Month: November 2022

The advances in melanoma staging and treatment

Posted on by Julie Scott, DNP

Melanoma Staging

Once a diagnosis of melanoma has been made, the oncologist may order imaging studies to see if melanoma has spread to other areas of the body. Melanoma is staged from stage 0 to IV, with melanoma becoming more advanced the higher the stage. 

When the biopsy has resulted with melanoma, and staging studies have been completed, the oncologist can develop a treatment plan. 

Melanoma Treatment

Surgery is often used as a treatment for melanoma, with the type of surgery being a wide local excision (WLE). During this type of surgery, the entire melanoma lesion along with a wide amount of healthy tissue surrounding it is taken out, to be sure the entire melanoma has been removed. The full amount of tissue that needs to be removed depends upon the size and thickness of the melanoma lesion. 

Along with a WLE, a sentinel lymph node biopsy is often done. This surgery identifies the first lymph node closest to the melanoma using a special dye. This helps the surgeon identify it and remove the lymph node for evaluation of the presence of cancer cells. 

In addition to surgery, other treatments may be recommended based on the stage of the cancer. A commonly used treatment is immunotherapy. Immunotherapy medications are usually intravenous medications that work by helping the immune system see any melanoma cells in the body. This allows the immune system to help fight against melanoma. Examples of immunotherapy include:

  • Yervoy
  • Opdivo
  • Keytruda

Targeted treatment

Targeted treatment for BRAF mutations is available as well. Some people may benefit from the use of these after surgery, to help reduce the risk of melanoma returning. These medications work by interfering with the BRAF pathway melanoma cells use to grow. Examples of BRAF targeted therapy include a medication called dabrafenib. 

Early stage melanoma and Standard chemotherapy

Standard chemotherapy and radiation are rarely used for early stage melanoma. 

 

Melanoma

Posted on by Julie Scott, DNP

What is Melanoma?

Melanoma is a cancer of the melanocytes, the pigment producing cells in the skin. Melanocytes can also be found in other areas outside of the skin, such as the eyes, genitals, and mouth, but melanoma most commonly develops in the skin. 

Risk Factors

The rates of melanoma have been steadily increasing over the years, and it is important to know the risk factors of developing melanoma, which include:

  • History of UV light exposure (tanning beds, sunburns)
  • Having light colored skin and freckles
  • Having moles
  • Family history of melanoma
  • Being biologically male
  • Increasing age

Signs and symptoms

A new mole on the skin or a change in an existing mole should be evaluated. The ABCDEs of moles should be used:

  • A: Asymmetry: the mole size is irregular and each sides of the mole don’t match
  • B: Borders: the borders are irregular or blurred
  • C: Color: the color of the mole is not the same throughout or is changing to different shades
  • D: Diameter: the mole is >6mm
  • E: Evolving: the mole’s shape, size, or color is changing

Diagnosis

If someone has a suspicious skin lesion, they may be recommended to undergo a biopsy. This is the only way to tell if a skin lesion is melanoma or not. A biopsy can be done one of a few ways, either a shave biopsy, punch biopsy, or excisional biopsy. 

A shave biopsy removes the top surface of the skin lesion to be tested for cancer cells. If a melanoma is suspected, this may not be the biopsy that’s ordered, as it may not get the full lesion for evaluation. 

A punch biopsy uses a special tool to get a biopsy and getting into a deeper layer of the skin. This also may not remove the entire lesion, but may be better able to get through to the deeper layers for a more complete evaluation. 

An excisional biopsy removes the suspicious lesion as well as an area of healthy tissue around it for testing. If this shows that the entire melanoma has been removed, it may be a curative procedure. 

When melanoma has been identified from a biopsy, additional testing is often done to learn some of the characteristics of it, such as for the presence of any gene mutations that the cancer may have. One in particular is called BRAF. This gene is seen in about 50% of all melanomas, and if it’s present, may be treated with targeted medications for that gene mutation. 

 

Interested in learning more about Melanoma staging and Treatments? Check out our next article on this topic.

 

Prostate cancer: who is at risk and how to catch it early

Posted on by Julie Scott, DNP

What is Prostate cancer?

Prostate cancer is common cancer in men. About 13% of men will be diagnosed with prostate cancer during their lifetime. It’s important to know that prostate cancer is very treatable, even in its advanced stages. 

Risk Factors

The biggest risk factor men face for prostate cancer is age. It’s rarely diagnosed in men under 40, with the average age at diagnosis of 66 years. In addition to age, other risk factors for developing prostate cancer include being of African American or Caribbean ancestry and having a father or brother who has had prostate cancer. 

Diagnosis

The prostate-specific antigen (PSA) is a simple blood test that can be done to help detect prostate cancer at an early stage. There is not one specific level that officially diagnoses prostate cancer. Still, it can be followed as a trend over time, with an increasing PSA being more likely to be caused by prostate cancer. 

PSA can fluctuate over time and can be elevated due to factors unrelated to prostate cancer. If a man is suspected of having prostate cancer, another testing will need to be done. 

A prostate biopsy will ultimately need to be done to diagnose someone with the disease. There are multiple ways the biopsy can be done, but typically biopsies are taken from multiple areas of the prostate for evaluation. 

Imaging tests such as ultrasound, MRI, CT scan, and PET scan can be done to assess the extent of the disease and provide staging information to see if the cancer is only in the prostate or has spread into lymph nodes or distant areas of the body. 

Treatment

There are multiple treatment options for prostate cancer, and which ones are used depends upon many factors. 

Some men won’t have any treatment, and will be appropriate for “watchful waiting”, and will be followed with imaging and labs every few months, only to be treated if or when the cancer progresses. 

Surgical removal of the prostate may be recommended for some but not all men with prostate cancer. 

Radiation is a commonly used treatment, and can be given through external beam radiation, or brachytherapy. Brachytherapy is the placement of seeds containing radiation directly into the prostate to treat the cancer. 

Hormone suppression is often given for prostate cancer as well. Testosterone is a fuel for the prostate cancer cells to grow, so decreasing the amount of testosterone in the body can help treat the cancer.  

 

Overview of signs & symptoms- Lung Cancer

Posted on by Zain Syed

The ABCs of Lung Cancer: Overview of signs & Symptoms

The symptoms of lunch cancer closely mimic other common illnesses such as a cold. It is very important to get screened early, especially if you have risk factors. The most common cause of lung cancer is smoking. Other common causes can include exposure to secondhand smoke, asbestos, family history, other lung diseases, and a history of infections such as tuberculosis.

Symptoms of lung cancer include

  • Persistent cough
  • Trouble breathing
  • Chest pain
  • Wheezing
  • Coughing up blood.
  • Feeling very tired all the time.
  • Weight loss with no known cause.

 

When should you get screened

  • 50 years of age or older
  • Smoking 20 or more pack years

 

What is a pack year?

Take the number of packs smoked a day multiplied by the number of years smoked.

Example: 2 packs a day x 20 years = 40 pack years

 

Why is screening important?

Lung cancer is the third most common type of cancer but the number one cause of cancer-related deaths. The 5-year survival rate decreases by almost half if cancer spreads further than the lungs.

 

5-Year Relative Survival 
Localized 61.2%
Regional 33.5%
Distant 7.0%
Unknown 9.9%
  • Localized cancer is limited to the primary site
  • Regional is cancer that has spread to the surrounding lymph nodes
  • Distant is cancer that has metastasized

 

The average 5-year survival rate for people with lung cancer is 22.9%. Most (55%) of it is diagnosed once it has metastasized. Death rates have decreased due to earlier screening and better treatment options.

Early screening is very important. If you or a loved one falls within the risk factors, reach out to your doctor and discuss being screened for lung cancer.

 

Sarcoma

Posted on by Zain Syed

What is Sarcoma?

Sarcoma is cancer that can develop in many body parts, including bone, muscle, fat, and connective tissue. There are two main types of Sarcoma, Bone and Soft tissue Sarcomas.

Soft tissue sarcomas can develop in soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. They can be found in any part of the body.

Most of them start in the arms or legs. They can also be found in the trunk, head and neck area, internal organs, and the area in the back of the abdominal (belly) cavity (known as the retroperitoneum).  Sarcomas that most often start in the bones are osteosarcoma, chondrosarcoma, and Ewing sarcoma.

There are more than 50 types of soft sarcomas, and some are quite rare. 

Diagnosis

If your doctor suspects you have sarcoma, they will do a diagnostic imagining. This includes magnetic resonance imaging (MRI), computed tomography (CT) scan, positron emission tomography (PET) scan, X-ray, and ultrasound.

A CT scan gives the doctor a detailed 3D view of the scanned area.

If they find that there might be cancer, they may do a positron emission tomography (PET) scan that can detect cancer that the CT scan could not by using radioactive sugar. Cancer cells will use sugar much faster than our normal body cells.

If the PET scan confirms what the scans show, the final step to confirming you have cancer is taking some tissue from the cancerous areas to test. This is called a biopsy.

Once they have all the information, they will determine your cancer stage. The stage of cancer will help your doctor decide how to treat you. Staging is done on a numerical scale of 1-4. The higher the number, the more it has grown.

Risk Factors

  • Family history
  • BRCA2 gene mutation
  • Li-Fraumeni syndrome
  • Carney-Stratakis syndrome
  • Hereditary retinoblastoma
  • Familial adenomatous polyposis (FAP) and Gardner’s syndrome
  • Neurofibromatoses

Treatment

The general rule of thumb with cancers in your tissue (solid tumor cancers) is if they can remove that tissue, they will do that. There are some reasons they would not be able to remove the tissue. If the tissue is too large, they may need to shrink it by using radiation therapy, chemotherapy, or a combination of both. If cancer has spread to other parts of the body, then surgery is not always an option either.

Follow-Up

After completing your therapy, you will follow up with your doctor every 3-6 months for the first 2-3 years. They may repeat your scans and blood work to ensure that the cancer is not returning or growing.

Your doctor might want to see you sooner if they think it is medically necessary.

Things to think about:

  • Always get a second opinion. Healthcare professionals are humans and can see things differently.
  • A biopsy is a gold standard for diagnosing solid tumor cancers. You should not just start therapy without having one.
  • If you are feeling ill, having nausea, or anything out of the ordinary during your treatment, let your treatment team know! They might be able to help you. Remember, they are trying to help you, not make you miserable.
  • The best way to fight cancer is to catch it early. So, see your doctor yearly for a physical and screen early, especially if you have risk factors. The slight inconvenience is worth it!

 

Renal Cell Cancer

Posted on by Zain Syed

What is Renal Cell Cancer?

Renal cell cancer is when you have cells in your kidneys are growing improperly. Renal cell cancer also called renal cell adenocarcinoma or kidney cancer, is a disease where the cancer cells are found in the lining of the tubules( tiny tubes) in the kidney.

Kidney cancer symptoms:

  •         Blood in the urine is the most common kidney cancer symptom.
  •         A lump or mass on the side or lower back
  •         Unexplained fever for a few weeks
  •         Unintentional weight loss
  •         Lingering dull ache or pain in the side, abdomen, or lower back
  •         Feeling fatigued or in poor health
  •         Swelling of ankles and legs, These symptoms do not always mean you have kidney cancer. 

However, discussing any symptoms with your doctor is essential since they may signal other health problems.

Diagnosis

If your doctor suspects you have kidney cancer, they will do a diagnostic computed tomography (CT) scan. A CT scan gives the Doctor a detailed 3D scan.

If they find that there might be cancer, they may do a positron emission tomography (PET) scan that can detect cancer that the CT scan could not by using radioactive sugar. Cancer cells will use sugar much faster than our normal body cells.

If the PET scan confirms what the CT scan shows, then the final step to confirming you have cancer is taking some tissue from the cancerous areas to test. This is called a biopsy.

Once they have all the information, they will determine your cancer stage. The stage of cancer will help your doctor decide how to treat you. Staging is done on a numerical scale of 1-4. The higher the number, the more it has grown.

Risk Factors

  • Smoking
  • Obesity
  • High blood pressure
  • Family history

Treatment

The general rule of thumb with cancers in your tissue (solid tumor cancers) is if they can remove that tissue, they will do that. There are some reasons they would not be able to remove the tissue. If the tissue is too large, they may need to shrink it by using radiation therapy, chemotherapy, or a combination of both. If cancer has spread to other parts of the body, surgery is not always an option.

Follow-Up

After completing your therapy, you will follow up with your doctor every 3-6 months for the first 2-3 years. They may repeat your scans and blood work to ensure that the cancer is not returning or growing.

Your doctor might want to see you sooner if they think it is medically necessary.

Things to think about:

  • Always get a second opinion. Healthcare professionals are humans and can see things differently.
  • A biopsy is a gold standard for diagnosing solid tumor cancers. You should not just start therapy without having one.
  • If you are feeling ill, having nausea, or anything out of the ordinary during your treatment, let your treatment team know! They might be able to help you. Remember, they are trying to help you, not make you miserable.
  • The best way to fight cancer is to catch it early. So, see your doctor yearly for a physical and screen early, especially if you have risk factors. The slight inconvenience is worth it!

 

Pancreatic cancer screening and symptoms

Posted on by Zain Syed

How to know if you have Pancreatic Cancer?

The pancreas is the organ in your body responsible for many things. One is releasing special enzymes that help break down your food. Most people know the pancreas as the organ that helps regulate the body’s sugars with insulin and glucagon.

The symptoms of pancreatic cancer include:

  • Weight loss
  • Pancreatitis
  • Newly diagnosed diabetes
  • Uncontrolled diabetes
  • Nausea and vomiting
  • Heartburn
  • Newly diagnosed blood clots
  • Yellowing of eyes and skin (jaundice)

When should you get screened?

Risk factors of pancreatic cancer include:

  • Smoking
  • Heavy alcohol use
  • Diabetes
  • Obesity
  • Lack of exercise
  • Chronic pancreatitis
  • Family history of pancreatic cancer
  • Genetics
  • Family history of pancreatic cancer

Why is screening important?

Localized cancer is limited to the primary site.

Regional is cancer that has spread to the surrounding lymph nodes

Distant is cancer that has metastasized

The 5-year survival rate for pancreatic cancer is 11.5%. Most (52%) of pancreatic cancer are diagnosed once it has metastasized. The 5-year survival rate of localized cancer is 43.9%.

 

As you can see early screening is very important. If you or a loved one falls within the risk factors or is experiencing any symptoms reach out to your doctor and discuss being screened for pancreatic cancer.

 

Pancreatic Cancer

Posted on by Zain Syed

What is Pancreatic Cancer?

Pancreatic cancer occurs when the cells within the pancreas grow out of control.  Pancreatic cancer is the third leading cause of cancer death in the United States. Pancreatic cancers are hard to diagnose early since the signs and symptoms aren’t obvious, resulting in an advanced-stage diagnosis when treatment options are limited.

Pancreatic cancer is the third leading cause of cancer death in the United States, with men having a slightly higher risk than women. 

Diagnosis:

If your doctor suspects pancreatic cancer, they may order a blood test that looks at a protein called CA 19-9. This is what is called a “tumor marker

Imaging:

If your Ca-19-9 is elevated, they may get a diagnostic computed tomography (CT) scan. A CT scan gives the doctor a detailed 3D scan.

Other scans used include a PET scan and an MRCP.

A positron emission tomography (PET) scan can detect cancer that the CT scan could not by using radioactive sugar. Cancer cells will use sugar much faster than our normal body cells.

A magnetic resonance cholangiopancreatography (MRCP) is a scan that will specifically show a picture of the pancreas and the surrounding areas.

Endoscopic retrograde cholangiopancreatography (ERCP) is when they take a long flexible tube with a camera on its end through, usually your mouth, to take pictures of the pancreas and the surrounding area.

If the other scans confirm what the CT scan shows, then the final step to confirming you have cancer is taking some tissue from the cancerous areas to test. This is called a biopsy.

Once they have all the information, they will determine your cancer stage. The cancer stage will help your doctor decide how to treat you. Staging is done on a numerical scale of 1-4. The higher the number, the more it has grown.

Treatment:

The general rule of thumb with cancers in your tissue (solid tumor cancers) is if they can remove that tissue, they will do that. There are some reasons they would not be able to remove the tissue. If the tissue is too large, they may need to shrink it by using radiation therapy, chemotherapy, or a combination of both. Surgery is not always an option if cancer has spread past the pancreas.

The backbone of pancreatic cancer chemotherapy is gemcitabine and 5-fluorouracil (5-FU). Your doctor may also look into clinical trials as a course of treatment.

Radiation therapy may also be used before, during, or after surgery.

Risk Factors

  • Smoking
  • Heavy alcohol use
  • Diabetes
  • Obesity
  • Lack of exercise
  • Chronic pancreatitis
  • Family history of pancreatic cancer
  • Genetics

Follow-up:

After completing your therapy, you will follow up with your doctor every 3-6 months for the first 2-3 years. They may repeat your scans and blood work to ensure that the cancer is not returning or growing.

Your doctor might want to see you sooner if they think it is medically necessary.

Things to think about:

  • Always get a second opinion. Healthcare professionals are humans and can see things differently.
  • A biopsy is a gold standard for diagnosing solid tumor cancers. You should not just start therapy without having one.
  • If you are feeling ill, having nausea, or anything out of the ordinary during your treatment, let your treatment team know! They might be able to help you. Remember, they are trying to help you, not make you miserable.
  • The best way to fight cancer is to catch it early. So, see your doctor yearly for a physical and screen early, especially if you have risk factors. The slight inconvenience is worth it!

 

Interested in learning more about Pancreatic screening and symptoms? Check out our next article on this topic.

Non-Small Cell Cancer (NSCLC)

Posted on by Zain Syed

Approximately  85% of lung cancer cases are considered NSCLC, which arises from the lung’s epithelial cells, a type of cell that lines the organ surface. Several types of non-small cell lung (NSCL) include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Non-small-cell lung cancer is when the cells in your lungs grow out of control

Diagnosis:

If your doctor suspects you have lung cancer, they might consider doing a diagnostic computed tomography (CT) scan. A CT scan gives the Doctor a detailed 3D scan.

If they find that there might be cancer, they may do a positron emission tomography (PET) scan. A PET scan can detect cancer that a CT scan could not by using radioactive sugar. Cancer cells will use up the sugar much faster than our normal body cells.

If the PET scan confirms what the CT scan shows, then the final step to confirming you have cancer is taking some tissue from the cancerous areas to test. This is called a biopsy.

Once they have all the information, they will determine what stage your cancer is. The stage of cancer will help your doctor decide how to treat you. Staging is done on a numerical scale of 1-4. The higher the number, the more it has grown.

Treatments: 

NSCLC is slower growing compared to small cell lung cancer (SCLC).

The general rule of thumb with cancers in your tissue (solid tumor cancers) is if they can remove that tissue they will do that. There are some reasons why they would not be able to remove the tissue. If the tissue is too large they may need to shrink it either by using radiation therapy, chemotherapy, or a combination of both. If the cancer has spread past the lungs surgery is not always an option either.

The type of chemotherapy that is used is based on how your cells looked like under the microscope. Some common medications that are used are cisplatin, carboplatin, pemetrexed, etoposide, paclitaxel, gemcitabine, and docetaxel. Cisplatin and or carboplatin are used in combination with the others mentioned.

After your treatment, you may go through what is called consolidation therapy. Which is used to kill any remaining cancer cells that might have been left behind. The agent commonly used for this is called durvalumab.

In summary, surgery is always the first option. If surgery cannot be done they may try to shrink the tumor or just treat you with radiation or chemoradiation. Once that is done you might go through what is called consolidation therapy which is used to kill any remaining cancer cells.

Risk Factors:

Smoking, exposure to secondhand smoke, exposure to asbestos, family history, other lung diseases, and a history of infections such as tuberculosis.

Follow-up:

After you have completed your therapy you will be following up with your doctor every 3-6 months for the first 2-3 years. They may repeat your scans and blood work to ensure that the cancer is not returning or growing.

Your doctor might want to see you sooner if they think it is medically necessary.

Things to think about:

  • Always get a second opinion. Healthcare professionals are humans and can see things differently.
  • A biopsy is the gold standard for diagnosing solid tumor cancers. You should not just start therapy without having one.
  • If you are feeling ill, having nausea, or anything out of the ordinary during your treatment let your treatment team know! They might be able to help you. Remember they are trying to help you not make you miserable.
  • The best way to fight cancer is to catch it early. So, see your doctor yearly for a physical and screen early especially if you have risk factors. The slight inconvenience is worth it!

Learn more about Lung Cancer Symptoms and signs in our next article.

Feedback/Question

We would love to hear your thoughts or questions.

Please fill and submit the form below and one of our program evangelists will reach out to you shortly.
Protected by reCAPTCHA
Terms of Service& Privacy Policy

Thank you for recommending your support group!
We will be reaching out to invite your group to participate in our network.

Request to Access was submitted

A specialist with this email already exists in cancerGO

Request Physician/Specialist Access

We are excited about your interest in cancerGO! Physicians/specialists provide deep insights, novel clinical methods, and invaluable advice to patients, their loved ones, and the broader community.

Please fill below to request early access and we will get back to you shortly with further details.
Protected by reCAPTCHA
Terms of Service& Privacy Policy