Gastric Cancer

The stomach is part of the digestive system. It is located in the upper abdomen, between the esophagus and the small intestine. Stomach cancer is also called gastric cancer.

Most (85%) cases of gastric cancer are adenocarcinomas that occur in the lining of the stomach (mucosa). Approximately 40% of cases develop in the lower part of the stomach (pylorus); 40% develop in the middle part (body); and 15% develop in the upper part (cardia). In about 10% of cases, cancer develops in more than one part of the organ.

Stomach cancer can spread (metastasize) to the esophagus or the small intestine, and can extend through the stomach wall to nearby lymph nodes and organs (e.g., liver, pancreas, colon). It also can metastasize to other parts of the body (e.g., lungs, ovaries, bones).

Incidence

According to the National Cancer Institute (NCI), approximately 760,000 cases of stomach cancer are diagnosed worldwide and more than 24,000 cases are diagnosed in the United States each year. Incidence is highest in Japan, South America, Eastern Europe, and parts of the Middle East. Worldwide, stomach cancer is the second leading cause of cancer-related deaths.

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Stomach cancer occurs twice as often in men and it is more common in people over the age of 55. In the United States, incidence is higher in African Americans than in Caucasians.
Changes in diet and food preparation have led to a recent decrease in the incidence of cancer of the lower stomach (distal gastric cancer). However, incidence of cancer of the upper stomach (proximal gastric cancer) has increased, primarily as a result of the prevalence of obesity and gastroesophageal reflux disease (GERD).

Stomach Cancer

Stomach cancer often does not have symptoms in the early stages, or they can be vague and non-specific such as nausea or weight loss. Also, there is no single symptom that exactly pinpoints stomach cancer, therefore further evaluation and testing is required for a diagnosis.

Blood in the Stool

Blood in the stool is a symptom of stomach cancer, you can't always actually see blood that may be in the stool. Tests like the fecal occult blood test (FOBT) detect blood in the stool. Blood in the stool can also be related to other types of cancer, like colon cancer. It is also associated with less severe health problems, such as hemorrhoids and anal fissures.

Abdominal Pain and Discomfort

Abdominal pain is one of the most common stomach cancer symptoms and is usually what prompts people to seek medical attention. Abdominal pain can range from persistent mild discomfort to severe pain. Pain and discomfort generally occurs in the upper abdomen area. Persistent abdominal pain, regardless of where it occurs, needs to be evaluated by your doctor.

Peristent Nausea and/or Vomiting

Nausea and vomiting are very non-specific symptoms that can be common among people with stomach cancer. Persistent nausea and/or vomiting needs to be checked by your doctor. It can indicate a serious health problem, and can cause damage to the lining of the esophagus. If you are vomiting blood, it is important to see your doctor right away.

Loss of Appetite

Not feeling like eating for a day or two can be normal, but anything longer should be really be reported to your doctor. Again, loss of appetite is a very vague symptom and is related to many health conditions.

Abdominal Bloating

Abdominal bloating is also a common symptom of stomach cancer, especially after meals. Indigestion and heartburn are also symptoms related to stomach cancer.

Changes in Bowel Habits

Changes in bowels habits related to stomach cancer include constipation and/or diarrhea.

Feeling Excessively Tired

Fatigue that last more than a few days can indicate a medical problem. In relation to stomach cancer, fatigue is often related to anemia, because of blood loss in the stool or from vomiting.

Losing Weight Without Trying

Most of us would welcome weight loss without dieting, but it really is a health concern that needs to be brought to your doctor's attention. If you have lost about 5 percent of your normal body weight in the course of six months or less, and haven't been dieting or exercising, call your doctor. Unintentional weight loss can be the result of many conditions, cancer included.

Stomach Cancer Symptoms

Stomach cancer often does not have symptoms in the early stages, or they can be vague and non-specific such as nausea or weight loss. Also, there is no single symptom that exactly pinpoints stomach cancer, therefore further evaluation and testing is required for a diagnosis.

Blood in the Stool

Blood in the stool is a symptom of stomach cancer, you can't always actually see blood that may be in the stool. Tests like the fecal occult blood test (FOBT) detect blood in the stool. Blood in the stool can also be related to other types of cancer, like colon cancet . It is also associated with less severe health problems, such as hemorrhoids and anal fissures .

Abdominal Pain and Discomfort

Abdominal pain is one of the most common stomach cancer symptoms and is usually what prompts people to seek medical attention. Abdominal pain can range from persistent mild discomfort to severe pain. Pain and discomfort generally occurs in the upper abdomen area. Persistent abdominal pain, regardless of where it occurs, needs to be evaluated by your doctor.

Peristent Nausea and/or Vomiting

Nausea and vomiting are very non-specific symptoms that can be common among people with stomach cancer. Persistent nausea and/or vomiting needs to be checked by your doctor. It can indicate a serious health problem, and can cause damage to the lining of the Esophagus . If you are vomiting blood, it is important to see your doctor right away.

Loss of Appetite:
Not feeling like eating for a day or two can be normal, but anything longer should be really be reported to your doctor. Again, loss of appetite is a very vague symptom and is related to many health conditions.

Abdominal Bloating:

Abdominal bloating is also a common symptom of stomach cancer, especially after meals. Indigestion and Heartburn are also symptoms related to stomach cancer.

Changes in Bowel Habits:

Changes in bowels habits related to stomach cancer include constipation and/or diarrhea.

Feeling Excessively Tired

Fatigue that last more than a few days can indicate a medical problem. In relation to stomach cancer, fatigue is often related to Anemia, because of blood loss in the stool or from vomiting.

Losing Weight Without Trying

Most of us would welcome weight loss without dieting, but it really is a health concern that needs to be brought to your doctor's attention. If you have lost about 5 percent of your normal body weight in the course of six months or less, and haven't been dieting or exercising, call your doctor. Unintentional weight loss can be the result of many conditions, cancer included.

Radiation Therapy

The side effects of radiation therapy depend mainly on the treatment dose and the part of the body that is treated. Common side effects of radiation include dry, reddened skin and hair loss in the treated area, loss of appetite, and extreme tiredness. Some women may have dryness, itching, tightening, and burning in the vagina. Radiation also may cause diarrhea or frequent and uncomfortable urination. It may reduce the number of white blood cells, which help protect the body against infection.

Doctors may advise their patients not to have intercourse during radiation therapy. However, most can resume sexual activity within a few weeks after treatment ends. The doctor or nurse may suggest ways to relieve any vaginal discomfort related to treatment.

Surgery

After a hysterectomy, women usually have some pain and feel extremely tired. Most women return to their normal activities within 4 to 8 weeks after surgery. Some may need more time than that.

Some women may have problems with nausea and vomiting after surgery, and some may have bladder and bowel problems. The doctor may restrict the woman's diet to liquids at first, with a gradual return to solid food.

Women who have had a hysterectomy no longer have menstrual periods and can no longer get pregnant. When the ovaries are removed, menopause occurs at once. Hot flashes and other symptoms of menopause caused by surgery may be more severe than those caused by natural menopause. Hormone replacement therapy is often given to women who have not had uterine cancer to relieve these problems. However, doctors usually do not give the hormone estrogen to women who have had uterine cancer. Because estrogen is a risk factor for this disease (see "Uterine Cancer: Who's at Risk?"), many doctors are concerned that estrogen may cause uterine cancer to return. Other doctors point out that there is no scientific evidence that estrogen increases the risk that cancer will come back. NCI is sponsoring a large research study to learn whether women who have had early stage uterine cancer can take estrogen safely.

For some women, a hysterectomy can affect sexual intimacy. A woman may have feelings of loss that may make intimacy difficult. Sharing these feelings with her partner may be helpful.

Treatment For Uterine Cancer

Women with uterine cancer have many treatment options. Most women with uterine cancer are treated with surgery. Some have radiation therapy. A smaller number of women may be treated with hormonal therapy. Some patients receive a combination of therapies.

Most women with uterine cancer have surgery to remove the uterus (hysterectomy) through an incision in the abdomen. The doctor also removes both fallopian tubes and both ovaries. (This procedure is called a bilateral .

The doctor may also remove the lymph nodes near the tumor to see if they contain cancer. If cancer cells have reached the lymph nodes, it may mean that the disease has spread to other parts of the body. The length of the hospital stay may vary from several days to a week.

In radiation therapy, high-energy rays are used to kill cancer cells. Like surgery, radiation therapy is a local therapy. It affects cancer cells only in the treated area.

Some women with Stage I, II, or III uterine cancer need both radiation therapy and surgery. They may have radiation before surgery to shrink the tumor or after surgery to destroy any cancer cells that remain in the area. Also, the doctor may suggest radiation treatments for the small number of women who cannot have surgery.

Doctors use two types of radiation therapy to treat uterine cancer

External radiation: In external radiation therapy, a large machine outside the body is used to aim radiation at the tumor area. The woman is usually an outpatient in a hospital or clinic and receives external radiation 5 days a week for several weeks. This schedule helps protect healthy cells and tissue by spreading out the total dose of radiation. No radioactive materials are put into the body for external radiation therapy.

Internal radiation: In internal radiation therapy, tiny tubes containing a radioactive substance are inserted through the vagina and left in place for a few days. The woman stays in the hospital during this treatment. To protect others from radiation exposure, the patient may not be able to have visitors or may have visitors only for a short period of time while the implant is in place. Once the implant is removed, the woman has no radioactivity in her body.

Some patients need both external and internal radiation therapies.

Hormonal therapy involves substances that prevent cancer cells from getting or using the hormones they may need to grow. Hormones can attach to hormone receptors, causing changes in uterine tissue. Before therapy begins, the doctor may request a hormone receptor test. This special lab test of uterine tissue helps the doctor learn if estrogen and progesterone receptors are present. If the tissue has receptors, the woman is more likely to respond to hormonal therapy.

Hormonal therapy is called a systemic therapy because it can affect cancer cells throughout the body. Usually, hormonal therapy is a type of progesterone taken as a pill.

The doctor may use hormonal therapy for women with uterine cancer who are unable to have surgery or radiation therapy. Also, the doctor may give hormonal therapy to women with uterine cancer that has spread to the lungs or other distant sites. It is also given to women with uterine cancer that has come back.

Side Effects of Cancer Treatment

Because cancer treatment may damage healthy cells and tissues, unwanted side effects sometimes occur. These side effects depend on many factors, including the type and extent of the treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, doctors and nurses will explain the possible side effects and how they will help you manage them.

Diagnosis

If a woman has symptoms that suggest uterine cancer, her doctor may check general signs of health and may order blood and urine tests. The doctor also may perform one or more of the exams or tests described on the next pages.

Pelvic exam A woman has a pelvic exam to check the vagina, uterus, bladder, and rectum. The doctor feels these organs for any lumps or changes in their shape or size. To see the upper part of the vagina and the cervix, the doctor inserts an instrument called a speculum into the vagina.

Pap test The doctor collects cells from the cervix and upper vagina. A medical laboratory checks for abnormal cells. Although the Pap test can detect cancer of the cervix, cells from inside the uterus usually do not show up on a Pap test. This is why the doctor collects samples of cells from inside the uterus in a procedure called a biopsy.

ultrasound The doctor inserts an instrument into the vagina. The instrument aims high-frequency sound waves at the uterus. The pattern of the echoes they produce creates a picture. If the looks too thick, the doctor can do a biopsy.

Biopsy The doctor removes a sample of tissue from the uterine lining. This usually can be done in the doctor's office. In some cases, however, a woman may need to have a dilation and curettage (D&). A D& is usually done as same-day surgery with anesthesia in a hospital. A pathologist examines the tissue to check for cancer cells and other conditions. For a short time after the biopsy, some women have cramps and vaginal bleeding.

Staging

If uterine cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body.

The doctor may order blood and urine tests and chest x-rays. The woman also may have other x-rays, CT scans, an ultrasound test, magnetic resonance imaging or .

In most cases, the most reliable way to stage this disease is to remove the uterus (hysterectomy). (The description of surgery in the "Methods of Treatment" section has more information.) After the uterus has been removed, the surgeon can look for obvious signs that the cancer has invaded the muscle of the uterus. The surgeon also can check the lymph nodes and other organs in the pelvic area for signs of cancer. A pathologist uses a microscope to examine the uterus and other tissues removed by the surgeon.

These are the main features of each stage of the disease

Stage I -- The cancer is only in the body of the uterus. It is not in the cervix.

Stage II -- The cancer has spread from the body of the uterus to the cervix.

Stage III -- The cancer has spread outside the uterus, but not outside the pelvis (and not to the bladder or rectum). Lymph nodes in the pelvis may contain cancer cells.

Stage IV -- The cancer has spread into the bladder or rectum. Or it has spread beyond the pelvis to other body parts.

Uterine Cancer

No one knows the exact causes of uterine cancer. However, it is clear that this disease is not contagious. No one can "catch" cancer from another person.
Women who get this disease are more likely than other women to have certain risk
factors. They are: Age. Cancer of the uterus occurs mostly in women over age 50.
The risk of uterine cancer is higher if a woman has . This condition and its treatment are described above.

Hormone replacement therapy . is used to control the symptoms of menopause, to prevent osteoporosis (thinning of the bones), and to reduce the risk of heart disease or stroke.

Obesity and related conditions. The body makes some of its estrogen in fatty tissue. That's why obese women are more likely than thin women to have higher levels of estrogen in their bodies. High levels of estrogen may be the reason that obese women have an increased risk of developing uterine cancer. The risk of this disease is also higher in women with diabetes or high blood pressure (conditions that occur in many obese women).

Women taking the drug to prevent or treat breast cancer have an increased risk of uterine cancer. This risk appears to be related to the estrogen-like effect of this drug on the uterus.

Race. White women are more likely than African-American women to get uterine cancer.
Colorectal cancer. Women who have had an inherited form of colorectal cancer have a higher risk of developing uterine cancer than other women.
Other risk factors are related to how long a woman's body is exposed to estrogen. Women who have no children, begin menstruation at a very young age, or enter menopause late in life are exposed to estrogen longer and have a higher risk.

Women with known risk factors and those who are concerned about uterine cancer should ask their doctor about the symptoms to watch for and how often to have checkups. The doctor's advice will be based on the woman's age, medical history, and other factors.

Recognizing Symptoms

Uterine cancer usually occurs after menopause. But it may also occur around the time that menopause begins. Abnormal vaginal bleeding is the most common symptom of uterine cancer. Bleeding may start as a watery, blood-streaked flow that gradually contains more blood. Women should not assume that abnormal vaginal bleeding is part of menopause.

A woman should see her doctor if she has any of the following symptoms:

Unusual vaginal bleeding or discharge

Difficult or painful urination

Pain during intercourse

Pain in the pelvic area

These symptoms can be caused by cancer or other less serious conditions. Most often they are not cancer, but only a doctor can tell for sure.

Uterus Cancer

The uterus is part of a woman's reproductive system. It is the hollow, pear-shaped organ where a baby grows. The uterus is in the pelvis between the bladder and the rectum.
The narrow, lower portion of the uterus is the cervix. The broad, middle part of the uterus is the body, or corpus. The dome-shaped top of the uterus is the . The fallopian tubes extend from either side of the top of the uterus to the ovaries.

In women of childbearing age, the lining of the uterus grows and thickens each month to prepare for pregnancy. If a woman does not become pregnant, the thick, bloody lining flows out of the body through the vagina. This flow is called menstruation.
Understanding Cancer

is a group of many related diseases. All cancers begin in cells, the body's basic unit of life. Cells make up tissues, and tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old and die, new cells take their place.

Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant

Benign tumors are not cancer. Usually, doctors can remove them. Cells from benign tumors do not spread to other parts of the body. In most cases, benign tumors do not come back after they are removed. Most important, benign tumors are rarely a threat to life.

Benign Conditions of the Uterus

Fibroids are common benign tumors that grow in the muscle of the uterus. They occur mainly in women in their forties. Women may have many fibroids at the same time. Fibroids do not develop into cancer. As a woman reaches menopause, fibroids are likely to become smaller, and sometimes they disappear.

Usually, fibroids cause no symptoms and need no treatment. But depending on their size and location, fibroids can cause bleeding, vaginal discharge, and frequent urination. Women with these symptoms should see a doctor. If fibroids cause heavy bleeding, or if they press against nearby organs and cause pain, the doctor may suggest surgery or other treatment.

Endometriosis is another benign condition that affects the uterus. It is most common in women in their thirties and forties, especially in women who have never been pregnant. It occurs when tissue begins to grow on the outside of the uterus and on nearby organs. This condition may cause painful menstrual periods, abnormal vaginal bleeding, and sometimes loss of fertility (ability to get pregnant), but it does not cause cancer. Women with endometriosis may be treated with hormones or surgery.

Is an increase in the number of cells in the lining of the uterus. It is not cancer. Sometimes it develops into cancer. Heavy menstrual periods, bleeding between periods, and bleeding after menopause are common symptoms of . It is most common after age 40.

To prevent from developing into cancer, the doctor may recommend surgery to remove the uterus (hysterectomy) or treatment with hormones (progesterone) and regular exams.

Malignant tumors are cancer. They are generally more serious and may be life threatening. Cancer cells can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or lymphatic system. That is how cancer cells spread from the original (primary) tumor to form new tumors in other organs. The spread of cancer is called metastasis.

When uterine cancer spreads (metastasizes) outside the uterus, cancer cells are often found in nearby lymph nodes, nerves, or blood vessels. If the cancer has reached the lymph nodes, cancer cells may have spread to other lymph nodes and other organs, such as the lungs, liver, and bones.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if cancer of the uterus spreads to the lungs, the cancer cells in the lungs are actually uterine cancer cells. The disease is metastatic uterine cancer, not lung cancer. It is treated as uterine cancer, not lung cancer. Doctors sometimes call the new tumor "distant" disease.

The most common type of cancer of the uterus begins in the lining . It is called cancer, uterine cancer, or cancer of the uterus. In this booklet, we will use the terms uterine cancer or cancer of the uterus to refer to cancer that begins in the .

A different type of cancer, uterine sarcoma, develops in the muscle . Cancer that begins in the cervix is also a different type of cancer.

Breast Cancer

Breast cancer or ‘breast carcinoma’ is the most common form of cancer and the second leading cause of death in women. This occurs when the abnormal cells multiply and go out of control. It begins with the formation of a tumor. If the tumor is malignant, it has the potential to grow and spread or metastasize to different parts of the body through the blood stream or the lymphatic system. In the recent years, the frequency of breast cancer has increased and has become a source of suffering to the persons affected and also their families. Men also can get affected with the breast cancer but the frequency is very less. Breast cancer can be completely cured if detected early, if not it is very difficult to get rid of it completely through treatment. Treatment of breast cancer involves controlling the spread of the disease for years.

Breast cancer can be ‘invasive’ (spreading) or ‘noninvasive’ (do not spread and is confined to the original site). There are different kinds of breast cancer and few of them are discussed below.

• carcinoma in situ : This is noninvasive type of breast cancer and the cancer occurs only in the ducts. If the women are diagnosed in this stage through a mammogram, it can be easily cured.

• Lobular carcinoma in situ : This condition is not a true cancer. It begins in the milk producing glands. Presence of this condition in women increases the risk of getting affected with breast cancer later.

• Invasive (infiltrating) carcinoma : This kind of cancer begins in the milk passage, breaks through the wall of the passage and spreads in the breast tissue. Later the cancer cells spreads to different parts of the body.

• Invasive (infiltrating) lobular carcinoma : This condition begins in the milk lobules and spreads to different parts of the body.

• Inflammatory breast cancer : This is a rare invasive condition where a tumor or lump is not seen, instead the skin of the breast looks red and warm to feel. The skin is thick with pitted appearance and looks like an orange peel. The breast becomes larger, firmer, tender and itchy.

Tongue cancer

The oral cavity and oropharynx contain several types of tissue and each of these tissues contains several types of cells. Different cancers can develop from each kind of cell. The differences are important, because they influence treatment options and outlook for recovery.

More than 90% of cancers of the oral cavity and oropharynx are squamous cell carcinomas, also called squamous cell cancer. Squamous cell cancer begins as a collection of abnormal squamous cells. The earliest form of squamous cell cancer is called carcinoma in situ meaning that the cancer cells are present only in the lining layer of cells called the epithelium. Invasive squamous cells cancer means that the cancer cells have spread beyond this layer into deeper layers of the oral cavity or oropharynx.

Oral cancer represents only about 3% of all cancers. The American Cancer Society estimates that approximately 30,000 new cases of oral cancer are diagnosed annually in the United States with about 20,000 cases occurring in men and 10,000 in women. Although the exact cause of tongue cancer remains unknown, it most often occurs in people who use tobacco products (cigarettes, cigars, pipes, and smokeless tobacco).

Treatments for tongue cancer are based on the stage (extent of spread) of the disease and may involve radiation therapy, chemotherapy, and surgery. These treatments may be used in combination. A speech therapist will usually be involved in helping patients improve speech function and swallowing capabilities following surgical or radiation treatments. A nutritionist can also be very helpful to ensure optimal nutritional and caloric intake that is vital to recovery from cancer and maintain overall good health.

How is breast cancer diagnosed and staged

Once a patient has symptoms suggestive of a breast cancer or an abnormal screening mammogram, she will usually be referred for a diagnostic mammogram. A diagnostic mammogram is another set of x-rays with additional angles and close-up views. Often, and ultrasound will be performed during the same session. An ultrasound uses high-frequency sound waves to outline the suspicious areas of the breast. It is painless and can often distinguish between benign and malignant lesions.
Depending on the results of the mammograms and/or ultrasounds, your doctors may recommend that you get a biopsy. A biopsy is the only way to know for sure if you have cancer, because it allows your doctors to get cells that can be examined under a microscope. There are different types of biopsies; they differ on how much tissue is removed. Some biopsies use a very fine needle, while others use thicker needles or even require a small surgical procedure to remove more tissue. Your team of doctors will decide which type of biopsy you need depending on your particular breast mass.
Once the tissue is removed, a doctor known as a pathologist will review the specimen. The pathologist can tell if is the cells are cancerous or not, If the tumor does represent cancer, the pathologist will characterize it by what type of tissue it arose from, how abnormal it looks (known as the grade), whether or not it is invading surrounding tissues, and whether or not the entire lump was removed during surgery. The pathologist will also test the cancer cells for the presence of estrogen and progesterone receptors as well as a receptor known as HER-2/neu. The presence of estrogen and progesterone receptors is important because cancers that have those receptors can be treated with hormonal therapies. HER-2/neu expression may also help predict outcome. There are also some therapies directed specifically at tumors dependent on the presence of HER-2/nue. See Understanding Your Pathology Report for more information.
In order to guide treatment and offer some insight into prognosis, breast cancer is staged into five different groups. This staging is done in a limited fashion before surgery taking into account the size of the tumor on mammogram and any evidence of spread to other organs that is picked up with other imaging modalities; and it is done definitively after a surgical procedure that removes lymph nodes and allows a pathologist to examine them for signs of cancer. The staging system is somewhat complex, but here is a simplified version of it:
Stage 0 (called carcinoma in situ)
Lobular carcinoma in situ (LCIS) refers to abnormal cells lining a gland in the breast. This is a risk factor for the future development of cancer, but this is not felt to represent a cancer itself.
Ductal carcinoma in situ (DCIS) refers to abnormal cells lining a duct. Women with DCIS have an increased risk of getting invasive breast cancer in that breast. Treatment options are similar to patients with Stage I breast cancers.
Stage I : early stage breast cancer where the tumor is less that 2 cm, and hasn't spread beyond the breast
Stage II : early stage breast cancer in which the tumor is either less than 2 cm across and has spread to the lymph nodes under the arm; or the tumor is between 2 and 5 cm (with or without spread to the lymph nodes under the arm); or the tumor is greater than 5 cm and hasn't spread outside the breast
Stage III : locally advanced breast cancer in which the tumor is greater than 5 cm across and has spread to the lymph nodes under the arm; or the cancer is extensive in the underarm lymph nodes; or the cancer has spread to lymph nodes near the breastbone or to other tissues near the breast
Stage IV : metastatic breast cancer in which the cancer has spread outside the breast to other organs in the body
Depending on the stage of your cancer, your doctor may want additional tests to see if you have metastatic disease. If you have a stage III cancer, you will probably get a chest x-ray, CT scan and bone scan to look for metastases. Each patient is an individual and your doctors will decide what is necessary to adequately stage your cancer.

What is bladder cancer

What is the Bladder

The bladder serves as a reservoir for urine in our bodies. It permits the storage of urine for a period of time before releasing it when we urinate. It can be thought of as a muscular balloon, it is a flat structure when there is no urine (immediately after a person urinates), but is able to fill up to a liter or so of urine when needed (though this would be very uncomfortable ). Normally, as the bladder nears 500 cc (1 / 2 of a liter), we feel the urge to urinate. The muscular structure of the bladder also helps other Pelvic muscles push the urine out when it is released. The bladder is located deep in the pelvis, just above the pubic symphysis, which is a bone that can be felt in the midline on the front of the pelvis. In fact, when the bladder is over distended, it can be felt by a physician. Ureters empty urine into the bladder from the Kidneys, and the urethra leads out from the bladder, emptying urine out of our bodies.

What is bladder cancer

A tumor is a mass of abnormally growing cells. Tumors can be either Benign or Malignant. Benign tumors may grow in an uncontrolled way, but without any invasion into normal tissues and without any risk of spreading to distant parts of the body. Malignant tumors are (or cancer) when cells gain the propensity to invade tissues and spread locally as well as to distant parts of the body. In this sense, bladder cancer occurs when cells in the lining of the bladder grow uncontrollably and form tumors that can invade normal tissues and spread to other parts of the body.

Cancers are described by the types of cells from which they arise. Bladder cancers arise almost exclusively from the lining of the bladder. In the United States, 98% of bladder cancers are called transitional cell carcinomen. This simply means that the cancer started in the lining of the bladder, which is made up of transitional cells that appear elliptical under the microscope. Less commonly, other types of cancers can arise from the lining of the bladder, called adenocarcinomas, squamous cell and small cell carcinomen carcinomen.

Commonly, bladder cancers grow in a "papillary" growth pattern. When a bladder cancer grows this way, it can be noninvasive, ie, Invading into tissues not at all, and hence not having a risk for distant spread (as long as it is treated). In addition to other invasive cancers, patients are sometimes diagnosed with precancerous lesions, called carcinoma-in-situ. Carcinoma-in-situ occurs when the lining of the bladder undergoes changes similar to cancerous changes without any invasion into the deeper tissues. Hence, while the cells themselves have cancer-like qualities, there is no risk of spread, as no invasion has occurred. However, both papillary bladder cancers and cancer-in-situ may become invasive, so treatment is very important.

risk for bladder cancer

Bladder cancer is the fourth most common cancer in men and the eighth most common cancer in women. Over 50,000 cases are diagnosed every year in the United States, with over 12.000 deaths. Internationally, the incidence of transitional cell bladder cancer varies substantially, with highest rates in Europe and North America. In Northern Africa, where infection with a type of parasite called Schistosoma haematobium is common squamous cell carcinomen of the bladder are more common. Classically, in the U.S., bladder cancer is thought of as a disease that affects older men, with men more affected than women by a 3:1 ratio and 2 / 3 of the cases diagnosed in people over the age of 65.

Cigarette smoking is the largest risk factor for bladder cancer (yet another reason to stop smoking). Smokers have 2-4 times the risk of having bladder cancer, and it contributes to up to 50% of all bladder cancers that are diagnosed. Chronic bladder irritation, either from stones or long-term catheter use, may increase risk of bladder cancer. Occupational exposures, such as polychromatic hydrocarbons (benzene, benzidine), can increase risk of bladder cancer. Recently, an association has been made between chlorinated drinking water and bladder cancer. Though there have been suggestions of Saccharin and high intake of dietary fat and cholesterol being causative for bladder cancer, these have yet to be substantiated.

What is anal cancer

What is the anus

The anus is an organ that lies at the end of the digestive tract below the rectum. It consists of two sections: the anal canal and the anus (or anal verge). The anal canal is a 3-4 cm long structure that lies between the anal sphincter (one of the muscles controlling bowel movements) just below the rectum and the anal verge which represents the transition point between the digestive tract and the skin on the outside of the body. Muscles within the anal canal and anus control the passage of stool from the rectum to outside the body.

What is anal cancer

Normally, cells in the body will grow and divide to replace old or damaged cells in the body. This growth is highly regulated, and once enough cells are produced to replace the old ones, normal cells stop dividing. Tumors occur when there is an error in this regulation and cells continue to grow in an uncontrolled way. Tumors can either be benign or malignant. Although benign tumors may grow in an uncontrolled fashion sometimes, they do not spread beyond the part of the body where they started (metastasize) and do not invade into surrounding tissues. Malignant tumors, however, will grow in such a way that they invade and damage other tissues around them. They also may spread to other parts of the body, usually through the blood stream or through the lymphatic system where the lymph nodes are located. Over time, the cells within a malignant tumor become more abnormal and appear less like normal cells. This change in the appearance of cancer cells is called the tumor grade, and cancer cells are described as being well-differentiated, moderately-differentiated, poorly-differentiated, or undifferentiated. Well-differentiated cells are quite normal appearing and resemble the normal cells from which they originated. Undifferentiated cells are cells that have become so abnormal that often we cannot tell what types of cells they started from.

Anal cancer is a malignant tumor of either the anal canal or anal verge. In the United States, 80% of anal cancers are squamous cell cancers,, resembling the cells found in the anal canal., This is not true in other parts of the world, however. In Japan, 80% of anal cancers are adenocarcinomas, resembling the glandular cells seen in the rectum. Cancers of the anal verge may be referred to as “perianal skin cancers,” because they usually behave more like skin cancers than like anal cancers. They may respond more poorly to treatment than other forms of anal cancers. Perianal skin cancers represent about 25% of all anal cancers. Occasionally, other types of cancer, such as melanoma, Kaposi’s sarcoma, and lymphoma may develop in the anus. These other types of cancer will be discussed separately, and will not be addressed further in this review.

Anal cancers frequently begin as anal dysplasia. Anal dysplasia is made up of cells of the anus that have abnormal changes, but do not show evidence of invasion into the surrounding tissue. The most severe form of anal dysplasia is called carcinoma in situ. In the case of carcinoma in situ, cells have become cancerous, but have not begun to invade normal tissue yet. Over time, anal dysplasia changes to the point where cells become invasive and gain the ability to metastasize, or break way to other parts of the body. Anal dysplasia is sometimes referred to as anal intraepithelial neoplasia (AIN), or a “pre-cancer”. When anal cancer does spread, it most commonly spreads through direct invasion into the surrounding tissue or through the lymphatic system. Spread of anal cancer through the blood is less common, although it can occur.