Types of Cancer : Keeywords

Cancer
cancer
prostate cancer
breast cancer
skin cancer
lung cancer
american cancer society
colon cancer
cancer research
clinical trials for cancer
celebrity cancer survivors
darth vader cancer
cancer star sign
support groups for cancer
national cancer institute
testicular cancer
new cancer drugs
cancer risk by state
pancreatic cancer
ovarian cancer
cervical cancer
what causes cancer
cancer constellation
famous people with cancer
cancer statistics
prostate cancer symptoms
cancer types
cancer the sign profile
signs of skin cancer
prostate cancer questions and answers
latest treatment on prostate cancer
prostate cancer warning signs
colon cancer early symptoms
cancer horoscope
cause of prostate cancer
lung cancer symptoms
cancer causes and symptoms
cancer research uk
patti labelle surviving cancer
smoking lung cancer
cancer fraud
liver cancer
types of skin cancer
colon cancer warning signs
celebrity cancer deaths
what causes colon cancer
bone cancer
what to write on a card to someone who has cancer
breast cancer facts
symptoms of breast cancer
bladder cancer
five signs of skin cancer
colon cancer survivability
cancer facts
inflammatory breast cancer
treatments for colon cancer
facts about lung cancer
cancer prevention
cancer statistics and graphs
finding celebrities with cancer
famous cancer survivors
throat cancer
stomach cancer
skin cancer warning signs
drugs used for cancer
thyroid cancer
what causes skin cancer
lance armstrong cancer
constellation cancer
breast cancer statistics
breast cancer new drug
when was skin cancer first discovered
breast cancer stages
list new cancer drugs
list of cancer treating drugs
media and cancer
colon cancer symptoms
metastatic renal cancer
national cancer institute of america
celebrities with breast cancer
mouth cancer
brain cancer
testicular cancer symptoms
dealing with cancer
uterine cancer
causes of lung cancer
what does testicular cancer look like
kidney cancer
ovarian cancer symptoms
effects of lung cancer
which celebrities have cancer
cancer survivor stories
new drug treatment for cancer
breast cancer walks
oral cancer
how does cancer start
breast cancer causes
prostrate cancer
signs of breast cancer
symptoms of colon cancer
cancer astrology

Types of Cancer : Esophageal Cancer

Definition

Esophageal cancer is cancer that occurs in the esophagus — a long hollow tube that runs from your throat to your stomach. Your esophagus carries food you swallow to your stomach to be digested.

Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus, but in people in the United States, it occurs most often in the lower portion of the esophagus.

Esophageal cancer isn't common in the United States. In other areas of the world, such as Asia and parts of Africa, esophageal cancer is much more common.

Symptoms

Signs and symptoms of esophageal cancer include:

• Difficulty swallowing
• Losing weight without trying
• Chest pain
• Fatigue

Early esophageal cancer typically causes no signs or symptoms.

When to see a doctor
Make an appointment with your doctor if you experience any persistent signs and symptoms that worry you.

If you've been diagnosed with Barrett's esophagus, a precancerous condition that increases your risk of esophageal cancer, ask your doctor what signs and symptoms to watch for that may signal that your condition is worsening. Also ask what screening tests you should consider.

Causes

It's not clear what causes esophageal cancer. Esophageal cancer occurs when cells in your esophagus develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.

Types of esophageal cancer
Esophageal cancer is classified according to the type of cells that are involved. The type of esophageal cancer you have helps determine your treatment options. Types of esophageal cancer include:

• Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States.
• Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the middle of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.
• Other rare types. Rare forms of esophageal cancer include choriocarcinoma, lymphoma, melanoma, sarcoma and small cell cancer.

Risk factors

It's thought that chronic irritation of your esophagus may contribute to the DNA changes that cause esophageal cancer. Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

• Alcohol
• Bile reflux
• Chewing tobacco
• Difficulty swallowing caused by an esophageal sphincter that won't relax (achalasia)
• Drinking very hot liquids
• Eating a diet low in fruits and vegetables
• Eating foods preserved in lye
• Gastroesophageal reflux disease (GERD)
• Obesity
• Precancerous changes in the cells of the esophagus (Barrett's esophagus)
• Radiation treatment to the chest or upper abdomen
• Smoking

Complications

As esophageal cancer advances, it can cause complications, such as:

• Obstruction of the esophagus. Cancer may make it difficult or impossible for food and liquid to pass through your esophagus. A number of treatments are available to relieve esophageal obstruction. One option includes using an endoscope and special tools to widen the esophagus and place a metal tube (stent) to hold the esophagus open. Other options include surgery, radiation therapy, chemotherapy, laser therapy and photodynamic therapy.
• Cancer pain. Advanced esophageal cancer can cause pain. Your doctor will work to determine causes of your pain and appropriate treatments to make you more comfortable.
• Bleeding in the esophagus. Esophageal cancer can cause bleeding. Though bleeding is usually gradual, it can be sudden and severe at times. Bleeding may require surgery or endoscopic procedures.
• Severe weight loss. Esophageal cancer can make it difficult and painful to swallow food and drinks. This can make maintaining your weight difficult. Your doctor may refer you to a nutritionist who can discuss strategies for finding easier-to-eat foods that are high in calories and nutrients. Your doctor may recommend the placement of a feeding tube to provide nutrition.
• Coughing. Esophageal cancer can erode your esophagus and create a hole into your wind pipe (trachea). Known as a tracheoesophageal fistula, this hole can cause severe and sudden coughing when swallowing.

Preparing for your appointment

If your family doctor suspects you have esophageal cancer, you may be referred to a number of doctors who will help to evaluate your condition. Your health care team may include doctors who:

• Evaluate the esophagus (gastroenterologists)
• Treat cancer (oncologists)
• Perform surgery (surgeons)
• Use radiation to treat cancer (radiation oncologists)

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, as well as any vitamins or supplements, that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important, in case time runs out. For esophageal cancer, some basic questions to ask your doctor include:

• Where is my esophageal cancer located?
• How advanced is my cancer?
• Can you explain the pathology report to me?
• What other tests do I need?
• What are my treatment options?
• What are the potential side effects of each treatment option?
• Is there one treatment option you feel is the best?
• What would you recommend to a friend or family member in my situation?
• Should I see a specialist? What will that cost, and will my insurance cover it?
• Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?
• What will determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

Tests and diagnosis

Tests and procedures used to diagnose esophageal cancer include:

• Using a scope to examine your esophagus (endoscopy). During endoscopy, your doctor passes a hollow tube equipped with a lens (endoscope) down your throat and into your esophagus. Using the endoscope, your doctor examines your esophagus looking for cancer or areas of irritation.
• X-rays of your esophagus. Sometimes called a barium swallow, an upper gastrointestinal series or an esophagram, this series of X-rays is used to examine your esophagus. During the test, you drink a thick liquid (barium) that temporarily coats the lining of your esophagus so that the lining shows up clearly on the X-rays.
• Collecting a sample of tissue for testing (biopsy). A special scope passed down your throat into your esophagus (endoscopy) or down your windpipe and into your lungs (bronchoscopy) can be used to collect a sample of suspicious tissue (biopsy). What type of biopsy procedure you undergo depends on your situation. The tissue sample is sent to a laboratory to look for cancer cells.

Esophageal cancer staging
When you're diagnosed with esophageal cancer, your doctor works to determine the extent (stage) of the cancer. Your cancer's stage helps determine your treatment options. Tests used in staging esophageal cancer include computerized tomography (CT) and positron emission tomography (PET), among others.

The stages of esophageal cancer are:

• Stage I. This cancer occurs only in the top layer of cells lining your esophagus.
• Stage II. At this stage, the cancer has invaded deeper layers of your esophagus lining and may have spread to nearby lymph nodes.
• Stage III. The cancer has spread to the deepest layers of the wall of your esophagus and to nearby tissues or lymph nodes.
• Stage IV. At this stage, the cancer has spread to other parts of your body.

Treatments and drugs

What treatments you receive for esophageal cancer are based on the type of cells involved in your cancer, your cancer's stage, your overall health and your own preferences for treatment.

Surgery
Surgery to remove the cancer can be used alone or in combination with other treatments. Operations used to treat esophageal cancer include:

• Surgery to remove very small tumors. If your cancer is very small, confined to the superficial layers of your esophagus and hasn't spread, your surgeon may recommend removing the cancer and margin of healthy tissue that surrounds it. Surgery for very early-stage cancers can be done using an endoscope passed down your throat and into your esophagus to access the cancer.
• Surgery to remove a portion of the esophagus (esophagectomy). During esophagectomy, your surgeon removes the portion of your esophagus that contains the tumor, along with nearby lymph nodes. The remaining esophagus is reconnected to your stomach. Usually this is done by pulling the stomach up to meet the remaining esophagus. In some situations, a portion of your colon is used to replace the missing section of your esophagus.
• Surgery to remove part of your esophagus and the upper portion of your stomach (esophagogastrectomy). During esophagogastrectomy, your surgeon removes part of your esophagus, nearby lymph nodes and the upper part of your stomach. The remainder of your stomach is then pulled up and reattached to your esophagus. If necessary, part of your colon is used to help join the two.

Esophageal cancer surgery carries a risk of serious complications, such as infection, bleeding and leakage from the area where the remaining esophagus is reattached. Surgery to remove your esophagus can be performed as an open procedure using large incisions or with special surgical tools inserted through several small incisions in your skin (laparoscopically). How your surgery is performed depends on your situation and your surgeon's experience and preferences.

Chemotherapy
Chemotherapy is drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs are typically used before or after surgery in people with esophageal cancer. Chemotherapy can also be combined with radiation therapy. In people with advanced cancer that has spread beyond the esophagus, chemotherapy may be used alone to help relieve signs and symptoms caused by the cancer.

The chemotherapy side effects you experience depend on which chemotherapy drugs you receive.

Radiation therapy
Radiation therapy uses high-powered energy beams to kill cancer cells. Radiation can come from a machine outside your body that aims the beams at your cancer (external beam radiation). Or radiation can be placed inside your body near the cancer (brachytherapy).

Radiation therapy is most often combined with chemotherapy in people with esophageal cancer. It can be used before or after surgery. Radiation therapy is also used to relieve complications of advanced esophageal cancer, such as when a tumor grows large enough to stop food from passing to your stomach.

Side effects of radiation to the esophagus include sunburn-like skin reactions, painful or difficult swallowing, and accidental damage to nearby organs, such as the lungs and heart.

Combined chemotherapy and radiation
Combining chemotherapy and radiation therapy may enhance the effectiveness of each treatment. Combined chemotherapy and radiation may be the only treatment you receive, or combined therapy can be used before surgery. Combining chemotherapy and radiation treatments increases the likelihood and the severity of side effects.

Clinical trials
Clinical trials are research studies testing the newest cancer treatments and new ways of using existing cancer treatments. While clinical trials give you a chance to try the latest in cancer treatment, they can't guarantee a cure. Ask your doctor if you're eligible to enroll in a clinical trial. Together you can discuss the potential benefits and risks.

Lifestyle and home remedies

Poor appetite, difficulty swallowing, weight loss and weakness are often problems for people with esophageal cancer. These symptoms may be compounded by cancer treatments and by the need for a liquid diet, tube feeding or intravenous feeding during the course of treatment.

Ask your doctor for a referral to a registered dietitian who can help you find solutions to dealing with difficulty eating or a loss of appetite. In the meantime, try to:

• Choose easy-to-swallow foods. If you have trouble swallowing, choose foods that are soothing and easy to swallow, such as soups, yogurt or milkshakes.
• Eat smaller meals more frequently. Eat several small meals throughout the day instead of two or three larger ones.
• Keep nourishing snacks within easy reach. If snacks are readily available, you're more likely to eat.
• Talk to your doctor about vitamin and mineral supplements. If you haven't been eating as much as you normally would or if your diet is restricted, you could be deficient in a variety of

Alternative medicine

Complementary and alternative therapies may help you cope with the side effects of cancer and cancer treatment. For instance, people with esophageal cancer may experience pain caused by cancer treatment or by a growing tumor. Your doctor can work to control your pain by treating the cause or with medications. Still, pain may persist, and complementary and alternative therapies may help you cope.

Options include:

• Acupuncture
• Guided imagery
• Hypnosis
• Massage
• Relaxation techniques

Ask your doctor whether these options are safe for you.

Types of Cancer : Cervical Cancer

=

Definition

Cervical cancer is one of the most common cancers that affect a woman's reproductive organs. Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cases of cervical cancer.

When exposed to HPV, a woman's immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years before it eventually converts some cells on the surface of the cervix into cancer cells. Cervical cancer occurs most often in women over age 30.

Thanks largely to Pap test screening, the death rate from cervical cancer has decreased greatly over the last 50 years. And today, most cases of cervical cancer can be prevented with a vaccine for young women.

Symptoms

You may not experience any cervical cancer symptoms — early cervical cancer generally produces no signs or symptoms. This is why regular screening is so important. As the cancer progresses, the following signs and symptoms of more advanced cervical cancer may appear:

• Vaginal bleeding after intercourse, between periods or after menopause
• Watery, bloody vaginal discharge that may be heavy and have a foul odor
• Pelvic pain or pain during intercourse

When to see a doctor
If you experience any unusual bleeding between periods or pain during intercourse, make an appointment with your doctor.

Talk to your doctor about when to begin screening for cervical cancer, how often the screening needs to be done and when do you no longer need to be screened. The American College of Obstetricians and Gynecologists recommends that girls have their first visit with an obstetrician-gynecologist between ages 13 and 15 to discuss sexual activity and ways to prevent sexually transmitted infections, including HPV.

Causes

In general, cancer begins when healthy cells acquire a genetic mutation that turns normal cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from an initial tumor to spread elsewhere in the body (metastasize).

There are two main types of cervical cancer:

• Squamous cell carcinomas begin in the thin, flat cells that line the bottom of the cervix (squamous cells). This type accounts for 80 to 90 percent of cervical cancers.
• Adenocarcinomas occur in the glandular cells that line the upper portion of the cervix. These cancers make up 10 to 20 percent of cervical cancers.

Sometimes both types of cells are involved in cervical cancer. Very rare cancers can occur in other cells in the cervix.

What causes squamous cells or glandular cells to become abnormal and develop into cancer isn't clear. However, it's certain that the sexually transmitted infection called human papillomavirus (HPV) plays a role. Evidence of HPV is found in nearly all cervical cancers. However, HPV is a very common virus and most women with HPV never develop cervical cancer. This means other risk factors, such as your genetic makeup, your environment or your lifestyle choices, also determine whether you'll develop cervical cancer.

Risk factors

These factors may increase your risk of cervical cancer:

• Many sexual partners. The greater your number of sexual partners — and the greater your partner's number of sexual partners — the greater your chance of acquiring HPV.
• Early sexual activity. Having sex before age 18 increases your risk of HPV. Immature cells seem to be more susceptible to the precancerous changes that HPV can cause.
• Other sexually transmitted diseases (STDs). If you have other STDs — such as chlamydia, gonorrhea, syphilis or HIV/AIDS — the greater your chance is of also having HPV.
• A weak immune system. Most women who are infected with HPV never develop cervical cancer. However, if you have an HPV infection and your immune system is weakened by another health condition, you may be more likely to develop cervical cancer.
• Cigarette smoking. The exact mechanism that links cigarette smoking to cervical cancer isn't known, but tobacco use increases the risk of precancerous changes as well as cancer of the cervix. Smoking and HPV infection may work together to cause cervical cancer.

Complications

Treatments for invasive cervical cancer often make it impossible to become pregnant in the future. For many women — especially younger women and those who have yet to begin a family — infertility is a distressing side effect of treatment. If you're concerned about your ability to get pregnant in the future, discuss this with your doctor.

For a specific subgroup of women with early cervical cancer, fertility-sparing surgery may be a treatment option. A surgical procedure to remove only your cervix and surrounding lymphatic tissue (radical trachelectomy) may preserve your uterus.

Studies of radical trachelectomy suggest that cervical cancer can be cured using this technique, though it isn't appropriate for every woman and there may be added risks to this surgery. Future pregnancies are possible, but must be managed carefully because removing the cervical tissue can lead to a higher incidence of miscarriage and premature birth.

Tell your doctor about your concerns about infertility before your treatment begins. In most cases, preserving fertility is more successful than trying to restore fertility after treatment.

Preparing for your appointment

Most cases of cervical cancer are detected during routine Pap tests. The most important thing you can to do prevent cervical cancer is to follow the recommended screening guidelines for your age group. For most young women, this means seeing your doctor for a Pap test every one to three years. Ask your doctor if you're not sure how often you should be screened for cervical cancer.

If you have pain during intercourse or any unusual bleeding — such as between periods, after sex or after menopause — call your doctor.

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Write down your medical history, including other conditions with which you've been diagnosed.
• Note any personal history that increased your risk of sexually transmitted disease, such as early sexual activity, multiple partners or unprotected sex.
• Make a list of your medications. Include any prescription or over-the-counter medications you're taking, as well as all vitamins, supplements and herbal remedies.
• Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Below are some basic questions to ask your doctor about cervical cancer. If any additional questions occur to you during your visit, don't hesitate to ask.

• Do I have cervical cancer?
• Has my cancer spread?
• What treatment approach do you recommend?
• What are the possible side effects or complications of this treatment?
• Am I at risk of this condition recurring?
• How often will I need follow-up visits after I finish treatment?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

• What are your symptoms?
• When did you first notice these symptoms?
• Have your symptoms changed over time?
• Have you had regular Pap tests since you became sexually active?
• Have you ever had abnormal Pap test results in the past?
• Have you ever been treated for a cervical condition in the past?
• Have you been diagnosed with any sexually transmitted diseases?
• Have you been diagnosed with any other medical conditions?
• Have you ever taken medications that suppress your immune system?
• Do you or did you smoke? How much?
• Do you want to have children in the future?

Tests and diagnosis

Screening
Each year more than 10,000 women in the United States are diagnosed with invasive cervical cancer, and nearly 4,000 die of the disease. Most of these deaths could be prevented if all women received recommended screening.

Most guidelines suggest beginning screening within three years of becoming sexually active, or no later than age 21. Screening may include:

• Pap test. During a Pap test, your doctor brushes cells from your cervix — the narrow neck of the uterus — and sends the sample to a lab to be examined for abnormalities.

  A Pap test can detect abnormal cells in the cervix. This is the precancerous stage, when the abnormal cells (dysplasia) exist only in the outer layer of the cervix and haven't invaded deeper tissues. If untreated, the abnormal cells may convert to cancer cells, which may spread in various stages into the cervix, the upper vagina and the pelvic areas and to other parts of your body. Cancer or precancerous conditions that are caught at the pre-invasive stage are rarely life-threatening and typically require only outpatient treatment.

• HPV DNA test. Your doctor also may use a lab test called the HPV DNA test to determine whether you are infected with any of the 13 types of HPV that are most likely to lead to cervical cancer. Like the Pap test, the HPV DNA test involves collecting cells from the cervix for lab testing. It can detect high-risk strains of HPV in cell DNA before changes to the cells of the cervix can be seen.

  The HPV DNA test isn't a substitute for regular Pap screening, and it's not used to screen women younger than 30 with normal Pap results. Most HPV infections in women of this age group clear up on their own and aren't associated with cervical cancer.

Diagnosis
If you experience signs and symptoms of cervical cancer or if a Pap test has revealed cancerous cells, you may undergo further tests to diagnose your cancer. To make a diagnosis, your doctor may:

• Examine your cervix. During an exam called colposcopy, your doctor uses a special microscope (colposcope) to examine your cervix for abnormal cells. If unusual areas are identified, your doctor may take a small sample of cells for analysis (biopsy).
• Take a sample of cervical cells. During a biopsy procedure your doctor removes a sample of unusual cells from your cervix using special tools. During one type of biopsy — punch biopsy — your doctor uses a circular knife to remove a small circular section of the cervix. Other special types of biopsy may be used depending on the location and size of the unusual area of cells.
• Remove a cone-shaped area of cervical cells. A cone biopsy (conization) — so called because it involves taking a cone-shaped sample of the cervix — allows your doctor to obtain deeper layers of cervical cells for laboratory testing. Your doctor may use a scalpel, laser or electrified wire loop to remove the tissue.

Staging
If your doctor determines that you have cervical cancer, you'll undergo further tests to determine whether your cancer has spread and to what extent — a process called staging. Your cancer's stage is a key factor in deciding on your treatment. Staging exams include:

• Imaging tests. Tests such as X-rays, computerized tomography (CT) scans and magnetic resonance imaging (MRI) help your doctor determine whether your cancer has spread beyond your cervix.
• Visual examination of your bladder and rectum. Your doctor may use special scopes to see inside your bladder (cystoscopy) and rectum (proctoscopy).

Your doctor then assigns your cancer a stage — typically a Roman numeral. Stages of cervical cancer include:

• Stage 0. Also called carcinoma in situ or noninvasive cancer, this early cancer is small and confined to the surface of the cervix.
• Stage I. Cancer is confined to the cervix.
• Stage II. Cancer at this stage includes the cervix and uterus, but hasn't spread to the pelvic wall or the lower portion of the vagina.
• Stage III. Cancer at this stage has moved beyond the cervix and uterus to the pelvic wall or the lower portion of the vagina.
• Stage IV. At this stage, cancer has spread to nearby organs, such as the bladder or rectum, or it has spread to other areas of the body, such as the lungs, liver or bones.

Treatments and drugs

Limited, noninvasive cancer
Treatment of cervical cancer that's confined to the outside layer of the cervix typically requires treatment to remove the abnormal area of cells. For most women in this situation, no additional treatments are needed. Procedures to remove noninvasive cancer include:

• Cone biopsy (conization). During this surgery, the doctor uses a scalpel to remove a cone-shaped piece of cervical tissue where the abnormality is found.
• Laser surgery. This operation uses a narrow beam of intense light to kill cancerous and precancerous cells.
• Loop electrosurgical excision procedure (LEEP). This technique uses a wire loop to pass electrical current, which cuts like a surgeon's knife, and remove cells from the mouth of the cervix.
• Cryosurgery. This technique involves freezing and killing cancerous and precancerous cells.
• Hysterectomy. This major surgery involves removal of the cancerous and precancerous areas, the cervix and the uterus. Hysterectomy is usually done only in certain selected cases of noninvasive cervical cancer.

Invasive cancers
Cervical cancer that invades deeper than the outside layer of cells on the cervix is referred to as invasive cancer and requires more extensive treatment. Treatment for cervical cancer depends on several factors, such as the stage of the cancer, other health problems you may have and your own preferences about treatment. Treatment options may include:

• Surgery. Surgery to remove the uterus (hysterectomy) is typically used to treat the early stages of cervical cancer. A simple hysterectomy involves the removal of the cancer, the cervix and the uterus. Simple hysterectomy is typically an option only when the cancer is very early stage — invasion is less than 3 millimeters (mm) into the cervix. A radical hysterectomy — removal of the cervix, uterus, part of the vagina and lymph nodes in the area — is the standard surgical treatment when there's an invasion of greater than 3 mm into the cervix and no evidence of tumor on the walls of the pelvis.

  Hysterectomy can cure early-stage cervical cancers and prevent cancer from coming back, but removing the uterus makes it impossible to become pregnant. Expect about six weeks of recovery time. Temporary side effects of radical hysterectomy include pelvic pain and difficulty with bowel movements and urination.

• Radiation. Radiation therapy uses high-powered energy to kill cancer cells. Radiation therapy can be given externally using external beam radiation or internally (brachytherapy) by placing devices filled with radioactive material near your cervix. Radiation therapy is as effective as surgery for early-stage cervical cancer. For women with more advanced cervical cancer, radiation combined with cisplatin-based chemotherapy is considered the most effective treatment.

  Side effects of radiation to the pelvic area include upset stomach, nausea, diarrhea, bladder irritation and narrowing of your vagina, which can make intercourse difficult. Premenopausal women may stop menstruating as a result of radiation therapy and begin menopause.

• Chemotherapy. Chemotherapy uses strong anti-cancer medications to kill cancer cells. Chemotherapy drugs, which can be used alone or in combination with each other, are usually injected into a vein and they travel throughout your body killing quickly growing cells, including cancer cells. The chemotherapy drug called cisplatin is often combined with radiation therapy to enhance overall treatment effectiveness. Side effects of chemotherapy depend on the drugs, but generally include diarrhea, fatigue, nausea and hair loss. Certain chemotherapy drugs may cause infertility and early menopause in premenopausal women.

Types of Cancer : Throat Cancer

Definition

Throat cancer refers to cancerous tumors that develop in your throat (pharynx) or voice box (larynx).

Your throat is a 5-inch-long muscular tube that begins behind your nose and ends in your neck. Your voice box sits just below your throat and is also susceptible to throat cancer. The voice box is made of cartilage and contains the vocal cords that vibrate to make sound when you talk. Throat cancer can also affect the piece of cartilage (epiglottis) that acts as a lid for your windpipe.

The American Cancer Society estimates that about 24,000 people in the United States are diagnosed with throat cancer each year. About half of those throat cancers occur in the pharynx, with the rest occurring in the larynx.

Symptoms

Signs and symptoms of throat cancer may include:

• Cough
• Changes in your voice, such as hoarseness
• Difficulty swallowing
• Ear pain
• Lump or sore that doesn't heal
• Sore throat
• Weight loss

When to see a doctor
Make an appointment with your doctor if you notice any new signs and symptoms that are persistent and last more than two weeks. Most throat cancer symptoms aren't specific to cancer, so your doctor will likely investigate other more common causes first.

Causes

Throat cancer occurs when cells in your throat develop genetic mutations. These mutations cause cells to grow uncontrollably and continue living after healthy cells would normally die. The accumulating cells can form a tumor in your throat.

It's not clear what causes the mutation that causes throat cancer. But doctors have identified factors that may increase your risk.

Types of throat cancer
Throat cancer is a general term that applies to cancer that develops in the throat (pharyngeal cancer) or in the voice box (laryngeal cancer). The throat and the voice box are closely connected, with the voice box sitting just below the throat. More specific terms to describe the types of throat cancer include:

• Nasopharyngeal cancer begins in the nasopharynx — the part of your throat just behind your nose.
• Oropharyngeal cancer begins in the oropharynx — the part of your throat that is right behind your mouth.
• Hypopharyngeal cancer (laryngopharyngeal cancer) begins in the hypopharynx (laryngopharynx) — the lower part of your throat, just above your esophagus and windpipe.
• Glottic cancer begins in the vocal cords.
• Supraglottic cancer begins in the upper portion of the larynx and includes cancer that affects the epiglottis, which is a piece of cartilage that blocks food from going into your windpipe.
• Subglottic cancer begins in the lower portion of your voice box, below your vocal cords.

Risk factors

Factors that can increase your risk of throat cancer include:

• Tobacco use, including smoking and chewing tobacco
• Excessive alcohol use
• Poor dental hygiene
• A sexually transmitted virus called human papillomavirus (HPV)
• A diet lacking in fruits and vegetables
• Exposure to asbestos, a naturally occurring fiber that's used in certain manufacturing industries

Complications

Treatment for throat cancer often causes complications that may require working with specialists to regain the ability to swallow, eat solid foods and talk. During and after throat cancer treatment, your doctor may have you seek help for:

• Caring for a surgical opening in your throat (stoma) if you had a tracheotomy
• Difficulty eating
• Difficulty swallowing
• Stiffness and pain in your neck
• Speech problems

Your doctor can discuss the potential side effects and complications of your treatments with you.

Preparing for your appointment

You're likely to start by first seeing your family doctor or a general practitioner. However, in some cases you may be referred immediately to a doctor who specializes in diseases and conditions that affect the ears, nose or throat (otolaryngologist, or ENT specialist).

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, as well as any vitamins or supplements, that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For throat cancer, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• Are there other possible causes for my symptoms or condition?
• What kinds of tests do I need?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?
• What will determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:

• When did you first begin experiencing symptoms?
• Have your symptoms been continuous, or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?

What you can do in the meantime
If you use tobacco, stop. Avoid doing things that worsen your symptoms. If you have throat pain, avoid foods and drinks that cause further irritation. If you're having trouble eating because of throat pain, consider nutritional supplement drinks. These may be less irritating to your throat, while still offering the calories and nutrients you need.

Tests and diagnosis

In order to diagnose throat cancer, your doctor may recommend:

• Using a scope to get a closer look at your throat. Your doctor may use a special lighted scope (endoscope) to get a close look at your throat during a procedure called endoscopy. A tiny camera at the end of the endoscope transmits images to a video screen that your doctor watches for signs of abnormalities in your throat. Another type of scope (laryngoscope) can be inserted in your voice box. It uses a magnifying lens to help your doctor examine your vocal cords. This procedure is called laryngoscopy.
• Removing a tissue sample for testing. If abnormalities are found during endoscopy or laryngoscopy, your doctor can pass surgical instruments through the scope to collect a tissue sample (biopsy). The sample is sent to a laboratory for testing.
• Imaging tests. Imaging tests, including X-ray, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET), may help your doctor determine the extent of your cancer beyond the surface of your throat or voice box.

Staging
Once throat cancer is diagnosed, the next step is to determine the extent, or stage, of the cancer. Knowing the stage helps determine your treatment options.

The stage of throat cancer is characterized with the Roman numerals I through IV. Each subtype of throat cancer has its own criteria for each stage. In general, stage I throat cancer indicates a smaller tumor confined to one area of the throat. Later stages indicate more advanced cancer, with IV being the most advanced.

Treatments and drugs

Your treatment options are based on many factors, such as the location and stage of your throat cancer, the type of cells involved, your overall health and your personal preferences. Discuss the benefits and risks of each of your options with your doctor. Together you can determine what treatments will be most appropriate for you.

Radiation therapy
Throat cancers are particularly sensitive to radiation therapy, so most people with throat cancer undergo radiation therapy as part of their treatment. Radiation therapy uses high-energy particles, such as X-rays, to deliver radiation to the cancer cells, causing them to die. Radiation therapy can come from a large machine outside your body (external beam radiation). Or radiation therapy can come from small radioactive seeds and wires that can be placed inside your body, near your cancer (brachytherapy).

For early-stage throat cancers, radiation therapy may be the only treatment necessary. For more advanced throat cancers, radiation therapy may be combined with chemotherapy or surgery. In very advanced throat cancers, radiation therapy may be used to reduce signs and symptoms and make you more comfortable.

Surgery
The types of surgical procedures you may consider to treat your throat cancer depend on the location and stage of your cancer. Options may include:

• Surgery for early-stage throat cancer. Throat cancer that is confined to the surface of the throat or the vocal cords may be treated surgically using endoscopy. Your doctor may insert a hollow endoscope into your throat or voice box and then pass special surgical tools or a laser through the scope. Using these tools, your doctor can scrape off, cut out or, in the case of the laser, vaporize very superficial cancers.
• Surgery to remove all or part of the voice box (laryngectomy). For smaller tumors, your doctor may remove the part of your voice box that is affected by cancer, leaving as much of the voice box as possible. Your doctor may be able to preserve your ability to speak and breathe normally. For larger, more extensive tumors, it may be necessary to remove your entire voice box. Your windpipe is then attached to a hole (stoma) in your throat to allow you to breathe (tracheotomy). If your entire larynx is removed, you have several options for restoring your speech. You will work with a speech pathologist to learn to speak without your voice box.
• Surgery to remove all or part of the throat (pharyngectomy). Smaller throat cancers may require removing only part of your throat during surgery. Parts that are removed may be reconstructed in order to allow you to swallow food normally. Surgery to remove your entire throat usually includes removal of your voice box as well. Your doctor may be able to reconstruct your throat to allow you to swallow food.
• Surgery to remove cancerous lymph nodes (neck dissection). If throat cancer has spread deep within your neck, your doctor may recommend surgery to remove one or more lymph nodes for laboratory testing.

Surgery carries a risk of bleeding and infection. Other possible complications, such as difficulty speaking or swallowing, will depend on the specific procedure you undergo

Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. Chemotherapy is often used along with radiation therapy in treating throat cancers. Certain chemotherapy drugs make cancer cells more sensitive to radiation therapy. But combining chemotherapy and radiation therapy increases the side effects of both treatments. Discuss with your doctor the side effects you're likely to experience and whether combined treatments will offer benefits that outweigh those effects.

Targeted drug therapy
Targeted drugs treat throat cancer by altering specific aspects of cancer cells that fuel their growth. Cetuximab (Erbitux) is one targeted therapy approved for treating throat cancer in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of throat cancer cells.

Other targeted drugs are being studied in clinical trials. Targeted drugs can be used in combination with chemotherapy or radiation therapy.

Lifestyle and home remedies

Quit smoking
Throat cancers are closely linked to smoking. Not everyone with throat cancer smokes. But if you do smoke, now is the time to stop because:

• Smoking makes treatment less effective
• Smoking makes it harder for your body to heal after surgery
• Smoking increases your risk of getting another cancer in the future

Quitting smoking can be very difficult. And it's that much harder when you're trying to cope with a stressful situation, such as a cancer diagnosis. Your doctor can discuss all of your options, including medications, nicotine replacement products and counseling.

Quit drinking alcohol
Alcohol, particularly when combined with smoking or chewing tobacco, greatly increases the risk of throat cancer. If you drink alcohol, stop now. This may help reduce your risk of a second cancer. Stopping drinking may also help you better tolerate your throat cancer treatments.

Alternative medicine

No alternative treatments have proved helpful in treating throat cancer. However, some complementary and alternative treatments may help you cope with your diagnosis and with the side effects of throat cancer treatment. Talk to your doctor about your options.

Alternative treatments you may find helpful include:

• Acupuncture
• Massage therapy
• Meditation
• Relaxation techniques

Types of Cancer : Testicular Cancer

Definition

Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction.

Compared with other types of cancer, testicular cancer is rare. But testicular cancer is the most common cancer in American males between the ages of 15 and 34. The cause of testicular cancer is unknown.

Testicular cancer is highly treatable, even when cancer has spread beyond the testicle. Depending on the type and stage of testicular cancer, you may receive one of several treatments, or a combination. Regular testicular self-examinations can help identify growths early, when the chance for successful treatment of testicular cancer is highest.

Symptoms

Testicular cancer can result in a number of signs and symptoms. These may include:

• A lump or enlargement in either testicle
• A feeling of heaviness in the scrotum
• A dull ache in the abdomen or groin
• A sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or the scrotum
• Enlargement or tenderness of the breasts
• Unexplained fatigue or a general feeling of not being well

Cancer usually affects only one testicle.

Causes

Nearly all testicular cancers begin in the germ cells — the cells in the testicles that produce immature sperm. What causes germ cells to become abnormal and develop into cancer isn't known.

Risk factors

Researchers don't know what causes testicular cancer. Risk factors may include:

• An undescended testicle (cryptorchidism). The testes form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than are other men are. The risk remains, even if the testicle has been surgically relocated to the scrotum. Still, the majority of men who develop testicular cancer don't have a history of undescended testicles.
• Abnormal testicle development. Conditions that cause testicles to develop abnormally, such as Klinefelter's syndrome, may increase your risk of testicular cancer.
• Family history. If other family members have had testicular cancer, you may have an increased risk.
• Age. Testicular cancer affects teens and younger men, particularly those between ages 15 and 34. However, it can occur at any age.
• Race. Testicular cancer is more common in white men than in black men. The reason for racial differences in the incidence of testicular cancer is unknown.

When to seek medical advice

See your doctor if you detect any pain, swelling or lumps in your testicles or groin area, especially if these signs and symptoms last longer than two weeks. Make an appointment with your doctor even if a lump in your testicle isn't painful. Only a small percentage of testicular cancers are painful from the outset.

Tests and diagnosis

Most men discover testicular cancer themselves, either unintentionally or while doing a testicular self-examination to check for lumps. In other cases, your doctor may detect a lump during a routine physical exam.

To determine whether a lump is testicular cancer, your doctor may recommend:

• Ultrasound. A testicular ultrasound test uses sound waves to create a picture of the scrotum. During an ultrasound you lie on your back with your legs spread. Your doctor then applies a clear gel to your scrotum. A hand-held probe is moved over your scrotum to make the ultrasound image.

  An ultrasound test can help your doctor determine the nature of any testicular lumps, such as if the lumps are solid or fluid filled. Ultrasound also tells your doctor whether lumps are inside or outside of the testicle. Your doctor uses this information to determine whether a lump is likely to be testicular cancer.

• Blood tests. Your doctor may order tests to determine the levels of tumor markers in your blood. Tumor markers are substances that occur normally in your blood, but the levels of these substances may be elevated in certain situations, including testicular cancer. A high level of a tumor marker in your blood doesn't mean you have cancer, but it may help your doctor in determining your diagnosis.

• Surgery to remove a testicle (radical inguinal orchiectomy). If your doctor determines the lump on your testicle may be cancerous, he or she may recommend surgery to remove the testicle. Your testicle will be analyzed in a laboratory to determine if the lump is cancerous and, if so, what type of cancer.

  In general, a biopsy or removal of the lump alone isn't used when testicular cancer is suspected. However, a biopsy may be an option in certain situations, for instance, if you have only one testicle.

Determining the type of cancer
Your doctor will have your extracted testicle analyzed to determine the type of the testicular cancer. The type of testicular cancer you have determines your treatment and your prognosis. In general, there are two types of testicular cancer:

• Seminoma. Seminomas occur in all age groups, but if an older man develops testicular cancer it is more likely to be seminoma. Seminomas, in general, aren't as aggressive as nonseminomas, and are particularly sensitive to radiation therapy.
• Nonseminoma. Nonseminoma tumors tend to develop earlier in life and grow and spread rapidly. Several different types of nonseminomatous tumors exist, including choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumor. Nonseminomatous tumors are sensitive to radiation therapy, but not as sensitive as seminomas. Chemotherapy is often very effective for nonseminomas, even if the cancer has spread.

Sometimes both types of cancer are present in a tumor. In that case, the cancer is treated as though it is nonseminoma.

Staging the cancer
Once your doctor confirms your diagnosis, the next step is to determine the extent (stage) of the cancer. To determine whether cancer has spread outside of your testicle, you may undergo:

• Computerized tomography (CT). CT scans take a series of X-ray images of your abdomen. Your doctor uses CT scans to look for signs of cancer in your abdominal lymph nodes.
• X-ray. An X-ray of your chest may determine whether cancer has spread to your lungs.
• Blood tests. Blood tests to look for elevated tumor markers can help your doctor understand whether cancer likely remains in your body after your testicle is removed.

After these tests, your doctor assigns your testicular cancer a stage. The stage helps determine what treatments are best for you. The stages of testicular cancer are:

• Stage I. Cancer is limited to the testis.
• Stage II. Cancer has spread to the lymph nodes in the abdomen.
• Stage III. Cancer has spread to other parts of the body. Testicular cancer most commonly spreads to the lungs, liver, bones and brain.

Complications

Testicular cancer treatment can cause infertility. Whether you'll experience infertility after cancer treatment depends on the extent of your cancer and what treatments you undergo. Many men with testicular cancer have decreased sperm production even before cancer treatment begins. Treatments that can cause infertility include:

• Surgery. Surgery to remove one testicle (orchiectomy) won't cause infertility, and it won't affect your ability to have an erection. If your surgery involves removal of lymph nodes (retroperitoneal lymph node dissection) you may experience difficulty ejaculating if nerves are severed during surgery. Lymph node dissection won't affect your ability to get an erection. Surgery using a nerve-sparing technique reduces the chance that you'll have trouble ejaculating after treatment. Ask your surgeon whether this procedure may be appropriate for you.

  Surgery to remove both testicles will leave you infertile. Also, your body will no longer be able to make testosterone, so your doctor will recommend testosterone replacement treatments.

• Radiation therapy. Radiation therapy can interfere with sperm production, causing infertility. For some men, sperm production may be limited for a year or two, eventually returning as the treated area heals. For other men, infertility may be permanent after radiation therapy.
• Chemotherapy. Certain chemotherapy drugs can cause infertility, while others won't. Ask your doctor about your particular chemotherapy drugs. In some cases, sperm production may come back with time. In other cases, infertility is permanent after chemotherapy.

Consider storing sperm in a sperm bank before you begin treatment — even if you've yet to consider having children or you think you won't want more children. In most cases, storing sperm now for later use is more successful than trying to restore fertility later if you decide you'd like to start a family. Sperm can be frozen (cryopreserved) for years in case you experience infertility after cancer treatment.

Treatments and drugs

The options you have for treating your testicular cancer depend on several factors, including the type and stage of your cancer, your overall health and your own preferences. Treatment options may include:

Surgery
Surgery to remove your testicle (radical inguinal orchiectomy) is the primary treatment for nearly all stages and types of testicular cancer. To remove your testicle, your surgeon makes an incision in your groin and extracts the entire testicle through the opening. A prosthetic, saline-filled testicle can be inserted if you choose. You'll receive anesthesia during surgery. All surgical procedures carry a risk of pain, bleeding and infection.

You may also have surgery to remove the lymph nodes in your groin (retroperitoneal lymph node dissection). Sometimes this is done at the same time as surgery to remove your testicle. In other cases it can be done later. Your lymph nodes are removed through a large incision in your abdomen. Your surgeon takes care to avoid severing nerves surrounding the lymph nodes, but in some cases severing the nerves may be unavoidable. Severed nerves can cause difficulty ejaculating, but won't prevent you from having an erection. A newer technique called nerve-sparing surgery may be an option.

In cases of early-stage testicular cancer, surgery may be the only treatment needed. Your doctor will give you a recommended schedule for follow-up appointments. At these appointments — typically every few months for the first few years and then less frequently after that — you'll undergo blood tests, CT scans and other procedures to check for signs that your cancer has returned. If you have a more advanced testicular cancer or if you're unable to adhere closely to the recommended follow-up schedule, your doctor may recommend other treatments after surgery.

Radiation therapy
Radiation therapy may be a treatment option if you have the seminoma type of testicular cancer. Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. During radiation therapy, you're positioned on a table and a large machine moves around you, aiming the energy beams at precise points on your body. Side effects may include fatigue, as well as skin redness and irritation in your abdominal and groin areas. You may experience infertility as a result of radiation therapy. However, as the treated area heals you may regain your fertility.

Chemotherapy
Chemotherapy treatment uses drugs to kill cancer cells. Chemotherapy drugs travel throughout your body to kill cancer cells that may have migrated from the original tumor. Your doctor might recommend chemotherapy after surgery. Chemotherapy may be used before or after lymph node removal. Side effects of chemotherapy depend on the drugs being used. Ask your doctor what to expect. Common side effects include fatigue, nausea, hair loss, infertility and an increased risk of infection.

Treatment for advanced or recurrent testicular cancer
If your cancer hasn't responded to other treatments or if your cancer has returned, you and your doctor may consider other treatments. You may consider enrolling in a clinical trial. These research studies give you a chance to try experimental treatments and procedures that are being developed for future use. Clinical trials aren't guaranteed to bring a cure, and side effects of new medications may not be known. Ask your doctor about clinical trials that are open to people with testicular cancer, as well as the possible risks and benefits of experimental treatments.

One treatment being studied for use in advanced testicular cancer is stem cell transplant. Before a stem cell transplant, you're given drugs that coax your body's bone marrow stem cells out of your bones and into your bloodstream. Then the stem cells are filtered from your blood and frozen for later use. You then undergo high doses of chemotherapy to kill any cancer cells in your body, which may also kill bone marrow cells. Your stored stem cells are thawed and put back into your body to replenish your bone marrow cells.

Prevention

There's no sure way to prevent testicular cancer. However, regularly self-examination may improve your chances of finding a tumor at its earliest stage. Beginning in your midteenage years, and continuing throughout your life, examine your testicles at least once a month.

A good time to examine your testicles is after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to find anything unusual.

To do this examination, follow these steps:

• Stand in front of a mirror. Look for any swelling on the skin of the scrotum.
• Examine each testicle with both hands. Place the index and middle fingers under the testicle while placing your thumbs on the top.
• Gently roll the testicle between the thumbs and the fingers. Remember that the testicles are usually smooth, oval shaped and somewhat firm. It's normal for one testicle to be slightly larger than the other. Also, the cord leading upward from the top of the testicle (epididymis) is a normal part of the scrotum. By regularly performing this exam, you will become more familiar with your testicles and aware of any changes that might be of concern.
• If you find a lump, call your doctor as soon as possible. Testicular cancer is highly treatable, especially when identified early.

Your doctor should also examine your testicles whenever you have a physical. If you have an undescended testicle, be sure to tell your doctor, who may refer you to a urologist for treatment or a more specialized exam.