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.

Understanding Myeloproliferative Neoplasm and Its Treatment Options

Posted on by Julie Scott, DNP

What are Myeloproliferative neoplasms (MPNs)

Myeloproliferative neoplasms (MPNs) are a group of blood cancers that affect the bone marrow and the blood cells it produces. They lead to the abnormal growth of one or more types of blood cells that the bone marrow produces, including white blood cells, red blood cells, or platelets. MPNs include conditions such as:

  • Polycythemia vera (PV)
  • Essential thrombocythemia (ET)
  • Myelofibrosis

Risk factors

Risk factors for MPNs include:

  • exposure to radiation
  • exposure to certain chemicals such as benzene
  • having a family history of the disease
  • Tobacco use
  • Exposure to pesticides and fertilizers

Symptoms

Symptoms of MPNs vary depending on the type of MPN, but common symptoms include:

  • Fatigue
  • Weakness
  • Night sweats
  • Fever
  • Weight loss
  • Itching
  • Enlarged spleen (splenomegaly)
  • Bone pain
  • Blood clots
  • Bleeding or bruising easily
  • Bone marrow transplant

Diagnosis

The ultimate diagnosis of MPNs usually requires a combination of blood tests, bone marrow biopsy, and genetic testing. Blood tests can help to identify the type of MPN and the level of certain blood cells. A bone marrow biopsy can help to confirm the diagnosis of MPN and to stage the disease.

Genetic testing can help identify specific genetic mutations associated with MPNs.

Sometimes imaging tests such as CT, MRI, or ultrasound may be needed to evaluate the body’s organs, such as the spleen or liver.

Treatment

Treatment for MPNs depends on the type of MPN and the stage of the disease. The goal of treatment is to control symptoms and to reduce the risk of complications such as blood clots and bleeding. Treatment options include:

  • Medications to lower blood counts
  • Medications to stimulate blood counts
  • Steroids
  • Phlebotomy (removing blood if there are too many red blood cells)
  • Interferon treatment
  • Splenectomy (surgical removal of the spleen)
  • Targeted therapy (medication to target specific genetic mutations)

 

In summary, MPN is a group of blood cancer disorders that affect the bone marrow and the production of blood cells. Although there is no cure for MPN, treatments are available to manage symptoms and reduce the risk of developing more serious complications. It is important to work with a healthcare team experienced in managing MPN to develop the best treatment plan for you.

 

Desmoplastic Small Round Cell Tumors (DSRCT): Causes, Symptoms and Treatment Options

Posted on by Julie Scott, DNP

What are Desmoplastic Small Round Cell Tumors?

Desmoplastic small round cell tumors (DSRCTs) are a rare and aggressive type of soft tissue sarcoma. The tumors typically develop in the abdomen and can spread to other body parts, such as the lungs, liver, and lymph nodes. DSRCTs are often difficult to diagnose and treat and have a poor prognosis.

This type of tumor is mostly found in White males between the ages of 10 and 30 years old.

Symptoms

The symptoms of Desmoplastic small round cell tumors (DSRCTs) can vary depending on the location and size of the tumor, but some common symptoms include:

  • Abdominal pain or swelling
  • Loss of appetite
  • Fatigue
  • Nausea and vomiting
  • Constipation or diarrhea
  • Abdominal mass or lump
  • Blood in stool or urine
  • Shortness of breath (if the tumor has spread to the lungs)
  • Jaundice (if the tumor has spread to the liver)
  • Swelling of the legs or arms (if the tumor has spread to the lymph nodes)

Diagnosis

DSRCTs are often challenging to diagnose because of how they appear on imaging. Ultimately, a diagnosis is made through a biopsy of the tumor tissue.

Imaging studies. Imaging tests such as CT or MRI scans can be used to see the presence of a tumor and to determine its size and location. These imaging studies can also help to determine if the tumor has spread to other parts of the body.

Biopsy. A biopsy is the removal of a small sample of tissue from the tumor for examination under a microscope to look for the presence of cancer cells.

Genetic testing. Genetic testing can be performed on the tumor tissue to detect the specific genetic changes that are seen with this type of cancer. This testing helps to confirm the diagnosis of DSRCT.

Treatment

The treatment of DSRCTs is often complex and can involve a combination of surgery, chemotherapy, and radiation therapy. Surgery is typically the first treatment used, and it is used to remove as much of the tumor as possible. However, due to the aggressive nature of the tumors, complete surgical removal may not be possible, and the tumors can come back after surgery.

Chemotherapy is often used to shrink tumors and help control the disease’s spread. Radiation therapy may also be used to shrink the tumors and help control the disease’s spread. However, due to the aggressive nature of the tumors and the poor prognosis, chemotherapy and radiation therapy are not always effective.

Desmoplastic small round cell tumors are a type of cancer that can be difficult to treat. While several treatment options are available, the best course of treatment will depend on the individual case. If you or someone you know has been diagnosed with DSRCT, it is important to discuss all available options with a medical professional.

Understanding Anal Cancer – Causes, Symptoms and Treatment Options

Posted on by Julie Scott, DNP

What is Anal Cancer?

When the cells of the anus become abnormal and begin to grow uncontrollably, anal cancer develops. The anus is the part of the intestine that opens to the outside of the body, allowing fecal material to pass through. Factors that can increase someone’s risk of developing anal cancer include:

  • Human papillomavirus (HPV) infection
  • HIV infection
  • Smoking
  • Taking medication to suppress the immune system
  • Anal sex
  • Anal warts

Symptoms

The symptoms of anal cancer can vary for each person, but the following is a list of some of the most common symptoms associated with anal cancer.

  • Bleeding when having a bowel movement
  • Itching around the anal area
  • Loss of control of bowel movements
  • Enlarged lymph nodes noted in the groin
  • Discharge from the anus
  • Change in the size of the stool
  • Difficulty passing stool

Diagnosis

The diagnosis of anal cancer is often made after seeking advice from the healthcare team about symptoms that may have been experienced. If your healthcare provider has concerns about the possibility of anal cancer, there can be a variety of tests that can be done.

A physical exam is done to evaluate the area of concern and inspect for any abnormal findings. An exam may occur in which the healthcare provider places a finger in the anus and rectum to feel for any lumps or masses and inspect for bleeding. Lymph nodes in the groin may be felt to see if they are enlarged.

Imaging studies may also be needed. These imaging tests may include the following:

  • X-ray
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Ultrasound

A person with suspected anal cancer will likely be referred to a gastroenterologist for further testing. These tests, such as anoscopy or endoscopy, are done using a camera to look into the anus and rectum to inspect the area visually.

If suspicious tissue is found, a biopsy will be taken to be evaluated under the microscope to look for the presence of cancer cells. If cancer is confirmed, these cancerous cells will be tested to see if HPV is present.

Once anal cancer is diagnosed, it must be staged to determine how far the cancer has spread or if it is just in the anus.

Treatment

Treatments for anal cancer often consist of surgery, radiation, and chemotherapy and can be used alone or in combination with each other. The final treatment plan is developed based on the stage of the cancer.

Anal cancer is a serious disease that can be life-threatening. However, it is also very treatable, especially when caught early. Be sure to see a doctor if you are experiencing any anal cancer symptoms so that you can get the treatment you need as soon as possible.

What is Uveal melanoma?

Posted on by Julie Scott, DNP

Uveal melanoma is a type of cancer that grows in the part of the eye that provides the pigment called melanin. Although it’s not a common form of cancer, it is the most common type affecting the eye.

Factors that can make someone at higher risk of developing uveal melanoma include:

  • Increasing age
  • Fair skin complexion
  • Having blue or light green eyes

Symptoms

Symptoms of uveal melanoma can vary for each person, but some common symptoms can include:

  • Blurry vision
  • Other visual changes
  • Spots in the vision, called floaters
  • Change in the size or shape of the pupil
  • Dark spot on the eye

Diagnosis

When uveal melanoma is suspected, a thorough eye examination will need to be done to help determine the cause of the symptoms. During an eye exam, specialized tests can be done to evaluate the eye and its structures to look for abnormalities. This cancer is often diagnosed without a biopsy, as sometimes a biopsy can be risky. However, a biopsy may be recommended. The stage or extent of cancer needs to be determined as well to help determine the exact treatment that will be best.

Imaging tests used to help determine the extent of melanoma can include CT scans, MRIs, and PET scans. Blood tests to evaluate blood cell counts, as well as kidney and liver function, is often done as well.

Treatment

The exact treatment for uveal melanoma will be determined once the diagnosis is made and the cancer stage is known.

Surgery may be recommended for uveal melanoma. This surgery can include removing the tumor and healthy tissue surrounding it or removing the entire eye.

Radiation therapy is a treatment that may be used as well. During radiation, high-energy beams are directed at the cancer cells to kill them. Sometimes small radiation plaques are implanted directly into the tumor to kill it.

For some, a type of treatment called watchful waiting is used. During this, no specific treatment is given. Exams are performed regularly to assess the melanoma and determine how quickly it is growing. It may not need treatment unless it grows to a certain size or is causing more significant visual problems.

If you’ve been diagnosed with uveal melanoma, be sure to talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

This disease affects adults more commonly than children and can be life-threatening if not treated effectively. Because early detection is crucial for treatment success, it is essential to be aware of the signs and symptoms of this condition. If you or someone you know has been diagnosed with uveal melanoma, there are treatments available that can improve prognosis and quality of life.

Germ cell ovarian cancer: what is it ?

Posted on by Julie Scott, DNP

Germ-cell ovarian cancer is a type of cancer that starts in the germ cell of the ovary, which is the egg in the ovary. This is a rare type of ovarian cancer, as most ovarian cancers form in the cells lining the ovaries.

This type of ovarian cancer is most likely found in younger women or teenagers. Most often, only one ovary is affected.

Symptoms

Symptoms of germ cell ovarian cancer can vary for each person, but some of the common symptoms of this cancer include:

  • Abnormal vaginal bleeding
  • Abdominal bloating
  • Pain in the abdomen
  • Feeling full quickly after eating

Diagnosis

The ultimate diagnosis of ovarian cancer will be made once a biopsy is obtained. A pelvic exam may be done if there is a suspected issue with the female reproductive system. During a pelvic exam, the practitioner can feel for any abnormalities.

When a diagnosis of ovarian cancer is suspected or confirmed, imaging studies such as CT scans or ultrasounds may be ordered to evaluate for the presence of a mass or any other area of concern. A biopsy may be ordered once a suspicious mass is identified.

Lab tests, such as beta-human chorionic gonadotropin (HCG) or alpha-fetoprotein (AFP), can serve as tumor markers. These tests can be elevated if germ cell ovarian cancer is present.

Further imaging can be ordered once a diagnosis is made to establish where the cancer is located. Once a diagnosis is made, the additional imaging allows the oncologist to determine the stage of cancer, which is how extensive cancer has grown.

Treatment

The exact treatment for ovarian cancer will be determined once the diagnosis is made and the cancer stage is known.

Surgery may be recommended to treat cancer and can include the removal of the ovary and fallopian tube. Still, it can also possibly include removing both ovaries and the uterus as well. Surgery may even be recommended to debulk the tumor even if it can’t all be removed.

Some people will need to be treated with chemotherapy. Chemotherapy is a medication that is given to kill cancer cells. Radiation therapy, where high beams of energy are directed at cancer cells, may also be given.

If you’ve been diagnosed with germ-cell ovarian cancer, be sure to talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

Germ cell ovarian cancer (GCOC) is one of the most common types of cancer in women. Early detection and treatment of GCOC are essential for successful outcomes.

The facts about floor of mouth cancer-what causes it, symptom, and treatment

Posted on by Julie Scott, DNP

Floor-of-mouth cancer is a type of cancer that starts in the cells that line the floor of the mouth, under the tongue. This cancer most often starts in the squamous cells that cover the oral cavity.

Factors that can make someone at higher risk of developing floor of the mouth cancer include:

  • Heavy alcohol use
  • Tobacco use
  • Poor dental hygiene
  • Being of the male sex
  • History of HPV infection

Symptoms

Symptoms of the floor of mouth cancer can vary for each person, but some common symptoms can include:

  • Non-healing sore or ulcer under the tongue
  • Bleeding from the sore or ulcer area
  • Pain in the mouth
  • Difficulty swallowing
  • Swelling of lymph nodes in the neck
  • Ear pain

Diagnosis

The ultimate diagnosis of floor-of-mouth cancer will be made once a biopsy is obtained. When someone is suspected of having the floor of mouth cancer, they will likely have a thorough exam done, in which the tongue and oral cavity will be inspected. A biopsy may be taken for an official diagnosis if a suspicious lesion is seen.

When cancer is confirmed, imaging tests will likely be ordered. Standard imaging tests can include CT scans, X-rays, MRIs, and PET scans. These tests can look to see if cancer cells have spread to other body areas.

Once a diagnosis is made and imaging studies are done, the cancer is given a stage to describe how advanced the cancer is.

Treatment

The exact treatment for floor-of-mouth cancer will be determined once the diagnosis is made and the cancer stage is known.

Surgery may be recommended for this cancer. The exact surgery that will be required is based on the tumor size and if any lymph nodes have cancer. Surgery may require a large amount of the floor of the mouth to be removed, which may result in reconstructive surgery.

Radiation therapy is a treatment that may be used as well. During radiation, high-energy beams are directed at the cancer cells to kill them.

Chemotherapy is another treatment that may be recommended as well. Chemotherapy is a medication that is given to kill cancer cells. Sometimes chemotherapy and radiation therapy are used at the same time.

If you’ve been diagnosed with a floor of mouth cancer, be sure to talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

Cancer of the floor of the mouth is relatively rare.  Early diagnosis and treatment are critical for successful outcomes. If you have any symptoms that concern you, please see your doctor as soon as possible. Cancer can be scary, but knowledge is power. The more we understand this disease, the better our chances of beating it.

What are the early warning signs of esophageal cancer?

Posted on by Julie Scott, DNP

Esophageal cancer is a type of cancer that grows in the esophagus, the tube that connects the throat to the stomach. Factors that can make someone at higher risk of developing esophageal cancer include:

  • Increasing age
  • Heavy alcohol use
  • History of Barrett esophagus
  • Tobacco use

Symptoms

Symptoms of esophageal cancer can vary for each person, but some common symptoms can include:

  • Difficulty swallowing
  • Pain with swallowing
  • Chest pain
  • Decreased appetite
  • Weight loss
  • Hoarse voice
  • Indigestion

Diagnosis

The ultimate diagnosis of esophageal cancer will be made once a biopsy is obtained. Imaging tests will likely be ordered when someone is suspected of having esophageal cancer. Standard imaging tests can include X-rays, CT scans, MRIs, and PET scans.

Another imaging test that will likely be needed is an upper endoscopy. During this exam, a gastroenterologist inserts an extended, flexible scope with a camera into the mouth, esophagus, and stomach. This camera allows them to visualize any suspicious areas for cancer. During an endoscopy, a biopsy of a suspicious lesion can be taken to be tested for cancer cells.

A specialized ultrasound may also be done, which can help look at how large the cancerous lesion is and evaluate the lymph nodes around the esophagus to see if they look suspicious for cancer.

Once a diagnosis is made and imaging studies are done, the cancer is given a stage to describe how advanced the cancer is.

Treatment

The exact treatment for esophageal cancer will be determined once the diagnosis is made and the cancer stage is known.

Surgery may be recommended for esophageal cancer. This surgery can include removing the part of the esophagus containing the tumor and pulling up the stomach to connect to the end of the esophagus. Surgery may also remove lymph nodes around the esophagus to check for the spread of cancer to those areas.

Radiation therapy is a treatment that may be used as well. During radiation, high-energy beams are directed at the cancer cells to kill them.

Chemotherapy is another treatment that may be recommended. Chemotherapy is a medication that is given to kill cancer cells. Sometimes chemotherapy is used before surgery to help shrink the tumor and allow the surgeon to perform less aggressive surgery.

Immunotherapy may be given for esophageal cancer that has spread into other areas of the body (metastasized). Immunotherapy is a type of treatment that helps the immune system see and attack cancer cells.

If you’ve been diagnosed with esophageal cancer, be sure to talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

In conclusion, esophageal cancer is a serious disease that can be difficult to detect and treat. However, understanding the risk factors and symptoms can improve your chances of early detection and treatment. If you are concerned about your risk for esophageal cancer, talk to your doctor. And remember, the best way to prevent any cancer is to live a healthy lifestyle.

 

The basics of Cutaneous T cell lymphoma: what it is and how it affects people

Posted on by Julie Scott, DNP

Cutaneous T cell lymphoma (CTCL) is a type of non-Hodgkin’s lymphoma, cancer that grows in the lymphatic system. More specifically, CTCL grows in the T cells, a type of white blood cell that helps to fight infection. With CTCL, these T-cells become cancerous and cause the skin to develop lesions. There are multiple types of CTCL, with the most common subtypes being mycosis fungoides and Sezary syndrome.

Symptoms

Symptoms of CTCL can vary for each person but often progress over a span of years. Some common symptoms can include the following:

  • Red rash on an area of the skin
  • Red, scaly patches
  • Elevated red or brown plaques on the skin
  • Severe itching
  • Peeling of the skin
  • Painful lesions
  • Thickening of the skin

Diagnosis

The ultimate diagnosis of CTCL will be made once a biopsy is obtained. A biopsy is generally done of a concerning skin lesion, and multiple biopsies may need to be taken to get an accurate diagnosis. Once CTCL is diagnosed, additional testing of chromosomes and other markers are done on the tumor to help determine the cancer’s grade and other characteristics.

Once a CTCL diagnosis is made, imaging studies such as CT scans may be ordered to see if cancer has spread to other body areas, including solid organs. A bone marrow biopsy may also need to be done to see if there is any evidence of lymphoma in the bone marrow.

Treatment

The exact treatment for mantle cell lymphoma will be determined once the diagnosis is made and the cancer stage is known.

Topical medications may be used to treat the skin in the area of cancer for those with an early stage of CTCL. These can include steroids and chemotherapy medications. Other local treatments can include radiation therapy, where high energy x rays target skin lesions and kill cancer cells. Phototherapy, with unique light treatments, can be used as well.

If CTCL is spread throughout the body, systemic treatments such as chemotherapy may be needed. In some cases, a stem cell transplant may be recommended.

If you’ve been diagnosed with cutaneous T-cell lymphoma, be sure to talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

While Cutaneous T cell lymphoma (CTCL) is not well known, it is essential to be aware of the signs and symptoms as it can be a serious condition. While there is no cure for CTCL, treatment options are available, and patients can often lead normal lives with proper management.

For more information about CTCL, visit The Leukemia & Lymphoma Society’s website at www.lls.org.

What is Acute Myeloid Leukemia?

Posted on by Julie Scott, DNP

Acute myeloid leukemia (AML) is cancer affecting blood cells. When the myeloid cells become abnormal, these cells then grow uncontrollably. White blood cells are often affected, but red blood cells and platelets can also be affected. As these abnormal cells grow, they crowd out the bone marrow. This prevents healthy cells from having room to grow.

AML is adults’ most common type of acute (fast-growing) leukemia. In addition to affecting the bone marrow, leukemia can invade other body areas.

Risk factors associated with developing AML can include:

  • Being of the male sex
  • Increasing age
  • Tobacco use
  • History of radiation exposure
  • History of having chemotherapy previously

Symptoms

Symptoms of AML can vary for each person, but some of the common symptoms of this cancer include:

  • Flu-like symptoms
  • Fevers
  • Chills
  • Night sweats
  • Unintentional weight loss
  • Easy bleeding or bruising
  • Feeling very fatigued
  • Frequent or recurrent infections

Diagnosis

When someone presents to their healthcare provider with their concerning symptoms, lab work may be done to help find the cause of the symptoms. One of the commonly ordered lab tests is a complete blood count or CBC. This gives the provider the number of all of the different types of blood cells that the bone marrow makes. In AML, these counts may be significantly out of range, and some levels can be significantly high or low.

Other blood tests can be drawn to help get a diagnosis. One test is called flow cytometry, which looks at the blood cells in a unique way to find characteristics that may be present in leukemia.

Another diagnostic test is a bone marrow biopsy, during which a sample of bone marrow and bone is removed to be tested for the presence of leukemia cells.

Imaging studies such as CT scan may be done to see if the internal organs appear normal or if there has been an invasion of cancer cells into any area outside of the bone marrow.

Treatment

The exact treatment for AML will be determined once the diagnosis is made and all testing is complete. Other lab tests will often be evaluated to assess chromosomes and other leukemia characteristics that may influence treatment decisions.

Chemotherapy is often used to treat AML and is given in different phases, the first to kill the cancer cells in the bone marrow and the next phase to keep the cells from growing back. Radiation therapy may also be used with high-energy beams targeted at cancerous areas.

A stem cell transplant may be done in some individuals with AML. During this procedure, high doses of chemotherapy are given to kill the cells of the bone marrow. Stem cells are then transfused to help the body make blood cells again.

If you’ve been diagnosed with AML, talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

 

In summary, acute myeloid leukemia is a blood and bone marrow cancer. The overproduction of abnormal white blood cells characterizes it. Early diagnosis and treatment are essential for the best possible outcome.

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