Cancer Archives - Craig's Story

A year out….

craig — Sun, 30 May 2021 19:26:33 +0000

What a difference a year makes

What a difference a year makes! Maybe not a day, but a year does change things for the better.

May 28th 2020 was my final radiation session, so one year 2 days ago. Last night, because my six monthly examinations are due this coming week, I posted on Facebook for the first time in a long time. I also read some of my old blogs and a year has certainly eased some of the awful memories I had of my treatment.

Starting at Autumn last year, I started picking up some website work and that helped me get back into the swing of things. I took on a project at a rock-bottom price to help a start-up and also help me to start designing again.

Last year took a toll on me and I was suffering with depression, anxiety and panic attacks - none of which I recommend to anyone! I saw my doc and went onto Prozac for a while to help calm myself and I stayed on the drug for a while until I felt better able to cope with things.

What I had been through was bad enough, but poor Linda who suffered an horrific burn to her right leg and foot in an accident at work, was also in a bad way and unable to work for something like two months. Her burns were awful.

What a pair we made...

Come Christmas I gave up trying to eat real food. Eating was almost impossible due to the lack of saliva. My taste buds were still shot to pieces and it became a real chore to chew away on 'food', which eventually turned to be like cardboard and unable to swallow it.

With a little experimentation, Linda came up with a great smoothie which I still drink to this day.

The base is cornflakes which are soaked in milk. Then strawberry/banana Greek yogurt is added along with whey protein, apple, melon, pineapple, strawberries, blueberries, spinach (got to have my greens!) and maybe a few more things I've forgotten. All this is then blended and the end result is a healthy, filling smoothie of which I drink one at breakfast time and two at dinner time. For lunch I have a couple of Ensure high protein shakes and a yogurt. In the evening I eat another yogurt and ice cream.

It works for me and my blood labs have been fantastic and my weight steady at around 156-157 lbs (71Kgs), or 11 stone in old money!

I had a PET scan towards the end of the year and got the all clear after that.

Now, six months later it is that time again and I have to go see my radiologist on Tuesday, where no doubt he will order another PET scan, and the following Tuesday I go and see my ENT doc for a visual examination of my throat.

I don't think my cancer has returned but it is always a rather worrying time until the results come in.

Throat-wise, things have got a lot better but there is still a long way to go. As I mentioned I don't produce enough saliva to be able to eat. My taste buds work minimally, unless there is anything spicy when they go berserk, and I have constant nasal drip which is both annoying and concerning.

The lack of saliva leads to another problem, which is tooth decay and this year I need dental work which is going to end up being very costly.

Talking of costs.....for those who read this in the UK, please bless the NHS! OK, I got lucky last year and through a friend, found a wonderful lady who was able to get me on an insurance plan. My only outlay was $1600 towards the cost of my treatment. My medical bills amounted to $427,000 - yes, over four hundred thousand dollars which is frightening. Had I not got the insurance, I don't know what the outcome would have been.

I am beginning to doubt whether I will ever fully recover from the radiation treatment. I am beginning to doubt whether I will ever eat real food again. I help out on a Facebook group which is all about Head and Neck cancer and I posted on there about the issues I was still having and someone replied to say that he was 9 years out of treatment and still couldn't eat.

It sometimes feels like we need a support group not just for cancer survivors but for radiation survivors - the treatment is that bad!

I'll post again once I get my test/exam results back - so in the next couple of weeks.

Thanks for reading and thanks for all the support and encouragement on the Facebook page

As an aside, Linda and myself have been blessed with 2 new grandchildren this year - Alfie and Max, who live in the UK. We are hoping to get over there, maybe at the end of this year to see them, Covid and finances allowing.

to be continued

~~~

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Neck Dissection

craig — Sun, 16 Feb 2020 18:54:38 +0000

What is a Neck Dissection and Why is it Performed?

Neck dissection is usually performed to remove cancer that has spread to lymph nodes in the neck.

Lymph nodes are small bean shaped glands scattered throughout the body that filter and process lymph fluid from other organs. The immune cells in the lymph nodes help the body fight infection. When cancer cells spread from another part of the body, they may get caught in a lymph node where they grow. An individual might feel a non-tender lump in the neck. The cancer in the lymph node is known as a metastasis. When someone undergoes surgery for cancer that has spread to lymph nodes, both the initial or primary cancer as well as the metastases must be removed.

Neck dissection refers to the removal of lymph nodes and surrounding tissue from the neck for the purpose of cancer treatment. The extent of tissue removal depends on many factors including, the stage of disease which reflects the extent of cancer as well as the type of cancer. The most common cancers removed from lymph nodes in the neck include head and neck squamous cell carcinomas, skin cancers including melanoma and thyroid cancers.. In general, the goal of neck dissection is to remove all the lymph nodes within a predefined anatomic area. Many of the lymph nodes removed during surgery will not prove to have cancer in them.

Many patients wonder why so many non-cancerous lymph nodes must be removed; why can’t surgery be done to remove only the lymph nodes with cancer in them?

A cancer may shed any number of metastases that lodge in lymph nodes, grow and spread. There are over 150 lymph nodes on each side of the neck. During an operation, a surgeon will not be able to tell if a lymph node is clean, or if it has cancer that will later grow into a visible neck lump. The lymph nodes must be processed and tested; this takes time. For that reason, it is recommended that the lymph nodes in a predefined region are removed, not just lymph nodes that are obviously enlarged with cancer.

In addition, different cancers spread differently. Skin cancers first spread to lymph nodes in different parts of the neck than thyroid cancers or oral or larynx cancers. Squamous cell carcinomas that start in the lining or mucosa of the mouth, throat or larynx have a tendency to spread to lymph nodes early; cancer cells can often be detected in lymph nodes in the neck when examined under the microscope, even in the absence of visible or palpable neck lumps.

Lymph node metastasis reduces the survival of patients with squamous cell carcinoma by half. The survival rate is less than 5% in patients who previously underwent surgery and have a recurrent metastasis in the neck. Therefore, the control of cancer that has spread to the neck is one of the most important aspects in the successful management of these particular cancers. The neck dissection is a standardized procedure that was developed to ensure the complete removal of cancer that has spread to the lymph nodes of the neck.

Radical vs. Modified Neck Dissection

Radical Neck Dissection

- This operation has been used for almost 100 years and describes the removal of lateral neck nodes and tissues to surgically remove cancer in the neck. Included in this tissue, which extends from the collarbone (clavicle) inferiorly to the jawbone (mandible) superiorly are dozens of lymph nodes. In addition to lymph nodes, this operation often includes remove the submandibular gland (a saliva-producing gland in the upper neck), the sternocleidomastoid muscle, the jugular vein and the spinal accessory nerve (to the trapezius muscle).
- The radical neck dissection was designed to ensure complete cancer removal in individuals with very advanced cancers in the neck. The radical neck dissection is effective but produces characteristic cosmetic changes. Because so much tissue is removed, one side of the neck may appear flatter than the other. More importantly, sacrifice of the nerve to the trapezius muscle results in visible drooping of the shoulder and difficulty in raising the arm over head. Some individuals develop pain in the neck and collarbone. An intensive physical therapy program may diminish some of these problems, but some long-term disability can be anticipated.

Historically, radical neck dissections were the most commonly performed type of neck dissection performed by surgeons. This is no longer the case. Most patients are candidates for a less radical operation.

Modified Radical Neck Dissection

This term describes a variety of neck dissections that preserve structures that are usually sacrificed in the radical neck dissection such as the spinal accessory nerve, the internal jugular vein or sternocleidomastoid muscle. Further, selective neck dissections are neck dissections that, in addition to preserving these important structures, are used to remove specific groups of lymph nodes, rather than all the lymph nodes on the side of the neck, based on the probability that those lymph nodes harbor cancer.
While radical neck dissections produce the greatest changes in cosmetic appearance and shoulder function, selective neck dissections produce the least. In fact, selective neck dissections frequently produce no obvious cosmetic changes, yielding a nearly invisible scar. Nevertheless, strength and flexibility may be enhanced with adherence to neck and shoulder range of motion exercises after surgery. The best results can be expected with faithful adherence to an exercise program over the long term.

The Procedure

Neck dissections are done under general anesthesia through an incision that runs along a skin crease in the neck, extending vertically on the side of the neck. Incisions are usually designed to enhance the visualization and protection of important structures in the neck, and enable the safe removal of lymph nodes that harbor cancer.

Beneath the skin, underlying fat, and a thin layer of muscle (the platysma), the dissection proceeds to identify and remove the tissue containing the lymph nodes. If the sternocleidomastoid muscle is removed as part of the operation, there may be some flattening of the neck, but removal of this muscle rarely results in significant weakness.

What are the risks of neck dissection?

Neck dissections are subject to numerous potential operative complications that are common to all operative procedures, as well as complications specific to this procedure. Some of these are described below, but do not include all potential complications associated with neck dissection. The risk of specific complications may be best determined for an individual by the nature and extent of their cancer, prior treatment and other circumstances.

Bleeding-Patients may bleed after an operation. Bleeding under the skin after a neck dissection is rare. Sometimes an operative procedure to remove the blood is required. Rarely, a blood transfusion is also needed.
Infection can occur after any surgical procedure including neck dissection (uncommon)
Chyle leak, which results in fluid accumulation in the neck from disruption of the thoracic duct (this problem is more common after left sided neck dissections) (rare)
Wound healing problems requiring additional surgery (rare)

Several important nerves are found in the neck around the lymph nodes, and depending on the area of the neck to be operated, these nerves can be at risk for damage. The primary nerves of concern are-

The marginal nerve, a small branch of the facial nerve which controls lower lip movement
The spinal accessory nerve which aids in shoulder mobility and raising the arm over head
The hypoglossal nerve, which controls movement of the tongue (uncommon)
The lingual nerve, which controls sensation on the side of the tongue (rare)
The vagus nerve which controls movement of one vocal cord (rare)

Additional potential long-term problems include:

Incision-Most incisions heal well, but some individuals develop scars.
Numbness of the skin along the incision as well as over the cheek, ear and neck can be anticipated which improves with time; some long term numbness can be anticipated
Neck stiffness or pain
Long term swelling in the neck or lymphedema
Shoulder weakness (uncommon)
Changes in speech and swallowing (rare)

Some problems are attributable to nerve injury; more commonly, scarring under the skin from surgery and radiation contributes to disability. Some problems may be avoided with early and faithful adherence to a shoulder range of motion exercise program, lymphedema or speech therapy rehabilitation programs.

to be continued

~~~

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Lymph Nodes and Cancer

craig — Sat, 15 Feb 2020 01:40:04 +0000

What is the lymph system?

Lymph Nodes and Cancer

Our bodies have a network of lymph vessels and lymph nodes. (Lymph is pronounced limf.) This network is a part of the body’s immune system. It collects fluid, waste material, and other things (like viruses and bacteria) that are in the body tissues, outside the bloodstream.

Lymph vessels are a lot like the veins that collect and carry blood through the body. But instead of carrying blood, these vessels carry the clear watery fluid called lymph.

Lymph fluid flows out from capillary walls to bathe the body’s tissue cells. It carries oxygen and other nutrients to the cells, and carries away waste products like carbon dioxide (CO₂) that flow out of the cells. Lymph fluid also contains white blood cells, which help fight infections.

Lymph fluid would build up and cause swelling if it were not drained in some way. That’s the role of the lymph vessels. Lymph vessels draw up the lymph fluid from around the cells to send it towards the chest. There, lymph fluid collects into a large vessel that drains into a blood vessel near the heart.

Lymph nodes and what they do

Lymph vessels route lymph fluid through nodes throughout the body. Lymph nodes are small structures that work as filters for harmful substances. They contain immune cells that can help fight infection by attacking and destroying germs that are carried in through the lymph fluid.

There are hundreds of lymph nodes throughout the body. Each lymph node filters the fluid and substances picked up by the vessels that lead to it. Lymph fluid from the fingers, for instance, works its way toward the chest, joining fluid from the arm. This fluid may filter through lymph nodes at the elbow, or those under the arm. Fluid from the head, scalp, and face flows down through lymph nodes in the neck. Some lymph nodes are deep inside the body, such as between the lungs or around the bowel, to filter fluid in those areas. The lymph fluid slowly flows in from all around the body, making its way back to the chest. At the end of its journey, the filtered fluid, salts, and proteins are dumped back into the bloodstream.

Swollen lymph nodes

When there’s a problem, such as infection, injury, or cancer, the node or the group of lymph nodes in that area may swell or enlarge as they work to filter out the “bad” cells. This may be called lymphadenopathy (LIMF-ad-uh-NOP-uh-thee). Swollen lymph nodes tell you that something is not right, but other symptoms help pinpoint the problem. For instance, ear pain, fever, and enlarged lymph nodes near your ear are clues that you may have an ear infection or cold.

Some areas where lymph nodes commonly swell are in the neck, groin, and underarms. In most cases, only one area of nodes swells at a time. When more than one area of lymph nodes is swollen it’s called generalized lymphadenopathy. Some infections (such as strep throat and chicken pox), certain medicines, immune system diseases, and cancers like lymphoma and leukemia can cause this kind of swelling. The health care provider will look for more information to figure out the cause of the swelling. Lymph node swelling is often caused by something other than cancer.

Cancer in the lymph nodes

Cancer can appear in the lymph nodes in 2 ways: it can either start there or it can spread there from somewhere else.

Cancer that starts in the lymph nodes is called lymphoma. You can read more about lymphoma in Hodgkin Disease and Non-Hodgkin Lymphoma.

More often, cancer starts somewhere else and then spreads to lymph nodes. That is the focus of this section.

How does cancer spread to lymph nodes?

Cancer can spread from where it started (the primary site) to other parts of the body.

When cancer cells break away from a tumor, they can travel to other areas of the body through either the bloodstream or the lymph system. Cancer cells can travel through the bloodstream to reach distant organs. If they travel through the lymph system, the cancer cells may end up in lymph nodes. Either way, most of the escaped cancer cells die or are killed before they can start growing somewhere else. But one or two might settle in a new area, begin to grow, and form new tumors. This spread of cancer to a new part of the body is called metastasis.

In order for cancer cells to spread to new parts of the body, they have to go through several changes. They first have to become able to break away from the original tumor and then attach to the outside wall of a lymph vessel or blood vessel. Then they must move through the vessel wall to flow with the blood or lymph to a new organ or lymph node.

When cancer grows inside lymph nodes, it usually affects the lymph nodes near the tumor itself. These are the nodes that have been doing most of the work to filter out or kill the cancer cells.

How is cancer in lymph nodes found?

Normal lymph nodes are tiny and can be hard to find, but when there’s infection, inflammation, or cancer, the nodes can get larger. Those near the body’s surface often get big enough to feel with your fingers, and some can even be seen. But if there are only a few cancer cells in a lymph node, it may look and feel normal. In that case, the doctor must check for cancer by removing all or part of the lymph node.

When a surgeon operates to remove a primary cancer, one or more of the nearby (regional) lymph nodes may be removed as well. Removal of one lymph node is called a biopsy. When many lymph nodes are removed, it’s called lymph node sampling or lymph node dissection. When cancer has spread to lymph nodes, there’s a higher risk that the cancer might come back after surgery. This information helps the doctor decide whether more treatment, like chemo or radiation, might be needed after surgery.

Doctors may also take samples of one or more nodes using needles. Usually, this is done on lymph nodes that are enlarged. This is called a needle biopsy. The tissue that’s removed is looked at under the microscope by a pathologist (a doctor who diagnoses illness using tissue samples) to find out if there are cancer cells in it

Under the microscope, any cancer cells in the nodes look like the cancer cells from the primary tumor. For instance, when breast cancer spreads to the lymph nodes, the cells in the nodes look like breast cancer cells. The pathologist prepares a report, which details what was found. If a node has cancer in it, the report describes what it looks like and how much was seen.

Doctors may also use scans or other imaging tests to look for enlarged nodes that deep in the body. For more on this, see Imaging (Radiology) Tests. Often, enlarged lymph nodes near a cancer are assumed to contain cancer.

What does it mean if there’s cancer in my lymph node?

It depends. Sometimes there are so few cancer cells in the node that the pathologist must use special tests to find them. In the case of a very few cancer cells in a lymph node, it may not change the treatment plan at all.

If there’s a lot of cancer in a node, the large mass can be seen easily. If the cancer is growing out of the lymph node through the layer of connective tissue on the outside (called the capsule), it’s called extracapsular extension.

More cancer in the nodes may mean that the cancer is fast growing and/or more likely to spread to other places in the body. But if nearby lymph nodes are the only other place cancer is found beyond the main (primary) site, surgery to remove the main tumor and the nearby lymph nodes may be able to get rid of it all.

Cancer that has spread to nodes further away from the primary cancer will more likely need extra treatment with chemo or radiation.

Cancer in nodes affects cancer stage

Treatment of cancer is based on the type of cancer a person has, and the stage of the cancer. Doctors use a system to assign a stage to the cancer. The most common staging system is the TNM system. The T in TNM stands for tumor, the M stands for metastasis, and the N stands for lymph nodes. If there’s no cancer found in the lymph nodes near the cancer, the N is assigned a value of 0. If nearby or distant nodes show cancer, the N is assigned a number such as 1, 2 or sometimes 3, depending on how many nodes are affected, how much cancer is in them, how large they are, and where they are.

A cancer with lower TNM numbers is usually easier to treat and has a better outlook for survival. For instance, a cancer with T1, N0, M0, would be a cancer that was found very early, before it spread. The T1 would mean a small tumor, the N0 means that no nodes are involved, and the M0 means that no metastases were found. For more information on staging, see information about your cancer type, or read Staging.

Effects of removing lymph nodes

Nodes that have been removed during cancer surgery can leave part of the body without a way to drain off the lymph fluid in the affected area. Many of the lymph vessels now run into a dead end where the node used to be, and fluid can back up. This is called lymphedema, and it can become a life-long problem. The more lymph nodes that are removed, the more likely it is to occur.

Source: https://www.cancer.org/cancer/cancer-basics/lymph-nodes-and-cancer.html

to be continued

~~~

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How fast does cancer spread?

craig — Tue, 11 Feb 2020 03:37:52 +0000

Cancer Progression

How Quickly Cancer Spreads

Our bodies are made up trillions of cells. Normally, new cells replace old or damaged cells as they die off.

Sometimes, a cell’s DNA becomes damaged. The immune system can generally control a small number of abnormal cells from further damage to our bodies.

Cancer occurs when there are more abnormal cells than the immune system can handle. Instead of dying, abnormal cells continue to grow and divide, piling up in the form of tumors. Eventually, that out-of-control growth causes the abnormal cells to invade surrounding tissues.

There are more than 100Trusted Source types of cancer named for the tissues or organs where they originate. All have the ability to spread, but some are more aggressive than others.

Continue reading to learn how cancer spreads, how it’s staged, and how various treatments work.

Why cancer spreads

Cancer cells don’t respond to signals telling them it’s time to die, so they continue rapidly dividing and multiplying. And they’re very good at hiding from the immune system.

When cancer cells are still contained in the tissue where they developed, it’s called carcinoma in situ (CIS). Once those cells break outside the tissue’s membrane, it’s called invasive cancer.

The spread of cancer from where it started to another place is called metastasis. No matter where else in the body it spreads, a cancer is still named for the place it originated. For instance, prostate cancer that has spread to the liver is still prostate cancer, not liver cancer, and treatment will reflect that.

While solid tumors are a feature of many types of cancer, that’s not always the case. For example, leukemias are cancers of the blood that doctors refer to as “liquid tumors.”

Exactly where cancer cells will spread next is dependent on their location in the body, but it’s likely to spread nearby first. Cancer can spread through:

Tissue. A growing tumor can push through surrounding tissues or into organs. Cancer cells from the primary tumor can break away and form new tumors nearby.
The lymph system. Cancer cells from the tumor can enter nearby lymph nodes. From there, they can travel the entire lymph system and start new tumors in other parts of the body.
The bloodstream. Solid tumors need oxygen and other nutrients to grow. Through a process called angiogenesis, tumors can prompt the formation of new blood vessels to ensure their survival. Cells can also enter the bloodstream and travel to distant sites.

Fastest- and slowest-spreading cancers

Cancer cells that have more genetic damage (poorly differentiated) usually grow faster than cancer cells with less genetic damage (well differentiated). Based on how abnormal they appear under a microscope, tumors are graded as follows:

GX: undetermined
G1: well-differentiated or low-grade
G2: moderately differentiated or intermediate-grade
G3: poorly differentiated or high-grade
G4: undifferentiated or high-grade

Some cancers that are generally slower growing are:

breast cancers, such as estrogen receptor-positive (ER+) and human epidermal growth factor receptor 2-negative (HER2-)
chronic lymphocytic leukemia (CLL)
colon and rectal cancers
most types of prostate cancer

Some cancers, such as prostate cancer, can grow so slowly that your doctor may recommend a “watchful waiting” approach rather than immediate treatment. Some may never require treatment.

Examples of fast-growing cancers include:

acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML)
certain breast cancers, such as inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC)
large B-cell lymphoma
lung cancer
rare prostate cancers such as small-cell carcinomas or lymphomas

Having a fast-growing cancer doesn’t necessarily mean you have a poor prognosis. Many of these cancers can be effectively treated. And some cancers don’t necessarily grow faster, but are less likely to be detected until they have metastasized.

What stages have to do with cancer spread

Cancers are staged according to tumor size and how far it has spread at the time of diagnosis. Stages help doctors decide which treatments are most likely to work and give a general outlook.

There are different types of staging systems and some are specific to certain types of cancer. The following are the basic stages of cancer:

In situ. Precancerous cells have been found, but they haven’t spread to surrounding tissue.
Localized. Cancerous cells haven’t spread beyond where they started.
Regional. Cancer has spread to nearby lymph nodes, tissues, or organs.
Distant. Cancer has reached distant organs or tissues.
Unknown. There’s not enough information to determine the stage.

Or:

Stage 0 or CIS. Abnormal cells have been found but have not spread into surrounding tissue. This is also called precancer.
Stages 1, 2, and 3. The diagnosis of cancer is confirmed. The numbers represent how large the primary tumor has grown and how far the cancer has spread.
Stage 4. Cancer has metastasized to distant parts of the body.

Your pathology report may use the TNM staging system, which provides more detailed information as follows:

T: Size of primary tumor

TX: primary tumor can’t be measured
T0: primary tumor can’t be located
T1, T2, T3, T4: describes the size of the primary tumor and how far it may have grown into surrounding tissue

N: Number of regional lymph nodes affected by cancer

NX: cancer in nearby lymph nodes can’t be measured
N0: no cancer is found in nearby lymph nodes
N1, N2, N3: describes the number and location of lymph nodes affected by cancer

M: Whether cancer has metastasized or not

MX: metastasis can’t be measured
M0: cancer hasn’t spread to other parts of the body
M1: cancer has spread

So, your cancer stage might look something like this: T2N1M0.

Tumor growth and spread

Benign tumors

Benign tumors are noncancerous. They’re covered with normal cells and aren’t able to invade nearby tissue or other organs. Benign tumors can cause a few problems if they:

are large enough to press on organs, cause pain, or are visually bothersome
are located in the brain
release hormones that affect body systems

Benign tumors can usually be surgically removed and are unlikely to grow back.

Malignant tumors

Cancerous tumors are called malignant. Cancer cells form when DNA abnormalities cause a gene to behave differently than it should. They can grow into nearby tissue, spread through the bloodstream or lymph system, and spread through the body. Malignant tumors tend to grow faster than benign tumors.

How treatment works to stop cancer spread

Generally speaking, it’s easier to treat cancer before it has the chance to spread. Treatment depends on the specific type of cancer as well as the stage. In many cases, treatment will consist of more than one therapy.

Surgery

Depending on the type of cancer you have, surgery may be the first-line treatment. When surgery is used to remove a tumor, the surgeon also removes a small margin of tissue around the tumor to lower the chances of leaving cancer cells behind.

Surgery can also help stage the cancer. For example, checking the lymph nodes near the primary tumor can determine if cancer has spread locally.

You may also need chemotherapy or radiation therapy following surgery. This may be an added precaution in case any cancer cells were left behind or have reached the blood or lymph system.

If a tumor can’t be completely removed, your surgeon may still remove part of it. This can be helpful if the tumor was causing pressure on an organ or causing pain.

Radiation therapy

Radiation uses high-energy rays to kill cancer cells or slow their growth. The rays target a specific area of the body where cancer has been found.

Radiation can be used to destroy a tumor or to relieve pain. It can also be used after surgery to target any cancer cells that may have been left behind.

Chemotherapy

Chemotherapy is a systemic treatment. Chemo drugs enter your bloodstream and travel throughout your body to find and destroy rapidly dividing cells.

Chemotherapy is used to kill cancer, slow its growth, and reduce the chance that new tumors will form. It’s useful when cancer has spread beyond the primary tumor or if you have a type of cancer for which there are no targeted therapies.

Targeted therapy

Targeted therapies depend on the specific type of cancer, but not all cancers have targeted therapies. These drugs attack specific proteins that allow tumors to grow and spread.

Angiogenesis inhibitors interfere with the signals that allow tumors to form new blood vessels and continue growing. These medicines can also cause already existing blood vessels to die, which can shrink the tumor.

Some types of cancer, like prostate and most breast cancers, need hormones to grow. Hormone therapy can stop your body from producing the hormones that feed the cancer. Others stop those hormones from interacting with cancer cells. Hormone therapy also helps to prevent recurrence.

Immunotherapy

Immunotherapies boost the power of your own body to fight cancer. These drugs can strengthen your immune system and help it recognize cancer cells.

Stem cell or bone marrow transplant

A stem cell transplant, sometimes called bone marrow transplant, replaces damaged blood-forming cells with healthy ones. The procedure takes place following large-dose chemotherapy or radiation therapy to kill cancer cells and to stop your stem cells from producing cancerous cells.

Stem cell transplants can be used for several types of cancer, including multiple myeloma and some kinds of leukemia.

Cancer isn’t a single disease. There are many types — and subtypes — of cancer. Some are more aggressive than others, but there are many variables that lead to different cancer characteristics.

Your oncologist can give you a better understanding of the typical behavior of a certain kind of cancer based on the specifics of your pathology report.

source: https://www.healthline.com/health/cancer/how-fast-does-cancer-spread

Text

to be continued

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What Is Nasopharyngeal Cancer?

craig — Mon, 27 Jan 2020 04:29:43 +0000

What Is Nasopharyngeal Cancer?

Nasopharyngeal cancer is a type of head and neck cancer. It starts in the nasopharynx, the upper part of the throat behind the nose and near the base of skull. Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas. (To learn more about how cancers start and spread, see What Is Cancer?)

Where nasopharyngeal cancer forms

The nasopharynx is the upper part of the throat (pharynx) that lies behind the nose. It's a box-like chamber about 1½ inches on each edge. It lies just above the soft part of the roof of the mouth (soft palate) and just in back of the nasal passages.

The nasopharynx serves as a passageway for air traveling from the nose to the throat (and then on to the lungs).

Types of nasopharyngeal tumors

Several types of tumors can develop in the nasopharynx. Some of these tumors are benign (not cancer), but others are malignant (cancer). It's important to talk with your doctor about what type of tumor you might have.

Nasopharyngeal carcinoma (NPC)

Most nasopharyngeal cancers are nasopharyngeal carcinoma (NPC). It is by far the most common cancer in the nasopharynx. Carcinoma is cancer that starts in the cells that line the internal and external surfaces of the body (called epithelial cells).

There are 3 types of NPC. They all start from epithelial sells that line the nasopharynx, but the cells of each type look different under a microscope:

Non-keratinizing undifferentiated carcinoma (this is the most common type of NPC in the US.)
Non-keratinizing differentiated carcinoma
Keratinizing squamous cell carcinoma

The treatment is the same for all types of NPC. The non-keratinizing types tend to respond better to treatment, but the stage of the cancer – how far it has grown and spread – is often more important than the type in predicting a person's outlook (prognosis).

Many NPCs also contain lots of immune system cells, especially white blood cells called lymphocytes. The term lymphoepithelioma is sometimes used to describe an undifferentiated NPC with many lymphocytes among the cancer cells. The presence of these cells does not usually affect the choice of treatment options. But they may help researchers develop new treatments, because they may be a clue to how the body attempts to fight the tumor. (See What's New in Nasopharyngeal Cancer Research?)

Other cancers in the nasopharynx

Other types of cancers can also be found in the nasopharynx:

Lymphomas can sometimes start in the nasopharynx. They are cancers of immune system cells called lymphocytes, which are found throughout the body, including in the nasopharynx. See Non-Hodgkin Lymphoma to learn more.
Adenocarcinoma and adenoid cystic carcinoma are cancers that can start in the minor salivary glands in the nasopharynx. But these cancers are more commonly found in the nose (nasal cavity) or mouth (oral cavity). See Oral Cavity and Oropharyngeal Cancer, Nasal Cavity and Paranasal Sinuses Cancer, or Salivary Gland Cancer for more about these cancers.

Benign nasopharyngeal tumors

Benign nasopharyngeal tumors are fairly rare and tend to develop in children and young adults. These tumors do not spread to other parts of the body and are usually not life-threatening. They include tumors or malformations of the vascular (blood-carrying) system, such as angiofibromas and hemangiomas, and benign tumors of minor salivary glands within the nasopharynx.

Benign nasopharyngeal tumors don't always need treatment. When they do, the treatment is not the same as for nasopharyngeal cancer. If you have a benign tumor, talk to your doctor about what to expect.

What Are the Symptoms of Nasopharyngeal Cancer?

Hearing loss, ringing in the ear, pain, or feeling of fullness in the ear (especially on one side only)
Ear infections that keep coming back
Nasal blockage or stuffiness
Nosebleeds
Headaches
Facial pain or numbness
Trouble opening the mouth
Blurred or double vision
Trouble breathing or talking

to be continued

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The post What Is Nasopharyngeal Cancer? appeared first on Craig's Story.

What is Cancer?

craig — Sun, 26 Jan 2020 23:35:39 +0000

What is Cancer?

At its heart, cancer is the result of uncontrolled cell growth. Our bodies are composed of trillions of cells, all working together. In cancer, one of those cells stops paying attention to the normal signals that tell cells to grow, stop growing or even to die.

Cancer cells still share many of the same needs and properties of normal cells but they become independent of the controls that make our body function smoothly.

The process by which a normal cell changes into one that behaves so abnormally can take a long time and is often triggered by outside influences.

Cancer is actually a general term that describes a large group of related diseases. Every case of cancer is unique, with its own set of genetic changes and growth properties. Some cancers grow quickly while others can take years to become dangerous to the patient.

The many differences between cases of cancer, even of the same organ (i.e. different cases of breast cancer), is one of the main reasons that treatment is so difficult.

Despite the differences between different types of cancer, all cancers DO share some common features, and these shared properties are the basis for many cancer treatments and research efforts. It is important to understand the basic, shared, features of cancer. This will allow for an understanding of detection, diagnosis and treatment options.

There are numerous changes that must occur for a normal cell to become a cancer cell. Additional changes are needed for that single cell to form a group of cancer cells, called a tumor, and then for that tumor to grow and spread.

Hallmarks Of Cancer: Growth Without 'GO' Signals

Normal cells will not divide unless they receive outside signals that cause it to enter the cell cycle. These signals are detected outside the cell (on the cell surface) and sent into the cell.

They come from three different sources; growth factors (what tells a cell to grow), cell-cell adhesion molecules (what connects one cell to another), and extracellular matrix components (what exists outside of the cell).

Normally these signals, along with other factors, help control the growth of cells, preventing them from dividing uncontrollably. Cancer cells develop the ability to grow in the absence of these external factors and no longer obey the normal regulations on cell division.

They do this by, producing their own growth factors, alter their growth receptors to divide more, and even influence surrounding cells to produce growth signals. At this point cancer cells begin to behave more like independent entities living without regard for the organism as a whole.

Hallmarks Of Cancer: Failure To Respond To 'STOP' Signals

The division of normal cells is restricted by signals from other cells. Cells will stop dividing when they are in contact with neighboring cells. This cell contacts send signals into the dividing cells that cause them to stop dividing. An alternative mechanism to stop cell division is called differentiation. This is the process by which a cell shows different characteristics because it has a certain function.

An example of this would be the maturation of a stem cell to a fully mature colon epithelial cell. The maturation process involves the cells ability to express certain genes, which results in differential properties for the cells.

Hallmarks Of Cancer: Unlimited Number Of Cell Divisions

While normal cells can only divide a finite number of times before stopping cell division and dying, cancer cells have the ability to divide endlessly without displaying the normal 'aging' seen in non-cancer cells.

In many cancers this is due to the activation of an enzyme, telomerase, that maintains the integrity of the chromosomes during cell division, keeping them functional and able to divide.

Hallmarks Of Cancer: Avoidance Of Cell Death

In normal tissue there is a balance between the generation of new cells via cell division and the loss of cells through cell death. Old cells become damaged over time and then go through a process called apoptosis, or cell death.

Apoptosis is a very orderly process in which the genome of the cell, all of its genetic information, is broken down, The cell is fragmented into smaller pieces and the debris is consumed by nearby cells that clean up the cell fragments (called phagocytic cells).

This process is normal and necessary for us to refresh our bodies with new and healthy cells. There are checkpoints built into the cell cycle that can recognize and eliminate the cells that are dividing in an abnormal way.

These checkpoints are responsible for preventing the development of cancer, since cancer cells develop and divide in a different way than normal cells. Cancer cells that get past these checkpoints have can avoid the cell death signals triggered by their abnormal behavior.

Avoidance of cell death, coupled with continued cell division leads to the growth of the tumor. Many of the chemotherapy drugs discussed in the Cancer Treatments section work by forcing the cancer cells to undergo apoptosis.

Hallmarks of Cancer: Getting a Blood Supply

When a tumor becomes large enough where it needs to increase the supply of nutrients and oxygen it receives, it will create new blood vessels. This process is called angiogenesis. Low oxygen levels (hypoxia) trigger the tumor and its surrounding environment to release signals that result in the growth of blood vessels towards and into the tumor. These new vessels supply oxygen and nutrients that allow the tumor to continue growing.

Because the development of blood vessels is so important in tumor growth and is a target of some cancer treatments, we have created separate section on angiogenesis.

Hallmark of Cancer: Metastasis

The spread of cancer from its original location to other parts of the body is called metastasis. This is a critical event in cancer. About 90% of the death associated with cancer is due to disease that has spread. On this page, we present an introduction to the steps in metastasis of a cancer cell. Because of its importance, we have also created a section on how cancer spreads.

Into the Blood
Intravasion, or the process of gaining entry into the blood circulation, is the first step in metastasis.

To accomplish this, individual cells must move away from the primary tumor, which occurs through a change in molecules on the cell's surface that normally keeps it in place. These molecules are called adhesion molecules and normally ensure that cells remain closely linked to each other and the tissue.

However, in some tumor cells these molecules are no longer present, allowing the cell to move away from the tumor and enter the blood stream.

For normal cells, the loss of adhesion molecules results in their death. This mechanism helps prevent them from entering the blood stream. However, metastatic cells have developed mutations that allow them to survive without being attached by adhesion molecules.

In the Blood
Once tumor cells have successfully entered the blood stream, they face an entirely new challenge: surviving transit in the blood. Most cells, including tumor cells, are not designed to survive the stresses of the blood system.

One of the primary ways in which tumor cells survive this transit is by using platelets to act as shields.

Platelets are small blood cells that can surround the cancer cells and protect them from both the force of blood flow and attacks from immune cells.

Out of the Blood
Extravasation, or exit from the blood vessel, is the final leg of the tumor cell's journey through the circulatory system. In some cases, tumor cells, which are often larger than blood cells, get stuck in the capillary bed of a distant organ.

A capillary bed is the network of small blood vessels that are too narrow for the tumor cells to get through. Here they can continue to grow until they burst through the vessel. In other cases, extravasion is more specific.

Tumor cells are often drawn to certain organs based on their adhesion molecules' abilities to bind to certain organ tissues better than others. Evidence for this is observed in breast cancer, which frequently travels to the lung. Breast cancer cells are capable of interacting with an adhesion molecule specifically present on cells of the lung.

Changes in Physical Properties of Cancer Cells

The changes in cell behavior that occur as cancer develops are, in part, dependent on changes in physical properties of the cells. Some of the changes have been identified and may be used to identify cancer cells.

Tumor cells display a characteristic set of features that distinguish them from normal cells. These traits allow the individual cells to form a tumor mass and eventually to metastasize to other parts of the body.

We will briefly consider the changes that affect cell functions and then discuss some of the capabilities that must be acquired by the tumors as a whole to enable them to grow and spread.

A wide range of changes occur during the transformation of a normal cell to a cell capable of forming a cancerous growth. All cancer cells acquire the ability to grow and divide in the absence of signals that are normally 'turned on' and/or in the presence of signals that are normally 'turned off'. There are also detectable changes in the physical properties of the cells.

These changes include the following:

Cytoskeletal changes: The distribution and activity of components in the cell infrastructure, namely microfilaments and microtubules, may change. These alterations change the ways in which the cell interacts with neighboring cells and alter the appearance of the cells. Changes in the cytoskeleton also affect cell adhesion and movement (motility).

Cell adhesion/motility: The reduction of cell:cell and cell:extracellular matrix adhesion allows large masses of cells to form. As described in the section on cell division, cancer cells are able to continue to grow even when surrounded by other cells. The alterations in cell adhesion also impact on the ability of the cells to move. Cancer cells must be able to move and migrate in order to spread, and cell adhesion plays a major role in regulating cell movement.

Nuclear changes: The shape and organization of the nuclei of cancer cells may be markedly different from that of the nuclei of normal cells of the same origin. This change in appearance may be useful in the diagnosis and staging of tumors.

Enzyme production: Cancer cells often secrete enzymes that enable them to invade neighboring tissues. These enzymes digest away the barriers to migration and spread of the tumor cells.

Summary

Hallmarks of Cancer

Cancer typically arises from genetic changes to a single cell.
Numerous changes are necessary to create a cancer cell from a normal cell.
Additional changes must occur to allow a tumor to form and spread.
Cancer cells must acquire the following set of capabilities in order to proliferate:
- Unlimited number of cell divisions
- Growth without external signals
- Failure to respond to 'stop' signals
- Avoidance of cell death
- Acquire an adequate food supply via the promotion of blood vessel formation
- The ability to leave the original tumor location and form a new tumor, or metastasis

Characteristics of Cancer Cells

Cytoskeletal changes allow a cell to alter its appearance and interactions. Helps in cell motility.
Cancer cells have less cell:cell and cell:surroundings connections allowing the cell to become mobile.
A cancer cell's nucleus may be markedly different from that of a normal cell's.
Cancer cells often secrete enzymes that allow it to invade neighboring tissues.
Cancerous tissue is disorganized and appears abnormal.

Source: https://www.cancerquest.org/patients/what-cancer

to be continued

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Cancer Archives - Craig's Story

A year out….

What a difference a year makes

Categories

to be continued

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Neck Dissection

What is a Neck Dissection and Why is it Performed?

Radical vs. Modified Neck Dissection

Categories

to be continued

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Lymph Nodes and Cancer

What is the lymph system?

Lymph Nodes and Cancer

Lymph nodes and what they do

Swollen lymph nodes

Cancer in the lymph nodes

How does cancer spread to lymph nodes?

How is cancer in lymph nodes found?

What does it mean if there’s cancer in my lymph node?

Cancer in nodes affects cancer stage

Effects of removing lymph nodes

Categories

to be continued

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How fast does cancer spread?

Cancer Progression

How Quickly Cancer Spreads

Why cancer spreads

Fastest- and slowest-spreading cancers

What stages have to do with cancer spread

Tumor growth and spread

Benign tumors

Malignant tumors

How treatment works to stop cancer spread

Surgery

Radiation therapy

Chemotherapy

Targeted therapy

Immunotherapy

Stem cell or bone marrow transplant

Categories

to be continued

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What Is Nasopharyngeal Cancer?

What Is Nasopharyngeal Cancer?

Where nasopharyngeal cancer forms

Types of nasopharyngeal tumors

Nasopharyngeal carcinoma (NPC)

Other cancers in the nasopharynx

Benign nasopharyngeal tumors

What Are the Symptoms of Nasopharyngeal Cancer?

Categories

to be continued

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What is Cancer?

What is Cancer?

Hallmarks Of Cancer: Growth Without 'GO' Signals

Hallmarks Of Cancer: Failure To Respond To 'STOP' Signals

Hallmarks Of Cancer: Unlimited Number Of Cell Divisions

Hallmarks Of Cancer: Avoidance Of Cell Death

Hallmarks of Cancer: Getting a Blood Supply

Hallmark of Cancer: Metastasis

Changes in Physical Properties of Cancer Cells

Summary

Hallmarks of Cancer

Categories

to be continued

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