Tag: cancersucks

The different types of leukemia

Posted on by Julie Scott, DNP

What is Leukemia?

Leukemia is a type of cancer that affects the white blood cells in the body. There are multiple types of leukemia, classified as either acute (which can grow quickly) or chronic (slower growing). They are also further divided into the types of cells they start in. The main types of leukemia are:

  • Acute Lymphocytic Leukemia (ALL)
  • Acute Myeloid Leukemia (AML)
  • Chronic Lymphocytic Leukemia (CLL)
  • Chronic Myeloid Leukemia (CML)
  • Chronic Myelomonocytic Leukemia (CMML)

Signs and Symptoms

The exact signs and symptoms that are associated with leukemia can differ based on the type of leukemia someone has. People with acute, quickly-growing leukemia, they may develop symptoms quickly and severely. For those who have chronic leukemia, they may not have any symptoms, and if they do, they may be mild. Generalized symptoms of leukemia include:

  • Unexplained fevers
  • Chills
  • Unintentional weight loss
  • Being very tired or feeling weak
  • Bruising without any injury to the skin
  • Bleeding, such as nosebleeds or gum bleeding
  • Feeling dizzy or lightheaded
  • Night sweats
  • Pale skin
  • Enlarged lymph nodes

Diagnosis

When someone presents with the above symptoms, the healthcare team may order testing to help determine the cause of what they’re experiencing. One of the most commonly ordered blood tests is a complete blood count (CBC). This blood test evaluates the numbers of white blood cells, red blood cells, and platelets. These levels can be significantly abnormal (both higher and lower than normal) in someone with leukemia. 

Along with CBC, a blood smear may also be done. This test allows the pathologist to look at how the different blood cells look under the microscope, to check for the presence of early white blood cells, called blasts, which can signify leukemia. 

Additional blood tests, such as flow cytometry, can be done to evaluate the white blood cells in a specific way. This test looks to see if leukemia cells are present in the sample. 

A bone marrow biopsy is often done when leukemia is suspected. This test takes a sample of bone and bone marrow (where blood cells are made) from the hip bone to evaluate for the presence of leukemia cells in the bone marrow. 

Once a diagnosis of leukemia is made, further testing is often done evaluating chromosomes of the cells to help further clarify the diagnosis. Exactly what tests are done can be a bit different for each type of leukemia. 

Imaging Tests

A CT scan may be done to check out the organs of the body, such as the lungs, liver, and spleen, to see if they look normal. A PET scan may also be done to look for the presence of leukemia cells outside of the bone marrow or bloodstream. 

Treatment

How leukemia is treated depends upon the type of leukemia someone has. Treatments can vary from no treatment needed except observation to intensive chemotherapy and bone marrow transplant. 

 

Lymphoma staging and how they affect treatment options

Posted on by Julie Scott, DNP

Lymphoma Staging

Once the biopsy confirms lymphoma, and all of the imaging has been done, the oncologist can stage the cancer. Staging describes how advanced the lymphoma is, and helps the oncologist determine the best treatment. 

Lymphoma staging is different from the staging for solid tumors such as lung cancer or breast cancer. The lymphoma staging system is determined based on the number of areas of lymph nodes that are affected, whether they are on the same or on both sides of the diaphragm (the muscle separating the chest from the abdomen), and if lymphoma is present in any solid organs. 

Lymphoma Treatment

Once the staging is determined, and the type of lymphoma has been diagnosed, the oncologist can develop the treatment plan. Chemotherapy is often used for both Hodgkin and non-Hodgkin lymphomas. 

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. The exact chemotherapy regimen can change from person to person based on the type of lymphoma they have. Some examples of chemotherapy that may be used include:

  • Adriamycin
  • Bleomycin
  • Cytoxan
  • Vincristine
  • Etoposide
  • Bendamustine
  • Carboplatin
  • Methotrexate

 

Combinations of chemotherapy are most often used to treat lymphoma. 

Immunotherapy is often used to treat lymphoma as well. Immunotherapy medications work by alerting the immune system to attack certain proteins on the outside of the lymphoma cells. These medications work differently than chemotherapy, but are often used along with chemo. 

Examples of immunotherapy include:

  • Rituxan
  • Gazyva
  • Arzerra
  • Adcetris

Radiation Therapy

Some types of both Hodgkin and non-Hodgkin lymphoma respond well to radiation. Radiation therapy uses high energy beams of radiation to treat and kill lymphoma cells. The radiation is most often given Monday through Friday for a period of a few weeks. Each treatment takes only a few minutes. This type of radiation is called external beam radiation.

Stem Cell Transplant

For people with certain types of lymphoma, or lymphoma that comes back quickly after treatment, a stem cell transplant may be suggested. During this treatment, high doses of chemotherapy, and sometimes radiation, are needed to completely kill the cancer cells. These high doses can cause the bone marrow to stop working properly, leaving someone at high risk for infection, severe anemia, or severe bleeding, because their blood cells are low. 

A stem cell transplant can be done by removing the stem cells from a person’s own body in the weeks before the procedure, which are frozen until they are ready to be used. Once the high doses of chemo are given, the stem cells are then infused back in, to help the bone marrow start to make blood cells again. 

Stem cells can also be used from a donor, either someone in the family or unrelated. They have to be a close match to the person who needs them though, or there is a high risk that the cells will be rejected, leading to many complications.

Lymphoma

Posted on by Julie Scott, DNP

What is Lymphoma?

Lymphoma is a cancer of the lymphocytes, which have a role to play in your immune system. When the lymphocytes become abnormal, they no longer function normally and become cancerous. Lymphoma can start in either the B lymphocytes or T lymphocytes of the immune system. 

There are many types of lymphoma, which are separated into two general groups: Hodgkin lymphoma and non-Hodgkin lymphoma. To further subdivide non-Hodgkin lymphoma, there are over 50 subtypes. 

Signs and Symptoms

There can be many signs and symptoms associated with lymphoma. These can include:

  • Enlargement of lymph nodes in the neck, armpits, or groin
  • Unexplained fevers or chills
  • Drenching night sweats
  • Unintentional weight loss
  • Severe itching
  • Extreme fatigue
  • Pale skin
  • Persistent cough
  • Difficulty breathing

Diagnostic tests

If someone is suspected of having lymphoma, or is experiencing symptoms that are suspicious and need further evaluation, a variety of tests may be ordered. 

Tests can include x-rays, which can show abnormal masses in the lungs that may be causing cough or shortness of breath. 

Another test that may be done is a CT scan, which can see abnormal lymph nodes as well as the other organs in the body to check for abnormalities. 

If lymphoma is confirmed or strongly suspected after the above tests, a PET scan may also be done. This type of imaging test shows not only the location of any abnormality, but also if those areas are actively growing or not. A sugar is attached to a radioactive tracer and given through an IV before the PET scan is done. The tracer is given time to circulate through the body, and then the person is scanned. Any areas of the body that take up alot of sugar, and are seen to be active, will be seen as bright areas on the screen. These areas may be very suspicious for cancer involvement. 

Biopsy

Ultimately a diagnosis of lymphoma is made through a biopsy. During a biopsy, a tissue sample from the suspicious lymph node is removed and tested for cancer cells. A biopsy can be done through a few different ways. 

In an excisional biopsy, an entire lymph node is removed to be evaluated for cancer. This is preferred when lymphoma is suspected, as sometimes just taking a small sample of a lymph node can miss the cancer cells. 

A needle biopsy may be done of a lymph node. During this procedure, a needle is placed into the suspicious area, and tissue is removed from it. Because less tissue is removed, it may not be as accurate of a way to diagnose lymphoma. 

Sometimes a bone marrow biopsy is done as well. During this procedure, a sample of bone and the marrow inside of it is removed from the hip area. The bone marrow is where blood cells are made, and it can be important to know if lymphoma cells are present there. This procedure is often done with anesthesia for patient comfort. 

Additional testing for specific chromosome changes and other markers may be done on the lymphoma tissue. This can help the oncologist with their treatment planning.

Are you interested in learning more about Lymphoma Staging and Treatments? Check out our next article on this topic.

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!

 

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