FAQs About Prostate Cancer, and other materials designed to help both men and women learn about prostate cancer.
Jul 30, 2007
How Cancer Spreads
Basic Information Of Cancer
Cancer is a disease in which abnormal cells in the body grow out of control. Cancers are named after the part of the body where the abnormal cell growth begins. Breast cancers are cancer cells from the breast. When breast cancer cells spread to other parts of the body, they are called metastases.
Common Kinds of Breast Cancer
There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer. Breast cancer can begin in different parts of the breast, like the ducts or the lobes.
Common kinds of breast cancer are
- Ductal carcinoma. The most common kind of breast cancer. It begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.
- Ductal carcinoma in situ (DCIS). The abnormal cancer cells are only in the lining of the milk ducts, and have not spread to other tissues in the breast.
- Invasive ductal carcinoma. The abnormal cancer cells break through the ducts and spread into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body.
- Lobular carcinoma. In this kind of breast cancer, the cancer cells begin in the lobes, or lobules, of the breast. Lobules are the glands that make milk.
- Lobular carcinoma in situ (LCIS). The cancer cells are found only in the breast lobules. Lobular carcinoma in situ, or LCIS, does not spread to other tissues very often.
- Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
Jul 28, 2007
What Causes Adrenal Cancer?
A risk factor is anything that increases a person's chance of getting a disease. Different cancers have different risk factors. Some risk factors, such as smoking, can be controlled. Others, like a person's age or race, can't be changed. But scientists have found few risk factors that make a person more likely to get adrenal cancer. Even if a person does have one or more risk factors for adrenal gland tumors, we can抰 know for sure how large a part they played in causing the cancer.
A family history: Most adrenal cancers are not linked to heredity. But a rare condition called Li-Fraumeni syndrome causes a higher risk of several types of cancer, including adrenal cancer.
Smoking has been suggested as a risk factor by some researchers.
How Many People Get Adrenal Cancer?
What Is Adrenal Cancer
The adrenals are small glands that sit above each of the kidneys. The kidneys are found deep inside the upper part of the abdomen.
The adrenal gland is made up of 2 parts. The outer part, called the cortex, is where adrenal cortical tumors start. The job of the cortex is to make certain hormones for the body. These hormones are called steroids.
The inner portion of the adrenal gland, called the medulla, is really a part of the nervous system. Nervous system hormones are made in the medulla. Tumors of the adrenal medulla are not covered in this article. The information here refers only to tumors of the adrenal cortex.
There are two main types of adrenal cortex tumors.
- benign (not cancerous) tumors, called adenomas
- adrenal cortical carcinoma; these tumors are cancerous
Most tumors of the adrenal cortex are benign adenomas. These are small tumors, usually less than 2 inches (5 centimeters) in diameter. They usually occur in only one adrenal gland, but sometimes are in both glands.
Most people with adenomas have no symptoms. They don?t know they have a tumor unless it is found when tests are being done because of other health problems. Some of these tumors make excess hormones, which may or may not cause symptoms. These symptoms are discussed in the section, "Can Adrenal Cortical Cancer Be Found Early?"
Adenomas can be cured by taking out the adrenal gland that contains the tumor. This operation can be done through a cut (incision) through the front of the belly (abdomen) or the back. It might also be done with laparoscopic surgery. To do this a thin tube with a tiny camera is inserted through a small cut in the patient?s side. Tools used through this small tube allow the surgeon to remove the adrenal gland with the tumor. Some adrenal adenomas can be treated with medicines. This might be a good option for patients with other medical problems who might not be able to withstand surgery. Still other small adenomas that are not causing any symptoms do not need any treatment at all.
The remainder of this document refers to adrenal cancers only, and not to adenomas.
Adrenal cortical carcinomas are usually found because of the symptoms they cause. They may make hormones that cause body changes such as weight gain, fluid build-up, early puberty in children, or excess facial or body hair in women. Some adrenal cancers get very large and cause symptoms by pressing on other organs. This can cause pain, a feeling of fullness, and weight loss because it is hard to eat very much. In most cases, adrenal cortical cancers are much larger than adenomas. If a tumor is larger than about 2 to 2-1/2 inches (5 or 6 centimeters), it is most likely cancer.
Some cancers start in other organs and then spread to the adrenal glands. For example, lung and breast cancers often spread to the adrenals. But these cancers are still named after the place where they started. They are not called adrenal cancers.
What Is Cancer?
Cancer occurs when cells in a part of the body begin to grow out of control. Normal cells divide and grow in an orderly fashion, but cancer cells do not. They continue to grow and crowd out normal cells. Although there are many kinds of cancer, they all have in common this out-of-control growth of cells.
Different kinds of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That抯 why people with cancer need treatment that is aimed at their kind of cancer.
Sometimes cancer cells break away from a tumor and spread to other parts of the body through the blood or lymph system. They can settle in new places and form new tumors. When this happens, it is called metastasis (meh-tas-tuh-sis). Cancer that has spread in this way is called metastatic cancer.
Even when cancer has spread to a new place in the body, it is still named after the part of the body where it started. For example, if prostate cancer spreads to the bones, it is still called prostate cancer. If breast cancer spreads to the lungs, it is still breast cancer. When cancer comes back in a person who appeared to be free of the disease after treatment, it is called a recurrence.