DURBAN: An Indian-origin doctor in South Africa has become the first health worker in the country to succumb to the swine flu virus.
Dr Irshad Moola from KwaDukuza, about 50km north of Durban, died of the H1N1 pandemic that currently has 11,253 official cases countrywide.
His father, Farouk Moola, said his son had flu symptoms and was admitted to hospital after he developed breathing problems.
The health ministry has confirmed Moola's death as the fifth caused by H1N1 in the KwaZulu-Natal province, home to about 70% of the 1.2 million South African Indians.
A close friend of Moola, also a medical practitioner, who asked not to be identified, told that the doctor had been committed to assisting people from the rural areas surrounding his birthplace, and had sacrificed his life in the process.
The National Institute for Communicable Diseases said in its latest report that 47 South Africans had died of H1N1 so far, with 11,253 recorded incidents so far.
Indian-origin doctor dies of swine flu in S Africa
DURBAN: An Indian-origin doctor in South Africa has become the first health worker in the country to succumb to the swine flu virus.
Dr Irshad Moola from KwaDukuza, about 50km north of Durban, died of the H1N1 pandemic that currently has 11,253 official cases countrywide.
His father, Farouk Moola, said his son had flu symptoms and was admitted to hospital after he developed breathing problems.
The health ministry has confirmed Moola's death as the fifth caused by H1N1 in the KwaZulu-Natal province, home to about 70% of the 1.2 million South African Indians.
A close friend of Moola, also a medical practitioner, who asked not to be identified, told that the doctor had been committed to assisting people from the rural areas surrounding his birthplace, and had sacrificed his life in the process.
The National Institute for Communicable Diseases said in its latest report that 47 South Africans had died of H1N1 so far, with 11,253 recorded incidents so far.
Dr Irshad Moola from KwaDukuza, about 50km north of Durban, died of the H1N1 pandemic that currently has 11,253 official cases countrywide.
His father, Farouk Moola, said his son had flu symptoms and was admitted to hospital after he developed breathing problems.
The health ministry has confirmed Moola's death as the fifth caused by H1N1 in the KwaZulu-Natal province, home to about 70% of the 1.2 million South African Indians.
A close friend of Moola, also a medical practitioner, who asked not to be identified, told that the doctor had been committed to assisting people from the rural areas surrounding his birthplace, and had sacrificed his life in the process.
The National Institute for Communicable Diseases said in its latest report that 47 South Africans had died of H1N1 so far, with 11,253 recorded incidents so far.
metastasis cancer;
Metastasis:
A major concern when diagnosing a pancreatic cancer is whether or not the cancer has already spread (metastasized) outside of the pancreas. The location of the metastases will determine whether the patient has locoregional or metastatic disease.The location of the metastases will also determine whether the cancer is able to be surgically removed (resectable) or unable to be surgically removed (unresectable).There are certain sites that pancreatic cancer may spread to that usually, but not always, eliminate surgery as a treatment option. They are:
Lymph nodes:
Metastases (mets) to lymph nodes does not automatically eliminate surgery as a treatment option. There are lymph nodes scattered throughout the body. The location of the affected lymph nodes makes a big difference.
For example, the lymph nodes in the groove between the duodenum and the pancreas are a very common site of metastases. These are considered locoregional and are routinely removed during the Whipple surgical procedure. However, the spread of cancer to more distant lymph nodes, such as lymph nodes closer to the liver, may mean the tumor is unresectable.
Liver:
Metastases to the liver are a common finding especially with tumors in the tail and the body of the pancreas. Usually, if there is evidence of liver "mets," surgery will not be an option.
Celiac plexus:
This is a network of many nerves that are grouped around the aorta where it passes through opening in the diaphragm.
It is these nerves that cause back pain when pressed upon by a growing tumor. Therefore, this is where an alcohol is injected during an alcohol nerve block to stop the sensation of pain.
Superior mesenteric vessels:
This artery and vein carry blood to and from the bowels and are closely associated with the pancreas. Therefore, they may become involved by the spreading of the tumor. These blood vessels run between the uncinate process and head of the pancreas. The artery is a branch off of the aorta and carries oxygen-rich blood to abdominal organs. The vein carries oxygen-poor blood to the portal vein which enters the liver.
Ligament of Treitz:
This is actually a thin muscle that wraps around the small intestine where the duodenum and jejunum meet. It passes behind the pancreas and is attached above to the spine and the diaphragm.
Portal vein:
This is another important blood vessel that runs right next to the pancreas. It carries oxygen poor blood to the liver where the blood is filtered. If the cancer has spread to involve the portal vein, the cancer may be considered unresectable. The surgeon may decide that surgery can proceed. If so, they can remove the affected portion of the portal vein and replace it with an artificial graft.
A major concern when diagnosing a pancreatic cancer is whether or not the cancer has already spread (metastasized) outside of the pancreas. The location of the metastases will determine whether the patient has locoregional or metastatic disease.The location of the metastases will also determine whether the cancer is able to be surgically removed (resectable) or unable to be surgically removed (unresectable).There are certain sites that pancreatic cancer may spread to that usually, but not always, eliminate surgery as a treatment option. They are:
Lymph nodes:
Metastases (mets) to lymph nodes does not automatically eliminate surgery as a treatment option. There are lymph nodes scattered throughout the body. The location of the affected lymph nodes makes a big difference.
For example, the lymph nodes in the groove between the duodenum and the pancreas are a very common site of metastases. These are considered locoregional and are routinely removed during the Whipple surgical procedure. However, the spread of cancer to more distant lymph nodes, such as lymph nodes closer to the liver, may mean the tumor is unresectable.
Liver:
Metastases to the liver are a common finding especially with tumors in the tail and the body of the pancreas. Usually, if there is evidence of liver "mets," surgery will not be an option.
Celiac plexus:
This is a network of many nerves that are grouped around the aorta where it passes through opening in the diaphragm.
It is these nerves that cause back pain when pressed upon by a growing tumor. Therefore, this is where an alcohol is injected during an alcohol nerve block to stop the sensation of pain.
Superior mesenteric vessels:
This artery and vein carry blood to and from the bowels and are closely associated with the pancreas. Therefore, they may become involved by the spreading of the tumor. These blood vessels run between the uncinate process and head of the pancreas. The artery is a branch off of the aorta and carries oxygen-rich blood to abdominal organs. The vein carries oxygen-poor blood to the portal vein which enters the liver.
Ligament of Treitz:
This is actually a thin muscle that wraps around the small intestine where the duodenum and jejunum meet. It passes behind the pancreas and is attached above to the spine and the diaphragm.
Portal vein:
This is another important blood vessel that runs right next to the pancreas. It carries oxygen poor blood to the liver where the blood is filtered. If the cancer has spread to involve the portal vein, the cancer may be considered unresectable. The surgeon may decide that surgery can proceed. If so, they can remove the affected portion of the portal vein and replace it with an artificial graft.
pancreatic cancer prognosis
Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas.
The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine.
Anatomy of the pancreas. The pancreas has three areas: head, body, and tail. It is found in the abdomen near the stomach, intestines, and other organs.
The pancreas has two main jobs in the body:
To produce juices that help digest (break down) food.
To produce hormones, such as insulin and glucagon, that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.
The digestive juices are produced by exocrine pancreas cells and the hormones are produced by endocrine pancreas cells. About 95% of pancreatic cancers begin in exocrine cells.
This summary provides information on exocrine pancreatic cancer. Refer to the PDQ summary on Islet Cell Tumors (Endocrine Pancreas) Treatment for information on endocrine pancreatic cancer.
Smoking and health history can affect the risk of developing pancreatic cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for pancreatic cancer include the following:
Smoking.
Long-standing diabetes.
Chronic pancreatitis.
Certain hereditary conditions, such as hereditary pancreatitis, multiple endocrine neoplasia type 1 syndrome, hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome), von Hippel-Lindau syndrome, ataxia-telangiectasia, and the familial atypical multiple mole melanoma syndrome (FAMMM).
Possible signs of pancreatic cancer include jaundice, pain, and weight loss.
These and other symptoms may be caused by pancreatic cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
Jaundice (yellowing of the skin and whites of the eyes).
Pain in the upper or middle abdomen and back.
Unexplained weight loss.
Loss of appetite.
Fatigue.
Pancreatic cancer is difficult to detect (find) and diagnose early.
Pancreatic cancer is difficult to detect and diagnose for the following reasons:
There aren’t any noticeable signs or symptoms in the early stages of pancreatic cancer.
The signs of pancreatic cancer, when present, are like the signs of many other illnesses.
The pancreas is hidden behind other organs such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts.
Tests that examine the pancreas are used to detect (find), diagnose, and stage pancreatic cancer.
Pancreatic cancer is usually diagnosed with tests and procedures that produce pictures of the pancreas and the area around it. The process used to find out if cancer cells have spread within and around the pancreas is called staging. Tests and procedures to detect, diagnose, and stage pancreatic cancer are usually done at the same time. In order to plan treatment, it is important to know the stage of the disease and whether or not the pancreatic cancer can be removed by surgery. The following tests and procedures may be used:
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A spiral or helical CT scan makes a series of very detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples for biopsy.
Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes pancreatic cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter (a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A dye is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken.
Percutaneous transhepatic cholangiography (PTC): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain bile into the small intestine or a collection bag outside the body. This test is done only if ERCP cannot be done.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. There are several ways to do a biopsy for pancreatic cancer. A fine needle may be inserted into the pancreas during an x-ray or ultrasound to remove cells. Tissue may also be removed during a laparoscopy (a surgical incision made in the wall of the abdomen).
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
Whether or not the tumor can be removed by surgery.
The stage of the cancer (the size of the tumor and whether the cancer has spread outside the pancreas to nearby tissues or lymph nodes or to other places in the body).
The patient’s general health.
Whether the cancer has just been diagnosed or has recurred (come back).
Pancreatic cancer can be controlled only if it is found before it has spread, when it can be removed by surgery. If the cancer has spread, palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease.
The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine.
Anatomy of the pancreas. The pancreas has three areas: head, body, and tail. It is found in the abdomen near the stomach, intestines, and other organs.
The pancreas has two main jobs in the body:
To produce juices that help digest (break down) food.
To produce hormones, such as insulin and glucagon, that help control blood sugar levels. Both of these hormones help the body use and store the energy it gets from food.
The digestive juices are produced by exocrine pancreas cells and the hormones are produced by endocrine pancreas cells. About 95% of pancreatic cancers begin in exocrine cells.
This summary provides information on exocrine pancreatic cancer. Refer to the PDQ summary on Islet Cell Tumors (Endocrine Pancreas) Treatment for information on endocrine pancreatic cancer.
Smoking and health history can affect the risk of developing pancreatic cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for pancreatic cancer include the following:
Smoking.
Long-standing diabetes.
Chronic pancreatitis.
Certain hereditary conditions, such as hereditary pancreatitis, multiple endocrine neoplasia type 1 syndrome, hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome), von Hippel-Lindau syndrome, ataxia-telangiectasia, and the familial atypical multiple mole melanoma syndrome (FAMMM).
Possible signs of pancreatic cancer include jaundice, pain, and weight loss.
These and other symptoms may be caused by pancreatic cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
Jaundice (yellowing of the skin and whites of the eyes).
Pain in the upper or middle abdomen and back.
Unexplained weight loss.
Loss of appetite.
Fatigue.
Pancreatic cancer is difficult to detect (find) and diagnose early.
Pancreatic cancer is difficult to detect and diagnose for the following reasons:
There aren’t any noticeable signs or symptoms in the early stages of pancreatic cancer.
The signs of pancreatic cancer, when present, are like the signs of many other illnesses.
The pancreas is hidden behind other organs such as the stomach, small intestine, liver, gallbladder, spleen, and bile ducts.
Tests that examine the pancreas are used to detect (find), diagnose, and stage pancreatic cancer.
Pancreatic cancer is usually diagnosed with tests and procedures that produce pictures of the pancreas and the area around it. The process used to find out if cancer cells have spread within and around the pancreas is called staging. Tests and procedures to detect, diagnose, and stage pancreatic cancer are usually done at the same time. In order to plan treatment, it is important to know the stage of the disease and whether or not the pancreatic cancer can be removed by surgery. The following tests and procedures may be used:
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A spiral or helical CT scan makes a series of very detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples for biopsy.
Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes pancreatic cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter (a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A dye is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken.
Percutaneous transhepatic cholangiography (PTC): A procedure used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain bile into the small intestine or a collection bag outside the body. This test is done only if ERCP cannot be done.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. There are several ways to do a biopsy for pancreatic cancer. A fine needle may be inserted into the pancreas during an x-ray or ultrasound to remove cells. Tissue may also be removed during a laparoscopy (a surgical incision made in the wall of the abdomen).
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
Whether or not the tumor can be removed by surgery.
The stage of the cancer (the size of the tumor and whether the cancer has spread outside the pancreas to nearby tissues or lymph nodes or to other places in the body).
The patient’s general health.
Whether the cancer has just been diagnosed or has recurred (come back).
Pancreatic cancer can be controlled only if it is found before it has spread, when it can be removed by surgery. If the cancer has spread, palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease.
Ruptured Ovarian Cyst Could Be Dangerous:
Ruptured Ovarian Cyst Could Be Dangerous:the ruptured ovarian cyst can cause not only intense pain, but also further serious medical complications
Ruptured ovarian cyst is a type of ovarian cyst, so we should know the symptoms of regular ovarian cyst before we talk about the ruptured ovarian cyst symptoms.
The following are some regular ovarian cyst symptoms:
•Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent -- this is the most common symptom
•Fullness, heaviness, pressure, swelling, or bloating in the abdomen
•Breast tenderness
•Pain during or shortly after beginning or end of menstrual period.
•Irregular periods, or abnormal uterine bleeding or spotting
•Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy
•Weight gain
•Nausea or vomiting
•Fatigue
•Infertility
•Increased level of hair growth
•Increased facial hair or body hair
•Headaches
•Strange pains in ribs, which feel muscular
•Bloating
•Strange nodules that feel like bruises under the layer of skin
•Feeling of lumps on the lower abdomen
.PS. Some or all of these symptoms may be present, though it is possible not to experience any symptoms.
Ruptured ovarian cyst is a type of ovarian cyst, so we should know the symptoms of regular ovarian cyst before we talk about the ruptured ovarian cyst symptoms.
The following are some regular ovarian cyst symptoms:
•Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent -- this is the most common symptom
•Fullness, heaviness, pressure, swelling, or bloating in the abdomen
•Breast tenderness
•Pain during or shortly after beginning or end of menstrual period.
•Irregular periods, or abnormal uterine bleeding or spotting
•Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy
•Weight gain
•Nausea or vomiting
•Fatigue
•Infertility
•Increased level of hair growth
•Increased facial hair or body hair
•Headaches
•Strange pains in ribs, which feel muscular
•Bloating
•Strange nodules that feel like bruises under the layer of skin
•Feeling of lumps on the lower abdomen
.PS. Some or all of these symptoms may be present, though it is possible not to experience any symptoms.
ovarian cysts and infertility
Ovarian cysts and infertility:
Because ovarian cysts are commonly found in young women, many infertile women will also be noted to have ovarian cysts . These are often detected on routine ultrasound scans, and cause considerable confusion and anxiety in the minds of patients.
An ovarian cyst is just a fluid-filled sac in the ovary. They can vary in size and contain liquid that is thin and watery, or thicker and paste-like. Cysts are very common in the ovary as a result of the ovulation cycle. Even normally, the follicle ( in which the egg grows) contains fluid. If the follicle doesn’t rupture at the time of ovulation ( when the egg is released) , the follicle gets bigger as it swells with fluid. This follicular cyst is also called a functional cyst, because it is a result of ovarian function. The other type of functional cyst is a corpus luteum cyst which develops when the corpus luteum fills with fluid or blood.When bleeding occurs within a functional cyst, this is called a hemorrhagic cyst.
Many women with endometriosis also have ovarian cysts. These are called chocolate cysts, because of the colour of their contents ( old dark blood). Cysts are also found in women with PCOD.
Occasionally a dermoid cyst or a may develop (sometimes called a benign mature cystic teratoma). This type of cyst can contain a range of tissues, such as hair, skin or teeth, because it forms from cells that make eggs in the ovaries. Dermoid cysts are more common in younger women and may need to be surgically removed.
A cystadenoma is a cyst that develops from the cells that cover the outer part of the ovary. There are different types – some are filled with a watery liquid ( serous cystadenoma) , and others with a thicker, mucous substance ( mucinous cystadenoma) . They’re not normally cancerous, but may need to be surgically removed.
Most ovarian cysts do not cause symptoms, and are usually first noted on ultrasound scanning. Partly because of the quality and resolution of the new ultrasound scanners, even small cysts ( which are of no clinical importance) are diagnosed and reported routinely. Many patients then start worrying about the effect of these cysts on their fertility. Unfortunately , sometimes instead of reassuring them, their doctors advise them to get these cysts removed. This often causes more harm than good !
Most cysts do not cause symptoms, and are best left alone. Occasionally, some cysts may cause irregular menstrual bleeding, if the cyst is hormonally active; or pelvic pain . While often the cyst is not the cause of the pain, once the patient knows she has a cyst, everytime she perceives pain, she feels it is the cyst which is causing it ! Cysts can cause pain only if:
· They are large and exert direct pressure on the ovaries and surrounding structures. This causes chronic pelvic fullness or a dull ache.
· Bleeding from a cyst into and around the ovary. This causes more intense, sharp pain.
In rare cases, an ovarian cyst may become twisted and cut off its own blood supply. It is called torsion This can cause severe abdominal pain, vomiting, and fever. This requires immediate medical attention. In other cases, the cyst may burst, causing sudden severe pain in the lower abdomen. The pain you feel depends on what the cyst contained, whether it is infected and whether there is any bleeding. This usually needs treatment in hospital as well.
The key tool for making a diagnosis of an ovarian cyst is an ultrasound scan. If the cyst is very large, an abdominal scan will need to be done to measure its size. Otherwise, the location and size of a cyst is best determined by a vaginal ultrasound scan. Ultrasound scanning allows us to assess the contents of the cyst; and cysts are classified into 3 types, depending upon their ultrasound appearance:
1. cystic . This is the commonest type. This cyst has a wall and contains only fluid.
2. solid. This type has multiple echoes within it, because it is full of solid tissue.
3. complex. This has a combination of both fluid and solid tissue within it. Many of these cysts have walls of tissue within them – these are called septae.
Simple cysts are usually functional cysts, and will resolve on their own. Complex cysts are more worrisome, and may need additional testing , including: MRI scanning; or a blood test to measure the level of CA-125. If there is a tumour, the level of this protein is usually higher than normal.
Treatment of Ovarian Cyst
Wait and See – This approach involves waiting a few months to see if the cyst goes away on its own. In some cases, observation may be all that’s necessary. This is common in pre-menopausal women who have a small, functional cyst. You’ll need to have another ultrasound scan after a month or so to check on the cyst, but most disappear after a few weeks without treatment.
Birth Control Pills – If you have a functional cyst, your doctor may prescribe birth control pills to help make it smaller. If you get ovarian cyst often, birth control pills decrease the chance of new ones forming.
A simple cyst can also be treated by vaginal ultrasound guided aspiration. This will allow the doctor to empty its fluid contents, and maybe useful as a temporizing and diagnostic measure.
Laparoscopic Surgery – Pelvic laparoscopy may be recommended to remove a cyst if it:
· Grows larger or reaches a size greater than 5 cm
· Has some solid material in it
· Causes persistent or worsening symptoms
· Lasts longer than two or three menstrual cycles
If the cyst is not cancerous, often just the cyst can be removed. However, in some cases, your whole ovary may need to be removed.
Most cysts can be removed with laparoscopic surgery by a skilled surgeon, irrespective of their size. ( No matter the size of the cyst, it can be decompressed laparoscopically, causing it to collapse, so that the cyst wall can be removed through a keyhole incision, saving the patient unnecessary major surgery. ) This is usually the preferred mode of treatment in infertile women, because it allows the doctor to save ( conserve) the normal ovarian tissue, thus preserving normal ovarian function.
Rarely, laparotomy ( open surgery) may be needed if the cyst is solid or complex; and if the doctor suspects a malignancy.
Ironically, in many infertile women, the major risk posed by ovarian cysts is not because of the cyst itself, but because of the overenthusiastic zeal of a misguided surgeon, who wants to remove the cyst. This is often much more dangerous, because many trigger-happy surgeons remove the entire ovary, thus compromising ovarian function; and because the surgery can result in scarring ( adhesions) which will then impair tubal function.
Because ovarian cysts are commonly found in young women, many infertile women will also be noted to have ovarian cysts . These are often detected on routine ultrasound scans, and cause considerable confusion and anxiety in the minds of patients.
An ovarian cyst is just a fluid-filled sac in the ovary. They can vary in size and contain liquid that is thin and watery, or thicker and paste-like. Cysts are very common in the ovary as a result of the ovulation cycle. Even normally, the follicle ( in which the egg grows) contains fluid. If the follicle doesn’t rupture at the time of ovulation ( when the egg is released) , the follicle gets bigger as it swells with fluid. This follicular cyst is also called a functional cyst, because it is a result of ovarian function. The other type of functional cyst is a corpus luteum cyst which develops when the corpus luteum fills with fluid or blood.When bleeding occurs within a functional cyst, this is called a hemorrhagic cyst.
Many women with endometriosis also have ovarian cysts. These are called chocolate cysts, because of the colour of their contents ( old dark blood). Cysts are also found in women with PCOD.
Occasionally a dermoid cyst or a may develop (sometimes called a benign mature cystic teratoma). This type of cyst can contain a range of tissues, such as hair, skin or teeth, because it forms from cells that make eggs in the ovaries. Dermoid cysts are more common in younger women and may need to be surgically removed.
A cystadenoma is a cyst that develops from the cells that cover the outer part of the ovary. There are different types – some are filled with a watery liquid ( serous cystadenoma) , and others with a thicker, mucous substance ( mucinous cystadenoma) . They’re not normally cancerous, but may need to be surgically removed.
Most ovarian cysts do not cause symptoms, and are usually first noted on ultrasound scanning. Partly because of the quality and resolution of the new ultrasound scanners, even small cysts ( which are of no clinical importance) are diagnosed and reported routinely. Many patients then start worrying about the effect of these cysts on their fertility. Unfortunately , sometimes instead of reassuring them, their doctors advise them to get these cysts removed. This often causes more harm than good !
Most cysts do not cause symptoms, and are best left alone. Occasionally, some cysts may cause irregular menstrual bleeding, if the cyst is hormonally active; or pelvic pain . While often the cyst is not the cause of the pain, once the patient knows she has a cyst, everytime she perceives pain, she feels it is the cyst which is causing it ! Cysts can cause pain only if:
· They are large and exert direct pressure on the ovaries and surrounding structures. This causes chronic pelvic fullness or a dull ache.
· Bleeding from a cyst into and around the ovary. This causes more intense, sharp pain.
In rare cases, an ovarian cyst may become twisted and cut off its own blood supply. It is called torsion This can cause severe abdominal pain, vomiting, and fever. This requires immediate medical attention. In other cases, the cyst may burst, causing sudden severe pain in the lower abdomen. The pain you feel depends on what the cyst contained, whether it is infected and whether there is any bleeding. This usually needs treatment in hospital as well.
The key tool for making a diagnosis of an ovarian cyst is an ultrasound scan. If the cyst is very large, an abdominal scan will need to be done to measure its size. Otherwise, the location and size of a cyst is best determined by a vaginal ultrasound scan. Ultrasound scanning allows us to assess the contents of the cyst; and cysts are classified into 3 types, depending upon their ultrasound appearance:
1. cystic . This is the commonest type. This cyst has a wall and contains only fluid.
2. solid. This type has multiple echoes within it, because it is full of solid tissue.
3. complex. This has a combination of both fluid and solid tissue within it. Many of these cysts have walls of tissue within them – these are called septae.
Simple cysts are usually functional cysts, and will resolve on their own. Complex cysts are more worrisome, and may need additional testing , including: MRI scanning; or a blood test to measure the level of CA-125. If there is a tumour, the level of this protein is usually higher than normal.
Treatment of Ovarian Cyst
Wait and See – This approach involves waiting a few months to see if the cyst goes away on its own. In some cases, observation may be all that’s necessary. This is common in pre-menopausal women who have a small, functional cyst. You’ll need to have another ultrasound scan after a month or so to check on the cyst, but most disappear after a few weeks without treatment.
Birth Control Pills – If you have a functional cyst, your doctor may prescribe birth control pills to help make it smaller. If you get ovarian cyst often, birth control pills decrease the chance of new ones forming.
A simple cyst can also be treated by vaginal ultrasound guided aspiration. This will allow the doctor to empty its fluid contents, and maybe useful as a temporizing and diagnostic measure.
Laparoscopic Surgery – Pelvic laparoscopy may be recommended to remove a cyst if it:
· Grows larger or reaches a size greater than 5 cm
· Has some solid material in it
· Causes persistent or worsening symptoms
· Lasts longer than two or three menstrual cycles
If the cyst is not cancerous, often just the cyst can be removed. However, in some cases, your whole ovary may need to be removed.
Most cysts can be removed with laparoscopic surgery by a skilled surgeon, irrespective of their size. ( No matter the size of the cyst, it can be decompressed laparoscopically, causing it to collapse, so that the cyst wall can be removed through a keyhole incision, saving the patient unnecessary major surgery. ) This is usually the preferred mode of treatment in infertile women, because it allows the doctor to save ( conserve) the normal ovarian tissue, thus preserving normal ovarian function.
Rarely, laparotomy ( open surgery) may be needed if the cyst is solid or complex; and if the doctor suspects a malignancy.
Ironically, in many infertile women, the major risk posed by ovarian cysts is not because of the cyst itself, but because of the overenthusiastic zeal of a misguided surgeon, who wants to remove the cyst. This is often much more dangerous, because many trigger-happy surgeons remove the entire ovary, thus compromising ovarian function; and because the surgery can result in scarring ( adhesions) which will then impair tubal function.
What is pancreatitis?
What is pancreatitis?
Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum—the first part of the small intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile—a liquid produced in the liver and stored in the gallbladder—to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body regulate the glucose it takes from food for energy.
Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them.
Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur.
The gallbladder and the ducts that carry bile and other digestive enzymes from the liver, gallbladder, and pancreas to the small intestine are called the biliary system.
Both forms of pancreatitis occur more often in men than women.
What is acute pancreatitis?
Acute pancreatitis is inflammation of the pancreas that occurs suddenly and usually resolves in a few days with treatment. Acute pancreatitis can be a life-threatening illness with severe complications. Each year, about 210,000 people in the United States are admitted to the hospital with acute pancreatitis. The most common cause of acute pancreatitis is the presence of gallstones—small, pebble-like substances made of hardened bile—that cause inflammation in the pancreas as they pass through the common bile duct. Chronic, heavy alcohol use is also a common cause. Acute pancreatitis can occur within hours or as long as 2 days after consuming alcohol. Other causes of acute pancreatitis include abdominal trauma, medications, infections, tumors, and genetic abnormalities of the pancreas.
Symptoms:
Acute pancreatitis usually begins with gradual or sudden pain in the upper abdomen that sometimes extends through the back. The pain may be mild at first and feel worse after eating. But the pain is often severe and may become constant and last for several days. A person with acute pancreatitis usually looks and feels very ill and needs immediate medical attention. Other symptoms may include
a swollen and tender abdomen
nausea and vomiting
fever
a rapid pulse
Severe acute pancreatitis may cause dehydration and low blood pressure. The heart, lungs, or kidneys can fail. If bleeding occurs in the pancreas, shock and even death may follow.
Diagnosis:
While asking about a person’s medical history and conducting a thorough physical examination, the doctor will order a blood test to assist in the diagnosis. During acute pancreatitis, the blood contains at least three times the normal amount of amylase and lipase, digestive enzymes formed in the pancreas. Changes may also occur in other body chemicals such as glucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the person’s condition improves, the levels usually return to normal.
Diagnosing acute pancreatitis is often difficult because of the deep location of the pancreas. The doctor will likely order one or more of the following tests:
Abdominal ultrasound. Sound waves are sent toward the pancreas through a handheld device that a technician glides over the abdomen. The sound waves bounce off the pancreas, gallbladder, liver, and other organs, and their echoes make electrical impulses that create a picture—called a sonogram—on a video monitor. If gallstones are causing inflammation, the sound waves will also bounce off them, showing their location.
Computerized tomography (CT) scan. The CT scan is a noninvasive x ray that produces three-dimensional pictures of parts of the body. The person lies on a table that slides into a donut-shaped machine. The test may show gallstones and the extent of damage to the pancreas.
Endoscopic ultrasound (EUS):After spraying a solution to numb the patient’s throat, the doctor inserts an endoscope—a thin, flexible, lighted tube—down the throat, through the stomach, and into the small intestine. The doctor turns on an ultrasound attachment to the scope that produces sound waves to create visual images of the pancreas and bile ducts.
Magnetic resonance cholangiopancreatography (MRCP): MRCP uses magnetic resonance imaging, a noninvasive test that produces cross-section images of parts of the body. After being lightly sedated, the patient lies in a cylinder-like tube for the test. The technician injects dye into the patient’s veins that helps show the pancreas, gallbladder, and pancreatic and bile ducts.
Treatment:Treatment for acute pancreatitis requires a few days’ stay in the hospital for intravenous (IV) fluids, antibiotics, and medication to relieve pain. The person cannot eat or drink so the pancreas can rest. If vomiting occurs, a tube may be placed through the nose and into the stomach to remove fluid and air.
Unless complications arise, acute pancreatitis usually resolves in a few days. In severe cases, the person may require nasogastric feeding—a special liquid given in a long, thin tube inserted through the nose and throat and into the stomach—for several weeks while the pancreas heals.
Before leaving the hospital, the person will be advised not to smoke, drink alcoholic beverages, or eat fatty meals. In some cases, the cause of the pancreatitis is clear, but in others, more tests are needed after the person is discharged and the pancreas is healed.
Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP) for Acute and Chronic Pancreatitis:
ERCP is a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis—gallstones, narrowing or blockage of the pancreatic duct or bile ducts, leaks in the bile ducts, and pseudocysts—accumulations of fluid and tissue debris.
Soon after a person is admitted to the hospital with suspected narrowing of the pancreatic duct or bile ducts, a physician with specialized training performs ERCP.
After lightly sedating the patient and giving medication to numb the throat, the doctor inserts an endoscope—a long, flexible, lighted tube with a camera—through the mouth, throat, and stomach into the small intestine. The endoscope is connected to a computer and screen. The doctor guides the endoscope and injects a special dye into the pancreatic or bile ducts that helps the pancreas, gallbladder, and bile ducts appear on the screen while x rays are taken.
The following procedures can be performed using ERCP:
Sphincterotomy:Using a small wire on the endoscope, the doctor finds the muscle that surrounds the pancreatic duct or bile ducts and makes a tiny cut to enlarge the duct opening. When a pseudocyst is present, the duct is drained.
Gallstone removal. The endoscope is used to remove pancreatic or bile duct stones with a tiny basket. Gallstone removal is sometimes performed along with a sphincterotomy.
Stent placement: Using the endoscope, the doctor places a tiny piece of plastic or metal that looks like a straw in a narrowed pancreatic or bile duct to keep it open.
Balloon dilatation. Some endoscopes have a small balloon that the doctor uses to dilate, or stretch, a narrowed pancreatic or bile duct. A temporary stent may be placed for a few months to keep the duct open.
People who undergo therapeutic ERCP are at slight risk for complications, including severe pancreatitis, infection, bowel perforation, or bleeding. Complications of ERCP are more common in people with acute or recurrent pancreatitis. A patient who experiences fever, trouble swallowing, or increased throat, chest, or abdominal pain after the procedure should notify a doctor immediately.
Complications:
Gallstones that cause acute pancreatitis require surgical removal of the stones and the gallbladder. If the pancreatitis is mild, gallbladder removal—called cholecystectomy—may proceed while the person is in the hospital. If the pancreatitis is severe, gallstones may be removed using therapeutic endoscopic retrograde cholangiopancreatography (ERCP)—a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis. Cholecystectomy is delayed for a month or more to allow for full recovery. If an infection develops, ERCP or surgery may be needed to drain the infected area, also called an abscess. Exploratory surgery may also be necessary to find the source of any bleeding, to rule out conditions that resemble pancreatitis, or to remove severely damaged pancreatic tissue.
Pseudocysts—accumulations of fluid and tissue debris—that may develop in the pancreas can be drained using ERCP or EUS. If pseudocysts are left untreated, enzymes and toxins can enter the bloodstream and affect the heart, lungs, kidneys, or other organs.
Acute pancreatitis sometimes causes kidney failure. People with kidney failure need blood-cleansing treatments called dialysis or a kidney transplant.
In rare cases, acute pancreatitis can cause breathing problems. Hypoxia, a condition that occurs when body cells and tissues do not get enough oxygen, can develop. Doctors treat hypoxia by giving oxygen to the patient. Some people still experience lung failure—even with oxygen—and require a respirator for a while to help them breathe.
What is chronic pancreatitis?
Chronic pancreatitis is inflammation of the pancreas that does not heal or improve—it gets worse over time and leads to permanent damage. Chronic pancreatitis, like acute pancreatitis, occurs when digestive enzymes attack the pancreas and nearby tissues, causing episodes of pain. Chronic pancreatitis often develops in people who are between the ages of 30 and 40.
The most common cause of chronic pancreatitis is many years of heavy alcohol use. The chronic form of pancreatitis can be triggered by one acute attack that damages the pancreatic duct. The damaged duct causes the pancreas to become inflamed. Scar tissue develops and the pancreas is slowly destroyed.
Other causes of chronic pancreatitis are
hereditary disorders of the pancreas
cystic fibrosis—the most common inherited disorder leading to chronic pancreatitis
hypercalcemia—high levels of calcium in the blood
hyperlipidemia or hypertriglyceridemia—high levels of blood fats
some medicines
certain autoimmune conditions
unknown causes
Hereditary pancreatitis can present in a person younger than age 30, but it might not be diagnosed for several years. Episodes of abdominal pain and diarrhea lasting several days come and go over time and can progress to chronic pancreatitis. A diagnosis of hereditary pancreatitis is likely if the person has two or more family members with pancreatitis in more than one generation.
Symptoms:
Most people with chronic pancreatitis experience upper abdominal pain, although some people have no pain at all. The pain may spread to the back, feel worse when eating or drinking, and become constant and disabling. In some cases, abdominal pain goes away as the condition worsens, most likely because the pancreas is no longer making digestive enzymes. Other symptoms include
nausea
vomiting
weight loss
diarrhea
oily stools
People with chronic pancreatitis often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally. Poor digestion leads to malnutrition due to excretion of fat in the stool.
Diagnosis:
Chronic pancreatitis is often confused with acute pancreatitis because the symptoms are similar. As with acute pancreatitis, the doctor will conduct a thorough medical history and physical examination. Blood tests may help the doctor know if the pancreas is still making enough digestive enzymes, but sometimes these enzymes appear normal even though the person has chronic pancreatitis.
In more advanced stages of pancreatitis, when malabsorption and diabetes can occur, the doctor may order blood, urine, and stool tests to help diagnose chronic pancreatitis and monitor its progression.
After ordering x rays of the abdomen, the doctor will conduct one or more of the tests used to diagnose acute pancreatitis—abdominal ultrasound, CT scan, EUS, and MRCP.
Treatment:
Treatment for chronic pancreatitis may require hospitalization for pain management, IV hydration, and nutritional support. Nasogastric feedings may be necessary for several weeks if the person continues to lose weight.
When a normal diet is resumed, the doctor may prescribe synthetic pancreatic enzymes if the pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the person digest food and regain some weight. The next step is to plan a nutritious diet that is low in fat and includes small, frequent meals. A dietitian can assist in developing a meal plan. Drinking plenty of fluids and limiting caffeinated beverages is also important.
People with chronic pancreatitis are strongly advised not to smoke or consume alcoholic beverages, even if the pancreatitis is mild or in the early stages.
Complications:
People with chronic pancreatitis who continue to consume large amounts of alcohol may develop sudden bouts of severe abdominal pain.
As with acute pancreatitis, ERCP is used to identify and treat complications associated with chronic pancreatitis such as gallstones, pseudocysts, and narrowing or obstruction of the ducts. Chronic pancreatitis also can lead to calcification of the pancreas, which means the pancreatic tissue hardens from deposits of insoluble calcium salts. Surgery may be necessary to remove part of the pancreas.
In cases involving persistent pain, surgery or other procedures are sometimes recommended to block the nerves in the abdominal area that cause pain.
When pancreatic tissue is destroyed in chronic pancreatitis and the insulin-producing cells of the pancreas, called beta cells, have been damaged, diabetes may develop. People with a family history of diabetes are more likely to develop the disease. If diabetes occurs, insulin or other medicines are needed to keep blood glucose at normal levels. A health care provider works with the patient to develop a regimen of medication, diet, and frequent blood glucose monitoring.
How common is pancreatitis in children?
Chronic pancreatitis in children is rare. Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis. Children with cystic fibrosis—a progressive and incurable lung disease—may be at risk of developing pancreatitis. But more often the cause of pancreatitis in children is unknown.
Hope through Research:The National Institute of Diabetes and Digestive and Kidney Diseases’ Division of Digestive Diseases and Nutrition supports basic and clinical research into gastrointestinal diseases, including the causes of pancreatitis and cell injury in the gastrointestinal tract. In addition, researchers are studying the genetics of hereditary pancreatitis and risk factors such as cystic fibrosis.
Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research.
Points To Remember:
Pancreatitis is inflammation of the pancreas, causing digestive enzymes to become active inside the pancreas and damage pancreatic tissue.
Pancreatitis has two forms: acute and chronic.
Common causes of pancreatitis are gallstones and heavy alcohol use.
Sometimes the cause of pancreatitis cannot be found.
Symptoms of acute pancreatitis include abdominal pain, nausea, vomiting, fever, and a rapid pulse.
Treatment for acute pancreatitis includes intravenous (IV) fluids, antibiotics, and pain medications. Surgery is sometimes needed to treat complications.
Acute pancreatitis can become chronic if pancreatic tissue is permanently destroyed and scarring develops.
Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, weight loss, diarrhea, and oily stools.
Treatment for chronic pancreatitis may involve IV fluids; pain medication; a low-fat, nutritious diet; and enzyme supplements. Surgery may be necessary to remove part of the pancreas.
Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum—the first part of the small intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile—a liquid produced in the liver and stored in the gallbladder—to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body regulate the glucose it takes from food for energy.
Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them.
Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur.
The gallbladder and the ducts that carry bile and other digestive enzymes from the liver, gallbladder, and pancreas to the small intestine are called the biliary system.
Both forms of pancreatitis occur more often in men than women.
What is acute pancreatitis?
Acute pancreatitis is inflammation of the pancreas that occurs suddenly and usually resolves in a few days with treatment. Acute pancreatitis can be a life-threatening illness with severe complications. Each year, about 210,000 people in the United States are admitted to the hospital with acute pancreatitis. The most common cause of acute pancreatitis is the presence of gallstones—small, pebble-like substances made of hardened bile—that cause inflammation in the pancreas as they pass through the common bile duct. Chronic, heavy alcohol use is also a common cause. Acute pancreatitis can occur within hours or as long as 2 days after consuming alcohol. Other causes of acute pancreatitis include abdominal trauma, medications, infections, tumors, and genetic abnormalities of the pancreas.
Symptoms:
Acute pancreatitis usually begins with gradual or sudden pain in the upper abdomen that sometimes extends through the back. The pain may be mild at first and feel worse after eating. But the pain is often severe and may become constant and last for several days. A person with acute pancreatitis usually looks and feels very ill and needs immediate medical attention. Other symptoms may include
a swollen and tender abdomen
nausea and vomiting
fever
a rapid pulse
Severe acute pancreatitis may cause dehydration and low blood pressure. The heart, lungs, or kidneys can fail. If bleeding occurs in the pancreas, shock and even death may follow.
Diagnosis:
While asking about a person’s medical history and conducting a thorough physical examination, the doctor will order a blood test to assist in the diagnosis. During acute pancreatitis, the blood contains at least three times the normal amount of amylase and lipase, digestive enzymes formed in the pancreas. Changes may also occur in other body chemicals such as glucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the person’s condition improves, the levels usually return to normal.
Diagnosing acute pancreatitis is often difficult because of the deep location of the pancreas. The doctor will likely order one or more of the following tests:
Abdominal ultrasound. Sound waves are sent toward the pancreas through a handheld device that a technician glides over the abdomen. The sound waves bounce off the pancreas, gallbladder, liver, and other organs, and their echoes make electrical impulses that create a picture—called a sonogram—on a video monitor. If gallstones are causing inflammation, the sound waves will also bounce off them, showing their location.
Computerized tomography (CT) scan. The CT scan is a noninvasive x ray that produces three-dimensional pictures of parts of the body. The person lies on a table that slides into a donut-shaped machine. The test may show gallstones and the extent of damage to the pancreas.
Endoscopic ultrasound (EUS):After spraying a solution to numb the patient’s throat, the doctor inserts an endoscope—a thin, flexible, lighted tube—down the throat, through the stomach, and into the small intestine. The doctor turns on an ultrasound attachment to the scope that produces sound waves to create visual images of the pancreas and bile ducts.
Magnetic resonance cholangiopancreatography (MRCP): MRCP uses magnetic resonance imaging, a noninvasive test that produces cross-section images of parts of the body. After being lightly sedated, the patient lies in a cylinder-like tube for the test. The technician injects dye into the patient’s veins that helps show the pancreas, gallbladder, and pancreatic and bile ducts.
Treatment:Treatment for acute pancreatitis requires a few days’ stay in the hospital for intravenous (IV) fluids, antibiotics, and medication to relieve pain. The person cannot eat or drink so the pancreas can rest. If vomiting occurs, a tube may be placed through the nose and into the stomach to remove fluid and air.
Unless complications arise, acute pancreatitis usually resolves in a few days. In severe cases, the person may require nasogastric feeding—a special liquid given in a long, thin tube inserted through the nose and throat and into the stomach—for several weeks while the pancreas heals.
Before leaving the hospital, the person will be advised not to smoke, drink alcoholic beverages, or eat fatty meals. In some cases, the cause of the pancreatitis is clear, but in others, more tests are needed after the person is discharged and the pancreas is healed.
Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP) for Acute and Chronic Pancreatitis:
ERCP is a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis—gallstones, narrowing or blockage of the pancreatic duct or bile ducts, leaks in the bile ducts, and pseudocysts—accumulations of fluid and tissue debris.
Soon after a person is admitted to the hospital with suspected narrowing of the pancreatic duct or bile ducts, a physician with specialized training performs ERCP.
After lightly sedating the patient and giving medication to numb the throat, the doctor inserts an endoscope—a long, flexible, lighted tube with a camera—through the mouth, throat, and stomach into the small intestine. The endoscope is connected to a computer and screen. The doctor guides the endoscope and injects a special dye into the pancreatic or bile ducts that helps the pancreas, gallbladder, and bile ducts appear on the screen while x rays are taken.
The following procedures can be performed using ERCP:
Sphincterotomy:Using a small wire on the endoscope, the doctor finds the muscle that surrounds the pancreatic duct or bile ducts and makes a tiny cut to enlarge the duct opening. When a pseudocyst is present, the duct is drained.
Gallstone removal. The endoscope is used to remove pancreatic or bile duct stones with a tiny basket. Gallstone removal is sometimes performed along with a sphincterotomy.
Stent placement: Using the endoscope, the doctor places a tiny piece of plastic or metal that looks like a straw in a narrowed pancreatic or bile duct to keep it open.
Balloon dilatation. Some endoscopes have a small balloon that the doctor uses to dilate, or stretch, a narrowed pancreatic or bile duct. A temporary stent may be placed for a few months to keep the duct open.
People who undergo therapeutic ERCP are at slight risk for complications, including severe pancreatitis, infection, bowel perforation, or bleeding. Complications of ERCP are more common in people with acute or recurrent pancreatitis. A patient who experiences fever, trouble swallowing, or increased throat, chest, or abdominal pain after the procedure should notify a doctor immediately.
Complications:
Gallstones that cause acute pancreatitis require surgical removal of the stones and the gallbladder. If the pancreatitis is mild, gallbladder removal—called cholecystectomy—may proceed while the person is in the hospital. If the pancreatitis is severe, gallstones may be removed using therapeutic endoscopic retrograde cholangiopancreatography (ERCP)—a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis. Cholecystectomy is delayed for a month or more to allow for full recovery. If an infection develops, ERCP or surgery may be needed to drain the infected area, also called an abscess. Exploratory surgery may also be necessary to find the source of any bleeding, to rule out conditions that resemble pancreatitis, or to remove severely damaged pancreatic tissue.
Pseudocysts—accumulations of fluid and tissue debris—that may develop in the pancreas can be drained using ERCP or EUS. If pseudocysts are left untreated, enzymes and toxins can enter the bloodstream and affect the heart, lungs, kidneys, or other organs.
Acute pancreatitis sometimes causes kidney failure. People with kidney failure need blood-cleansing treatments called dialysis or a kidney transplant.
In rare cases, acute pancreatitis can cause breathing problems. Hypoxia, a condition that occurs when body cells and tissues do not get enough oxygen, can develop. Doctors treat hypoxia by giving oxygen to the patient. Some people still experience lung failure—even with oxygen—and require a respirator for a while to help them breathe.
What is chronic pancreatitis?
Chronic pancreatitis is inflammation of the pancreas that does not heal or improve—it gets worse over time and leads to permanent damage. Chronic pancreatitis, like acute pancreatitis, occurs when digestive enzymes attack the pancreas and nearby tissues, causing episodes of pain. Chronic pancreatitis often develops in people who are between the ages of 30 and 40.
The most common cause of chronic pancreatitis is many years of heavy alcohol use. The chronic form of pancreatitis can be triggered by one acute attack that damages the pancreatic duct. The damaged duct causes the pancreas to become inflamed. Scar tissue develops and the pancreas is slowly destroyed.
Other causes of chronic pancreatitis are
hereditary disorders of the pancreas
cystic fibrosis—the most common inherited disorder leading to chronic pancreatitis
hypercalcemia—high levels of calcium in the blood
hyperlipidemia or hypertriglyceridemia—high levels of blood fats
some medicines
certain autoimmune conditions
unknown causes
Hereditary pancreatitis can present in a person younger than age 30, but it might not be diagnosed for several years. Episodes of abdominal pain and diarrhea lasting several days come and go over time and can progress to chronic pancreatitis. A diagnosis of hereditary pancreatitis is likely if the person has two or more family members with pancreatitis in more than one generation.
Symptoms:
Most people with chronic pancreatitis experience upper abdominal pain, although some people have no pain at all. The pain may spread to the back, feel worse when eating or drinking, and become constant and disabling. In some cases, abdominal pain goes away as the condition worsens, most likely because the pancreas is no longer making digestive enzymes. Other symptoms include
nausea
vomiting
weight loss
diarrhea
oily stools
People with chronic pancreatitis often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally. Poor digestion leads to malnutrition due to excretion of fat in the stool.
Diagnosis:
Chronic pancreatitis is often confused with acute pancreatitis because the symptoms are similar. As with acute pancreatitis, the doctor will conduct a thorough medical history and physical examination. Blood tests may help the doctor know if the pancreas is still making enough digestive enzymes, but sometimes these enzymes appear normal even though the person has chronic pancreatitis.
In more advanced stages of pancreatitis, when malabsorption and diabetes can occur, the doctor may order blood, urine, and stool tests to help diagnose chronic pancreatitis and monitor its progression.
After ordering x rays of the abdomen, the doctor will conduct one or more of the tests used to diagnose acute pancreatitis—abdominal ultrasound, CT scan, EUS, and MRCP.
Treatment:
Treatment for chronic pancreatitis may require hospitalization for pain management, IV hydration, and nutritional support. Nasogastric feedings may be necessary for several weeks if the person continues to lose weight.
When a normal diet is resumed, the doctor may prescribe synthetic pancreatic enzymes if the pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the person digest food and regain some weight. The next step is to plan a nutritious diet that is low in fat and includes small, frequent meals. A dietitian can assist in developing a meal plan. Drinking plenty of fluids and limiting caffeinated beverages is also important.
People with chronic pancreatitis are strongly advised not to smoke or consume alcoholic beverages, even if the pancreatitis is mild or in the early stages.
Complications:
People with chronic pancreatitis who continue to consume large amounts of alcohol may develop sudden bouts of severe abdominal pain.
As with acute pancreatitis, ERCP is used to identify and treat complications associated with chronic pancreatitis such as gallstones, pseudocysts, and narrowing or obstruction of the ducts. Chronic pancreatitis also can lead to calcification of the pancreas, which means the pancreatic tissue hardens from deposits of insoluble calcium salts. Surgery may be necessary to remove part of the pancreas.
In cases involving persistent pain, surgery or other procedures are sometimes recommended to block the nerves in the abdominal area that cause pain.
When pancreatic tissue is destroyed in chronic pancreatitis and the insulin-producing cells of the pancreas, called beta cells, have been damaged, diabetes may develop. People with a family history of diabetes are more likely to develop the disease. If diabetes occurs, insulin or other medicines are needed to keep blood glucose at normal levels. A health care provider works with the patient to develop a regimen of medication, diet, and frequent blood glucose monitoring.
How common is pancreatitis in children?
Chronic pancreatitis in children is rare. Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis. Children with cystic fibrosis—a progressive and incurable lung disease—may be at risk of developing pancreatitis. But more often the cause of pancreatitis in children is unknown.
Hope through Research:The National Institute of Diabetes and Digestive and Kidney Diseases’ Division of Digestive Diseases and Nutrition supports basic and clinical research into gastrointestinal diseases, including the causes of pancreatitis and cell injury in the gastrointestinal tract. In addition, researchers are studying the genetics of hereditary pancreatitis and risk factors such as cystic fibrosis.
Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research.
Points To Remember:
Pancreatitis is inflammation of the pancreas, causing digestive enzymes to become active inside the pancreas and damage pancreatic tissue.
Pancreatitis has two forms: acute and chronic.
Common causes of pancreatitis are gallstones and heavy alcohol use.
Sometimes the cause of pancreatitis cannot be found.
Symptoms of acute pancreatitis include abdominal pain, nausea, vomiting, fever, and a rapid pulse.
Treatment for acute pancreatitis includes intravenous (IV) fluids, antibiotics, and pain medications. Surgery is sometimes needed to treat complications.
Acute pancreatitis can become chronic if pancreatic tissue is permanently destroyed and scarring develops.
Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, weight loss, diarrhea, and oily stools.
Treatment for chronic pancreatitis may involve IV fluids; pain medication; a low-fat, nutritious diet; and enzyme supplements. Surgery may be necessary to remove part of the pancreas.
pancreatic cancer adenocarcinoma
The most common type of cancer of the pancreas is an adenocarcinoma of the pancreas. 85% of all cancerous tumors of the pancreas are adenocarcinomas. Pancreatic adenocarcinoma is the 4th leading cause of cancer deaths in men and women in the United States. The American Cancer Society estimates that each year 29,000 American are diagnosed with adenocarcinoma of the pancreas and approximately 28,000 die of pancreatic cancer.
About 20-40% of patients with pancreatic cancer appear to have the cancer contained entirely within the pancreas at the time of the diagnosis. Surgical removal of the tumor is recommended in this group of patients and this provides the best option for long term survival. Surgery for pancreatic cancer is a highly specialized operation and therefore the patient should be evaluated by a surgeon who is highly experienced in treating this disorder.
About 60-80% of the patients are found to have a locally advanced cancer because it is invading into the surrounding tissues outside the pancreas or where the cancer has metastasized (spread outside of the pancreas).
Risk factors for cancer of the pancreas:
Some of the risk factors for cancer of the pancreas include:
Cigarette Smoking: Cigarette smoking is the single most risk factor for pancreatic cancer. Approximately 30% of pancreatic cancers are thought to be related to excessive cigarette smoking.
Diet: A diet high in meat and fats increase pancreatic cancer risks while fruits, vegetables and dietary fiber appear to have a protective effect.
Diabetes Mellitus: While it is not clear whether diabetes mellitus is a risk factor for pancreatic cancer often patients develop diabetes few months to two to three years prior to manifestation of their cancer. Development of diabetes in an elderly patient should raise concern for pancreatic cancer and lead to a work up for pancreatic cancer.
Chronic pancreatitis: Chronic pancreatitis is long term inflammation of the pancreas. This condition is associated as an increased risk for pancreatic cancer.
Family History: Cancer of the pancreas seems to run in some families. An inherited tendency to develop this cancer may occur in about 5 to 10% of all cases of pancreatic cancer. Some of the DNA changes that give rise to pancreatic cancer can be recognized by genetic testing.
Staging and treatment of pancreatic cancer:
A simplified staging of pancreatic cancer places patients in the following groups for determining appropriate treatment:
Surgically resectable (removable) pancreatic cancer
Advance cancer that is surgically not removable with no evidence of spread to other organs
Metastatic cancer or cancer that has spread to other organs
Resectable (surgically removable) pancreatic cancer
For patients whose tumors are in the pancreas based on information from preoperative staging removal of the tumor by surgical means is the optimal form of therapy.
The type of the surgery depends on the location of the tumor. For tumors that are located in the first part or the head of the pancreas a whipple operation is the required treatment.
For patients whose tumors are located in the body and tail of the pancreas removal of the bottom half with a distal pancreatectomy together with removal of the spleen is the preferred form of surgical treatment.
All patients who undergo resection (removal) of the pancreas will require chemotherapy and/or radiation therapy after the surgery.
Locally advanced cancer:
Here the cancer has grown outside the pancreas to involve surrounding structures particularly blood vessels that are closely associated with the pancreas such as the superior mesenteric artery and superior mesenteric vein. Invasion of the cancer into these blood vessels precludes surgical removal of the tumor.
A determination of a locally advanced cancer should be made by an experienced surgeon based on careful evaluation of radiological (x-ray) studies such as a high quality CT scan. It is important to note that CT scans that are not done in centers specialized in the treatment of pancreatic cancer may not provide optimal information for staging of patients with pancreatic cancer. Removal of the pancreas for pancreatic cancer is a highly specialized operation and therefore the evaluation of the patient for possible surgery should be by a surgeon who is highly experienced in treating this disorder.
In patients who are determined to have unresectable cancer at a center specialized in the treatment of pancreatic cancer, treatment with chemotherapy and/or radiation therapy is recommended since this treatment has been shown clinical studies to provide improved survival.
Some patients with locally advanced tumor may have excellent response to chemotherapy and/or radiation therapy and shrinkage of the tumor may allow an experienced pancreatic surgeon to remove the cancer.
Metastatic pancreatic cancer:
In patients with metastatic pancreatic cancer the tumor is found to have spread outside of the pancreas. The common sites for spread of the tumor is to the liver and to the lining of the intestines or peritoneal surfaces. In general the prognosis is poor when pancreatic cancer is metastatic and treatment is directed toward relief of symptoms to provide a good quality of life. In some patients chemotherapy may provide an improvement in their symptoms.
About 20-40% of patients with pancreatic cancer appear to have the cancer contained entirely within the pancreas at the time of the diagnosis. Surgical removal of the tumor is recommended in this group of patients and this provides the best option for long term survival. Surgery for pancreatic cancer is a highly specialized operation and therefore the patient should be evaluated by a surgeon who is highly experienced in treating this disorder.
About 60-80% of the patients are found to have a locally advanced cancer because it is invading into the surrounding tissues outside the pancreas or where the cancer has metastasized (spread outside of the pancreas).
Risk factors for cancer of the pancreas:
Some of the risk factors for cancer of the pancreas include:
Cigarette Smoking: Cigarette smoking is the single most risk factor for pancreatic cancer. Approximately 30% of pancreatic cancers are thought to be related to excessive cigarette smoking.
Diet: A diet high in meat and fats increase pancreatic cancer risks while fruits, vegetables and dietary fiber appear to have a protective effect.
Diabetes Mellitus: While it is not clear whether diabetes mellitus is a risk factor for pancreatic cancer often patients develop diabetes few months to two to three years prior to manifestation of their cancer. Development of diabetes in an elderly patient should raise concern for pancreatic cancer and lead to a work up for pancreatic cancer.
Chronic pancreatitis: Chronic pancreatitis is long term inflammation of the pancreas. This condition is associated as an increased risk for pancreatic cancer.
Family History: Cancer of the pancreas seems to run in some families. An inherited tendency to develop this cancer may occur in about 5 to 10% of all cases of pancreatic cancer. Some of the DNA changes that give rise to pancreatic cancer can be recognized by genetic testing.
Staging and treatment of pancreatic cancer:
A simplified staging of pancreatic cancer places patients in the following groups for determining appropriate treatment:
Surgically resectable (removable) pancreatic cancer
Advance cancer that is surgically not removable with no evidence of spread to other organs
Metastatic cancer or cancer that has spread to other organs
Resectable (surgically removable) pancreatic cancer
For patients whose tumors are in the pancreas based on information from preoperative staging removal of the tumor by surgical means is the optimal form of therapy.
The type of the surgery depends on the location of the tumor. For tumors that are located in the first part or the head of the pancreas a whipple operation is the required treatment.
For patients whose tumors are located in the body and tail of the pancreas removal of the bottom half with a distal pancreatectomy together with removal of the spleen is the preferred form of surgical treatment.
All patients who undergo resection (removal) of the pancreas will require chemotherapy and/or radiation therapy after the surgery.
Locally advanced cancer:
Here the cancer has grown outside the pancreas to involve surrounding structures particularly blood vessels that are closely associated with the pancreas such as the superior mesenteric artery and superior mesenteric vein. Invasion of the cancer into these blood vessels precludes surgical removal of the tumor.
A determination of a locally advanced cancer should be made by an experienced surgeon based on careful evaluation of radiological (x-ray) studies such as a high quality CT scan. It is important to note that CT scans that are not done in centers specialized in the treatment of pancreatic cancer may not provide optimal information for staging of patients with pancreatic cancer. Removal of the pancreas for pancreatic cancer is a highly specialized operation and therefore the evaluation of the patient for possible surgery should be by a surgeon who is highly experienced in treating this disorder.
In patients who are determined to have unresectable cancer at a center specialized in the treatment of pancreatic cancer, treatment with chemotherapy and/or radiation therapy is recommended since this treatment has been shown clinical studies to provide improved survival.
Some patients with locally advanced tumor may have excellent response to chemotherapy and/or radiation therapy and shrinkage of the tumor may allow an experienced pancreatic surgeon to remove the cancer.
Metastatic pancreatic cancer:
In patients with metastatic pancreatic cancer the tumor is found to have spread outside of the pancreas. The common sites for spread of the tumor is to the liver and to the lining of the intestines or peritoneal surfaces. In general the prognosis is poor when pancreatic cancer is metastatic and treatment is directed toward relief of symptoms to provide a good quality of life. In some patients chemotherapy may provide an improvement in their symptoms.
treatments:
Chemotherapy:
What Is Chemotherapy?
Chemotherapy is a term used by doctors to refer to drugs that can kill cancer cells. Chemotherapy drugs can be given in a variety of ways, including intravenously by injection, intravenously with a pump, or even in pill form taken by mouth. Each drug works against a specific cancer, and each drug has specific doses and schedules for taking it. Chemotherapy can be given in a variety of situations:
Primary chemotherapy is used when colorectal cancer is advanced and has already spread to different parts of your body. In this situation, surgery cannot eliminate the cancer, so your best bet is to be treated with chemotherapy, which can shrink tumor nodules, alleviate symptoms, and prolong life.
Adjuvant chemotherapy is when chemotherapy is given after the cancer is surgically removed. The surgery may not eliminate all the cancer, so the adjuvant chemotherapy treatment is used to kill any cancer cells that may have been missed, such as cells that may have metastasized or spread to the liver.
Neoadjuvant chemotherapy is chemotherapy given before surgery. Chemotherapy drugs may be given prior to surgery in order to shrink the tumor so that the surgeon can completely remove the tumor with fewer complications. Chemotherapy is also given with radiation, as it makes the radiation more effective.
Talk to your doctor to determine the best treatment strategy for you.
Chemotherapy Drugs Used for Colorectal Cancer
5-Fluorouracil (5-FU) has been the first-choice chemotherapy drug for colorectal cancer for many years. It is used in combination with leucovorin (a vitamin), which makes 5-FU more effective. 5-FU is given intravenously. Recently, a pill form of 5-FU has been developed, called Xeloda, which is used for colorectal cancer that has spread to other organs.
Several new chemotherapy drugs also are used for the treatment of colorectal cancer that has spread. These include Camptosar, Eloxatin, Avastin and Erbitux. Camptosar, Eloxatin, and Avastin are usually given along with 5-FU for metastatic colorectal cancer. Erbitux is administred intravenously either alone or with Camptosar.
What Are the Side Effects of Chemotherapy?
Because the mechanism of chemotherapy is to kill rapidly dividing cancer cells, it also kills other rapidly dividing healthy cells in our bodies, such as the membranes lining the mouth, the lining of the gastrointestinal tract, the hair follicles, and the bone marrow. As a result, the side effects of chemotherapy relate to these areas of damaged cells.
The side effects of chemotherapy can include:
Nausea and vomiting
Loss of appetite
Hair loss
Mouth sores
Rash on the hands and feet
Diarrhea
Other side effects associated with chemotherapy's effects on the bone marrow include an increased risk of infection (due to low white blood cell counts), bleeding or bruising from minor injuries (due to low blood platelet counts), and anemia-related fatigue (due to low red blood cell counts).
The side effects that occur with chemotherapy depend upon the particular drugs given and the individual. For example, hair loss is not common in most chemotherapy treatment currently offered for colorectal cancer. However, some people may experience some hair thinning. Although it may take some time, side effects related to chemotherapy will resolve when chemotherapy is stopped.
If you are experiencing any side effects, tell your doctor. In many cases, side effects can be treated or prevented with medications or change in diet.
What Is Chemotherapy?
Chemotherapy is a term used by doctors to refer to drugs that can kill cancer cells. Chemotherapy drugs can be given in a variety of ways, including intravenously by injection, intravenously with a pump, or even in pill form taken by mouth. Each drug works against a specific cancer, and each drug has specific doses and schedules for taking it. Chemotherapy can be given in a variety of situations:
Primary chemotherapy is used when colorectal cancer is advanced and has already spread to different parts of your body. In this situation, surgery cannot eliminate the cancer, so your best bet is to be treated with chemotherapy, which can shrink tumor nodules, alleviate symptoms, and prolong life.
Adjuvant chemotherapy is when chemotherapy is given after the cancer is surgically removed. The surgery may not eliminate all the cancer, so the adjuvant chemotherapy treatment is used to kill any cancer cells that may have been missed, such as cells that may have metastasized or spread to the liver.
Neoadjuvant chemotherapy is chemotherapy given before surgery. Chemotherapy drugs may be given prior to surgery in order to shrink the tumor so that the surgeon can completely remove the tumor with fewer complications. Chemotherapy is also given with radiation, as it makes the radiation more effective.
Talk to your doctor to determine the best treatment strategy for you.
Chemotherapy Drugs Used for Colorectal Cancer
5-Fluorouracil (5-FU) has been the first-choice chemotherapy drug for colorectal cancer for many years. It is used in combination with leucovorin (a vitamin), which makes 5-FU more effective. 5-FU is given intravenously. Recently, a pill form of 5-FU has been developed, called Xeloda, which is used for colorectal cancer that has spread to other organs.
Several new chemotherapy drugs also are used for the treatment of colorectal cancer that has spread. These include Camptosar, Eloxatin, Avastin and Erbitux. Camptosar, Eloxatin, and Avastin are usually given along with 5-FU for metastatic colorectal cancer. Erbitux is administred intravenously either alone or with Camptosar.
What Are the Side Effects of Chemotherapy?
Because the mechanism of chemotherapy is to kill rapidly dividing cancer cells, it also kills other rapidly dividing healthy cells in our bodies, such as the membranes lining the mouth, the lining of the gastrointestinal tract, the hair follicles, and the bone marrow. As a result, the side effects of chemotherapy relate to these areas of damaged cells.
The side effects of chemotherapy can include:
Nausea and vomiting
Loss of appetite
Hair loss
Mouth sores
Rash on the hands and feet
Diarrhea
Other side effects associated with chemotherapy's effects on the bone marrow include an increased risk of infection (due to low white blood cell counts), bleeding or bruising from minor injuries (due to low blood platelet counts), and anemia-related fatigue (due to low red blood cell counts).
The side effects that occur with chemotherapy depend upon the particular drugs given and the individual. For example, hair loss is not common in most chemotherapy treatment currently offered for colorectal cancer. However, some people may experience some hair thinning. Although it may take some time, side effects related to chemotherapy will resolve when chemotherapy is stopped.
If you are experiencing any side effects, tell your doctor. In many cases, side effects can be treated or prevented with medications or change in diet.
colon cancer treatment
Colon Cancer Chemotherapy:
As one of the treatment options for colon cancer, chemotherapy uses drugs to stop the growth of cancer cells. The drugs either kill the cancer cells or stop them from dividing. Chemotherapy may be administered orally, injected into a vein, or placed directly in an area of the body. When used to treat people with colon cancer, chemotherapy may cause side effects, including an increased risk of infection, hair loss,An Overview of Colon Cancer Chemotherapy
Chemotherapy for colon cancer uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken orally or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body. This is called systemic chemotherapy. When chemotherapy is placed directly into the spinal column, an organ, or a body cavity (such as the abdomen), the drugs mainly affect cancer cells in those areas. This is called regional chemotherapy.
Chemoembolization of the hepatic artery may be used for colon cancer treatment when the cancer has spread to the liver. This involves blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver's arteries then deliver the drugs throughout the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.
The way the colon cancer chemotherapy is administered depends on the stage of colon cancer being treated.
Side Effects Associated With Colon Cancer Chemotherapy
Side effects associated with colon cancer chemotherapy depend mainly on the specific drugs used and the dose. In general, anticancer drugs affect cells that divide rapidly, especially:
•Blood cells. These cells fight infection, help the blood to clot, and carry oxygen to all parts of the body. When drugs affect blood cells, patients are more likely to get infections, bruise or bleed easily, or feel very weak and tired.
•Cells in hair roots. Chemotherapy can cause hair loss. The hair grows back, but sometimes the new hair is somewhat different in color and texture.
•Cells that line the digestive tract. Chemotherapy can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Many of these side effects can be controlled with drugs. nausea, vomiting, and lip sores.
As one of the treatment options for colon cancer, chemotherapy uses drugs to stop the growth of cancer cells. The drugs either kill the cancer cells or stop them from dividing. Chemotherapy may be administered orally, injected into a vein, or placed directly in an area of the body. When used to treat people with colon cancer, chemotherapy may cause side effects, including an increased risk of infection, hair loss,An Overview of Colon Cancer Chemotherapy
Chemotherapy for colon cancer uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken orally or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body. This is called systemic chemotherapy. When chemotherapy is placed directly into the spinal column, an organ, or a body cavity (such as the abdomen), the drugs mainly affect cancer cells in those areas. This is called regional chemotherapy.
Chemoembolization of the hepatic artery may be used for colon cancer treatment when the cancer has spread to the liver. This involves blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver's arteries then deliver the drugs throughout the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.
The way the colon cancer chemotherapy is administered depends on the stage of colon cancer being treated.
Side Effects Associated With Colon Cancer Chemotherapy
Side effects associated with colon cancer chemotherapy depend mainly on the specific drugs used and the dose. In general, anticancer drugs affect cells that divide rapidly, especially:
•Blood cells. These cells fight infection, help the blood to clot, and carry oxygen to all parts of the body. When drugs affect blood cells, patients are more likely to get infections, bruise or bleed easily, or feel very weak and tired.
•Cells in hair roots. Chemotherapy can cause hair loss. The hair grows back, but sometimes the new hair is somewhat different in color and texture.
•Cells that line the digestive tract. Chemotherapy can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Many of these side effects can be controlled with drugs. nausea, vomiting, and lip sores.
Ovarian Cysts, Polycystic Ovary syndrome and ovarian cancer
Ovarian cysts:
Ovarian cysts are very common and often exist without symptoms. In a normal cycle, every month several follicles, each containing an egg, develop. A surge of luteinizing hormone and follicle-stimulating hormone helps release the egg, and progesterone increases. If the egg is not fertilized, the cycle starts all over again. Sometimes, however, no egg is released. Then no progesterone is secreted and more estrogen is released, thus maturing the follicles into fluid-filled sacs or cysts that will grow larger every month until progesterone is secreted.
Cysts can appear in a very short time and disappear just as quickly. Cysts can be alone or in groups, small or large (even as big as a lemon!). Often when cysts are a few centimeters in size, doctors will recommend surgery. However, if a diet and supplementation program is followed, those cysts will usually reduce and disappear. The risk of cancer increases when cysts become solid. Ovarian cancer is rare, but it is difficult to diagnose and remission rates with conventional medicine are poor.
Sometimes a follicle is able to grow tissue or skin cells within the cyst. These types of cysts will not dissipate and must be surgically removed.
Symptoms:
Often ovarian cysts are not noticed until a pelvic examination is performed by the doctor or by an ultrasound scan. This is why it is so important to go for your annual PAP test because doctors perform a pelvic exam at the same time. For those with symptoms, the most obvious symptom is pain, either tenderness to the touch or a constant sore or burning sensation in the abdomen, located in the lower abdomen off to the right or left. Pain may occur during ovulation or intercourse. If a cyst erupts in the pelvic cavity, blood and fluid will discharge, possibly causing pain.
Causes:
Ovarian cysts occur when there is a hormone imbalance. Estrogen dominance brought on by poor elimination of waste by the lymphatic system, colon, liver and kidneys is a factor. Emotional or physical trauma, prolonged stress, and even heavy exercise can cause increased estrogen. A diet rich in meat and dairy products is also responsible for elevating estrogen. Cysts that occur after menopause should be looked at by a physician, as there is a greater risk of them being cancerous. The risk of ovarian cancer is increased with the use of fertility drugs or birth control pills, or if you have never been pregnant.
Polycystic Ovary Syndrome:
Polycystic ovary syndrome (PCOS) is a disorder where many fluid-filled cysts are present and male hormones are excessively high. In this disorder, excess luteinizing hormone increases the production of male hormones that can cause acne and coarse hair growth.
Affecting up to 10 percent of the U.S. population, Polycystic Ovary Syndrome is the most common hormone dysfunction among women in their reproductive years. Because eggs are frequently not released, fertility is a problem. If pregnancy does occur, it often ends with first trimester miscarriage or is associated with gestational diabetes. The condition seems to run in families, with 20 percent of mothers and 40 percent of sisters of those with PCOS also demonstrating varying degrees of the syndrome.
With the approach of menopause, androgen production declines, and there is a more normal pattern of menstruation. If left untreated, PCOS can lead to cancer of the uterine lining. Women with PCOS also are at increased risk for development of Type 2 diabetes, cardiovascular disease and hypertension.
Symptoms:PCOS usually shows with coarse hair growth on the face and chest, and higher levels of male androgenic hormones, caused when the pituitary gland releases an excess of luteinizing hormone. Acne and oily skin are also evident. Ovaries are typically enlarged and contain multiple cysts. Symptoms often become apparent in puberty when menstruation is to begin: irregular menstrual periods with copious bleeding may occur, or PCOS can cause a lack of periods altogether. Infertility is a major concern of women with PCOS.
Causes:
Although historically considered a gynecological problem, research now shows that PCOS is associated with hyperinsulinemia (production of too much of the insulin hormone) and impaired glucose metabolism. Perhaps not surprisingly, more than 65 percent of women who suffer from PCOS are obese. Reports indicate that early pubarche (breast budding and pubic hair growth) is linked to ovarian hyperandrogenism and insulin resistance, suggesting another hormonal trigger. Doctors typically try to determine if a tumor is responsible for the production of male hormones. Thyroid and prolactin abnormalities should also be investigated as possible causes of amenorrhea (lack of period).
Since the extra weight seems to be an important issue, those with PCOS should work toward losing excess weight gradually, using proper nutrition and exercise. Doing so will also lessen risks for diabetes and cardiovascular disease.
Ovarian Cancer:
Ovarian cancer is the fifth most diagnosed cancer, accounting for almost 5 percent of all cancer deaths. In fact, about one in 70 women will eventually develop ovarian cancer. Known as the silent killer, vague symptoms make this cancer difficult to detect and allow it to invade other tissues. Ovarian cancer normally strikes between the ages of 50 and 70, and with an almost 60 percent death rate, women need to understand the symptoms so that they can seek treatment early.
Symptoms:
Symptoms of ovarian cancer can mimic common illness and are often vague. According to the Canadian Cancer Society, symptoms of early stage ovarian cancer include a mild discomfort in the lower part of the abdomen, a sense of incomplete evacuation of stool, gas, a frequent need to urinate, indigestion, feeling full after a light meal, low back pain and vaginal discharge. More advanced symptoms include painful intercourse, abnormal bleeding, diarrhea or constipation, abdominal pain, nausea, vomiting and fatigue. A build-up of fluid in the abdomen makes clothes feel tight. At this point, a woman may lose weight or become anemic.
Tests to diagnose ovarian cancer are simple and include a transvaginal ultrasound, a CA-125 blood test and a pelvic exam. Many doctors believe that the CA-125 blood test is not reliable, but the National Ovarian Cancer Association recommends it be done on women with above-noted symptoms. A 1983 Harvard University study found elevated levels in 80 percent of women with stages three and four ovarian cancer. The test was not as reliable with stage one and two cancer, and test results can also be high in women with uterine fibroids and endometriosis. Despite its imperfections, it is the best test that we have when combined with a transvaginal ultrasound. Fortunately, in Canada the CA-125 is covered under provincial health plans. Surgery is the only definitive method of detecting ovarian cancer.
PRESCRIPTION FOR WOMEN'S HEALTH:
Nutrients:
Dosage
Action
Multivitamins with minerals; (contains no iron)
FemmEssentials or MultiEssentials for women
As directed. See Appendix A for the complete listing of recommended nutrients and their actions.
Provides all the nutrients a woman needs every day to support all functions
EstroSense:
Take four capsules. Two at breakfast, two at dinner containing:
Milk Thistle 100 mg
Supports liver health, which is important for metabolism of hormones
D-glucarate 300 mg
Important for healthy metabolism of estrogen; supports normal cell growth
Turmeric 100 mg
95% curcumin)
Prevents abnormal cell growth, detoxifies cancer-causing form of estrogen
Indole-3-carbinol 300 mg
Stops healthy estrogen from converting into the cancer-causing form. Has been shown to reverse abnormal PAP tests within 3 menstrual cycles
Green tea extract 200 mg Protects against abnormal cell growth, detoxifies excess estrogens
Rosemary extract 50 mg
Reduces tumor formation; is antioxidant
Lycopene 10 mg
Antioxidant; reduces risk of cancer
Sulforaphane 400 mcg daily
Reduces risk of cancer; stops abnormal cell growth
Natural progesterone cream:
In Canada, progesterone cream is a prescription drug. Use 6% natural progesterone 1/4to 1/2 tsp morning and night between day 5-28 (or whenever your normal cycle ends). In the U.S., ProgestaCare by Life Flo is niceas it delivers 20 mg in a pre-measured pump dose.
Limits abnormal cell growth caused by too much estrogen. Aids ovulation
Evening Primrose Oil or Borage Oil:
3000 mg per day of Evening Primrose or 2000 mg per day of Borage oil
Anti-inflammatory; controls negative prostaglandins involved in pain and inflammation
Chaste Tree (Vitex) berry:
100-175 mg daily
Balances estrogen-to-progesterone ratio, important for proper cell function Normalizes ovulation and prolactin
HEALTH TIPS TO ENHANCE HEALING:
See health tips for Endometriosis.
Weight loss is essential in those with polycystic ovarian syndrome. See Diabetes for tips on normalizing insulin and improving insulin resistance, which aids PCOS
Ovarian cysts are very common and often exist without symptoms. In a normal cycle, every month several follicles, each containing an egg, develop. A surge of luteinizing hormone and follicle-stimulating hormone helps release the egg, and progesterone increases. If the egg is not fertilized, the cycle starts all over again. Sometimes, however, no egg is released. Then no progesterone is secreted and more estrogen is released, thus maturing the follicles into fluid-filled sacs or cysts that will grow larger every month until progesterone is secreted.
Cysts can appear in a very short time and disappear just as quickly. Cysts can be alone or in groups, small or large (even as big as a lemon!). Often when cysts are a few centimeters in size, doctors will recommend surgery. However, if a diet and supplementation program is followed, those cysts will usually reduce and disappear. The risk of cancer increases when cysts become solid. Ovarian cancer is rare, but it is difficult to diagnose and remission rates with conventional medicine are poor.
Sometimes a follicle is able to grow tissue or skin cells within the cyst. These types of cysts will not dissipate and must be surgically removed.
Symptoms:
Often ovarian cysts are not noticed until a pelvic examination is performed by the doctor or by an ultrasound scan. This is why it is so important to go for your annual PAP test because doctors perform a pelvic exam at the same time. For those with symptoms, the most obvious symptom is pain, either tenderness to the touch or a constant sore or burning sensation in the abdomen, located in the lower abdomen off to the right or left. Pain may occur during ovulation or intercourse. If a cyst erupts in the pelvic cavity, blood and fluid will discharge, possibly causing pain.
Causes:
Ovarian cysts occur when there is a hormone imbalance. Estrogen dominance brought on by poor elimination of waste by the lymphatic system, colon, liver and kidneys is a factor. Emotional or physical trauma, prolonged stress, and even heavy exercise can cause increased estrogen. A diet rich in meat and dairy products is also responsible for elevating estrogen. Cysts that occur after menopause should be looked at by a physician, as there is a greater risk of them being cancerous. The risk of ovarian cancer is increased with the use of fertility drugs or birth control pills, or if you have never been pregnant.
Polycystic Ovary Syndrome:
Polycystic ovary syndrome (PCOS) is a disorder where many fluid-filled cysts are present and male hormones are excessively high. In this disorder, excess luteinizing hormone increases the production of male hormones that can cause acne and coarse hair growth.
Affecting up to 10 percent of the U.S. population, Polycystic Ovary Syndrome is the most common hormone dysfunction among women in their reproductive years. Because eggs are frequently not released, fertility is a problem. If pregnancy does occur, it often ends with first trimester miscarriage or is associated with gestational diabetes. The condition seems to run in families, with 20 percent of mothers and 40 percent of sisters of those with PCOS also demonstrating varying degrees of the syndrome.
With the approach of menopause, androgen production declines, and there is a more normal pattern of menstruation. If left untreated, PCOS can lead to cancer of the uterine lining. Women with PCOS also are at increased risk for development of Type 2 diabetes, cardiovascular disease and hypertension.
Symptoms:PCOS usually shows with coarse hair growth on the face and chest, and higher levels of male androgenic hormones, caused when the pituitary gland releases an excess of luteinizing hormone. Acne and oily skin are also evident. Ovaries are typically enlarged and contain multiple cysts. Symptoms often become apparent in puberty when menstruation is to begin: irregular menstrual periods with copious bleeding may occur, or PCOS can cause a lack of periods altogether. Infertility is a major concern of women with PCOS.
Causes:
Although historically considered a gynecological problem, research now shows that PCOS is associated with hyperinsulinemia (production of too much of the insulin hormone) and impaired glucose metabolism. Perhaps not surprisingly, more than 65 percent of women who suffer from PCOS are obese. Reports indicate that early pubarche (breast budding and pubic hair growth) is linked to ovarian hyperandrogenism and insulin resistance, suggesting another hormonal trigger. Doctors typically try to determine if a tumor is responsible for the production of male hormones. Thyroid and prolactin abnormalities should also be investigated as possible causes of amenorrhea (lack of period).
Since the extra weight seems to be an important issue, those with PCOS should work toward losing excess weight gradually, using proper nutrition and exercise. Doing so will also lessen risks for diabetes and cardiovascular disease.
Ovarian Cancer:
Ovarian cancer is the fifth most diagnosed cancer, accounting for almost 5 percent of all cancer deaths. In fact, about one in 70 women will eventually develop ovarian cancer. Known as the silent killer, vague symptoms make this cancer difficult to detect and allow it to invade other tissues. Ovarian cancer normally strikes between the ages of 50 and 70, and with an almost 60 percent death rate, women need to understand the symptoms so that they can seek treatment early.
Symptoms:
Symptoms of ovarian cancer can mimic common illness and are often vague. According to the Canadian Cancer Society, symptoms of early stage ovarian cancer include a mild discomfort in the lower part of the abdomen, a sense of incomplete evacuation of stool, gas, a frequent need to urinate, indigestion, feeling full after a light meal, low back pain and vaginal discharge. More advanced symptoms include painful intercourse, abnormal bleeding, diarrhea or constipation, abdominal pain, nausea, vomiting and fatigue. A build-up of fluid in the abdomen makes clothes feel tight. At this point, a woman may lose weight or become anemic.
Tests to diagnose ovarian cancer are simple and include a transvaginal ultrasound, a CA-125 blood test and a pelvic exam. Many doctors believe that the CA-125 blood test is not reliable, but the National Ovarian Cancer Association recommends it be done on women with above-noted symptoms. A 1983 Harvard University study found elevated levels in 80 percent of women with stages three and four ovarian cancer. The test was not as reliable with stage one and two cancer, and test results can also be high in women with uterine fibroids and endometriosis. Despite its imperfections, it is the best test that we have when combined with a transvaginal ultrasound. Fortunately, in Canada the CA-125 is covered under provincial health plans. Surgery is the only definitive method of detecting ovarian cancer.
PRESCRIPTION FOR WOMEN'S HEALTH:
Nutrients:
Dosage
Action
Multivitamins with minerals; (contains no iron)
FemmEssentials or MultiEssentials for women
As directed. See Appendix A for the complete listing of recommended nutrients and their actions.
Provides all the nutrients a woman needs every day to support all functions
EstroSense:
Take four capsules. Two at breakfast, two at dinner containing:
Milk Thistle 100 mg
Supports liver health, which is important for metabolism of hormones
D-glucarate 300 mg
Important for healthy metabolism of estrogen; supports normal cell growth
Turmeric 100 mg
95% curcumin)
Prevents abnormal cell growth, detoxifies cancer-causing form of estrogen
Indole-3-carbinol 300 mg
Stops healthy estrogen from converting into the cancer-causing form. Has been shown to reverse abnormal PAP tests within 3 menstrual cycles
Green tea extract 200 mg Protects against abnormal cell growth, detoxifies excess estrogens
Rosemary extract 50 mg
Reduces tumor formation; is antioxidant
Lycopene 10 mg
Antioxidant; reduces risk of cancer
Sulforaphane 400 mcg daily
Reduces risk of cancer; stops abnormal cell growth
Natural progesterone cream:
In Canada, progesterone cream is a prescription drug. Use 6% natural progesterone 1/4to 1/2 tsp morning and night between day 5-28 (or whenever your normal cycle ends). In the U.S., ProgestaCare by Life Flo is niceas it delivers 20 mg in a pre-measured pump dose.
Limits abnormal cell growth caused by too much estrogen. Aids ovulation
Evening Primrose Oil or Borage Oil:
3000 mg per day of Evening Primrose or 2000 mg per day of Borage oil
Anti-inflammatory; controls negative prostaglandins involved in pain and inflammation
Chaste Tree (Vitex) berry:
100-175 mg daily
Balances estrogen-to-progesterone ratio, important for proper cell function Normalizes ovulation and prolactin
HEALTH TIPS TO ENHANCE HEALING:
See health tips for Endometriosis.
Weight loss is essential in those with polycystic ovarian syndrome. See Diabetes for tips on normalizing insulin and improving insulin resistance, which aids PCOS
ovarian cysts
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than a cantaloupe.
Most ovarian cysts are functional in nature, and harmless (benign). In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
Most ovarian cysts are functional in nature, and harmless (benign). In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
ovarian cancer prevention
The first step of ovarian cancer prevention is recognizing your personal risk factors for the condition and controlling them, if possible. Risk factors that can be controlled include use of fertility drugs or hormone replacement therapy. The second step of ovarian cancer prevention is engaging in behaviors that may protect you against the disease. For example, women with a fam
Ovarian Cancer Prevention: An Overview
Doctors cannot always explain why one person will get ovarian cancer and another person will not. However, research scientists have studied general patterns of cancer in the population to learn what may increase a person's chances of developing cancer.
Anything that increases a person's chances of developing a disease is called a risk factor; anything that decreases a person's chances is called a protective factor. Ovarian cancer prevention means avoiding the risk factors and increasing the protective factors that can be controlled so that the chances of developing ovarian cancer decrease.
Ovarian Cancer Prevention: Know the Risk Factors
The first step in ovarian cancer prevention is knowing what the risk factors are for the disease. Some ovarian cancer risk factors can be avoided, but many cannot.
Studies have identified the following ovarian cancer risk factors:
Family history of ovarian cancer
Age over 50
No history of childbirth
Personal history of breast cancer or colon cancer
Use of fertility drugs
Use of talc in the genital area
Use of hormone replacement therapy.
ily history of ovarian cancer may have a prophylactic oophorectomy
Ovarian Cancer Prevention: An Overview
Doctors cannot always explain why one person will get ovarian cancer and another person will not. However, research scientists have studied general patterns of cancer in the population to learn what may increase a person's chances of developing cancer.
Anything that increases a person's chances of developing a disease is called a risk factor; anything that decreases a person's chances is called a protective factor. Ovarian cancer prevention means avoiding the risk factors and increasing the protective factors that can be controlled so that the chances of developing ovarian cancer decrease.
Ovarian Cancer Prevention: Know the Risk Factors
The first step in ovarian cancer prevention is knowing what the risk factors are for the disease. Some ovarian cancer risk factors can be avoided, but many cannot.
Studies have identified the following ovarian cancer risk factors:
Family history of ovarian cancer
Age over 50
No history of childbirth
Personal history of breast cancer or colon cancer
Use of fertility drugs
Use of talc in the genital area
Use of hormone replacement therapy.
ily history of ovarian cancer may have a prophylactic oophorectomy
ovarian cancer research
Ovarian Cancer Research
The goals of research on ovarian cancer are to improve current treatments and discover new ones. For example, scientists are currently studying biotherapy and high-dose chemotherapy with stem cell transplant as possible treatments for this disease. In order for research to be conducted, volunteers are needed. These people play an important role in furthering our understanding o
Ovarian Cancer Research: An Introduction
Doctors and scientists are hard at work conducting research on ovarian cancer. These studies are designed to answer important questions and to find out whether new approaches are safe and effective. This research has already led to many advances, and scientists are continuing to explore more effective methods for dealing with this disease.
Current Areas of Research on Ovarian Cancer
Ovarian cancer research scientists are currently studying surgery, radiation therapy, chemotherapy (including high-dose chemotherapy), biological therapy, and combinations of these types of treatments for ovarian cancer.
Biological therapy is a treatment that uses the person's immune system to fight cancer. In biological therapy, substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
f ovarian cancer, and may benefit from new treatment methods.
The goals of research on ovarian cancer are to improve current treatments and discover new ones. For example, scientists are currently studying biotherapy and high-dose chemotherapy with stem cell transplant as possible treatments for this disease. In order for research to be conducted, volunteers are needed. These people play an important role in furthering our understanding o
Ovarian Cancer Research: An Introduction
Doctors and scientists are hard at work conducting research on ovarian cancer. These studies are designed to answer important questions and to find out whether new approaches are safe and effective. This research has already led to many advances, and scientists are continuing to explore more effective methods for dealing with this disease.
Current Areas of Research on Ovarian Cancer
Ovarian cancer research scientists are currently studying surgery, radiation therapy, chemotherapy (including high-dose chemotherapy), biological therapy, and combinations of these types of treatments for ovarian cancer.
Biological therapy is a treatment that uses the person's immune system to fight cancer. In biological therapy, substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
f ovarian cancer, and may benefit from new treatment methods.
ovarian cancer research foundation
Ovarian Cancer Research FoundationThe Ovarian Cancer Research Foundation (OCRF) was established in May 2000 and led by eminent gynaecological oncology specialist, Chairman/Co-Founder Associate Professor Thomas Jobling and CEO/Co-Founder Liz Heliotis. It has developed to become one of Australia’s pre-eminent body supporting ovarian cancer research programs that occur nationally, and are focused upon the understanding of the causes of ovarian cancer, its early detection and improve patient survival.
A gynaecological cancer, cancer of the ovaries is one of the most common cancers affecting women and is often detected in the advanced stage of the disease, resulting in a high mortality rate. This is because the symptoms of ovarian cancer are not recognised immediately. Once diagnosed, treatment will usually include surgery and chemotherapy, depending on the stage of the cancer at diagnosis.
One goal of the OCRF is to improve the mortality rate and long-term survival rates for ovarian cancer. This may be achieved by the development of an early detection program - which is the focus of much of the ovarian cancer fundraising activities of the OCRF - and by raising community awareness.
Many fundraising initiatives are undertaken by the OCRF, such as the annual Silver Ribbon Campaign, the proceeds of which directly provide funding for research into an early detection program for cancer of the ovaries. Donations can also be made directly to the Foundation - to make a donation to the OCRF for ovarian cancer research, go to the Make a Donation page of this website or contact the Ovarian Cancer Research Foundation
A gynaecological cancer, cancer of the ovaries is one of the most common cancers affecting women and is often detected in the advanced stage of the disease, resulting in a high mortality rate. This is because the symptoms of ovarian cancer are not recognised immediately. Once diagnosed, treatment will usually include surgery and chemotherapy, depending on the stage of the cancer at diagnosis.
One goal of the OCRF is to improve the mortality rate and long-term survival rates for ovarian cancer. This may be achieved by the development of an early detection program - which is the focus of much of the ovarian cancer fundraising activities of the OCRF - and by raising community awareness.
Many fundraising initiatives are undertaken by the OCRF, such as the annual Silver Ribbon Campaign, the proceeds of which directly provide funding for research into an early detection program for cancer of the ovaries. Donations can also be made directly to the Foundation - to make a donation to the OCRF for ovarian cancer research, go to the Make a Donation page of this website or contact the Ovarian Cancer Research Foundation
Treatment
Treatment
Health care professionals specializing in pelvic cancers at UCSF Medical Center will discuss all available therapies with you and make recommendations based on the stage of your disease, age and the overall condition of your health.
Surgery — Surgery to remove the cancerous growth is the primary method for diagnosing and treating ovarian cancer.
Radiation Therapy — This treatment uses high-energy rays to damage cancer cells and stop them from growing. It is a localized treatment, which means that it works to attack cancer cells in one area. The radiation may come from a large machine, which is called external radiation, or from radioactive materials placed directly into the ovaries, called implant radiation. Some patients receive both types of radiation therapy.
Chemotherapy — Drugs to kill cancer cells are most often used when ovarian cancer has spread to other parts of the body. A patient may receive just one drug or a combination of drugs in cycles. Chemotherapy may be given by injection into a vein or orally. It is a systematic treatment, meaning that the drugs flow through the body in the bloodstream
Health care professionals specializing in pelvic cancers at UCSF Medical Center will discuss all available therapies with you and make recommendations based on the stage of your disease, age and the overall condition of your health.
Surgery — Surgery to remove the cancerous growth is the primary method for diagnosing and treating ovarian cancer.
Radiation Therapy — This treatment uses high-energy rays to damage cancer cells and stop them from growing. It is a localized treatment, which means that it works to attack cancer cells in one area. The radiation may come from a large machine, which is called external radiation, or from radioactive materials placed directly into the ovaries, called implant radiation. Some patients receive both types of radiation therapy.
Chemotherapy — Drugs to kill cancer cells are most often used when ovarian cancer has spread to other parts of the body. A patient may receive just one drug or a combination of drugs in cycles. Chemotherapy may be given by injection into a vein or orally. It is a systematic treatment, meaning that the drugs flow through the body in the bloodstream
ovarian cancer
Ovarian cancer originates in the cells of the ovaries, including surface epithelial cells, germ cells and the sex cord-stromal cells. Ovarian tumors include:
Germ Cell Tumors — Ovarian germ cell tumors develop from cells that produce the ova or eggs. Most germ cell tumors are benign, although some are cancerous and may be life-threatening. The most common germ cell malignancies are maturing teratomas, dysgerminomas and endodermal sinus tumors. Teenagers and women in their 20s are most often diagnosed with germ cell malignancies. Before combination chemotherapy was available as a treatment, the most aggressive of these tumors — the GNP abnormal sinus tumor — was associated with a one-year disease-free survival rate of only 10 percent to 19 percent, even though 70 percent of these tumors were diagnosed very early. Today, however, 90 percent of women with ovarian germ cell malignancies can be cured and their fertility preserved.
Stromal Tumors — Ovarian stromal tumors develop from connective tissue cells that hold the ovary together and those that produce the hormones estrogen and progesterone. The most common types are granulosa-theca tumors and Sertoli-Leydig cell tumors. These tumors are fairly rare and usually are considered low-grade cancers.
Epithelial Tumors — Epithelial ovarian cancer develops from the thin layer of cells, called the epithelium, that covers the ovary. Most epithelial ovarian tumors are benign, including including serous adenomas, mucinous adenomas and Brenner tumors. Cancerous epithelial tumors are the most common and the most serious of ovarian cancers, accounting for 85 percent to 90 percent of all ovarian cancer. Some ovarian epithelial tumors don't appear clearly cancerous under the microscope and are called borderline tumors or tumors of low malignant potential (LMP tumors).
When cancer is diagnosed early while the tumor is limited to the ovary, the cure rate is better than 90 percent. Unfortunately, about two-thirds of women with ovarian cancer initially seek medical attention when the tumor is already advanced and has spread outside of the ovary. In these instances, the five-year survival rate is significantly lower.
Ovarian cancer often does not have signs or symptoms until later in its development. Symptoms may include:
Abdominal bloating or swelling
Abdominal or pelvic pain
Difficulty eating or feeling full quickly
Frequent urination or feeling a need to urinate
If these symptoms are persistent and a change from the norm, you should see a gynecologist.
Others symptoms of ovarian cancer can include:
Back pain
Constipation
Fatigue
Menstrual changes
Pain during sex
Upset stomach
These symptoms, however, may be caused by other conditions and aren't necessarily signs of ovarian cancer.
Germ Cell Tumors — Ovarian germ cell tumors develop from cells that produce the ova or eggs. Most germ cell tumors are benign, although some are cancerous and may be life-threatening. The most common germ cell malignancies are maturing teratomas, dysgerminomas and endodermal sinus tumors. Teenagers and women in their 20s are most often diagnosed with germ cell malignancies. Before combination chemotherapy was available as a treatment, the most aggressive of these tumors — the GNP abnormal sinus tumor — was associated with a one-year disease-free survival rate of only 10 percent to 19 percent, even though 70 percent of these tumors were diagnosed very early. Today, however, 90 percent of women with ovarian germ cell malignancies can be cured and their fertility preserved.
Stromal Tumors — Ovarian stromal tumors develop from connective tissue cells that hold the ovary together and those that produce the hormones estrogen and progesterone. The most common types are granulosa-theca tumors and Sertoli-Leydig cell tumors. These tumors are fairly rare and usually are considered low-grade cancers.
Epithelial Tumors — Epithelial ovarian cancer develops from the thin layer of cells, called the epithelium, that covers the ovary. Most epithelial ovarian tumors are benign, including including serous adenomas, mucinous adenomas and Brenner tumors. Cancerous epithelial tumors are the most common and the most serious of ovarian cancers, accounting for 85 percent to 90 percent of all ovarian cancer. Some ovarian epithelial tumors don't appear clearly cancerous under the microscope and are called borderline tumors or tumors of low malignant potential (LMP tumors).
When cancer is diagnosed early while the tumor is limited to the ovary, the cure rate is better than 90 percent. Unfortunately, about two-thirds of women with ovarian cancer initially seek medical attention when the tumor is already advanced and has spread outside of the ovary. In these instances, the five-year survival rate is significantly lower.
Ovarian cancer often does not have signs or symptoms until later in its development. Symptoms may include:
Abdominal bloating or swelling
Abdominal or pelvic pain
Difficulty eating or feeling full quickly
Frequent urination or feeling a need to urinate
If these symptoms are persistent and a change from the norm, you should see a gynecologist.
Others symptoms of ovarian cancer can include:
Back pain
Constipation
Fatigue
Menstrual changes
Pain during sex
Upset stomach
These symptoms, however, may be caused by other conditions and aren't necessarily signs of ovarian cancer.
ovarian cancer prognosis
A prognosis is a medical opinion as to the likely course and outcome of the disease based on the experiences of hundreds of patients. However, various factors can affect this, such as the patient's general health and response to treatment, as well as the cancer's stage. For that reason, a prognosis for ovarian cancer cannot be used to predict with certainty what will happen to a specific person
Prognosis for Ovarian Cancer: An Overview
Women who are facing ovarian cancer are naturally concerned about what their future holds. Understanding ovarian cancer and what to expect can help patients and their loved ones plan appropriate treatment, think about lifestyle changes, and make decisions about their quality of life and finances. Many people with ovarian cancer want to know their prognosis, so they may ask their doctor or search for ovarian cancer statistics on their own.
What Is an Ovarian Cancer Prognosis?
A prognosis is a medical opinion as to the likely course and outcome of a disease. In other words, the prognosis is the chance that a patient will recover or have a recurrence (return of the cancer).
Factors that can affect a woman's ovarian cancer prognosis include:
The type and location of the cancer
The stage of the disease (the extent to which the cancer has metastasized, or spread)
The person's age, general health, and response to treatment
Prognosis for Ovarian Cancer: An Overview
Women who are facing ovarian cancer are naturally concerned about what their future holds. Understanding ovarian cancer and what to expect can help patients and their loved ones plan appropriate treatment, think about lifestyle changes, and make decisions about their quality of life and finances. Many people with ovarian cancer want to know their prognosis, so they may ask their doctor or search for ovarian cancer statistics on their own.
What Is an Ovarian Cancer Prognosis?
A prognosis is a medical opinion as to the likely course and outcome of a disease. In other words, the prognosis is the chance that a patient will recover or have a recurrence (return of the cancer).
Factors that can affect a woman's ovarian cancer prognosis include:
The type and location of the cancer
The stage of the disease (the extent to which the cancer has metastasized, or spread)
The person's age, general health, and response to treatment
ovarian cyst:ruptured:
Ruptured Ovarian Cyst
Ovarian cyst is a very common incidence among the menstruating women. In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.
Most often, a regular ovarian cyst causes no symptoms and resolve by itself. But some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
In some cases, especially when an ovarian cyst is not found and resolved earlier on, it can rupture. We call this kind of ovarian cyst a ruptured ovarian cyst. The ruptured ovarian cyst can cause not only intense pain, but also further serious medical complications.
Ovarian cyst is a very common incidence among the menstruating women. In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.
Most often, a regular ovarian cyst causes no symptoms and resolve by itself. But some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
In some cases, especially when an ovarian cyst is not found and resolved earlier on, it can rupture. We call this kind of ovarian cyst a ruptured ovarian cyst. The ruptured ovarian cyst can cause not only intense pain, but also further serious medical complications.
colon cancer symptoms
What is the Colon?
In order to understand what colon cancer symptoms might feel like, it helps to learn a bit about the colon. The colon is an important part of the digestive system, and as such, it has a major role in helping the body absorb nutrients, minerals, and water. The colon also helps rid the body of waste in the form of stool. The colon makes up the majority of the large intestine, approximately six feet in length. The last six inches or so of the large intestine are the rectum and the anal canal.
What are the Symptoms of Colon Cancer?
Colon cancer can have many symptoms. However, in the early stages, people with colon cancer often have no symptoms at all. This is why regular screening beginning at 50 is an important investment in your healthy future.
Colon cancer symptoms come in two general varieties:
1.Local
2.Systemic
Local Colon Cancer Symptoms
Local colon cancer symptoms affect your bathroom habits and the colon itself. Some of the more common local symptoms of colon cancer include:
•Changes in your bowel habits, such as bowel movements that are either more or less frequent than normal
•Constipation (difficulty having a bowel movement or straining to have a bowel movement)
•Diarrhea (loose or watery stools)
•Intermittent (alternating) constipation and diarrhea
•Bright red or dark red blood in your stools or black, dark colored, "tarry" stools
•Stools that are thinner than normal ("pencil stools") or feeling as if you cannot empty your bowels completely
•Abdominal (midsection) discomfort, bloating, frequent gas pains, or cramps
If you experience any of these for two or more weeks, call your doctor right away to discuss your concerns and arrange for tests to get to the bottom of your symptoms.
Systemic Colon Cancer Symptoms
Systemic colon cancer symptoms are those that affect your whole body, such as weight loss, and include:
•Unintentional weight loss (losing weight when not dieting or trying to lose weight)
•Loss of appetite
•Unexplained fatigue (extreme tiredness)
•Nausea or vomiting
•Anemia (low red blood cell count or low iron in your red blood cells)
•Jaundice (yellow color to the skin and whites of the eyes)
If you experience any of these for any length of time, even a few days, call your doctor right away to discuss your concerns and arrange for tests to get to the bottom of your symptoms.
What Should I Do if I Have Colon Cancer Symptoms?
Call your doctor so he or she can set up an appointment to see you. During the appointment your doctor will take a medical history, collect blood samples for testing, and schedule you for follow-up tests, if needed.
Many people are afraid of colon cancer screening. They worry that it will hurt and that it is embarrassing. Your doctor and nurse have performed hundreds, and in some cases even thousands, of these procedures. There is nothing to be embarrassed about and remember: Even your doctor and nurse undergo these same tests to take care of their own health.
Preparing for Colon Cancer Tests
If you are worried about preparing for your colon cancer tests, ask your doctor about how best to get ready for any procedures. There are different medications for clearing your colon of stool to ensure a good screening. There is no reason to suffer in silence!
Diagnosis of Colon Cancer and How Not to Dread Colon Cancer Screening provide detailed information on screening procedures, plus tips on how to make preparing for these tests easier.
In order to understand what colon cancer symptoms might feel like, it helps to learn a bit about the colon. The colon is an important part of the digestive system, and as such, it has a major role in helping the body absorb nutrients, minerals, and water. The colon also helps rid the body of waste in the form of stool. The colon makes up the majority of the large intestine, approximately six feet in length. The last six inches or so of the large intestine are the rectum and the anal canal.
What are the Symptoms of Colon Cancer?
Colon cancer can have many symptoms. However, in the early stages, people with colon cancer often have no symptoms at all. This is why regular screening beginning at 50 is an important investment in your healthy future.
Colon cancer symptoms come in two general varieties:
1.Local
2.Systemic
Local Colon Cancer Symptoms
Local colon cancer symptoms affect your bathroom habits and the colon itself. Some of the more common local symptoms of colon cancer include:
•Changes in your bowel habits, such as bowel movements that are either more or less frequent than normal
•Constipation (difficulty having a bowel movement or straining to have a bowel movement)
•Diarrhea (loose or watery stools)
•Intermittent (alternating) constipation and diarrhea
•Bright red or dark red blood in your stools or black, dark colored, "tarry" stools
•Stools that are thinner than normal ("pencil stools") or feeling as if you cannot empty your bowels completely
•Abdominal (midsection) discomfort, bloating, frequent gas pains, or cramps
If you experience any of these for two or more weeks, call your doctor right away to discuss your concerns and arrange for tests to get to the bottom of your symptoms.
Systemic Colon Cancer Symptoms
Systemic colon cancer symptoms are those that affect your whole body, such as weight loss, and include:
•Unintentional weight loss (losing weight when not dieting or trying to lose weight)
•Loss of appetite
•Unexplained fatigue (extreme tiredness)
•Nausea or vomiting
•Anemia (low red blood cell count or low iron in your red blood cells)
•Jaundice (yellow color to the skin and whites of the eyes)
If you experience any of these for any length of time, even a few days, call your doctor right away to discuss your concerns and arrange for tests to get to the bottom of your symptoms.
What Should I Do if I Have Colon Cancer Symptoms?
Call your doctor so he or she can set up an appointment to see you. During the appointment your doctor will take a medical history, collect blood samples for testing, and schedule you for follow-up tests, if needed.
Many people are afraid of colon cancer screening. They worry that it will hurt and that it is embarrassing. Your doctor and nurse have performed hundreds, and in some cases even thousands, of these procedures. There is nothing to be embarrassed about and remember: Even your doctor and nurse undergo these same tests to take care of their own health.
Preparing for Colon Cancer Tests
If you are worried about preparing for your colon cancer tests, ask your doctor about how best to get ready for any procedures. There are different medications for clearing your colon of stool to ensure a good screening. There is no reason to suffer in silence!
Diagnosis of Colon Cancer and How Not to Dread Colon Cancer Screening provide detailed information on screening procedures, plus tips on how to make preparing for these tests easier.
ovarian cancer:survical rates
What is the survival rate for ovarian cancer?
Every woman with ovarian cancer is treated as an individual case, depending on the stage of the disease and other personal factors, and so it is difficult to give a general prognosis.
If the cancer is diagnosed and treated early, between 80-100% of patients will survive for more than five years. Approximately 20% of women diagnosed at later stages will survive for more than five years. This figure, however, is improving all the time with better treatment. See 'How is Ovarian Cancer Treated?' for further discussion about survival rates.
Every woman with ovarian cancer is treated as an individual case, depending on the stage of the disease and other personal factors, and so it is difficult to give a general prognosis.
If the cancer is diagnosed and treated early, between 80-100% of patients will survive for more than five years. Approximately 20% of women diagnosed at later stages will survive for more than five years. This figure, however, is improving all the time with better treatment. See 'How is Ovarian Cancer Treated?' for further discussion about survival rates.
colon cancer
Colon cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Such cancer is sometimes referred to as "colorectal cancer."
Other types of colon cancer, such as lymphoma, carcinoid tumors, melanoma, and sarcomas, are rare. In this article, use of the term "colon cancer" refers to colon carcinoma and not these rare types of colon cancer.
Causes
According to the American Cancer Society, colorectal cancer is one of the leading causes of cancer-related deaths in the United States. (However, early diagnosis often leads to a complete cure.)
There is no single cause for colon cancer. Nearly all colon cancers begin as noncancerous (benign) polyps, which slowly develop into cancer.
You have a higher risk for colon cancer if you have:
Cancer elsewhere in the body
Colorectal polyps
Crohn's disease
Family history of colon cancer
Personal history of breast cancer
Ulcerative colitis
Certain genetic syndromes also increase the risk of developing colon cancer.
What you eat may play a role in your risk of colon cancer. Colon cancer may be associated with a high-fat, low-fiber diet and red meat. However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear.
Smoking cigarettes is another risk factor for colorectal cancer.
Symptoms
Many cases of colon cancer have no symptoms. The following symptoms, however, may indicate colon cancer:
Abdominal pain and tenderness in the lower abdomen
Blood in the stool
Diarrhea, constipation, or other change in bowel habits
Intestinal obstruction
Narrow stools
Unexplained anemia
Weight loss with no known reason
Exams and Tests
With proper screening, colon cancer can be detected before symptoms develop, when it is most curable.
Your doctor will perform a physical exam and press on your belly area. The physical exam rarely shows any problems, although the doctor may feel a mass in the abdomen. A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.
Imaging tests to diagnose colorectal cancer include:
Colonoscopy
Sigmoidoscopy
Note: Only colonoscopy can see the entire colon.
A fecal occult blood test (FOBT) may detect small amounts of blood in the stool, which could suggest colon cancer. However, this test is often negative in patients with colon cancer. For this reason, a FOBT must be done along with colonoscopy or sigmoidoscopy. It is also important to note that a positive FOBT doesn't necessarily mean you have cancer.
A complete blood count may show signs of anemia with low iron levels.
If your doctor learns that you do have colorectal cancer, more tests will be done to see if the cancer has spread. This is called staging.
Stage 0: Very early cancer on the innermost layer of the intestine
Stage I: Cancer is in the inner layers of the colon
Stage II: Cancer has spread through the muscle wall of the colon
Stage III: Cancer has spread to the lymph nodes
Stage IV: Cancer has spread to other organs
Treatment
Treatment depends partly on the stage of the cancer. In general, treatments may include:
Chemotherapy to kill cancer cells
Surgery to remove cancer cells
Radiation therapy to destroy cancerous tissue
Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. (See: Colon resection)
There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.
Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 - 8 months. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients.
Chemotherapy is also used to treat patients with stage IV colon cancer. Irinotecan, oxaliplatin, and 5-fluorouracil are the three most commonly used drugs. In addition, monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), and bevacizumab (Avastin) have been used alone or in combination with chemotherapy.
You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluorouracil.
For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include:
Burning the cancer (ablation)
Cutting out the cancer
Delivering chemotherapy or radiation directly into the liver
Freezing the cancer (cryotherapy)
Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.
Support Groups
For additional resources and information, see colon cancer support groups.
Outlook (Prognosis)
Colon cancer is, in almost all cases, a treatable disease if caught early.
How well you do depends on many things, including the stage of the cancer. In general, when treated at an early stage, the vast majority of patients survive at least 5 years after their diagnosis. (This is called the 5-year survival rate.) However, the 5-year survival rate drops considerably once the cancer has spread.
If the colon cancer does not come back (recur) within 5 years, it is considered cured. Stage I, II, and III cancers are considered potentially curable. In most cases, stage IV cancer is not curable.
Possible Complications
Cancer returning in the colon
Cancer spreading to other organs or tissues (metastasis)
Development of a second primary colorectal cancer
When to Contact a Medical Professional
Call your health care provider if you have:
Black, tar-like stools
Blood during a bowel movement
Change in bowel habits
Prevention
The death rate for colon cancer has dropped in the last 15 years. This may be due to increased awareness and screening by colonoscopy.
Colon cancer can almost always be caught in its earliest and most curable stages by colonoscopy. Almost all men and women age 50 and older should have a colon cancer screening. Patients at risk may need screening earlier.
For information on this procedure, see:
Colon cancer screening
Colonoscopy
Colon cancer screening can find precancerous polyps. Removing these polyps may prevent colon cancer.
Dietary and lifestyle modifications are important. Some evidence suggests that low-fat and high-fiber diets may reduce your risk of colon cancer.
The U.S. Preventive Services Task Force recommends against taking aspirin or other anti-inflammatory medicines to prevent colon cancer if you have an average risk of the disease -- even if someone in your family has had the condition. Taking more than 300 mg a day of aspirin and similar drugs may cause dangerous gastrointestinal bleeding and heart problems in some people.
Although low-dose aspirin may help reduce your risk of other conditions, such as heart disease, it does not lower the rate of colon cancer.
Other types of colon cancer, such as lymphoma, carcinoid tumors, melanoma, and sarcomas, are rare. In this article, use of the term "colon cancer" refers to colon carcinoma and not these rare types of colon cancer.
Causes
According to the American Cancer Society, colorectal cancer is one of the leading causes of cancer-related deaths in the United States. (However, early diagnosis often leads to a complete cure.)
There is no single cause for colon cancer. Nearly all colon cancers begin as noncancerous (benign) polyps, which slowly develop into cancer.
You have a higher risk for colon cancer if you have:
Cancer elsewhere in the body
Colorectal polyps
Crohn's disease
Family history of colon cancer
Personal history of breast cancer
Ulcerative colitis
Certain genetic syndromes also increase the risk of developing colon cancer.
What you eat may play a role in your risk of colon cancer. Colon cancer may be associated with a high-fat, low-fiber diet and red meat. However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear.
Smoking cigarettes is another risk factor for colorectal cancer.
Symptoms
Many cases of colon cancer have no symptoms. The following symptoms, however, may indicate colon cancer:
Abdominal pain and tenderness in the lower abdomen
Blood in the stool
Diarrhea, constipation, or other change in bowel habits
Intestinal obstruction
Narrow stools
Unexplained anemia
Weight loss with no known reason
Exams and Tests
With proper screening, colon cancer can be detected before symptoms develop, when it is most curable.
Your doctor will perform a physical exam and press on your belly area. The physical exam rarely shows any problems, although the doctor may feel a mass in the abdomen. A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.
Imaging tests to diagnose colorectal cancer include:
Colonoscopy
Sigmoidoscopy
Note: Only colonoscopy can see the entire colon.
A fecal occult blood test (FOBT) may detect small amounts of blood in the stool, which could suggest colon cancer. However, this test is often negative in patients with colon cancer. For this reason, a FOBT must be done along with colonoscopy or sigmoidoscopy. It is also important to note that a positive FOBT doesn't necessarily mean you have cancer.
A complete blood count may show signs of anemia with low iron levels.
If your doctor learns that you do have colorectal cancer, more tests will be done to see if the cancer has spread. This is called staging.
Stage 0: Very early cancer on the innermost layer of the intestine
Stage I: Cancer is in the inner layers of the colon
Stage II: Cancer has spread through the muscle wall of the colon
Stage III: Cancer has spread to the lymph nodes
Stage IV: Cancer has spread to other organs
Treatment
Treatment depends partly on the stage of the cancer. In general, treatments may include:
Chemotherapy to kill cancer cells
Surgery to remove cancer cells
Radiation therapy to destroy cancerous tissue
Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. (See: Colon resection)
There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.
Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 - 8 months. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients.
Chemotherapy is also used to treat patients with stage IV colon cancer. Irinotecan, oxaliplatin, and 5-fluorouracil are the three most commonly used drugs. In addition, monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), and bevacizumab (Avastin) have been used alone or in combination with chemotherapy.
You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluorouracil.
For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include:
Burning the cancer (ablation)
Cutting out the cancer
Delivering chemotherapy or radiation directly into the liver
Freezing the cancer (cryotherapy)
Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.
Support Groups
For additional resources and information, see colon cancer support groups.
Outlook (Prognosis)
Colon cancer is, in almost all cases, a treatable disease if caught early.
How well you do depends on many things, including the stage of the cancer. In general, when treated at an early stage, the vast majority of patients survive at least 5 years after their diagnosis. (This is called the 5-year survival rate.) However, the 5-year survival rate drops considerably once the cancer has spread.
If the colon cancer does not come back (recur) within 5 years, it is considered cured. Stage I, II, and III cancers are considered potentially curable. In most cases, stage IV cancer is not curable.
Possible Complications
Cancer returning in the colon
Cancer spreading to other organs or tissues (metastasis)
Development of a second primary colorectal cancer
When to Contact a Medical Professional
Call your health care provider if you have:
Black, tar-like stools
Blood during a bowel movement
Change in bowel habits
Prevention
The death rate for colon cancer has dropped in the last 15 years. This may be due to increased awareness and screening by colonoscopy.
Colon cancer can almost always be caught in its earliest and most curable stages by colonoscopy. Almost all men and women age 50 and older should have a colon cancer screening. Patients at risk may need screening earlier.
For information on this procedure, see:
Colon cancer screening
Colonoscopy
Colon cancer screening can find precancerous polyps. Removing these polyps may prevent colon cancer.
Dietary and lifestyle modifications are important. Some evidence suggests that low-fat and high-fiber diets may reduce your risk of colon cancer.
The U.S. Preventive Services Task Force recommends against taking aspirin or other anti-inflammatory medicines to prevent colon cancer if you have an average risk of the disease -- even if someone in your family has had the condition. Taking more than 300 mg a day of aspirin and similar drugs may cause dangerous gastrointestinal bleeding and heart problems in some people.
Although low-dose aspirin may help reduce your risk of other conditions, such as heart disease, it does not lower the rate of colon cancer.
ovarian cysts:causes and factors
Whilst the occurence of an ovary cyst or the development of ovary cyst symptoms are several, we have concentrated on they key factors.
1. Genetic predisposition is often considered to be the primary cause of ovarian cyst as research has shown that the genetic pattern of women who suffer from this chronic condition is different as compared to women who never get ovarian cysts or PCOS. However, this should not be a death warrant as many times the genetic characteristics can be modified with the help of environmental factors and proper lifestyle related changes.
2. As with many illnesses, a weak immune system can contribue to the inability to prevent ovary cysts forming. When your body is unable to generate the properties needed to fight disease and infection, the likelihood of suffering from ovarian cysts is increased.
3. Poor Diet: Scientific research also tells us that certain dietary choices may lead to the formation of ovarian cysts, including those that are rich with carbohydrates, or processed foods, or those that are high in preservatives. These foods may trigger a hormone imbalance, weaken the body's natural immune system and leave you susceptible to cysts on the ovaries.
4. Serum sex-hormone binding globulin or SHGB can worsen the condition of ovarian cysts. This will result from a resistance to insulin which the leads to the ovaries producing an abnormal amount of the male hormone androgen.
5. An ovarian cyst can result from a hormonal imbalance, when there is a lack of ovulation. If the egg is not released as normal one month, progesterone may not be produced, which impacts the imbalance.
Although one of these causes or risk factors on their own may not mean that ovarian cysts are inevitable, a few of them together may definitely heighten one's risk. Besides these known causes, other factors such as toxins within the environment may also be to blame for the formation of ovarian cysts, leaving modern medicine unarmed to combat this often painful condition.
Besides the above primary factors, toxins in liver and even environmental toxins can aggravate ovarian cysts. Hence, ovarian cyst condition is not a simple one to understand or treat. Conventional wisdom blinded by hackneyed forms of treatment cannot treat and cure ovarian cysts. To treat this complex disease, a multidimensional view adopted by the holistic approach is needed. Holistic approach is also effective as it deals with a variety of factors and manages to find out the root cause of the disease. Then, systematically with a comprehensive method, the practitioner can help you bring about many lifestyle changes, which can aid in treatment. Hence, when it comes to curing ovarian cyst, a holistic approach is required to understand the causes of ovarian cysts and to treat this condition in a scientific and holistic manner.
1. Genetic predisposition is often considered to be the primary cause of ovarian cyst as research has shown that the genetic pattern of women who suffer from this chronic condition is different as compared to women who never get ovarian cysts or PCOS. However, this should not be a death warrant as many times the genetic characteristics can be modified with the help of environmental factors and proper lifestyle related changes.
2. As with many illnesses, a weak immune system can contribue to the inability to prevent ovary cysts forming. When your body is unable to generate the properties needed to fight disease and infection, the likelihood of suffering from ovarian cysts is increased.
3. Poor Diet: Scientific research also tells us that certain dietary choices may lead to the formation of ovarian cysts, including those that are rich with carbohydrates, or processed foods, or those that are high in preservatives. These foods may trigger a hormone imbalance, weaken the body's natural immune system and leave you susceptible to cysts on the ovaries.
4. Serum sex-hormone binding globulin or SHGB can worsen the condition of ovarian cysts. This will result from a resistance to insulin which the leads to the ovaries producing an abnormal amount of the male hormone androgen.
5. An ovarian cyst can result from a hormonal imbalance, when there is a lack of ovulation. If the egg is not released as normal one month, progesterone may not be produced, which impacts the imbalance.
Although one of these causes or risk factors on their own may not mean that ovarian cysts are inevitable, a few of them together may definitely heighten one's risk. Besides these known causes, other factors such as toxins within the environment may also be to blame for the formation of ovarian cysts, leaving modern medicine unarmed to combat this often painful condition.
Besides the above primary factors, toxins in liver and even environmental toxins can aggravate ovarian cysts. Hence, ovarian cyst condition is not a simple one to understand or treat. Conventional wisdom blinded by hackneyed forms of treatment cannot treat and cure ovarian cysts. To treat this complex disease, a multidimensional view adopted by the holistic approach is needed. Holistic approach is also effective as it deals with a variety of factors and manages to find out the root cause of the disease. Then, systematically with a comprehensive method, the practitioner can help you bring about many lifestyle changes, which can aid in treatment. Hence, when it comes to curing ovarian cyst, a holistic approach is required to understand the causes of ovarian cysts and to treat this condition in a scientific and holistic manner.
cancer of the ovaries
The ovaries
The ovaries are part of a woman's reproductive system. They are in the pelvis. Each ovary is about the size of an almond.
The ovaries make the female hormones -- estrogen and progesterone. They also release eggs. An egg travels from an ovary through a fallopian tube to the womb (uterus).
When a woman goes through her "change of life" (menopause), her ovaries stop releasing eggs and make far lower levels of hormones.
Understanding ovarian cancer
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
Benign tumors are not cancer:
Benign tumors are rarely life-threatening.
Generally, benign tumors can be removed. They usually do not grow back.
Benign tumors do not invade the tissues around them.
Cells from benign tumors do not spread to other parts of the body.
Malignant tumors are cancer:
Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
Malignant tumors often can be removed. But sometimes they grow back.
Malignant tumors can invade and damage nearby tissues and organs.
Cells from malignant tumors can spread to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the lymphatic system or bloodstream. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.
Benign and malignant cysts
An ovarian cyst may be found on the surface of an ovary or inside it. A cyst contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are benign (not cancer).
Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst that does not go away or that gets larger. The doctor may order tests to make sure that the cyst is not cancer.
Ovarian cancer
Ovarian cancer can invade, shed, or spread to other organs:
Invade: A malignant ovarian tumor can grow and invade organs next to the ovaries, such as the fallopian tubes and uterus.
Shed: Cancer cells can shed (break off) from the main ovarian tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants.
Spread: Cancer cells can spread through the lymphatic system to lymph nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through the bloodstream to organs such as the liver and lungs.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in the liver are actually ovarian cancer cells. The disease is metastatic ovarian cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.
The ovaries are part of a woman's reproductive system. They are in the pelvis. Each ovary is about the size of an almond.
The ovaries make the female hormones -- estrogen and progesterone. They also release eggs. An egg travels from an ovary through a fallopian tube to the womb (uterus).
When a woman goes through her "change of life" (menopause), her ovaries stop releasing eggs and make far lower levels of hormones.
Understanding ovarian cancer
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
Benign tumors are not cancer:
Benign tumors are rarely life-threatening.
Generally, benign tumors can be removed. They usually do not grow back.
Benign tumors do not invade the tissues around them.
Cells from benign tumors do not spread to other parts of the body.
Malignant tumors are cancer:
Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
Malignant tumors often can be removed. But sometimes they grow back.
Malignant tumors can invade and damage nearby tissues and organs.
Cells from malignant tumors can spread to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the lymphatic system or bloodstream. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.
Benign and malignant cysts
An ovarian cyst may be found on the surface of an ovary or inside it. A cyst contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are benign (not cancer).
Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst that does not go away or that gets larger. The doctor may order tests to make sure that the cyst is not cancer.
Ovarian cancer
Ovarian cancer can invade, shed, or spread to other organs:
Invade: A malignant ovarian tumor can grow and invade organs next to the ovaries, such as the fallopian tubes and uterus.
Shed: Cancer cells can shed (break off) from the main ovarian tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants.
Spread: Cancer cells can spread through the lymphatic system to lymph nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through the bloodstream to organs such as the liver and lungs.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in the liver are actually ovarian cancer cells. The disease is metastatic ovarian cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.
ovarian cancer:how is oc staged
How Is Ovarian Cancer Staged?
Staging is the process of finding out how widespread a cancer is. Most ovarian cancers that are not obviously widespread are staged at the time of surgery. One of the goals of surgery for ovarian cancer is to obtain tissue samples for diagnosis and staging. In order to stage the cancer, samples of tissues are taken from different parts of the pelvis and abdomen and examined under the microscope.
Staging is very important because ovarian cancers have a different prognosis at different stages and are treated differently. The accuracy of the staging may determine whether or not a patient will be cured. If the cancer is not properly staged, then cancer that has spread outside the ovary may be missed and not treated. Once a stage has been given it does not change, even when the cancer comes back or spreads to new locations in the body.
Ask your cancer care team to explain the staging procedure. Also ask them if they will perform a thorough staging procedure. After surgery, ask what your cancer's stage is. In this way, you will be able to take part in making informed decisions about your treatment.
Ovarian cancer is staged according to the AJCC/TNM System. This describes the extent of the primary Tumor (T), the absence or presence of metastasis to nearby lymph Nodes (N), and the absence or presence of distant Metastasis (M). This closely resembles the system that is actually used by most gynecologic oncologists, called the FIGO system. Both rely on the results of surgery for the actual stages. Fallopian tube cancer is staged like ovarian cancer, but with different "T" categories. Primary peritoneal cancer (PPC) is staged like ovarian cancer, with all cases being either stage III or IV depending on whether the cancer has spread to distant sites.
T categories for ovarian cancer
Tx: No description of the tumor's extent is possible because of incomplete information.
T1: The cancer is confined to the ovaries -- one or both.
T1a: The cancer is only inside one ovary - it is not on the outside of the ovary, it doesn’t penetrate the tissue covering the ovary (called the capsule) and is not in fluid taken from the pelvis.
T1b: The cancer is inside both ovaries but doesn't penetrate to the outside and is not in fluid taken from the pelvis (like T1a except the cancer is in both ovaries).
T1c: The cancer is in one or both ovaries and is either on the outside of an ovary, grown through the capsule of an ovary, or is in fluid taken from the pelvis.
T2: The cancer is in one or both ovaries and is extending into pelvic tissues.
T2a: The cancer has spread (metastasized) to the uterus and/or the fallopian tubes but is not in fluid taken from the pelvis.
T2b: The cancer has spread to pelvic tissues besides the uterus and fallopian tubes but it is not in fluid taken from the pelvis.
T2c: The cancer has spread to the uterus and/or fallopian tubes and/or other pelvic tissues (like T2a or T2b) and is also in fluid taken from the pelvis.
T3: The cancer is in one or both ovaries and has spread to the abdominal lining outside the pelvis. This lining is called the peritoneum.
T3a: The cancer metastases are so small that they can not be seen except under a microscope.
T3b: The cancer metastases can be seen but no tumor is bigger than 2 centimeters (0.8 inches).
T3c: The cancer metastases are larger than 2 centimeters (0.8 inches).
T categories for fallopian tube cancer
Tx: No description of the tumor's extent is possible because of incomplete information.
Tis: Cancer cells are only in the inner lining of the fallopian tube. They have not grown into deeper layers. Also called carcinoma in situ.
T1: The cancer is in the fallopian tube(s), but has not grown outside of them.
T1a: The cancer is only inside one fallopian tube -- it has not grown through to the outside of the tube. It hasn't grown through the tissue covering the tumor (called the capsule) and is not in fluid taken from the pelvis.
T1b: The cancer is growing in both fallopian tubes -- it has not grown through to the outside of the tube. It hasn't grown through the tissue covering the tumor (called the capsule) and is not in fluid taken from the pelvis (like T1a but with tumor in both tubes).
T1c: The tumor is in one or both fallopian tubes and has either grown through the outer wall of the tube or cancer cells are found in fluid taken from the pelvis.
T2: The tumor has grown from one or both fallopian tubes into the pelvis.
T2a: The cancer is growing into the uterus and/or the ovaries.
T2b: The cancer is growing into other parts of the pelvis.
T2c: The cancer has spread from the fallopian tubes into other parts of the pelvis and cancer cells are found in fluid taken from the pelvis (either from ascites or from washings obtained at surgery.
T3: The tumor has spread outside the pelvis to the lining of the abdomen.
T3a: The areas of cancer spread outside the pelvis can only be found when the area is biopsied and looked at under the microscope.
T3b: The areas of spread can be seen with the naked eye, but are 2 cm or less in size (less than an inch).
T3c: The areas of spread are greater than 2 cm in size.
N categories
N categories indicate whether or not the cancer has spread to regional (nearby) lymph nodes.
Nx: No description of lymph node involvement is possible because of incomplete information.
N0: No lymph node involvement.
N1: Cancer cells are found in the lymph nodes close to tumor.
M categories
M categories indicate whether or not the cancer has spread to distant organs, such as the liver, lungs, or non-regional lymph nodes.
Mx: No description of distant spread is possible because of incomplete information.
M0: No distant spread.
M1: Cancer has spread to the inside of the liver, to the lungs, or other organs.
Grade categories
(The higher the grade, the more likely it is that the cancer will spread.)
Grade 1: Well differentiated -- looks similar to normal ovarian tissue.
Grade 2: Not as well differentiated -- looks less like ovarian tissue.
Grade 3: Poorly differentiated – does not look like ovarian tissue.
Stage grouping
Once a patient's T, N, and M categories have been determined, this information is combined in a process called stage grouping to determine the stage, expressed in Roman numerals from stage I (the least advanced stage) to stage IV (the most advanced stage). The following table illustrates how TNM categories are grouped together into stages. This stage grouping also applies to fallopian tube carcinoma.
What the stages of ovarian cancer mean
Stage I
The cancer is still contained within the ovary (or ovaries).
Stage IA (T1a, N0, M0): Cancer has developed in one ovary, and the tumor is confined to the inside of the ovary. There is no cancer on the outer surface of the ovary. Laboratory examination of washings from the abdomen and pelvis did not find any cancer cells.
Stage IB (T1b, N0, M0): Cancer has developed within both ovaries without any tumor on their outer surfaces. Laboratory examination of washings from the abdomen and pelvis did not find any cancer cells.
Stage IC (T1c, N0, M0): The cancer is present in one or both ovaries and one or more of the following are present:
Cancer is on the outer surface of at least one of the ovaries.
In the case of cystic tumors (fluid-filled tumors), the capsule (outer wall of the tumor) has ruptured (burst)
Laboratory examination found cancer cells in fluid or washings from the abdomen.
Stage II
The cancer is in one or both ovaries and has involved other organs (such as the uterus, fallopian tubes, bladder, the sigmoid colon, or the rectum) within the pelvis.
Stage IIA (T2a, N0, M0): The cancer has spread to or has actually invaded (grown into) the uterus or the fallopian tubes, or both. Laboratory examination of washings from the abdomen did not find any cancer cells.
Stage IIB (T2b, N0, M0): The cancer has spread to other nearby pelvic organs such as the bladder, the sigmoid colon, or the rectum. Laboratory examination of fluid from the abdomen did not find any cancer cells.
Stage IIC (T2c, N0, M0): The cancer has spread to pelvic organs as in stages IIA or IIB and laboratory examination of the washings from the abdomen found evidence of cancer cells.
Stage III
The cancer involves one or both ovaries, and one or both of the following are present: (1) cancer has spread beyond the pelvis to the lining of the abdomen; (2) cancer has spread to lymph nodes.
Stage IIIA (T3a, N0, M0): During the staging operation, the surgeon can see cancer involving the ovary or ovaries, but no cancer is grossly visible (can be seen without using a microscope) in the abdomen and the cancer has not spread to lymph nodes. However, when biopsies are checked under a microscope, tiny deposits of cancer are found in the lining of the upper abdomen.
Stage IIIB (T3b, N0, M0): There is cancer in one or both ovaries, and deposits of cancer large enough for the surgeon to see, but smaller than 2 cm (about 3/4 inch) across, are present in the abdomen. Cancer has not spread to the lymph nodes.
Stage IIIC: The cancer is in one or both ovaries, and one or both of the following are present:
Cancer has spread to lymph nodes (any T, N1, M0)
Deposits of cancer larger than 2 cm (about 3/4 inch) across are seen in the abdomen (T3c, N0, M0).
Stage IV (any T, any N, M1):
This is the most advanced stage of ovarian cancer. In this stage the cancer has spread to the inside of the liver, the lungs, or other organs located outside of the peritoneal cavity. (The peritoneal cavity, or abdominal cavity is the area enclosed by the peritoneum, a. membrane that lines the inner abdomen and covers most of its organs.). Finding ovarian cancer cells in the fluid around the lungs (called pleural fluid) is also evidence of stage IV disease.
Recurrent ovarian cancer: This means that the disease went away with treatment but then came back (recurred).
Survival by stage
The numbers below are based on patients diagnosed from 1988 to 2001. These numbers come from the National Cancer Institute, SEER Data Base.
Invasive epithelial ovarian cancer
Stage
Relative 5-Year Survival Rate
I
89%
IA
94%
IB
91%
IC
80%
II
66%
IIA
76%
IIB
67%
IIC
57%
III
34%
IIIA
45%
IIIB
39%
IIIC
35%
IV
18%
Ovarian tumors of low malignant potential
Stage
Relative 5-yr Survival Rate
I
99%
II
98%
III
96%
IV
77%
Germ cell tumors of the ovary
Stage
Relative 5-yr Survival Rate
I
98%
II*
80%
III
84%
IV
55%
*stage II cancer survival not based on many cases - may not be reliable
Fallopian tube carcinoma
Stage
Relative 5-yr Survival Rate
I
93%
II*
74%
III
66%
IV
40%
The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Five-year rates are used to produce a standard way of discussing prognosis. Of course, many people live much longer than 5 years. Five-year relative survival rates take into account that people will die of other causes and compare the observed survival with that expected for people without ovarian cancer. This is a better way to describe the deaths from ovarian cancer.
Custom Search