Month: November 2022

What are the symptoms of Non-Hodgkin’s lymphoma?

Posted on by Julie Scott, DNP

What is Non-Hodgkin’s lymphoma?

Non-Hodgkin’s lymphoma is a type of cancer of the lymphocytes, a type of white blood cell of the body’s immune system. When these cells become abnormal, they grow uncontrollably and become cancerous. The growth of non-Hodgkin’s lymphoma can start anywhere these lymphocytes are, including the lymph nodes, spleen, and bone marrow.

Some cancers have screening tests available to help look for cancer development early before cancer starts causing any symptoms. Non-Hodgkin’s lymphoma has no screening tests available and is discovered when evaluating the cause of symptoms.

Risk factors for Non-Hodgkin’s Lymphoma

Some of the risk factors for developing non-Hodgkin’s lymphoma can include:

● Increasing age

● Family history of non-Hodgkin’s lymphoma

● Exposure to chemicals such as benzine or pesticides

● History of radiation exposure

● Having a history of autoimmune disorders

● History of HIV infection

 

Symptoms of Non-Hodgkin’s lymphoma

Symptoms of non-Hodgkin’s lymphoma can include:

● Fevers, chills, night sweats

● Unintentional weight loss

● Appetite changes

● Enlarged lymph nodes

● Bleeding or easy bruising

● Frequent infections

● Abdominal pain

● Difficulty breathing

Tests for Non-Hodgkin’s lymphoma

If you present to your healthcare provider for any of the above symptoms, they will likely start with a physical examination and evaluation of your history. They will pay particular attention to any lymph nodes that can be felt and examine the abdomen to see if the spleen is enlarged. Blood work may also be done to evaluate the blood count and see how many white blood cells, red blood cells, and platelets are present. Other blood tests may also be done to check for infection, inflammation, or other disorders.

Imaging studies such as a CT scan, ultrasound, or PET scan may be ordered to get a better picture of any enlarged lymph nodes in the body and to see if they look suspicious for lymphoma involvement.

The ultimate diagnosis of non-Hodgkin’s lymphoma is made after a biopsy. If a lymph node is felt from the outside or a lymph node found on imaging studies that are easy to access for a biopsy, this will likely be done.

Either a sample of tissue from the lymph node can be removed through a needle aspiration, or the entire lymph node can be removed and tested for the presence of lymphoma.

Non-Hodgkin lymphoma is the seventh most common cancer in the United States. The best way to screen for this type of cancer is through a physical examination and blood tests. However, there are other ways to screen for this type of cancer, including imaging tests and biopsies. If you have any symptoms that concern you, please see your doctor immediately. Early detection is key to the successful treatment of this disease.

Increasing awareness of the importance of screening for Non-Hodgkin lymphoma can save lives.

The Benefit of Routine Bladder Cancer Screenings

Posted on by Julie Scott, DNP

What is Bladder Cancer?

Bladder cancer is a disease in which abnormal cells begin to grow in the cells that line the bladder. Screening tests are done to look for cancer when there are no signs or symptoms. Currently, there is no screening test available for bladder cancer. However, the symptoms of bladder cancer will be reviewed, and some tests might be ordered if bladder cancer is suspected.

Bladder cancer risk factors

The risk factors for the development of bladder cancer can include the following:

● Smoking cigarettes

● Exposure to certain chemicals, including those used in the businesses of making leather, paint products, and rubber

● Exposure to arsenic

● White race

● Male sex

● History of chronic urinary tract infections

● Family history of bladder cancer

● History of radiation to the pelvic area

● Long-term use of urinary catheters

 

Bladder cancer symptoms

The symptoms of bladder cancer include:

● Blood in the urine

● Frequent urination

● Pain with urination

● Unable to urinate

● Lower back pain

● Feeling very fatigued

● Weight loss and loss of appetite

 

If your healthcare provider is suspicious of bladder cancer or is ordering tests to evaluate any symptoms that are being experienced, the following are some tests they may order.

Urine tests can be done to look for the presence of blood or other abnormalities in the urine. A urine cytology test can be done to see if any cancer cells are present. A urine culture can be done to see if any bacteria are growing.

A cystoscopy can be done if bladder cancer is suspected. During this procedure, a thin camera is placed into the bladder through the urethra, the opening to the outside of the body through which urine passes. The urologist can look at the wall of the bladder to see if any cancer is present. If there are any suspicious areas, a biopsy can be taken to test for cancer cells.

Other imaging tests may also be done, most likely after the diagnosis of bladder cancer and the healthcare provider is looking for signs of cancer has spread to other areas of the body. These tests can include CT scans, MRIs, or ultrasounds.

It is important to be aware of the risk factors and symptoms associated with bladder cancer, as well as available screening options. Early detection is key to successful treatment, so please talk to your doctor if you have any concerns.

Together, we can help make a difference in the fight against bladder cancer.

The importance of regular melanoma screenings

Posted on by Julie Scott, DNP

What is Melanoma or Skin Cancer?

Melanoma is a cancer of melanocytes, the cells in the skin that give the skin color. When melanocytes become abnormal and start to grow uncontrollably, melanoma develops. There are no specific screening tests for melanoma other than a visual skin check.

These skin checks can include a self-skin check and one done by a dermatologist.

Self-skin check

When performing a self-skin check, it’s important to remember that melanomas can grow on any part of the body, so checking out all areas of the skin is important. The skin check should be done in a well-lit room with a full-length mirror. Having a hand mirror available is helpful as well. Some steps for the self-skin check include:

● Start with a look at the entire front of the body, then the back.

● Raise up each arm and look there as well as each side of your body

● Look in detail at each arm, both front and back, starting at the fingers, looking in between them and up the forearms to the upper arms.

● Examine the legs well, starting at the toes and working up. Don’t forget to look in between the toes as well.

● Use a hand mirror to check your back well.

● Also use a hand mirror to evaluate the skin on the genitals.

● Look at the inside of your mouth, including inside the cheeks and under the tongue.

● Note any areas that may have changed or look different. Take a picture.

Self-skin checks should be done once a month.

 

Dermatologist skin check

If there are any areas on your skin that you think have changed or look suspicious, contact your dermatologist for a skin check. The dermatologist will be able to get a better look at your skin with a special tool to help magnify the skin and look for any suspicious changes. If there is something they find to be worrisome, they can perform a skin biopsy and test the cells for cancer.

 

ABCDEs of melanoma

The ABCDE of melanoma describes the various changes that can be present in a skin lesion that signal the possibility of melanoma.

A: Asymmetry. Each half of the lesion doesn’t match in shape.

B: Borders: The edges of the lesion are not smooth; they can be blurred or uneven.

C: Color: Multiple colors are present or may become a different color.

D: Diameter: Lesion is growing or is at least 6mm wide.

E: Evolving: The lesion has changed, in either size, color, or shape, and may itch or bleed

 

There are many ways to prevent melanoma; the best way is through early detection. Self-check skin cancer examinations should be done every month, and any changes in moles or new growths should be promptly checked out by a dermatologist. In addition to self-checks, regular screenings by a physician can play an important role in the early detection of melanoma.UV exposure is the main cause of melanoma, so protecting your skin from harmful sun rays is important. Wearing sunscreen, covering up with clothing when outdoors, and avoiding peak UV hours can help reduce your risk of developing this disease.

By increasing awareness of the importance of early detection and taking preventive measures against UV exposure, we can work together to help fight melanoma.

What you need to know about colon cancer screenings

Posted on by Julie Scott, DNP

What is Colorectal Cancer?

Colorectal cancer is a disease of abnormal cells developing in the digestive organs of the intestines or rectum. When abnormal cells develop in either the colon or rectum, cancer starts. Colorectal cancer most often starts growing in polyps, which can be precancerous lesions in the colon.

Screening tests for colorectal cancer are meant to catch the cancer (if present) at an early stage before it’s causing any symptoms. Per the U.S. Preventive Services Task Force, colon cancer screening is recommended for those aged 45 to 75. Those who are aged 76 to 85 should have a conversation with their healthcare provider about the need to continue screening.

Multiple screening options exist for colorectal cancer.

These include:

● Stool tests

● Flexible sigmoidoscopy

● Colonoscopy

● CT colonography

 

Stool tests

There are tests that can be run on samples of stool. The sample is generally collected at home and returned to a lab for testing. One test, called a fecal occult blood test, looks for the presence of blood in the stool that isn’t visible to the naked eye.

Another stool test is called a FIT-DNA test. FIT stands for fecal immunochemical test, which looks for blood in the stool. It is combined with a DNA test that looks for the presence of any DNA changes which might suggest the presence of cancer.

Flexible sigmoidoscopy

A flexible sigmoidoscopy is a test in which a flexible camera is inserted into the rectum. This looks for the presence of cancer cells in the rectum and lower third of the colon. This test does not evaluate the entire colon.

Colonoscopy

A colonoscopy is a test which looks at the rectum and the entire colon. It can be done as a screening test itself or is done if any of the other screening tests are positive and there is a need for further evaluation. In the day or two before a colonoscopy, laxative medications will be taken to help induce frequent bowel movements to clean out the colon so the gastroenterologist will be able to see the colon well. The procedure is done with sedation so you’re not awake during the procedure.

If there are any suspicious areas in the colon, such as polyps, they can be removed during the colonoscopy and tested to see if cancer cells are present.

CT colonography

This exam, sometimes referred to as a virtual colonoscopy, it is performed using a CT (computed tomography) scan. Using a CT machine, pictures are taken of the colon and images are reconstructed to look for any suspicious areas. This type of test may be best for people who are at risk for complications of anesthesia needed for standard colonoscopy.

 

Early detection is key in colon cancer, and screening is the best way to achieve that. Screening tests can find precancerous polyps so they can be removed before becoming cancer. They can also find colon cancer early when it is easier to treat. The bottom line is this: if you are 50 years old or older, you should get screened for colon cancer.

Speak with your doctor about which test is right for you, and get screened regularly. It could save your life.

Importance of Prostate Cancer Screenings

Posted on by Julie Scott, DNP

What is a Prostate gland?

The prostate is a gland which is part of the male reproductive system. Its job is to produce fluid that is part of the semen. When cells in the prostate begin to grow out of control, cancer develops. The risk for developing prostate cancer increases as men age. To screen for prostate cancer, a blood test called a PSA (prostate specific antigen), and a digital rectal examination may be done.

 

Who should be screened?

According to the U.S. Preventive Services Task Force (USPSTF), the group who provides guidelines for health screening services in the U.S., suggest the following for prostate cancer screening:

● Men aged 55-69 years old should make an individual decision about getting PSA screening. They should have this conversation with their healthcare team about the risks and benefits of screening

● Men over the age of 70 should not be routinely screened

 

The potential risks of screening include getting a false-positive result, which would then lead to unnecessary tests such as imaging studies and biopsies. For some men, screening will find prostate cancer that would otherwise not have caused them any significant health problems. This could then lead to treatment of their cancer that puts them at risk of developing side effects.

Screening Guidelines.

The American Cancer Society suggests a variation to the USPSTF guidelines above. They suggest that the discussion of screening should be held at the following times:

● Age 40 for those at highest risk, meaning men with more than one first-degree relative with prostate cancer diagnosed at an early age (younger than age 65)

● Age 45 for men at high risk, those who are African American men, and those with a first degree relative who have been diagnosed with prostate cancer younger than age 65

● Age 50 for men at average risk and who are expected to live at least 10 more

 

In conclusion, prostate cancer is a serious disease that affects many men. However, there are ways to reduce your risk of developing prostate cancer, including getting screened regularly. You should talk to your doctor about whether or not you should be getting screened for prostate cancer based on your personal risk factors.

Increasing awareness of the importance of early detection and screening can help save the lives of those affected by prostate cancer.

What are the benefits of lung cancer screening?

Posted on by Julie Scott, DNP

Lung Cancer

Lung cancer is a type of cancer that affects the lungs. Cancer most often starts in the cells of the lining of the airways in the lungs. When these cells become abnormal, they grow uncontrollably, and cancer develops. There are two main types of lung cancer- non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

Lung cancer screening

Screening tests are done when someone does not have any symptoms of the disease but are looking for it before it becomes symptomatic. There is currently only one screening test in use for lung cancer screening, which is the low dose computed tomography (CT) scan.

Who should be screened?

Lung cancer screening is not recommended for everyone. Those who are at highest risk of developing lung cancer are recommended for screening. This group includes adults aged 50 to 80 years old, who have a 20 pack-year smoking history, and who currently smoke or have quit smoking in the last 15 years.

A pack-year history is a measure of how much someone has smoked over a specific time period. It is calculated by multiplying the number of years someone has smoked by the average number of packs of cigarettes smoked per day.

Screening is recommended to be done once a year. Once someone has quit smoking for at least 15 years or has developed another health condition that is limiting their life expectancy, screening can be discontinued.

Low-dose CT scan

The screening test used for lung cancer is the low-dose CT scan. There is no pain with this exam, and it only takes a few minutes. During this test, you lie on a table of a CT machine, which is an open, donut-shaped x-ray machine. The table will move you through the machine while low amounts of radiation are used to take pictures of your lungs.

The radiologist will then evaluate the scan, looking for any nodules or areas that look suspicious for lung cancer. Based on the results of the CT, further instructions will be given.

Despite the high rates of lung cancer incidence and mortality, many people are unaware of the symptoms of lung cancer or that it is possible to detect the disease early through screening.  It is important to raise awareness of both the risks and benefits of screening so that people can make informed decisions about whether or not to be screened.

Are you aware of your risk factors for lung cancer?  Have you discussed Screening with your doctor?

Breast cancer systemic treatment

Posted on by Julie Scott, DNP

The exact treatment prescribed for you will be based on the stage and characteristics of your breast cancer. It’s important to talk to your oncology team if you have any specific questions about your particular treatment. 

Treatment is often classified into local therapy or systemic therapy. Local therapy means that it only treats the breast, and not any other parts of the body. Systemic therapy is treatment that goes around your entire body, treating cancer cells that may be present outside of the breast. A combination of local and systemic therapy may be given for breast cancer. 

This article will focus on the systemic therapy options for breast cancer – chemotherapy, hormone therapy, and HER2 therapy. 

Chemotherapy

Chemotherapy is medication that is used to stop the division of cells, causing cell death. Because cancer cells are abnormal and usually grow out of control, they are killed by chemotherapy. Unfortunately, chemotherapy can cause side effects because healthy cells are affected as well. 

Chemotherapy can be given before surgery (called neoadjuvant chemo) or after surgery (adjuvant chemo). 

Some examples of chemotherapy used to treat breast cancer include:

  • Anthracyclines (Adriamycin)
  • Taxanes (Taxol, Taxotere)
  • Carboplatin
  • Cyclophosphamide

The specific side effects of chemotherapy can differ for each medication, as well as the dose that is given. 

Hormone Therapy

When breast cancer is ER+ and/or PR+, hormonal, or endocrine, therapy is given to prevent the growth of breast cancer cells. Some of these medications work by blocking the hormone receptors, while others work at decreasing levels of estrogen in the body. These medications are usually given for years to reduce the risk of breast cancer coming back. Some examples of hormone therapy include:

  • Tamoxifen
  • Aromatase inhibitors (Femara, Arimidex, Aromasin)
  • Faslodex
  • Zoladex
  • Lupron

Side effects can differ for each medication, but are generally related to low levels of estrogen (ex: hot flashes, vaginal dryness, decreased bone density).

HER2 Therapy

If breast cancer is HER2+, systemic therapy to target the HER2 receptors specifically is given to treat the breast cancer. These are usually used in combination with chemotherapy, and multiple HER2 medications may be used together. Some examples of HER2 targeted therapy used for early stage breast cancer include Herceptin and Perjeta. 

Breast cancer local treatment

Posted on by Julie Scott, DNP

The exact treatment prescribed for you will be based on the stage and characteristics of your breast cancer. It’s important to talk to your oncology team if you have any specific questions about your particular treatment. 

Treatment is often classified into local therapy or systemic therapy. Local therapy means that it only treats the breast, and not any other parts of the body. Systemic therapy is treatment that goes around your entire body, treating cancer cells that may be present outside of the breast. A combination of local and systemic therapy may be given for breast cancer. 

This article will focus on the local therapy options for breast cancer – surgery and radiation. 

Surgery

Surgery is often used in early stage breast cancer. Surgery can involve removing only the area of cancer along with a small area of healthy tissue around it (called a lumpectomy or partial mastectomy) or the removal of the entire breast (called a mastectomy). 

Nearby lymph nodes may also be removed during surgery as well. The two types of these are called a sentinel lymph node (SLN) biopsy, and an axillary lymph node dissection. During a SLN biopsy, the first lymph node leaving the breast is identified by using a special dye. It’s then removed and checked for cancer cells. During an axillary lymph node dissection, many lymph nodes are removed from under the armpit of the side of the body where the breast cancer originated. 

When you consult with a surgeon, they will review your records, likely do a physical exam, and talk with you about the best surgical option. 

Radiation

Radiation therapy uses high energy beams of radiation to treat the entire breast and kill any remaining breast cancer cells. This is often done after a breast biopsy or a lumpectomy. The radiation will most likely be given Monday through Friday for a period of about 6 weeks. Each treatment takes only a few minutes. This type of radiation is called external beam radiation. 

There are some other forms of radiation, called brachytherapy, where seeds of radiation are placed within the cavity of the breast left by surgery. This can treat the area locally and help reduce the risk of recurrence. Sometimes it can even be given during surgery. Brachytherapy is not used as often as external beam radiation. 

Are you interested in learning more about Breast Cancer systemic treatments? Check out our next article on this topic.

Characteristics of breast cancer

Posted on by Julie Scott, DNP

Characteristics of breast cancer

When a biopsy is done, and cancer has been confirmed, there are additional things the oncologist needs to know about the cancer. 

Hormone receptor status: This determines if the cancer cells use either estrogen or progesterone (or both) to grow. If there are estrogen receptors on the cancer cells, it is called ER+, and for progesterone, PR+. If there aren’t any, then it is referred to as ER- and PR-. 

HER2 status: The HER2 protein can be used by some cancer cells to grow quickly. If there are high levels of HER2 on the cancer cells, it is called HER2+ breast cancer. If little or no HER2 receptors are seen, then it is HER2-. 

Breast cancer can be described as triple positive (ER+, HR+, HER2+), triple negative (ER-, PR-, HER2-), or can be a combination of positivity or negativity of any of them. 

Ductal vs lobular: This describes the area of the breast where the cancer cells originated, either the milk ducts or the lobules of the breast. 

Additionally, other characteristics such as how quickly the cancer cells are dividing, and how similar (or not) they look to normal cells, helps round out all of the information the oncologist needs to develop the correct treatment plan for each person with breast cancer. 

Are you interested in learning more about Breast Cancer local treatments? Check out our next article on this topic.

 

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