Author: Julie Scott, DNP

Julie is an oncology certified Oncology Nurse Practitioner with over a decade of medical oncology experience. In addition to her clinical work, she is an accomplished healthcare writer providing oncology content for various publications. She also serves as an adjunct faculty member for a Master's nursing program and a chair for Doctoral nursing students.

Adenoid cystic carcinoma (ACC)

Posted on by Julie Scott, DNP

What is Adenoid cystic carcinoma (ACC)?

Adenoid cystic carcinoma (ACC) is a rare and slow-growing cancer that usually affects the salivary glands, but can also occur in other parts of the body. It is known for its tendency to recur and metastasize, making early detection and treatment crucial. Here’s an overview of the signs, symptoms, diagnosis, and treatment of adenoid cystic carcinoma.

Signs and Symptoms

The symptoms of adenoid cystic carcinoma vary depending on the location and size of the tumor. Some common symptoms include:

  • A lump or swelling in the affected area, such as the mouth, throat, or neck
  • Difficulty swallowing or speaking
  • Pain or numbness in the face or neck
  • Facial weakness
  • Facial droop
  • Enlarged lymph nodes

Diagnosis

To diagnose adenoid cystic carcinoma, a doctor will likely perform a physical examination and review the patient’s medical history. They may also order imaging tests, such as a CT scan, MRI, or PET scan, to get a better look at the suspicious area and determine if it has spread to other parts of the body. Ultimately, a biopsy will need to be performed to confirm the diagnosis.

Treatment

The treatment for adenoid cystic carcinoma depends on the size, location, and stage of the tumor, as well as the patient’s overall health. The main treatments for ACC include surgery, radiation therapy, and chemotherapy. Sometimes a combination of treatments is needed to achieve the best outcome.

Surgery: Surgery is the primary treatment for adenoid cystic carcinoma. The goal is to remove the tumor and a margin of healthy tissue surrounding it to ensure that all cancer cells are eliminated. In some cases, surgery may be followed by radiation therapy to help prevent cancer from returning.

Radiation Therapy: Radiation therapy uses high-energy radiation to kill cancer cells. It can be used before or after surgery to help shrink the tumor or to eliminate any remaining cancer cells.

Chemotherapy: Chemotherapy is a treatment that uses drugs to kill cancer cells. It may not be used if someone has surgery but may be used in some cases to help slow the growth of the tumor and relieve symptoms if cancer has spread to other areas.

Prognosis

Adenoid cystic carcinoma is slow-growing cancer, and it may take years for cancer to spread. However, it has a tendency to recur and metastasize even after treatment. The prognosis for adenoid cystic carcinoma depends on the stage and location of the tumor, as well as the patient’s age and overall health. In general, early detection and treatment can improve the chances of a successful outcome.

 

Brain cancer and Glioma.

Posted on by Julie Scott, DNP

What are Gliomas?

Cancer in the brain is a serious condition that affects the brain and can lead to a variety of symptoms. One of the most common types of brain cancer is glioma, which is a type of tumor that starts in the glial cells that surround the nerve cells in the brain. Here’s an overview of the symptoms, diagnosis, and treatment of brain cancer and gliomas.

Symptoms

The symptoms of brain cancer and gliomas can vary depending on the location and size of the tumor. Some common symptoms include:

  • Headaches
  • Seizures
  • Nausea and vomiting
  • Vision problems
  • Difficulty speaking or understanding speech
  • Weakness or numbness in the arms or legs
  • Memory loss
  • Personality changes
  • Cognitive impairment

Diagnosis

To diagnose brain cancer and gliomas, a doctor will perform a physical exam, review the patient’s medical history, and order various tests. These may include:

  • Imaging tests: A variety of imaging tests, such as CT scans or MRI scans, can provide detailed images of the brain and help identify any tumors or abnormalities.
  • Biopsy: A biopsy involves removing a small piece of the tumor for analysis in a laboratory to determine the type of cancer and its grade.
  • Neurological tests: These tests can assess the patient’s cognitive function, vision, hearing, and other neurological symptoms.

Treatment

The treatment for brain cancer and gliomas depends on several factors, such as the type and grade of the tumor, its location in the brain, and the patient’s overall health. Some common treatments include:

  • Surgery: Surgery may be recommended to remove the tumor, especially if it is causing significant symptoms or is in a location where the tumor can be removed safely
  • Radiation therapy: Radiation therapy involves using high-energy radiation to kill cancer cells and shrink the tumor. Radiation can be used to target only the tumor or the entire brain.
  • Chemotherapy: Chemotherapy involves using medications to kill cancer cells and stop them from growing and spreading.
  • Targeted therapy: This type of treatment uses drugs that specifically target certain mutations in cancer cells and limit damage to healthy cells.
  • Clinical trials: Clinical trials may be available for patients who are not responding to other treatments or who have a particularly aggressive form of brain cancer.

Prognosis

The prognosis for brain cancer and gliomas depends on several factors, such as the type and grade of the tumor, its location, and the patient’s overall health. In general, the higher the grade of the tumor, the more aggressive it is and the worse the prognosis. However, advances in treatment options and improvements in care have led to better outcomes for many patients with brain cancer and gliomas.

 

Amyloidosis

Posted on by Julie Scott, DNP

What is Amyloidosis?

Amyloidosis is a rare condition that occurs when an abnormal protein, called amyloid, builds up in the body’s organs and tissues. Over time, this buildup can cause damage and lead to organ failure. Here’s an overview of the symptoms, diagnosis, and treatment of amyloidosis.

Symptoms

The symptoms of amyloidosis can vary depending on which organs or tissues are affected. Some common symptoms include:

  • Fatigue
  • Shortness of breath
  • Swelling in the ankles and legs
  • Numbness or tingling in the hands or feet
  • Weight loss
  • Diarrhea or constipation
  • Enlarged tongue
  • Skin changes
  • Irregular heartbeat
  • Kidney problems

Diagnosis

To diagnose amyloidosis, a doctor will perform a physical exam, review the patient’s medical history, and order various tests. These may include:

  • Blood tests to measure levels of abnormal proteins and assess the function of organs such as the kidneys and liver
  • Urine tests to check for abnormal proteins and assess kidney function
  • Imaging tests such as X-rays, CT scans, or MRI scans to visualize the organs and tissues
  • Biopsy, where a sample of tissue is taken from the affected area and examined under a microscope to look for signs of amyloid deposits

Treatment

The treatment for amyloidosis depends on the type of amyloidosis, the extent of organ damage, and the patient’s overall health. The goal of treatment is to slow down or stop the progression of the disease and manage symptoms. Some common treatments for amyloidosis include:

  • Chemotherapy: Chemotherapy drugs may be used to kill off the abnormal cells that produce amyloid deposits.
  • Immunomodulatory drugs: These drugs help regulate the immune system and may help slow down the production of amyloid.
  • Stem cell transplant: In some cases, a patient may receive high-dose chemotherapy and then a stem cell transplant to help rebuild healthy blood cells.
  • Organ transplant: For patients with advanced organ damage, an organ transplant may be necessary to replace the damaged organ.
  • Supportive care: Other treatments may be used to manage symptoms such as pain, swelling, and organ dysfunction. These may include medications, dietary changes, and other supportive therapies.

Prognosis

The prognosis for amyloidosis depends on many factors, including the type of amyloidosis, the extent of organ damage, and the patient’s overall health. Some types of amyloidosis are more aggressive and may have a poorer prognosis. In general, early detection and treatment are important for improving the outlook of people living with amyloidosis.

 

Nasopharyngeal cancer

Posted on by Julie Scott, DNP

What is Nasopharyngeal cancer?

Nasopharyngeal cancer is a rare type of cancer that affects the nasopharynx, the upper part of the throat that connects the nose to the back of the mouth. Here’s an overview of the symptoms, risk factors, diagnosis, and treatment of nasopharyngeal cancer.

Symptoms

The symptoms of nasopharyngeal cancer may be mild or unnoticeable at first and may be mistaken for other conditions. Some common symptoms include:

  • A lump in the neck
  • Persistent nasal congestion or feeling stuffy
  • Hearing loss
  • Tinnitus (ringing in the ears)
  • Difficulty speaking or swallowing
  • Sore throat
  • Headaches
  • Numbness or tingling in the face
  • Facial pain

Risk Factors

There are several risk factors that may increase a person’s likelihood of developing nasopharyngeal cancer, including:

  • Ethnicity: Nasopharyngeal cancer is most common in people of Asian descent, particularly those from southern China.
  • Epstein-Barr virus (EBV) infection: EBV is a common virus that can cause infectious mononucleosis, and it has been linked to an increased risk of nasopharyngeal cancer.
  • Family history: People with a family history of nasopharyngeal cancer may be at increased risk.
  • Exposure to certain chemicals: Exposure to wood dust, formaldehyde, or other chemicals may increase the risk of nasopharyngeal cancer.

Diagnosis

To diagnose nasopharyngeal cancer, a doctor will perform a physical exam, review the patient’s medical history, and order various tests. These may include:

  • Endoscopy: An endoscope is a thin, flexible tube with a camera that is used to examine the nasopharynx.
  • Biopsy: A biopsy involves removing a small piece of tissue for evaluation in a laboratory to determine if cancer cells are present.
  • Imaging tests: A variety of imaging tests, such as CT scans or MRI scans, can provide detailed images of the nasopharynx and help identify any tumors or abnormalities.

Treatment

The treatment for nasopharyngeal cancer depends on several factors, such as the stage of the cancer, its location in the nasopharynx, and the patient’s overall health. Some common treatments include:

  • Radiation therapy: Radiation therapy involves using high-energy radiation to kill cancer cells and shrink the tumor.
  • Chemotherapy: Chemotherapy involves using powerful drugs to kill cancer cells and stop them from growing and spreading.
  • Surgery: Surgery may be recommended to remove the tumor, especially if it is in a location that can be safely accessed.
  • Targeted therapy: This type of treatment uses drugs that specifically target cancer cells and limit damage to healthy cells.

Prognosis

The prognosis for nasopharyngeal cancer depends on several factors, such as the stage of the cancer, the patient’s overall health, and the type of treatment used. In general, early-stage nasopharyngeal cancer has a better prognosis than advanced-stage cancer. However, advances in treatment options and improvements in care have led to better outcomes for many patients with nasopharyngeal cancer.

 

Polycythemia vera

Posted on by Julie Scott, DNP

What is Polycythemia vera?

Polycythemia vera (PV) is a rare type of blood cancer that causes an overproduction of red blood cells in the bone marrow. This results in the thickening of the blood, which can lead to an increased risk of blood clots, stroke, and heart attack.

PV is a rare disease, with an incidence rate of about 2 per 100,000 people per year. It usually affects people over the age of 60, but it can occur at any age. Men are more likely to develop the disease than women.

Symptoms

The symptoms of PV are often mild or absent in the early stages of the disease. However, as the disease progresses, symptoms may become more noticeable. The most common symptoms of PV include:

  • Fatigue
  • Headaches
  • Dizziness
  • Shortness of breath
  • Itchy skin, especially after a warm bath or shower
  • Redness, warmth, or swelling in the hands or feet
  • Joint pain
  • Increased sweating
  • Enlarged spleen

Diagnosis

The diagnosis of PV is usually made through a series of tests, including a complete blood count (CBC), bone marrow biopsy, and genetic testing. A CBC will show an increase in the number of red blood cells, and possibly even the white blood cells, and platelets in the blood.

A bone marrow biopsy is used to confirm the diagnosis and to determine the extent of the disease. This is often done in an outpatient setting.

Genetic testing is used to look for mutations in the JAK2 gene, which is present in more than 95% of patients with PV.

Treatment

The goal of treatment for PV is to reduce the risk of blood clots and other complications. Treatment options include:

  • Phlebotomy: This is the most common treatment for PV. It involves the removal of a certain amount of blood from the patient’s body, which reduces the number of red blood cells in the blood. The procedure is very similar to a blood donation.
  • Medications: Medications, such as hydroxyurea or others, may be prescribed to reduce the number of red blood cells in the blood.
  • Low-dose aspirin: This medication can help prevent blood clots.
  • Blood thinners: Blood thinners, such as warfarin or heparin, may be prescribed to reduce the risk of blood clots.
  • Radiation therapy: This treatment is used in some cases to reduce the size of an enlarged spleen.
  • Bone marrow transplant: In rare cases, a bone marrow transplant may be recommended for patients with severe PV.

 

Port-a-Cath

Posted on by Julie Scott, DNP

What is a Port-a-Cath?

A Port-a-Cath is a small medical device used for patients who require frequent or long-term access to the bloodstream for medication (such as chemotherapy), blood products, or other treatments. It is surgically implanted under the skin and connected to a catheter that leads to a large vein near the heart. The Port-a-Cath is easy to access and provides a convenient alternative to traditional IV lines.

Placement of a Port-a-Cath

The placement of a Port-a-Cath is a surgical procedure that requires a small incision in the chest area. The device is placed under the skin and connected to a catheter that is inserted into a large vein near the heart. The procedure is often done with some form of anesthesia and takes approximately 30 to 45 minutes.

Maintenance of a Port-a-Cath

After the placement of a Port-a-Cath, proper maintenance is important to make sure it functions well. The patient or caregiver will be taught how to care for the Port-a-Cath and how to clean the area around the device. This includes keeping the area clean and dry, and changing the dressing as needed. It is important to avoid using harsh chemicals or soaps on the area and to avoid any tight-fitting clothing or jewelry that could irritate the skin.

These may only be necessary as the incision heals. Once healed, there may be little to no restrictions for the device.

The Port-a-Cath also requires regular flushing to prevent blockages and ensure proper flow. The flushing is done using a solution to keep the catheter open and free from clots. The frequency of flushing may vary depending on the patient’s individual needs and the type of medication or treatment being administered. The flushing is most often done by the healthcare staff who are administering chemotherapy. In some instances though, the patient or their caregiver may be given instructions on what to do.

Removal of a Port-a-Cath

The removal of a Port-a-Cath is a simple procedure that typically takes only a few minutes. It’s often performed with some sort of anesthesia. A small incision is made to remove the device. The catheter is gently pulled out, and the incision is closed with stitches or adhesive strips. The area may be sore or tender for a few days after the procedure, and the patient will be instructed on how to care for the area as it heals.

 

Preserving fertility before undergoing cancer treatment

Posted on by Julie Scott, DNP

Cancer treatment can significantly impact a person’s fertility, of both sexes, particularly for young patients.  However, there are options available for those who wish to preserve their fertility before undergoing cancer treatment.

Cancer treatments, such as chemotherapy, radiation therapy, and surgery, can damage the reproductive organs and potentially affect a person’s ability to conceive naturally. The extent of the damage depends on the type of treatment, dosage, and duration of treatment. Certain types of cancer, such as testicular cancer, can also affect fertility directly.

In women, chemotherapy can cause damage to the ovaries, leading to a decrease in the number of eggs or even premature menopause. Radiation therapy can also damage the ovaries, uterus, and cervix, leading to infertility or a high-risk pregnancy. Surgery, particularly for gynecologic cancers, can also damage the reproductive organs.

In men, chemotherapy and radiation therapy can affect the production of sperm, leading to decreased sperm count, abnormal sperm shape or motility, and even infertility. Surgery, particularly for prostate or testicular cancer, can also affect the production of sperm.

To preserve fertility, cancer patients can consider fertility preservation options before undergoing cancer treatment. These options include:

  1. Egg freezing: This involves collecting eggs from a woman’s ovaries, freezing them, and storing them for future use. The eggs can be thawed and fertilized with sperm through in vitro fertilization (IVF) when the patient is ready to conceive.
  2. Embryo freezing: This involves fertilizing the collected eggs with sperm to create embryos, which are then frozen and stored for future use. The embryos can be thawed and implanted in the woman’s uterus through IVF when the patient is ready to conceive.
  3. Ovarian tissue freezing: This involves removing a portion of a woman’s ovary and freezing it for future use. The frozen ovarian tissue can be transplanted back into the woman’s body, where it can resume its normal function and produce eggs.
  4. Sperm banking: This involves collecting and freezing a man’s sperm for future use. The frozen sperm can be thawed and used for insemination or IVF when the patient is ready to conceive.

It is essential to discuss fertility preservation options with a healthcare provider before starting cancer treatment. Fertility preservation options may not be suitable for all cancer patients, and the timing and type of cancer treatment may impact the success of fertility preservation options.

Chemo Brain

Posted on by Julie Scott, DNP

What is a Chemo Brain?

Chemotherapy is a common treatment for cancer that involves the use of drugs to destroy cancer cells. While chemotherapy can be an effective way to fight cancer, it can also have side effects that impact a person’s quality of life. One such side effect is known as chemo brain.

Chemo brain is a term used to describe the cognitive changes that some people experience during and after chemotherapy treatment. The symptoms of chemo brain can include difficulty concentrating, memory problems, and trouble with organization and planning. These symptoms can be distressing to the person experiencing them.

The exact causes of chemo brain are not fully understood. Some researchers believe that the chemotherapy drugs can damage healthy brain cells, while others think that the side effects of chemotherapy, such as fatigue and stress, may contribute to cognitive changes. The specific chemotherapy drugs used, the dose and duration of treatment, and the individual’s overall health and age can all influence the likelihood and severity of chemo brain.

Chemo brain can have a significant impact on a person’s life. People who experience cognitive changes may have difficulty completing daily tasks, working, and maintaining relationships. It can also cause emotional distress, as people may feel frustrated or embarrassed by their symptoms.

If you are experiencing chemo brain, there are several things that you can do to manage your symptoms. Here are a few tips:

– Stay organized: Keep a planner or to-do list to help you remember important tasks. Write down things you want to be sure to remember.

– Prioritize rest: Give yourself time to rest and recover. If you are feeling tired or overwhelmed, take a break.

– Exercise: Exercise has been shown to improve cognitive function and may help reduce the symptoms of chemo brain.

– Stay mentally active: Engage in activities that stimulate your brain, such as puzzles, reading, or learning a new skill.

– Ask for help: Don’t be afraid to ask for help from friends and family when you need it.

If your symptoms are severe or impacting your daily life, talk to your healthcare provider. They may be able to recommend additional treatments or therapies to help manage your symptoms.

 

Chemotherapy Administration

Posted on by Julie Scott, DNP

How is Chemotherapy administered?

Chemotherapy is a commonly used treatment for cancer that uses medication to kill cancer cells. There are several different ways that Chemotherapy can be administered, and the best method for a patient will depend on the type of cancer they have and where it’s located.

Intravenous (IV) chemotherapy

IV chemotherapy is the most common way Chemotherapy is given. It involves injecting the chemotherapy drugs directly into a vein using a needle or catheter. The drugs then travel through the bloodstream to the cancer cells. This method is typically used for cancers that have spread throughout the body or for patients who need high doses of Chemotherapy. IV chemotherapy is usually given in a hospital or clinic setting.

Oral Chemotherapy

Oral Chemotherapy involves taking chemotherapy drugs in pill or capsule form. Oral Chemotherapy can be taken at home, which can be more convenient for patients who live far from a treatment center. However, it’s important for patients to follow their treatment schedule closely and to notify their healthcare provider if they experience any side effects. Not all chemo medications come in an oral form.

Intrathecal Chemotherapy

Intrathecal Chemotherapy involves injecting the drugs directly into the spinal fluid using a needle. This method is used to treat cancers that have spread to the brain or spinal cord, as the drugs can reach the cancer cells more directly. Intrathecal Chemotherapy is typically given in a hospital or clinic setting.

Topical Chemotherapy

Topical Chemotherapy involves applying the drugs directly to the skin using a cream or gel. This method is used to treat skin cancers, such as basal cell carcinoma and

squamous cell carcinoma. Topical Chemotherapy is usually applied at home, and patients may need to follow specific instructions to prevent the drugs from spreading to other parts of the body.

Intra-arterial Chemotherapy

Intra-arterial Chemotherapy involves injecting the drugs directly into the artery that supplies blood to the cancerous tissue. This method is used to treat cancers that are localized to a specific area, such as liver or kidney cancer. Intra-arterial Chemotherapy is typically performed in a hospital or clinic setting.

 

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