Chemotherapy What is it Part 1

This is dr kevin ryanmd mba facp and hematologist oncologist here, medical oncologist professor and retired colonel and cancer survivor and this is when tumor is the rumor and cancer is the answer. Modeled after my non profit book of the same name available on the web site of the same name you can find it on the web site and a lot more, interviews, films excerpts on the site and it is also available on amazon     in all formats it is also on my blog off the web site  say name  and on www.w4cs  and in a few days iheart radio

Think of this show as a mixture of nova and the wonderful world of disney- what is chemo and how does it work

 

For this show the word “chemotherapy” when used without any modifying terms, will refer to drugs used to fight malignant cells. Typically, these drugs are given in some kind of standardized regimen, either alone or in some well thought out rationally designed and previously tested and developed manner to fight cancer. We are not talking about immunotherapy and targeted molecular therapy although you can make an argument for the former being included

Sadly and fascinatingly, the field owes a lot to the observed effects and later understood chemistry of what lethal mustard gas was doing to humans in ww i. Without too profound a modification, so called nitrogen mustard became one of the first successful agents against human malignancy. Then the fda and national institutes of health and national cancer institute for all intents rose to master the how of safe and expedient new drug development and testing .

The noticing of the mustard gases’ affect on the bone marrow in patients with cancers of cells of part of the immune system, known as lymphomas, led in december 1942 to several patients with advanced  lymphomas getting the compound by vein with massive improvement that was dramatic but short lived. After the war records were declassified, the race to exploit what these drugs were doing and use of them against cancer was underway. Soon, mustine, the first chemotherapy drug, was developed. Since then, many other drugs were used in combination and remissions with cures of some lymphomas, one in particularly known as hodgkin’s disease or hodgkin’s lymphoma were being tentatively reported. After that, drug development has exploded into a multibillion-dollar industry, although the principles and limitations and rules of new chemotherapy development discovered by the early researchers still apply.

Cancer cells not only tend to divide and have children or daughter cells more often than their normal counterparts, they keep doing it, your liver does not keep growing, it knows when it has reached just right “liverness” and if the injury is not too bad it will regenerate right back, after some types of injuries, to just right “liverness”- no more no less. Not so with malignancy.

Chemotherapy can try to take advantage of that growth trait of cancer cells but this means one may see affects on other rapidly dividing cells such as bone marrow, digestive track, and hair follicles. Obviously, and particularly in the case of the bone marrow, decrease in normal marrow contents can occur known as “myelosupression”, this can be dangerous and require careful monitoring and support. This is when and if red cell counts fall with serious anemia, platelets fall increasing the risk of bleeding and certain types of white blood cells fall dramatically increasing the risk of infection.

Notionally, the overarching purpose of cancer chemotherapy may in some cases be expressed as palliative, which means there is no hope of cure. In such cases, the treatment is intended to alleviate symptoms and perhaps prolong life and do so in a manner the patient agrees was worth the effort as it is often not free from toxicities that must be weighed against benefit.

Then there is therapy clearly planned as a regimen intended for cure.  This is an all out attack against all the cancer cells with or without surgery or radiation or other therapies as part of the plan. Thus, the oncologist will tend to give doses known to have the power to kill cancer cells and support the patient through the dangers and toxicities possibly requiring hospitalizations or transfusions or other support, as the goal of cure is possible. Dosing at full dose and on time is a consistent theme.

Then there is the use of chemotherapy before a primary modality of therapy, which might be radiation or surgery, to reduce the burden of cancer cells and eradicate non-local metastasis or sites of spread as well as make surgery more feasible with a better result. This is called neoadjuvant chemotherapy and it may have cure as intent.

In contrast to neoadjuvant therapy, adjuvant chemotherapy is a post-primary treatment modality or given after primary treatment, typically radiation or surgery, to mop up supposed remaining local, as well as distant cancer cells. This therapy is done based on the understanding for a particular cancer that both local or especially distant development of cancer is at risk to occur post original therapy but may not ever or rather take a long symptom free time to do so with the adjuvant therapy being given after local therapy. It is done also because it is known to decrease the risk of relapse  especially when one looks at the original stage remember these are all individual decisions

           There are about 500 drugs approved and mainly used for the treatment of or directly in principal support of the treatment of human cancer. Broadly, chemotherapy is  the treatment of cancer with drugs that can destroy cancer cells by impeding their growth, reproduction and spread. Thus we can broadly classify drugs by names that are meaningless to many but will ring bells with anyone one who has taken a few chemistry courses.

Amazingly, many of these come from stumbled upon observations in the plant and animal kingdom. Others are products of so-called rational drug design. The national cancer institute (nci) and other nations institutes has played an active role in the development of drugs for cancer treatment with over half of those drugs currently used coming from the us national cancer institute (nci) drug development program. Consider this; over 400,000 compounds have gone through nci screening and are in its drug repository of which 80,000 have been screened since 1990. Drugs can enter any level of this program depending on how much  is already known regarding them. Thus, it is a system designed to not waste time. The nci supports the majority of clinical trials in the world with over 1500 ongoing at one time which have some major nci connection. Then there are some private foundation funded trials and university trials and other nations bringing the total to over 2000 ongoing per year in the u.s., representing well over 70% of all trials worldwide.

The sales of cancer drugs will grow at nearly double the rate of the global pharmaceutical market and may pass $150 billion by 2018, according to ims health, the leading provider of information services for the healthcare industry who covers markets in 100+ countries around the world. Expensive new treatments, an increasing number of patients on chemotherapy in major markets and evidence that more people in emerging markets are gaining access to modern targeted therapies will contribute to sales of cancer drugs growing at a compound rate of 12 to 15 percent, ims said.

In 2008, u.s. Sales of oncology products exceeded $50 billion. This comprises nearly 17 percent of all of worldwide pharmaceutical sales growth for that year. As techniques to diagnose disease earlier as well as detect spread or metastatic disease earlier develop and the understanding on a genetic and immunologic basis of each patient’s cancer cells abound, much more elegant and specific therapies will rapidly shuttle their way through the fda’s drug approval pipeline. This will not slow down.

In 2007, titus plattel, ims vice president for oncology showed laser accurate vision when correctly predicting that, “double-digit sales growth in oncology drugs (would be) fueled by increased use of targeted therapeutic agents introduced over the past 10 years… (in addition to ) first-time innovations coming to the market and longer treatment periods for growing numbers of patients,”  indeed, since 2007 over 60 new and important chemical entities were released as safe and effective either alone or in combination with other drugs or types of therapies contributing to the exploding cost of treatment.

The more we learn of the why of  the development of malignant cells that escape  or overcome immunologic surveillance and destruction and  the how of their potential and timing  for spread on a basic science , genetic and immunological and clinical level, the more that knowledge will be exploited. The distance from laboratory bench to patient’s bedside will continue to shrink as not only new drug classes with mechanisms of action helpful to many sufficiently similar patients will be proven safe and effective but the more so-called tailor made therapies for your specific cancer could become a reality.

“ten years ago it was all about chemo,” said dr. Kim lyerly, director of the duke university comprehensive cancer center at the 2007 american society of clinical oncology annual meeting (largest cancer care meeting in the world). “this time you walk down the convention center and it’s all about new targets. And we can get more mileage out of these drugs if we can predict who will respond.”

Here is a brief explanation of the how of present anti cancer chemotherapy therapy.

Chemotherapy is the use of powerful medicines to kill cancer cells. However, not all chemotherapy agents act the same way. Some of the newer therapy  is aimed at specific targets within cells and not principally at highly dividing ( multiplying) cells. Nonetheless, the idea is either to try to exploit some level of an achilles heel present in the malignant cell that is either absent or not as crucial for cell survival in healthy cells. This can be done directly or by means of a cascade of events.

Some chemotherapy drugs affect the behavior of cancer cells without directly attacking them and some directly attack the dna of the cells, preventing them from multiplying or by triggering their ultimate demise. Others do not act directly; they target the molecular abnormality in certain types of cancer. Depending on their biochemical mode of action, chemotherapy drugs (also called an antineoplastic or cytotoxic drug that means toxic to cells or cell killing) are grouped into different therapeutic classes i will mention you may find it useful to have a deeper understanding of just what drugs are being used and why. Feel free to talk with your treating physician regarding these drugs and their combinations. This may also be of great help when looking on the web for new clinical trials and treatments with different combinations than what you have seen. It will also help you understand the differing spectrum of toxicities that may occur with these drugs. By no means is this a chemistry course but it is a window of clever attacks by anticancer drugs

           Alkylating agents (also called dna damaging agents): alkylating agents form chemical bonds with the dna of cells of all kinds but more so with those that are more actively dividing (more target available). The drugs incorrectly link rungs on the ladder like structure that dna can be envisioned as; a ladder of two legs of what are called nucleotides that match up only one complementary or matching like a puzzle base pair at their ladder rungs. The pair called a always matches up with t and g always matches with c at the rung area. Then the whole ladder is twisted and folded. The explicit pattern of those “rung-connected pairs” with nonsense spaces and other fillers and such is your dna. That code, when read through unzipping and sending a messenger of the unsoiled code to   protein factories of the cell are instructions for proteins of all the functions of your body. If the  code is wrong or unreadable all manner of havoc can break loose in this intricate system. Alkylating agents can stop tumor growth and set the stage for tumor cell death directly or in time by creating cross links of chemical bonds in the ladder of the two complementary strands that should not be there. So linked, cells cannot go through the normal cycle of cell division, repair, and production of daughter cells  as they are unable to reproduce their dna, an essential step to cell division . Alkylating agents include several drugs, the most common are: cisplatin, carboplatin (paraplatin), ifosfamide, chlorambucil, busulfan, and thiotepa.

            Anti-metabolites: these anticancer agents work by inhibiting the synthesis of nucleic acids (dna, rna), which are essential in cell division and the making of daughter cells. So, while not making wrong chemical bonds as the drugs above, the outcome is very similar. Normal cells which divide rapidly will be adversely affected. The benefit comes from the fact that unless and until cancer cells show resistance specifically (unusually) or generally to these drugs, they are often initially more sensitive to the effects of these drugs than normal cells during the necessary processes of cell multiplication. In nature, cancer cells divide more frequently than normal cells; and therefore any halt in cell division affects cancer cells more than healthy cells.

The antimetabolites are among the oldest chemical agents used in chemotherapy and are broadly divided into three groups depending on their therapeutic action.

  • Pyrimidine analogues – those molecules are found mainly in nitrogen containing bases that mimic the essential building blocks, the nucleotide, of dna and rna that hold the source code the blueprint and further directions of everything in that cell and made by that cell. One of the anti pyrimidines agents is 5-fluorouracil (5fu), a drug used in the treatment of many cancers, principally colorectal cancer and pancreatic cancer.
  • Purine analogues – they are substances that inhibit enzymes that are crucial for the assembly, maintenance, and duplication and normal tying together of dna: dna polymerase, dna primase and dna ligase. One powerful common example is fludarabine, a chemotherapeutic drug used to treat chronic lymphocytic leukemia.
  • Antifolates – these are drugs that through direct competition interfere with a crucial vitamin used in many levels of mammalian cells, the synthesis of folate. One of the most common of antifolates is methotrexate; it acts by inhibiting dihydrofolate reductase, an enzyme essential for synthesis of purines and pyrimidines.
  • Plant alkaloids and terpenoids: alkaloids of vegetable origin that have therapeutic properties that are used to produce anti cancer drugs by preventing the formation of what is known as the spindle, an egg shaped structure like what is used to shake up dice in some betting games. During cell division, the spindles run the long axis of an egg shaped device and are what chromosomes needs to guide themselves along when the mother cell divides into two daughter cells and takes a full complement of chromosome to each of the two cells. Cancer cells are more sensitive, to a degree, than normal cells the process causes the cells to remain blocked at a stage of cell division and are then unable to divide and thus multiply in number. The most common alkaloids that affect the spindle like tracks include vincristine, vinblastine, vinorelbine, paclitaxel and docetaxel.
  • Taxanes: the taxanes also halt cell division and were originally found in the english yew tree. Many tumors find it difficult to grow with a taxane on board. Although they can be used in the treatment of many tumor types’ cancerous conditions, the taxanes are used mainly to treat advanced stages of breast cancer, lung cancer and metastatic ovarian cancers. The taxanes include paclitaxel and docetaxel. You may here them called taxol and taxotere
  • Topoisomerase inhibitors: wow, that’s a mouthful .dna topoisomerases are essential enzymes that maintain the highly specific and elegant coiling, twisting and orientation in three-dimensional space, of dna. This is not only not random but its integrity must be maintained for accurate functions such as copying, reading of the   dna code and then recombining when dna unzips , reads itself and makes perfect complementary strands of itself         for each daughter cell. Again remember we are talking in three dimensional space among this class of chemotherapy drugs include amsacrine, anthracyclines, camptothecin derivative (irinotecan), and epipodophyllotoxin derivatives (etoposide and teniposide). The topoisomerase inhibitors are used to treat several types of cancers.

           Antitumor antibiotics: antitumor antibiotics are a class of chemotherapy drugs used to treat many malignancies such as acute myeloid leukemia, breast cancer, and non-small cell lung cancer. These drugs act by preventing cell division in both cancerous cells and healthy cells that multiply rapidly so the therapeutic index or margin of safety between where they seriously impair normal cells versus irreversibly damage cancer cells is very narrow. The most common  antitumor antibiotics include :

·       Aclarubicin

·       Bleomycin

·       Dactinomycin

·       Daunorubicin

·       Doxorubicin

·       Epirubicin

·       Mythramycin

·       Mitomycin

·       Zorubicin.

 

 

              Hormones:  some cancers- especially breast and prostate are either hormone-dependent or hormone sensitive cancers this can be both a positive or negative effect and drugs are used to exploit this. Hormone therapy can be used to block hormonal stimulation by acting at various aspects of their metabolism, thus stopping or slowing tumor growth. For example, some drugs manipulate circulating testosterones affect on prostate cancer; other drugs interfere with hormone responsive breast cancer cells ability to reproduce and thrive in a progesterone or estrogen rich environment. Some drugs work at local cancer cell receptors and some work distantly in aspects of the endocrine system to include the brain in areas such as the pituitary gland and elsewhere. It is really rather marvelous the ways that these cells mimic and try to exploit the norm as well as the ways science has uncovered this and exploited them doing so.

                Monoclonal antibodies: these were a giant breakthough at the lab bench of the late eighties and are now expolding in medicine such as rheumatoid arthritis and psoriasis and more than just cancer all of us are equipped with an amazingly intricate immune surveillance system that has a liquid ( antibodies and cytokines and inter leukins and interferon and more) , and a cellular system somewhat analogous to a complete army of intelligence cells, short lived marines,  cannibalizing cells and a metaphor that really does go on and on. The immune system is wonderfully connected and communicates rapidly with all of its aspects. We fight bacteria, cancers, viruses, anything we sense as foreign, such as organ transplants and of course tumors. The noble prize in 1975 went to scientists who discovered we can engineer antibodies highly specific for just one foreign entity one single tiny foreign enitity as long as it can be recognized  and seen as foreign. One can then imagine how the race was on to make these antibodies against cancers and perhaps even attach payloads of radiation or biologic toxins and chemotherapy as well as to try to deliver cancer cell specific therapy .think of somewhat like a silver bullet in some cases, the antibody alone does the trick. The  whole point is specificity  leaving healthy tissues and cells alone while trying to target something very unique about the cancer cells thus addressing the achilles heel notion that was raised earlier.   This is now a multibillion-dollar industry and growing rapidly.

Of course, never underestimate the workarounds cancer cells already have or develop and they are many and can develop very quickly but overall, the direction of research and therapy with monoclonal antibodies is positive with this notional type of approach. A common bottom line of therapy is the antibody singles out the cancer cell and deprives them of something essential, blocks some important pathway or delivers a payload of something toxic. In many cases, it triggers the cancer cells to commit suicide by many different mecanisms. In the beginning, these antibodies used mouse cells to make the antibodies and humans reacted with anti-mouse human antibodies. I was on the first team to publish the building of techniques to humanize these antibodies. In so doing we “ saw”, by tacking radioactive light to the antibody, breast cancer metastasis in a patient which other scans could not see.i was on active duty then or otherwise i would be a very rich man today  oh well was not meant to be and it was exciting to be first in short order, a billion dollar industry was thriving principally involving non hodgkin’s lymphomas and soon other cancers on a large scale. Among drugs classed as monoclonal antibodies include:

·       Herceptin, used in the treatment of breast cancer.

·       Rituximab, used to treat lymphoma and other similar malignancies.

·       And many more.

 

              Podophyllotxin – podophyllotxin is a plant-derived  (american and endangered himalayan mayapple) compound  from which we get two drugs. These make cells get hung up and unable to proceed to multiply just before the life cycle phase called g    one. This is the starting of doubling up their dna prior to dividing . It also  blocks cells caught past g1 trying to actually make the double dna ( to give half to each daughter cell). We see what these drugs, etoposide and teniposide do but we still cannot clearly state exactly how. The mechanism of its action is not yet fully known. Owing to the rarity of their plant of origin scientists are trying to find the genes for the dna codes (just like forensic scientists do in crime solving) to be able in time make the chemicals in the lab by teaching certain cells to be factories for the chemical and they are  suceeding.

                Nanoparticles – now this sounds like science fiction picture this. These particles fall in the size between atoms and small molecules and can be designed to be identical to each other. They are finding increasing use in biomedicine. For example, some of our drugs are very insoluble using conventional techniques. By getting the essential active agents into the size of nanoparticles it allows a highly concentrated delivery of drugs. Here is one example of getting clever and combining breakthroughs nanoparticles made of magnetic material can be used to concentrate agents at tumor sites in the body that have been first identified with monoclonal antibodies with a few atoms of iron attached. You now have tumor sitting vulnerable to agents affiliated with external magnetic fields. This is a novel way to localize at the near atomic level a highly toxic therapy that might well leave other  wise non engaged ( magnetically speaking ) tissues alone. Think of as a  laser site whose focus is as tight as a few molecules on target.

               Electro chemotherapy: this is the idea of somehow giving a physical chemistry or immunologic or biochemical fingerprint to that which you want to singularly find and eliminate. Imagine injecting a chemotherapeutic drug that is then followed by application of high voltage electric pulses locally to the tumor that opens and facilitates the passage of some drugs that normally cannot get transported across the cancer cell wall defenses to it interior. Early work with the antitumor antibiotic bleomycin and the alkylating agent cisplatin is showing some benefit in combination for treatment of skin cancers or those just under the skin no matter what the original tumor type may be. Using this as a cue, endoscospists (clinicians using flexible fibreoptics scopes to look into tubular structures, such as the gi track) are combining these lessons to catch tumors at extremely early phases avoiding more invasive surgery later. The idea is to minimize impact on normal surrounding functioning cells, specifically target, and then eliminate the tumor cells because of either identifying them easily or using techniques to which they are uniquely vulnerable. This should result in an increased tumor kill and/or reduced toxicity.

Specially targeted delivery vehicles may be shown to have a differentially higher affinity for tumor cells by interacting with tumor-specific or tumor-associated antigens. In addition to their targeting component, they also carry a payload – whether this is a traditional chemotherapeutic agent, or a radioisotope or an immune stimulating factor.  These vehicles will vary in  stability, selectivity and targeting motif but they all have the same aim of increasing the maximum effective dose that can be delivered to the tumor cells.

 

The hope and some cases reality is that reduced systemic toxicity means that they can also be used in sicker patients, and that they can carry new chemotherapeutic agents that would have been far too toxic to deliver via traditional systemic approaches. Think of the drone technology we now have in warfare that is designed for the drone to single out a vehicle with a specific license plate or some other highly specific trait with laser accuracy and spares all non intended targets while delivering a payload.

More non dna or antigen targeted therapies

 

Some cancers, one in particular known as chronic myelogenous leukemia, has a well defined defect known as the philadelphia chromosome wherein in the malignant cells and all its children one portion of genes or dna material have a highly specific deletion and movement to other section of dna strands making a chromosome known as the philadelphia chromosome  ( named after the city it was discovered in …by a woman). This leads to the bone marrow cells getting a message to code for a category of gene family  known as a type of tyrosine kinase which leads to out of control, and overtime bone marrow activity. The disease was only curable by bone marrow transplant with highly matched donors and recipient. The death rate from therapy was high with more likely death rates if you wait too long to try the risky transplant. In time,  rational drug design and targeted drug therapy led to an almost non-toxic pill that blocks the aberrant type of tyrosine kinase the aberrant mimicking malignant kinase the philadelphia chromasome  in the cancer cells gave the instructions to make that is seen in the disease. Now most patients have high quality remissions if not cures.- from a highly non toxic pill with response rates of over 90% that are probably cures instead of waiting with the chroninc disease to convert  to acute leukemia and then a transplant being the only hope and a very very high mortality rate

             Other targeted therapies : in one form of acute leukemia a class of drugs known as the retinoids yes like the aniti acne family of drugs  were discovered to  force the arrested maturity of one type of adult leukemia into maturation and eventual control.  These retinoids drugs are  being looked at in multiple malignancies : bexarotene, isotretinoin, tretinoin and atra. In addition we now see exciting work with:

            Vaccines : the well known example is to prevent a large proportion of cervical cancers. And now hpv vaccination works

Also vaccine work is early but encourqaging with a modifiend virus vaccine in the most lethal from of brain cancer

  • Targeted therapies against cellular enzymes or products unique or essential to the cancer cell more than normal cells.
  • Genetic manipulation by inserting specific work horse pieces of dna that help single out malignant cells or programs them to self destruct selectively.this is just taking off and flying in the laboratory we are now looking at finding ealry recurrence or maybe even diagnose of malignancy by finding snippets of cancer specific gene products from cancer dna in the blood
  • High dose chemotherapy with stem cell rescue including auotologous (yourself) or allogeneic ( other humans) peripheral blood or bone marrow transplantation. Better techniques of support and combining this with other therapies and in particular anitbodies is adding months and perhaps years to some people with specific types of cancer
  • Biologic response modifiers: such as interferon and interleukins which use the body’s own immune system to fight cancer and to reduce treatment-related side effects.
  • Ultra sound and cryotherapy which use high frequency microwaves to try and break apart tumor cells or freezing them using inserted probes. Not proven to have more than limited use but some success has been reported
  • Radiation sensitizers: this is where drugs that can concentrate in cancer cells can increase the sensitivity to radiation of just those cells allowing for less damage to surrounding cells and more targeted treatment.
  • Anti angiogenesis angiogenesis means making new blood vessels ,,,,these inhibitors are ; drugs which when delivered block the tendency of some cancers to cause the blood vessel system to be stolen   in a manner that brings more nutrients to the cancer giving it a growth advantage as well as help it have highways that facilitate their ability to access more remote areas of the body. Amazing

In sum, the more we understand that which confers malignant behavior  to malignant cells as well as all the special tricks and traits malignant cells use, the more we single out those seeming advantages as targets for design of increasingly specific therapy with decreasing toxicity. The same holds true for finding the vulnerabilities some of these cancers have separately or in excess to their normal counterparts.

Thus, we see how the word chemotherapy is not only complex and colorful but not at all necessarily a bad thing. Furthermore, the search for new and more specific agents from the plant and animal kingdom for rational drug design and tailored therapy have brought us over 500 approved effective compounds. More on the types of therapy and beauty of the rationally designed clinical trials comes later.

So what is the scope of lay knowledge of malignancy

              Numerous studies have assessed in not only western nations but worldwide the extent of knowledge and understanding of cancer by the nonprofessional. It matters little if one is asking about the diagnosis, biological behaviors, types, effects, and benefits of therapies, causes or odds of response and long term effects; the fund of knowledge by the layman is abysmally low. Hearing this hopefully you see that all manner of research has and is going on and is very clever and building on itself this underscores the argument supporting the need for books such as mine abd this radio show as well as reminds us of the enormous power anxiety has in this disease due to lack of knowledge. The gap of fact versus fiction existing in the non-professional population is a mish mashed jumble with lack of clarity and discernment on all fronts. It is driven by fear …of the unknown.

              People in rich and poor nations alike have faulty understandings of the causes of cancer and need further education as to how to fend off the disease. Studies have shown that in all parts of the world there is a greater tendency to believe that factors out of our individual control as opposed to lifestyle choices are the main cause. The sentiment that we are tossed to the winds of fate or bad luck from genes is largely present and of course, wrong. After simply aging how we have lived is a major factor

A 2007 report, based on a survey sponsored by the international union against cancer (uicc) of nearly 30,000 people in 29 countries was released at the start of a four-day world cancer congress in geneva. In high-income countries like australia, britain, canada, greece, spain and the united states, as well as low-income nations the survey found refusal to recognize that alcohol consumption increases the cancer risk ran at 30-50 percent of the population. Of course, cancer risk rises as alcohol consumption rises.

 

There was overall denial that obesity is a cancer risk factor and a greater belief that fruits and vegetables consumption increasing in the standard western diet will have a more powerful impact that moderation of alcohol and cessation of smoking. This is of course, wrong.

 

Strikingly, there was an unfounded perception that stress posed an ominous proven danger as regards developing cancer similar to the common understanding of the credible data regarding stress as a contributing factor to heart disease.this too is wrong  just like living near high voltage power lines or using cell phones. There is a lot of crap out there

 

Air pollution was also incorrectly held as a major  remember we said major  cause of cancer. “in general, people in all countries are more ready to accept that things outside of their control might cause cancer, like air pollution, than things that are within their own control, such as  being overweight which is a well-established cancer risk factor,” declared the uicc.

           The survey showed that in low and middle-income countries, people were more pessimistic about the chances of treatment curing cancer.

 

In the poorest countries 48 percent felt not much could be done once the disease had taken hold. In middle-income countries, 39 percent had the same view, but in the richest countries, pessimists totaled only 17 percent. The problem with the fatalistic view, said the uicc, was that it could deter people not only from seeking treatment but also from participating in cancer screening programs that can save many lives.

This is only a snapshot of studies that echo the same point. The fund of knowledge what we think we know by non professionals and accuracy of that knowledge regarding causes, methods of diagnosis, treatment modalities and odds of response, morbidity of treatments and frankly most of the relevant aspects of human malignancy are archaic and a poor reflection of reality meaning of the truth why; because it is the very nature of a beast with so many  frightening faces.

 

Cancer is a disease not always externally seen that can affect anyone in any organ, spread at will causing all manners of havoc and whose therapies, without guidance and correct counseling are held by many to be worse than the disease. It is a disease that can cause inexplicable wasting and distant effects from only local tumors and alter quality of life in dizzying arrays. This is why the profound anxiety. Imagine a process wherein a few cells somehow imitate their benign counterpart organ on a genetic level. Then  add in their selective growth advantage ; not stopping, not staying put and then tricking and fooling the defenses of the body, escaping detection and eradication and using the body’s own building blocks to spread. Then they require typically difficult intense therapies to eradicate which may not be sufficiently cancer specific to spare normal functions and tissues so that not only the disease causes all manner of  impairment of health quality issues and risks, but so may the therapy. Imagine the problems that arise when the scope of accurate, sufficiently detailed knowledge of the enemy is sparse and largely incorrect. Thus again, the need for this show and my book.

 

Any more questions?????

 

This has ben dr kevin ryanmd mba facp and hematologist oncologist here, medical oncologist professor and retired colonel and cancer survivor and this has been when tumor is the rumor and cancer is the answer. Modeled after my non profit book of the same name available on the web site of the same name  you can find it on the web site and a lot more, interviews, films excerpts on the site and it is also available on amazon         in all formats i am signing off radio www.w4cs.com the cancer support radio program remind you the program is archived here and the iheart radio as well as the www.w4cs blog and myblog accessed easily from the web site

 

Summary ! part 2 CANCER

Hi I am DR KEVIN Ryan MD MBA FACP ,hematologist oncologist, , PROFESSOR ,RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer. Modeled after my book of the same name available on the web site OF THE SAME NAME.  Www.whentumoristherumorandcanceristheanswer.com You can find it on the web site and a lot more, interviews, films excerpts on the site and it is also available on Amazon all formats are available.        The whole endeavor is non profit and the goal is to reach as many of the 15 million folks affected by cancer every year and help, calm their anxieties with knowledge Thus my show on www.w4cs.com the cancer support radio program live every Tuesday at 3 pm EST noon PST I’d like to remind you REMIND YOU THE PROGRAM IS ARCHIVED HERE AND THE iheart RADIO station  AS WELL AS THE WWW.W4CS BLOG AND MYBLOG ACCESSED EASILY FROM THE WEB SITE We have been doing a summary of the first 9 talks about cancer  and this is part 2 This is what about our enemy  CANCER

 

Part 2 Cancer

WE MUST KNOW THAT WHICH WE ARE  AFRAID OF. WE MUST KNOW THE PERSONALITY OF THE BEAST TO BE BETTER ABLE TO FIGHT IT , WE MUST KNOW THE ENEMY AND THAT IS WHAT WE ARE GOING TO TALK ABOUT

 

SO LETS SINK OUR TEETH INTO THE BEAST..THE ENEMY ..WHAT IS CANCER

 

 

Some CANCER BASICS

 

PONDER THIS

HOW DO LIVER CELLS KNOW WHEN IT IS TIME TO STOP GROWING BECAUSE THEY HAVE REACHED LIVER NESS  OR KIDNEY CELLS  WHEN REACHING KIDNEYESS OR YOUR BRAIN OR SKIN OR ANY ORGAN OR SYSTEM OF YOUR BODY

In cancer the cells do not stop , they escape or impair immune detection or fool it , They simply do not stop growing and having children. They just do not  stop growing .

They have ways of turning off natural timing of A cells death or making vascular highways for themselves to feed themselves as well as have highways to travel on and spread either by direct extension or through the blood. They are clever and they are persistent

What Is Cancer?

Cancer can start any place in the body. It starts when cells grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.

Cancer can be treated very well for many people. In fact, more people than ever before lead full lives after cancer treatment. 65% The numbers used to be opposite

Here we will explain what cancer is and how it’s treated IN VERY general terms. You’ll find a list of words about cancer and what they mean at the end of this.

Cancer basics

Causes

 

How cancer begins

Cells are the basic units that make up the human body. Cells grow and divide to make new cells as the body needs them. Usually, when cells get too old or damaged, they die. Then new cells take their place. AT A NORMAL HEALTHY PACE

Cancer begins when genetic changes in the cancer cell impair this orderly process. Cells start to grow uncontrollably. These cells may form a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Some types of cancer do not form a tumor. These include leukemias, most types of lymphoma, and myeloma..These are so called liquid tumors

Cancer is caused by changes (mutations) to the DNA within cancer cells. The DNA inside a cell is packaged into a large number of individual genes, each of which contains a set of instructions telling the cell what functions to perform, as well as how to grow and divide. It tells it what proteins to make that might block the immune systems. Errors in the instructions, especially an accumulation of them or from multiple sites in the cells DNA can cause the cell to stop its normal function and may allow a cell to become cancerous.

What do gene mutations do?

A gene mutation can instruct a healthy cell to:

  • Allow rapid growth.
  • Fail to stop uncontrolled cell growth.
  • Gene mutations can cause normal cells to Make mistakes when repairing DNA errors as we have a ormal mechanism for self repair. Those mutations are the most common ones found in cancer. But many other gene mutations can contribute to causing cancer.

What causes gene mutations?

Gene mutations can occur for several reasons, for instance:

  • Gene mutations you’re born with.. This type of mutation accounts for a small percentage of cancers. Perhaps 5-8%
  • Gene mutations that occur after birth. Most gene mutations occur after you’re born and aren’t inherited. A number of forces can cause gene mutations, such as smoking, radiation, viruses, cancer-causing chemicals (carcinogens), obesity, hormones, chronic inflammation and a lack of exercise. But again usually it is an accumulation overwhelming or blinding immune detection or eradication

Gene mutations occur frequently during normal cell growth. However, cells and especially those in our immune system when it works correctly contain a mechanism that recognizes when a mistake occurs and repairs the mistake. Occasionally, a mistake is missed. Occurring enough times unchecked could cause a cell to become cancerous.

How do gene mutations interact with each other?

The gene mutations you’re born with and those that you acquire throughout your life work together to cause cancer.

For instance, if you’ve inherited a genetic mutation that predisposes you to cancer, that doesn’t mean you’re certain to get cancer. Instead, you may need one or more other gene mutations to cause cancer. Your inherited gene mutation could make you more likely than other people to develop cancer when exposed to a certain cancer-causing substance.

It’s not clear just how many mutations must accumulate for cancer to form. It’s likely that this varies among cancer types

 

While doctors have an idea of what may increase your risk of cancer, MANY of cancers occur in people who don’t have any known risk factors. Factors known to increase your risk of cancer include:

Your age

A big factor. Cancer can take decades to develop. That’s why most people diagnosed with cancer are 65 or older. While it’s more common in older adults, cancer isn’t exclusively an adult disease — cancer can be diagnosed at any age.

 

Your habits

Certain lifestyle choices are known to increase your risk of cancer. Smoking, drinking more than one alcoholic drink a day (for women of all ages and men older than age 65) or two drinks a day (for men age 65 and younger), excessive exposure to the sun or frequent blistering sunburns, being obese, and having unsafe sex can contribute to cancer. Failure to exercise

You can change these habits to lower your risk of cancer — though some habits are easier to change than others.

 

Your family history

Only a small portion of cancers are due to an inherited condition. If cancer is common in your family, it’s possible that mutations are being passed from one generation to the next. You might be a candidate for genetic testing to see whether you have inherited mutations that might increase your risk of certain cancers. Keep in mind that having an inherited genetic mutation doesn’t necessarily mean you’ll get cancer.

 

Your health conditions

Some chronic health conditions, such as ulcerative colitis, can markedly increase your risk of developing certain cancers. Talk to your doctor about your risk. Chronic inflammatory states can do this

 

Your environment

The environment around you may contain harmful chemicals that can increase your risk of cancer. Even if you don’t smoke, you might inhale secondhand smoke if you go where people are smoking or if you live with someone who smokes. Chemicals in your home or workplace, such as asbestos and benzene, also are associated with an increased risk of cancer

 

1. The Sun

The damage caused by ultraviolet (UV) rays from the sun have been studied immensely over the years. Tanning beds are bad and so is sun exposure

Genes

As we stated People can be at a higher risk of developing cancer from their genetic makeup, or DNA. More specifically, certain mutated genes can be passed onto children from generation to generation, something you can’t prevent or control the effect of. The American Cancer Society explains that cancer is believed to be formed from more than one gene mutation, so you aren’t likely to develop cancer just from one mutated gene inherited through DNA. However, people who inherit these faulty genes are then at a disadvantage because they’re automatically starting off with one mutated gene.

 

Breast cancer is a prime example of this—there are two genes that can be inherited, which can greatly increase the risk of breast cancer within families or lineages. There’s testing that can be done to find out if you have one of these risky genes, and it’s believed that around 5- to 10-percent of breast cancer cases are caused by them. Although many women and some men are diagnosed with breast cancer each year, it’s something that is often caught early enough to treat and overcome.

 

. Smoking

No list of factors that cause cancer would be complete without smoking. Cigarettes kill a staggering amount of people each year because of various types of cancer, many of which develop in the lung, esophagus, mouth, throat, and stomach. More and more cities are banning the use of cigarettes inside public establishments, on patios, and in vehicles as research has shown that second hand smoke is harmful and even deadly for those who don’t smoke. It seriously increases the risk of developing several types of cancer, as well as harmful diseases in other organs.

Smoking trends since 1965, and the amount of adult smokers has decreased by over 20-percent in that time frame. If you need help quitting smoking, take advantage of the many helpful online tools available, join a support group, and talk to your doctor about kicking the habit for good.

Eating Habits and (Lack of) Physical Activity

There are many things that increase the risk of or cause cancer that can’t be prevented. But there are some lifestyle choices that contribute to the risk of developing it, and poor eating habits and little physical activity are two of them.

How we treat our bodies is a major factor in being healthy—. Exercising and getting regular physical activity play a role in this too. Lack of it has been connected to cancer, so taking care of your body in every way is important.

 

AGE Age

It’s a common fact that as you grow older, your chance of developing cancer increases. Cells don’t mutate into cancerous cells overnight, so slow changes can happen over a healthy person’s lifetime without them knowing. Sometimes it happens naturally,IS DETECTED AND DEALT with BECAUSE OF EARLY SCREENING OR A HEALTHY IMMUNE SYSTEM while in some cases the cell mutates from the person being exposed to carcinogens, like cigarettes or environmental hazards.

No one can prevent cancer completely but there are steps that can be taken to help lower the risk of developing cancer. You can’t stop the aging process, but eating healthy, exercising, limiting exposure to carcinogens, and seeing your doctor for regular physicals, GETTING SCREENS are all important for your future—what you do now and how you treat your body as you grow older can have a long-term impact, and being as healthy as possible is the best way to avoid certain preventable diseases, including contributing to your risk of certain cancers.

 

Asbestos

Asbestos exposure, and mesothelioma as a result of this exposure, might be rare these days, In addition to lung cancer and mesothelioma, asbestos has shown to increase the risk of cancer in the larynx and ovaries. People working in construction are most at risk because of the materials used and potential for mishandling and other ways of exposure

Excessive Alcohol Consumption

The impact of alcohol consumption on our health has been widely studied. Many experts believe a drink a day, or specifically a glass of wine a day, could be good for your health. Others believe there are too many potential harmful effects and that alcohol should be completely avoided. Regardless of these two sides, it’s agreed that excessive alcohol consumption can lead to numerous serious medical conditions, including cancer, cardiovascular disease, and mental health problems..

 

Some of the most common cancers linked to drinking too much over a long period of time are liver, colon, throat and breast cancer, so most experts agree that moderation is key.

 

Sex HPV

Conditions Affecting the Immune System

The immune system is your body’s way to defend and prevent infections and diseases. Weakened immune systems or those that don’t function properly are at risk of allowing harmful cells to hurt the body. An unfortunate cause of cancer stems from immune systems that are already affected by another medical condition or syndrome..

 

Since viruses weaken the immune system, there are certain types of viruses that could cause cancer or put the person at a higher risk of developing it in their lifetime. According to the American Cancer Society, some of these viruses include hepatitis B and C, human immunodeficiency virus (HIV), human pappiloma viruses (hpvs), and human herpes virus 8 (HHV-8). Several other viruses have been linked to causing cancer but there isn’t enough evidence yet to prove the connection

 

AGENT ORANGE OTHER TOXINS

Types of cancer

Doctors divide cancer into types based on where it began. Four main types of cancer are:

 

There are many other types of cancer. These above are the main groups

 

How cancer spreads

As a cancerous tumor grows, the bloodstream or lymphatic system may carry cancer cells to other parts of the body. During this process, known as metastasis, the cancer cells grow and may develop into new tumors.

One of the first places a cancer often spreads is to regional lymph nodes draining the area. Lymph nodes are tiny, bean-shaped organs that help fight infection. They are located in clusters in different parts of the body, such as the neck, groin area, and under the arms.

Cancer may also spread through the bloodstream to distant parts of the body. These parts may include the bones, liver, lungs, or brain. Even if the cancer spreads, it is still named for the area where it began. For example, if breast cancer spreads to the lungs, it is called metastatic breast cancer, not lung cancer. A very very common mistake and not just grammar

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Diagnosing cancer

Sometimes a doctor diagnoses cancer after a cancer screening test in an otherwise healthy person. Examples of screening tests include colonoscopy, mammography, and a Pap test and soon genetic blood tests. A person may need additional tests to confirm or disprove the result of the screening test.

 

For most cancers, a biopsy is the only way to make a definite diagnosis. A biopsy is the removal of a small amount of tissue for further study. The following expression is crude but memorable tissue is the issue and no meat no treat. You must know the tissue diagnosis not guess

 

Cancer and its treatment can cause several complications, including:

  • Pain. Pain can be caused by cancer or by cancer treatment, though not all cancer is painful. Medications and other approaches can effectively treat cancer-related pain
  • .
  • Fatigue. Fatigue in people with cancer has many causes, but it can often be managed. Fatigue associated with chemotherapy or radiation therapy treatments is common, but it’s usually temporary.
  • Difficulty breathing. Cancer or cancer treatment may cause a feeling of being short of breath. Treatments may bring relief.
  • Nausea. Certain cancers and cancer treatments can cause nausea. Your doctor can sometimes predict if your treatment is likely to cause nausea. Medications and other treatments may help you prevent or decrease nausea. Mj is once again like the 1980’s showing a possible role as is hypnosis, meditation acupuncture and acupressure
  • Diarrhea or constipation. Cancer and cancer treatment can affect your bowels and cause diarrhea or constipation.
  • Weight loss. Cancer and cancer treatment may cause weight loss. Cancer steals food from normal cells and deprives them of nutrients. This is often not affected by how many calories or what kind of food is eaten; it’s difficult to treat. In most cases, using artificial nutrition through tubes into the stomach or vein does not help change the weight loss. But it is tried on rare occasions. Medical therapy is tried and once again the cannabanoids- the munchies – may have a role. Research is really difficult to do as MJ is still stupidly classified as a stage 1 drug up there with opium and heroin but there is more than just hope
  • Chemical changes in your body. Cancer can upset the normal chemical balance in your body and increase your risk of serious complications. Signs and symptoms of chemical imbalances might include excessive thirst, frequent urination, constipation and confusion. Sometimes it can be very severe
  • Brain and nervous system problems. Cancer can press on nearby nerves and cause pain and loss of function of one part of your body. Cancer that involves the brain can cause headaches and stroke-like signs and symptoms, such as weakness on one side of your body. There is also a lot of research into so called chemo brain especially in breast cancer.
  • Unusual immune system reactions to cancer. In some cases the body’s immune system may react to the presence of cancer by attacking healthy cells. Called paraneoplastic syndrome, these very rare reactions can lead to a variety of signs and symptoms, such as difficulty walking and seizures. High and low calcium, increased clotting and many more
  • Cancer that spreads. As cancer advances, it may spread (metastasize) to other parts of the body. Where cancer spreads depends on the type of cancer. And cancers of a particular type typically spread to the same list of sites for that cancer
  • Cancer that returns. Cancer survivors have a risk of cancer recurrence. Some cancers are more likely to recur than others..

Remember Cancer is not just one disease.

. Cancers are alike in some ways, but they are different in the ways they grow and spread.

So as a review : Cancer cells can also spread to other parts of the body. For instance, cancer cells in the lung can travel to the bones and grow there. When cancer cells spread, it’s called metastasis (meh-TAS-tuh-sis). When lung cancer spreads to the bones, it’s still called lung cancer. And folks often confuse this The distinction is not academic as the original cancer behaves like the behavior of the original cancer not like the place is spread to. To doctors, the cancer cells in the bones look just like the ones from the lung. It’s not called bone cancer unless it started in the bones.

 

How are cancers different?

Some cancers grow and spread fast. Others grow more slowly. They also respond to treatment in different ways. Some types of cancer are best treated with surgery; others respond better to drugs called chemotherapy (key-mo-THER-uh-pee). Often 2 or more treatments are used to get the best results.

When someone has cancer, the doctor will want to find out what kind of cancer it is. People with cancer need treatment that works for their type of cancer.

What are tumors?

Most cancers form a lump called a tumor or a growth. But not all lumps are cancer. Doctors take out a piece of the lump and look at it to find out if it’s cancer. Lumps that are not cancer are called benign (be-NINE). Lumps that are cancer are called malignant (muh-LIG-nunt).

There are some cancers, like leukemia (cancer of the blood), that don’t form tumors. They grow in the blood cells or other cells of the body such as the bone marrow and or lymphnodes.

MOVING ON What stage is the cancer? And we will talk more about that later

The doctor also needs to know if and how far the cancer has spread from where it started. This is called the cancer stage. You may have heard other people say that their cancer was stage 1 or stage 2. Knowing the stage of the cancer helps the doctor decide what type of treatment is best.

For each type of cancer there are tests that can be done to figure out the stage of the cancer. As a rule, a lower stage (such as a stage 1 or 2) means that the cancer has not spread very much. A higher number (such as a stage 3 or 4) means it has spread more. Stage 4 is the highest stage.

Ask your doctor to explain the stage of your cancer and what it means for you.

 

How is cancer treated?

The most common treatments for cancer are surgery, chemotherapy, and radiation (ray-dee-A- shun). Although immuno therapy and a number of precision and targeted medicines  and techniques are exciting , on the rise in treatment , early detection, screening finding early relapse  with some in previously hopeless situations. We are on the edge of a brave new world and much later we will cover future treatments

Surgery can be used to take out the cancer ON OCCASION IT OFTEN HAS NO ROLE IN ALTERRING SURVIVAL. The doctor might also take out some or all of the body part the cancer affects. For breast cancer, part (or all) of the breast might be removed. For prostate cancer, the prostate gland might be taken out. Surgery is not used for all types of cancer. For example, blood cancers like leukemia are best treated with drugs.

 

Chemo (short for chemotherapy) is the use of drugs to kill cancer cells or slow their growth. Some chemo can be given by IV (into a vein through a needle), and others are a pill you swallow. Because chemo drugs travel to nearly all parts of the body, they are useful for cancer that has spread. BUT AGAIN IT MAY BE ONLY LOCAL AS WE ARE TRYING TO GET MORE PRECISE TARGETING

 

Radiation is also used to kill or slow the growth of cancer cells. It can be used alone or with surgery or chemo. Radiation treatment is like getting an x-ray. Sometimes it’s given by putting a “seed” inside the cancer to give off the radiation.

 

What treatment is best for me?

Your cancer treatment will depend on what’s best for you. Some cancers respond better to surgery; others respond better to chemo or radiation. Knowing the type of cancer you have is the first step toward knowing which treatments will work best for you.

The stage of your cancer will also help the doctor decide on the best treatment for you. A stage 3 or 4 cancer is likely to respond better to treatments that treat the whole body, like chemo.

Your health and the treatment you prefer will also play a part in deciding about cancer treatment. Not all types of treatment will work for your cancer, so ask what options you have. And treatments do have side effects, so ask about what to expect with each treatment.

Don’t be afraid to ask questions. It’s your right to know what treatments are most likely to help and what their side effects may be.

 

Why did this happen to me?

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Some people think they’re being punished for something they did or didn’t do in the past. Most people wonder if they did something to cause the cancer. In many cases they did but the guilt has no role and stopping the behavior and starting healthy ones even after diagnosis can actually be beneficial but in terms of the cancer, quality of life and psycho emotional status and sense of control and fighting back

If you’re having these feelings, you’re not alone. Thoughts and beliefs like this are common for people with cancer. You need to know that cancer is not a punishment for your past actions..It may be a consequence though. Try to not blame yourself or focus on looking for ways you might have prevented cancer. It does no good other than what I said

 

How to talk to your loved ones about cancer I cover this in the section called But What Do I say and we will repeat them then but here are some tips..

 

It can be hard to talk both ways.

Here are some tips to help you and your loved ones deal with cancer:

  • Tell your family and friends about your cancer as soon as you feel up to it. Sooner or later, they’ll all know you have cancer. They might feel hurt or left out if they haven’t heard about it from you.
  • When you talk to them, explain what kind of cancer you have and how it will be treated. Let them know that no one can catch it from you.
  • Allow friends and family to help you, and tell them what kind of help you need. If you need a ride to the doctor’s office or hospital, let them know. If you need help around the house, let them know that, too. There may be times when you’re not sure what you need. That’s OK. Just let them know you aren’t sure, but you’ll let them know when you are.
  • Tell the people who are closest to you how you feel. This may not be easy, but it can be a very important way to get the support you need when you need it most. If you have trouble talking about your feelings, you might find a support group or a mental health counselor to help you.
  • If you have friends or family who tell you to “cheer up” when you’re not feeling good, it’s OK to ask them to just listen, and not tell you what to do. Sometimes you need to talk about what’s going on without getting advice in return.
  • If some people are not OK with talking about your feelings, don’t be upset. Try talking to others who might listen.
  • You may not be able to do things you were doing before you got cancer. If that’s true, let your family and friends know.
  • It’s best for your family and friends to keep doing the things they did before you had cancer. They should not feel guilty about doing this.
  • If you’re feeling sad or depressed, talk to your doctor, nurse, or religious leader. You can also call the American Cancer Society at 1-800-227-2345.

How can I learn more about my cancer?

If you have questions about cancer or need help finding resources in your area, please call the American Cancer Society at 1-800-227-2345. We’re there when you need us – 24 hours a day, 7 days a week.

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What are the most common forms of cancer?

Cancer may occur anywhere in the body. In women, breast cancer is one of the most common. In men, it’s prostate cancer. Lung cancer and colorectal cancer affect both men and women in high numbers.

There are five main categories of cancer: Carcinomas begin in the skin or tissues that line the internal organs Sarcomas develop in the bone, cartilage, fat, muscle or other connective tissues Leukemia begins in the blood and bone marrow Lymphomas start in the immune system. Central nervous system cancers develop in the brain and spinal cord.

Once again and to repeat as this comes up a lot How is cancer treated?

Treatment options depend on the type of cancer, its stage, if the cancer has spread and your general health. The goal of treatment is to kill as many cancerous cells while reducing damage to normal cells nearby. Advances in technology make this possible.

: The most common treatments for cancer are surgery, chemotherapy, and radiation (ray-dee-A- shun). Although immuno therapy and a number of precision and targeted medicines  and techniques are exciting , on the rise in treatment ,  the following still remain key =early detection, screening, finding early relapse  with some in previously thought hopeless situations. We are on the edge of a brave new world and much later we will cover future treatments

Surgery can be used to take out the cancer. The doctor might also take out some or all of the body part the cancer affects. For breast cancer, part (or all) of the breast might be removed. For prostate cancer, the prostate gland might be taken out. Surgery is not used for all types of cancer. For example, blood cancers like leukemia are best treated with drugs.

 

Chemo) is the use of drugs to kill cancer cells or slow their growth. Some chemo can be given by IV (into a vein through a needle), and others are a pill you swallow. Because chemo drugs travel to nearly all parts of the body, they are useful for cancer that has spread.

 

Radiation is also used to kill or slow the growth of cancer cells. It can be used alone or with surgery or chemo. Radiation treatment is like getting an x-ray. Sometimes it’s given by putting a “seed” inside the cancer to give off the radiation.

 

What treatment is best for me?

Your cancer treatment will depend on what’s best for you. Some cancers respond better to surgery; others respond better to chemo or radiation. Knowing the type of cancer you have is the first step toward knowing which treatments will work best for you.

The stage of your cancer will also help the doctor decide on the best treatment for you. A stage 3 or 4 cancer is likely to respond better to treatments that treat the whole body, like chemo.

Your health and the treatment you prefer will also play a part in deciding about cancer treatment. Not all types of treatment will work for your cancer, so ask what options you have. And treatments do have side effects, so ask about what to expect with each treatment.

Don’t be afraid to ask questions. It’s your right to know what treatments are most likely to help and what their side effects may be.

How can I learn more about my cancer?

If you have questions about cancer or need help finding resources in your area, please call the American Cancer Society at 1-800-227-2345. They are there when you need them – 24 hours a day, 7 days a week.

As we have said Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.

Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun. Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.

In general, cancer cells have more genetic changes, such as mutations in DNA, than normal cells. Some of these changes may have nothing to do with the cancer; they may be the result of the cancer, rather than its cause.

“Drivers” of Cancer

The genetic changes that contribute to cancer tend to affect three main types of genes—proto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.

Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes), allowing cells to grow and survive when they should not.

Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.

DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes. Together, these mutations may cause the cells to become cancerous.

As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Because of this, cancers are sometimes characterized by the types of genetic alterations that are believed to be driving them, not just by where they develop in the body and how the cancer cells look under the microscope.

DNA IS LIKE A LADDER WITH TWO IDENTICAL LONG LEGS AND RUNGS THAT ALWAYS MATCH IN A CERTAIN WAY THE LADDER AND RUNGS ARE MADE OF BUILDING BLOCKS CALLED NUCLEOTIDES

The fidelity, THE integrity of the human genome or the DNA is maintained by multiple pathways of DNA repair that respond to DNA damage or errors in replication.1 Mismatch repair (MMR) proteins proofread newly replicated DNA strands for mistakes and fix them but if overwhelmed or stopped then bad disruptions in otherwise normal DNA and all the functions of it can occur

When Cancer Spreads

 

Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

 

 

Tissue Changes that Are Not Cancer

Not every change in the body’s tissues is cancer. Some tissue changes may develop into cancer if they are not treated, however. Here are some examples of tissue changes that are not cancer but, in some cases, are monitored:

Hyperplasia occurs when cells within a tissue divide faster than normal and extra cells build up, or proliferate. However, the cells and the way the tissue is organized look normal under a microscope..

Dysplasia is a more serious condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form.

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An even more serious condition is carcinoma in situ. Although it is sometimes called cancer, carcinoma in situ is not cancer because the abnormal cells do not spread beyond the original tissue

Blood Cancers

Blood cancers such as multiple myeloma affect the function and production of blood cells. In most MYELOMA blood cancers, normal blood cell development is interrupted by uncontrolled growth of abnormal blood cells called plasma cells which make antibodies. The abnormal blood cells can prevent blood from fighting off infection or preventing uncontrolled bleeding. In rare cases myeloma is found in one place in the body, and is called solitary myeloma or a plasmacytoma. Myeloma blood cancer treatment may include chemotherapy, radiation and stem cell transplant. Meaning transplant of the Adam and eve cells in your bone marrow the ones that all blood cells eventually come from There are ways to isolate them HUGE PROGRESS IN MULTIPLE RELAPSES

There are three main blood cancer types:Myeloma as we have said and

Leukemia

 

And lymphoma

Leukemia is a blood cancer in both the bone marrow and in blood itself. Both types of leukemia involve an over-production of white blood cells. Lymphocytic leukemia involves over-production of lymphocytes, and myelogenous leukemia involves over-production of white blood cells that are the parents of what their normal mature counterpart, the granulocytes Over time, leukemia cells crowd out normal blood cells leading to serious bleeding and infection.

Lymphoma

Lymphoma is a blood cancer that develops in the lymphatic system. The lymphatic system is made up of groups of lymph nodes which keep body fluids free from infection. The blood cancer may spread from one group of lymph nodes to another in order (Hodgkin lymphoma) or spread randomly (non-Hodgkin lymphoma).The cells also have different appearances and behavior and responses that actually get quite complicated when dealing with non Hodgkin’s lymphoma

Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system.

 

Melanoma

Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.

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Brain and Spinal Cord Tumors

There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Other Types of Tumors

Germ Cell Tumors

Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.

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Neuroendocrine Tumors

Carcinoid Tumors

Carcinoid syndrome. Symptoms may include flushing of the face, flat angiomas (small collections of dilated blood vessels) of the skin, diarrhea, bronchial spasms, rapid pulse, and sudden drops in blood pressure

Let’s see if there are any questions

 

This has been DR KEVIN Ryan MD mba FACP and hematologist oncologist here, medical oncologist, PROFESSOR AND RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer. This is all Modeled after my book of the same name available on the web site OF THE SAME NAME www.whentumoristherumorandcanceristheanswer.com you can find it on the web site and a lot more, interviews, films excerpts on the site and it is also available on Amazon. This is all non profit with goal being to educate as many of the 15 million that cancer touches in some way every day     i AM Signing off radio www.w4cs.com the cancer support radio program REMIND YOU THE PROGRAM IS ARCHIVED HERE AND THE iheart RADIO AS WELL AS THE WWW.W4CS BLOG AND MYBLOG ACCESSED EASILY FROM THE WEB SITE

 

 

Summary of first 8 Lectures Part 1

SUMMARY PART 1

 

Hi DR Ryan here, medical oncologist , PROFESSOR, RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer. THIS IS first of two parts of a summary OF OUR FIRST 9 WEEKS TOGETHER SO I WILL TAKE QUESTIONS AS NEEDED and take them as we go along as the division into two parts will give us more time

We first covered the only set of attitudes that work to improve the quality of life and perhaps even survival because of all the spin off benefits of being more engaged in your care. We also embraced the mind body connection that is not to be denied for all of us. Quality of life improves when attitudes and knowledge improves , anxiety diminishes and most likely so does odds of survival. So listen up,

 

 

There is no grand mystery to the ingredients to be happy no matter what the circumstances but when we have a cancer or a loved one does we tend to panic and forget them when we need them most

 

But if there was ever a time to do so- get real friends close , it is when you are in the worst times , your quality of life largely depends on you and who you surround yourself with.

Equally true is that the mindset, the lifestyle with which you embrace the disease has immense impact. Repeatedly, I have seen families and patients have meaningful improvement in handling the gamut of emotions that occur from rumor of tumor to cancer as the answer when they affect a simple yet profound attitude.

There is good news. Being with those you love

.. Doing so pays for itself. It is its own reward and doing so with those you love is one of the greatest rewards of all

The more you can nourish and sustain yourself in the company and care of those who love you and whom you love, the better

 

. Again the suffering is not to be alone and rarely are you.

SO       GET INFORMED

 

We are hard wired with a blueprint to happiness, a map to finding peace and serenity and we lose our way most when we are most afraid but I assure you the hardwiring and map are there

Beware pretenders and offenders to common sense when it comes to treatments just as you would beware magical promises of cancer cures.. Beware internet promises, rumors, well meaning totally uniformed family or friends, anecdotes, Dr. Google without discernment , unproven therapy, things that seem to be too good to be true and promises of magical cures. Demand high caliber proof  and multisite corroboration with strong statistically valid controls over any new claims of Uncles Joes Kickapoo Joy Juice

. Look to the experts first and foremost,, those who have dealt with folks in your situation hundreds of time and draw on knowledge of folks like you thousands of times and who have been studied in controlled scientifically proven manners. Although you are in charge, do not ignore the VALUE OF THE ultimate truism that you are co captain of your ship

.

. .. Have a purpose in your life when things are dark, a laser focus to get knowledge to kill anxiety born of ignorance. Have a direction

Add productivity...  Don’t just sit there. Be engaged and active in your team. Do not let things happen to you. Be involved.  Be productive in your therapy and in your life- never never ever underestimate the profundity of this

. God made you as the only being truly capable of creativity. It keeps the flame alive. It matters not what it is but make something else other than your misery. You will be amazed at the power of doing so

Be gentle with yourself , there is no timer on your tempering your emotions so move your mind deliberately in the right direction but move

Remember being productive and creative are best pals, they go together. Remember all these things fit together in a wonderful  way …let them

Next is forgiveness giving it gets more then you give-including to yourself. Unpack those bags of a guilt trip

 

Forgive yourself for whatever you may have done to assist this cancer like smoking, alcohol, obesity no exercise and so on . You will tend to feel guilty about many things sometimes. Drop that in the crapper where it belongs and stop the behavior and move forward and do not surround yourself with those who have bad behaviors . Forgiveness of self is mighty powerful when sometimes, not always , it is needed

Laugh at yourself. Humor is a fantastic treatment especially when we look to it early and always.

 

. Never forget the power of music,

Stay active. Fight the weariness. Exercise because it changes not just attitude but response rates and possibly survival. There is more than observational data on this, there is a scientifically explained basis similar to the runners high and the heightened immune system of someone in shape versus a slug. Exercise helps

. Do simple sweet things that bring back fond reminiscences

Remember,. Life is not pain free, especially emotionally and psychologically, pain will happen. Embrace it but do not dwell on it . You will get burned, roll with it and remember the fear of pain can be many times more disabling than the pain itself.

Remember a lot of the non physical pain is a choice, a hard one to be sure, but a choice and choosing mindfulness and positive attitudes towards real body pain due to the cancer or how the therapy can make a difference as well.

Things ranging from hypnosis, to acupuncture, meditation, yoga acupressure massage, and in some cases even pot,( but there is a lot to say about that and it is no panacea at all) all can  assist and even lower needed pain medications and can work

 

Remember you are not in this alone . Others have gone through similar experiences, talk with them in the chemo suites, the waiting rooms, with the nurses, the support groups you should be in/ family friends in most cases but especially those who have travelled the road before you, or are on it now.

 

There is immense power in the connection  that we in cancer medicine, with powerful friendships can form.

If you are open, you probably have a boatload of those capable of rowing a similar boat to the one you are in . You are not alone. Attitude  can bring a better aptitude of how all this treatment goes and as I have said many times…the data  show it in quality of life and remission duration and even survival.

Common sense and life all show that you are not alone . So…. Despite all the weightiness, the sorrow, the guilt , the fear of loss on control and dignity, set the table of your heart and mind with help from others in a beautiful way and bon appétit

 

Now that we have reviewed attitude let’s talk about autonomy

 

You are the center of all your care and you are the co captain of your ship. Remember, your doctors degree, MD, does not mean magnificent demagogue.

I am sure you are familiar with our opening song   from chariots  of fire. A man has a plan and in a day it is crushed…… so it is when you have been told you have cancer ,thoughts of loss of control, soul sucking anxiety, what about your family and the list goes on as it hits  you like a ton of bricks.

In the film he rose above it  …he took control… and so you too will be a hero ………I have seen no exception… no matter how afraid you are, and control is what we are going to talk about today … your AUTONOMY when first diagnosed and through your course of therapy.. What works?

The supreme court said so a long time ago and more than once

 

You need this next topic, autonomy, as part of your repertoire of thinking when suspected of cancer all the way to whatever end.

 

 

 

 Autonomy may come naturally to some but usually not

 

How to achieve being the co captain of the ship as much as possible when diagnosed…. Yes , that seems impossible when everything turns to crap and you are most scared

 

What works?

Trust me you need this…

 

Autonomy.

It is something you must do, something you must demand, ……autonomy.

 

Your quality of life and those that love you will increase dramatically, so will your response to therapy because you are more in tune with your disease, your therapy and your options and……. Your physician is on notice as is the whole team that it is a team effort , you are co captain of your ship;;;

 

Autonomy….so what does it mean especially in oncology

 

This is the single most important word and concept the reader of my book or listener to this show must grasp. Philosophically, it refers to the fundamental principle that all humans are independent moral agents with the personal capacity to make moral decisions and act on them.

In modern days, autonomy most often equates with the phrase, self-determination. Individuals are autonomous when their actions are truly their own without coercion or inappropriate influence.

The final decision of the competent adult is theirs.

Thus, patient autonomy refers to the capability and right of patients to control the course of their own medical treatment and participate in the treatment decision-making process.

Physicians and their teams must fully inform their patients to the best of their ability and the best of the patients’ ability to understand. Health care providers lead the patient to intelligence. However, it is the patient’s job, once lead, to think..

God gave you the gift of choice and the greater gift of sufficient intelligence to make those choices if you are sufficiently informed. That is exactly what I am and the show and the book are attempting to do; inform. That is why this section appeared early on.

 

So empowered , you will be able to transform the pain of anxiety, which is fear of the unknown , into the hero producing powers behind fear which are a god given hard wired set of emotional, physical and intellectual responses that can and do lead us to wise, autonomous personal decisions

It is improving with the advent of integrative medicine and the advent of patient centered care  See comment in PubMed Commons below

The medical practice of patient autonomy and cancer treatment refusals: a patients’ and physicians’ perspective.

The idea that patients should take up an autonomous position in the decision-making process is generally appreciated.

However, what does patient autonomy mean in the case of patients who refuse a recommended oncologic treatment.

In contrast to what is generally believed, decisions of patients to refuse an oncologic treatment do not so much rely on the medical information about disease and treatment options, but are rather inspired by patients’ own experiences or those of close others…or Dr Google. You would be amazed  .

In certain unique circumstances government may have the right to temporarily override the right to bodily integrity and autonomy in order to preserve the life and well-being of the person.

 

Such action can be described using the principle of “supported autonomy”,[13] a concept that was developed to describe unique situations in mental health (examples include the forced feeding of a person dying from the eating disorder anorexia nervosa, or the temporary treatment of a person living with a psychotic disorder with antipsychotic medication).

While controversial, the principle of supported autonomy aligns with the role of government to protect the life and liberty of its citizens. But even then there is some debate…. I fall on the side of government

How about when the disease approaches a terminal phase Perhaps autonomy should have been the guiding principle long before this transpired in case it came to pass and thus avoid ethical quagmires, distressed next of kin and playing god

Medical and social attitudes toward cancer have evolved rapidly during the last 20 years, particularly in north america.1,2 most physicians, most of the time, in most hospitals, accept the ethical proposition that patients are entitled to know their diagnosis.

However, there remains in my experience a significant minority of cases in which patients are never informed that although informed of the diagnosis, are not informed when disease progresses toward a terminal phase..

There are cultural and family differences..

Korean-American and mexican-american subjects are more likely to hold a family-centered model of medical decision making rather than the patient autonomy model favored by most of the african-american and european-american subjects. This finding suggests that physicians should ask their patients if they wish to receive information and make decisions or if they prefer that their families handle such matters.

Nonetheless, You, the patient, are the co captain of the ship. You have a responsibility to know the sails, the keel, the rudder the rigging, the set of the sails, the heading the clinical trials you have been taught about and demanded to know about or learnt how to responsibly find out about trials, You are a co expert on you

It is your body

No your are not an MD but you are a MD on your person in a large sense with your own personal doctorate, not just another case or person with a disease

Think of it.

You make autonomous decisions everyday, where and how you live, what you buy, a new car a mortgage, planning for you or your children’s future,

We are wired with free will and its exercise is manifested in autonomy, not arrogance and  not idiocy ,,,autonomy.

Just like in school,,, the more you know the smarter you get and you progress and the less the anxiety…and it is infectious to those around you

Believe it or not most physicians in oncology love the appropriately autonomous patient , they are partners with you when there are no right decisions as well as when there is . They can unburden themselves and you from the sense of playing god and being the only one in the know which will happen naturally because of their superior training often enough

But rarely are patients so intellectually challenged that they cannot grasp major decisions and make them together with their doctor ,,,

Caretakers are consultants but are not the patient

They are invaluable but are not the patient

They are loving but are not the patient

This is your life and you are dying to live not living to die….

Act like it

You will be more in touch with your signs and symptoms

You will actually trust yourself more and your doctor,

Your will handle therapy better and not surrender yourself into hands you do not know ,

Dying to live not living to die…..   Autonomy

Anxiety

 

Anxiety and fear

It is anxiety that is the killer, NOT FEAR. We humans suffer most when not knowing all that needs known, especially when there is so much to fear. Anxiety is fear of the unknown

Anxiety is not abnormal and may in fact be an emotion that leads to a positive outcome. Nonetheless, it hurts the cancer patient and family.

. It is knowledge that is the oncologists’ first and most precious gift to the patient. It is knowledge that the patient and family must demand. Knowledge delivered through teaching that must be thorough, comprehensible, and empathetic. Physicians must teach patients how to deal with family, friends, sources on the internet, the staging procedures and their meaning, the treatment and the value of second opinions. Patients must learn well that they will not be alone, that thousands have handled this and that others were no less anxious and no braver.

Physicians must speak to their patients of the odds of cure, remission and durability of remission. They must not shy away from discussing spirituality, life’s goals, and the effects of treatment on normal bodily function. Common anxiety-laden patient questions, as “what functions or abilities will I lose” as well as “what will I keep” are essential front burner issues. Discussions must be frank regarding the specter that pain, nausea and vomiting often represent to patients. Moreover, physicians will find the more empathetic time spent the greater the patient’s trust and quality of life.

Patients need to know if research studies hold out a realistic promise. Oncologists must explain the amazing armamentarium of medications they have, the psychological assistance patients will be given and potentially, the beautiful role which hospice may play.

Remember it’s ok to tell someone you are not ok

Other issues are what some have called scanziety and also the issue of telephone messages.

Scanxiety refers to the fear and worry associated with imaging, both before and after a test is performed, and lasts until the test results are communicated to the patient. As described by cancer survivor, “scans are like revolving doors, emotional roulette wheels that spin us around for a few days and spit us out the other side. Land on red, we’re in for another trip to cancerland; land on black, we have a few more months of freedom.”  The root of this anxiety is  related to the uncertainty of the test results and the amount of time that elapses between when the test is performed and the results known. Not surprisingly, most patients report an escalation of anxiety that correlates with longer wait times.

In an ideal world, scanxiety could be alleviated by immediate test results. When scans show no evidence of disease, or a blood test is within normal limits, the phone calls are easy to make. It’s a different story when the scans or tests are abnormal or indicate disease progression. In these cases, face-to-face conversations about treatment options are best.

“phone tag” frustration

So, what can healthcare providers do to reduce scanxiety? Some oncology practices schedule patients for a clinic visit on the same day a scan or test is performed or results known

Every oncology facility should have procedures that reduce the likelihood that patients will “fall through the cracks” and not be followed up.

An option is the doximity dialer, an app that allows healthcare providers to call patients without revealing their personal cell phone numbers. Patients see an office or clinic number instead. The app allows healthcare providers to call patients at any US number, choose the caller id that appears, and send return calls to an office or clinic.

The app can be downloaded for iphones at the app store and for android devices at Google play.

 

The bottom line is that there are a number of strategies to help patients reduce scanxiety and cope with its effects . Being diagnosed with cancer is hard enough; we need to do all we can do to make the journey less stressful. –

The physical changes regarding patient’s anxiety are measurable assessments after chemotherapy included distress, fatigue, and mindfulness.

Researchers have put yoga and mindfulness to the scientific test for years, and the results so far have been impressive. The practice has been shown to lower anxiety.

But it can also help those who are already ill feel better. A new study suggests that doing yoga twice a week may improve quality of life for men being treated for prostate cancer and may help reduce the side effects of radiation, which include fatigue, sexual dysfunction and urinary incontinence.

So again if you have any of these tell your doctor, there is help

  • Difficulty concentrating and making decisions
  • Heart palpitations, sweating, shaking
  • Shortness of breath, feeling faint
  • Numbness or tingling in the hands or feet
  • Heightened sense of alertness
  • Anticipating feeling anxious or a persistent worry
  • Feelings of guilt, worthlessness, and/or helplessness
  • Feeling of unreality or detachment from oneself
  • Fear of dying or losing control
  • Irritability, restlessness
  • Dry mouth
  • Muscle tension
  • Nausea
  • Sleep difficulties
  • Cold or sweaty hands
  • Loss of interest in activities or hobbies once pleasurable
  • Withdrawal from normal activities and friends (avoidance)
  • Appetite change or weight change (usually loss)
  • Persistent aches or pains, headaches, cramps, or digestive problems
  • Lets also give a non scholarly but becoming so, nod to smoked cannabis, the psychoactive form in alleviating anxiety- there are some early trials in the 80’s mostly about control of nauseas and vomiting where it was no better than what was then the standard and inferior to what we have now with exceptions existing on a case by case basis. It being a class 1 drug highly controlled by the FDA has made scholarly work hard but there is a growing body of evidence that supports a possible role in alleviating anxiety, besides improving mood , appetite and pain as well as anticipatory nauseas Mostly we are left with it being no better than standard of care but there are some powerful small studies and of course individual anecdotes. Remember ,anecdote does not equal antidote

 

None of the above is true for any other herbal substance despite what you think or may have heard

Remember anecdote does not equal antidote

 

Family-centered care is crucial to the care of children with cancer,

Challenges associated with a cancer diagnosis, treatment, and adaptation impact the entire family. Recent research has demonstrated that families experience altered family function and may face an accumulation of risk for mental health and severe emotional problems including anxiety over the course of illness,

Other research reports that the experience of cancer increases family cohesion and family resilience. So it can bond as well as break- it is a case by case , family member by family member SITUATION even within the same family .

The nurse’s role

. Oncology nurses directly impact families through communication and can model open, compassionate, developmentally appropriate communication with families. Moreover, coaching and teaching are inherent to nursing care of families. Thus, oncology nurses role can be 2-fold: communicating with families across settings to increase their comfort or to provide education and

 

Coaching in discussing sensitive, emotional topics related to the illness. .

 

Typical anxious fears are

fear of getting recurrence of cancer

Anxiety about having cancer

Constant fear of getting cancer

Fear of cancer diagnosis

Fear of cancer

Cancer and anxiety attacks

Cancer anxiety symptoms

Anxiety after cancer

So, anxiety is soul sucking, it has many forms and presentations, it is harmful and it is treatable in cancer patients and families by MANY approaches

DEPRESSION

The topic, as it is so often, is the “hidden” curse and THE NEVER AND forever lie= it will never change and will forever be this way .

Depression incidence in cancer patients is twice that of the general population, under diagnosed and has twice the suicide rate.

OVERVIEW

Over 15.5 million cancer survivors are alive today in the US, which is similar to the populations of New York City, Los Angeles, and Chicago combined.

The number of survivors continues to grow, not just because of earlier detection and treatment AND AGING OF THE POPULATION , but because of revolutionary new therapies that have been emerging over the past decade.

Now, patients with poor-prognosis metastatic cancers such as lung cancer and melanoma can live many years with good quality of life while on active treatment. For many individuals, this changes the landscape from a terminal illness to more of a chronic illness.

Concurrent with advances in cancer treatment, the importance of psychosocial care of individuals with cancer is being increasingly recognized. There is documented under-detection and failure to optimally manage psychiatric disorders and psychosocial needs in patients with cancer and their families.

 

Unmet needs can have negative consequences for quality of life, treatment adherence, and survival..

 

GUIDELINES ARE NOT ALWAYS FOLLOWED NOR IS  SCREENING ALWAYS DONE

 

SORRY BUT THAT IS REALITY AND RESEARCH SUPPORTS THAT

 

 

Although most cancer centers provide some psychosocial services AND IT IS IMPROVING , increased attention to the psychosocial needs of patients with cancer may result in increased referrals to mental health professionals . Some basic knowledge about a patient’s cancer and treatment are essential for psychiatric management.

 

Studies have documented that a cancer diagnosis results in high levels of emotional distress. Patients go through an adjustment period for about 4 to 6 weeks after diagnosis. SOME LONGER AND EXPECT THAT.

 

Cancer for many patients is synonymous with death and debilitating treatments, with images of a prolonged painful dying process. Patients often say they feel overwhelmed trying to assimilate medical information and make treatment decisions—all while continuing to manage family, work, and other responsibilities.

 

However, for the majority of patients, once they receive a plan of action and begin treatment, their emotions tend to level out.

 

Yet, cancer IS a series of crises that may occur at any time in the disease trajectory from diagnosis, treatment, cycles of recurrences and remissions, post-treatment, and sometimes palliative care.

 

Assessment and treatment

SIGNIFICANCE FOR THE PRACTICING PSYCHIATRIST

 

Coordinating with the oncology team. With the patient’s permission, consulting and informing the oncology team of your involvement is critical. As mentioned earlier, psychiatrists need to understand the patient’s cancer diagnosis, staging, treatments, adverse effects of treatment, and prognosis to appreciate the challenges the patient is coping with throughout treatment as well as survivorship or end-of-life. Medical concerns can cause or MAKE WORSE, BOTH depression and anxiety.

 

Knowing that survival with metastatic breast cancer can be years is critical in providing psychiatric care for the patient.. Psychiatrists contribute to oncology care by providing information to the oncology team regarding the patient’s emotional status and potential barriers to care and treatment adherence.

 

 

Pharmacotherapy. The most prescribed antide­pressants in cancer patients are WHAT YOU HAVE HEARD CALLED ssris OF WHICH THERE ARE MANY, At times the choice of an antidepressant is made based on the antidepressant adverse-effect profile.

 

.

Some psychiatric medications may adversely affect the efficacy, THAT IS , THEY MAY INTERFERE WITH of commonly used systemic cancer therapies.

.

Be aware that some systemic cancer treatments are associated with psychiatric adverse effects. DRUGS TO TREAT leukemia and some lymphomas, may cause depression. Interferon at high doses can cause depression and even suicidal THOUGHTS. SOME CAN CAUSE can cause lethargy, depression, mania, confusion, and hallucinations. THEY can potentiate the effects of alcohol, opiod, and tricyclic antidepressants.

 

Glucocorticosteroids such as prednisone and dexamethasone are widely used in cancer care. They can cause a range of psychiatric symptoms, from emotional lability, depression, anxiety, restlessness, irritability, and insomnia to paranoia, delusions, and hallucinations..

 

Pain management. Suffering from uncontrollable pain is one of the most common fears of cancer patients. Unfortunately, pain is under-recognized and undertreated in patients with cancer. Explaining to the patient that at times she may need to use opiods under the care of her oncologist without fearing addiction can prevent the patient from suffering unnecessarily. Poorly managed pain can lead to depression and anxiety. Once pain is appropriately managed, depressive and anxiety symptoms often diminish or resolve. ONCE THE PAIN MEDS ARE RESPNOSIBLY GIVEN THERE IS OFTEN GREAT RELIEF

 

HOWEVER     While some psychiatrists and oncologists have expertise in pain management, others may not and are reluctant to prescribe the necessary medications at the appropriate doses. AND SOME OVERPRESCRIBE

 

Speaking with the oncology team and helping to get appropriate referral to a cancer pain specialist or palliative care team is crucial to the quality of life of cancer patients, especially those with advanced disease.

 

Before the patient’s visit with the pain specialist, it is helpful for the psychiatrist to provide education and correct some common misconceptions. The following 3 key issues should be considered regarding referral for pain management:

  1. A majority of cancer patients do not have a history of addiction and actually fear becoming addicted to pain medications
  2. Patients view the taking of pain medications as associated with death and dying: “Only a patient who is dying takes morphine”    3)Patients may need education on the difference between addiction and tolerance, in order to comply with prescribed pain medications Psychiatry appointmentsPatients often include their family in oncology visits,. Family members may need support in coping with their own concerns and often need educationThe American Psychosocial Oncology Society (www.apos-society.org) has published quick reference handbooks on psychosocial care for adults, children, and elderly adults with cancer and produces webinars on particular topics, such as sexual health and cancer.
  3.  
  4. The traditional paradigm for psychiatric treatment may require a more flexible approach to scheduling to adjust to the reality of the patient’s needs during treatment. . FLEXIBILITY IS CRUCIAL. SUFFERRING HAS NO TIMECLOCK
  5.  
  6.  

7 Physical Clues You Could Have Depression

 

Many people who suffer from chronic illnesses also suffer from depression. Depression isn’t something that should be overlooked; it should be brought to your doctor’s attention so that it can be treated. But how do you spot depression?  With help from prevention.com, we’ve put together a list of some of the most common physical signs that someone is suffering from depression.

 

Aches and Pains

Although many chronic illnesses have their share of aches and pains, depression can also make muscles and joints feel sore or exacerbate the problem. People who are happy or content generally feel pain less than those who have depression.

Difficulty Sleeping or Waking Through the Night

Not being able to relax enough to fall asleep or frequently waking up during the night and finding it difficult to go back to sleep could both be signs of depression. Lack of sleep or disturbed sleep can have a profound effect on mood and the ability to concentrate.

Changes in Weight

Loss of appetite or comfort eating are both associated with depression, but you may not realize you have either until you step on the scale and notice a difference. In addition, if you’re not sleeping well because you’re anxious or depressed, this can also mess with your appetite leading to weight loss or gain.

Skin Complaints

Because depression affects hormones, this often becomes apparent in our skin. Depression can lead to skin complaints like acne, psoriasis, and eczema and treating the depression can help with the skin complaint.

Stomach Problems

Mood definitely affects the gut, and people with depression may suffer from symptoms like nausea, constipation, diarrhea, heartburn and indigestion.

Headaches and Migraines People with depression are more likely to experience frequent headaches or migraines. Although this could also be a side effect of medication or treatments you take for your chronic illness.

Oral Problems

People with depression are more likely to need dental work such as tooth extractions and cavities than those who don’t. The thought behind this is that if you’re depressed, you’re less likely to be as diligent about oral health.

Suicide is twice the rate as least in cancer patients and in depressed ones some studies say it is 4 times higher

Once again REMEMBER Suicide IN DEPRESSED CANCER PATIENTS WHO HAVE TWICE THE RATE OF DEPRESSION IS ALSO TWICE THE RATE OF NON CANCER PATIENTS

AND STUDIES SUGGEST  THAT FEWER THAN 30% OF ONCOLOGISTS FORMALLY SCREEN FOR IT AND THE PATIENT OR CLOSEST CAREGIVER MORE COMMONLY SILENTLY SUFFERS THAN SPEAK UP

Elderly patients with cancer and depression

Are far less likely to be diagnosed with depression than patients in any other age group for two primary reasons: There is an overlap between cancer symptoms,/treatment side effects and the diagnostic criteria for depression, …….and older adults are more likely to present with anhedonic “depression without sadness,”

“This represents a significant public health concern that will grow in importance as the U.S. population continues to age.”AND THAT IS KEY AS THE BOOMERS ARE HOME TO ROOST

Diagnosing Depression IN THE ELDERLY

Common symptoms of depression—fatigue, diminished concentration, thoughts of death/suicide, weight loss/gain—are confounded with side effects from cancer treatments or, potentially, the cancer itself.

Depressed mood and loss of interest—anhedonia depressed mood without sadness , reduction in social relationships/loneliness, loss of meaning and purpose, and lack of usefulness and sense of being a burden are all common.

Four minor themes also emerge: attitude toward treatment, mood, regret and guilt, as well as physical symptoms and limitations.

. “THIS IS CRITICAL AND PATIENTS GO BACK TO IT (WHAT THEY DID IN THE PAST) OVER AND OVER AGAIN. They perseverate. “The depressed patients seemed to ruminate on their regrets, ,”

Cancer survivors show patients how to overcome the ordeal WITH so called head foods….this is MEDICINE FOR WHICH THERE IS SCANT TO NO PROOF OF POSITIVELY HELPING THE DEPRESSED PATIENT…. REMEMBER ANECDOTE DOES NOT MEAN ANTIDOTE LETS SAY IT AGAIN ANECDOTE DOES EQUAL ANITIDOTE AND NO HEAD FOOD EXISTS

But

New SUGGESTED clinical guidelines on integrative, mind-body therapies for patients with breast cancer finds IMPROVED RATES OF AND TREATMENT OF DEPRESSION AS PART OF INTEGRATIVE MEDICINE WITH :

    • Use of music therapy, meditation, stress management, and yoga for anxiety and stress reduction;
    • Use of meditation, relaxation, yoga, massage, and music therapy for depression and mood disorders;
    • Use of meditation and yoga to improve quality of life;
    • Use of acupressure and acupuncture for reducing chemotherapy-induced nausea and vomiting;
  • NOTE THIS LAST POINT WELL… THIS IS NOT JUST ME TALKING. THERE IS A lack of evidence supporting the use of ingested dietary supplements OR OTHERWISE MANIPULATING THE DIET or botanical natural products as part of supportive care and/or to manage breast cancer treatment-related side effects.

 

Yet Studies show that up to 80 percent of people with a history of cancer use one or more complementary and integrative therapies,

ALSO Patients NEED TO fully understand the potential risks of not using a conventional therapy that may effectively treat cancer or manage side effects associated with cancer treatment, DO NOT GO RUNNING HELTER SKELTER WITH DR GOOGLE OR UNPROVEN THERAPIES WHICH MAY NOT ONLY NOT WORK BUT CAUSE HARM.

 

Patients are using many forms of integrative therapies with little or no supporting evidence and that remain understudied,

Then in the last of part of one of our summary we looked at some of the nuts and bolts of oncology

Overview of Specialty

Let us first look at what is required to become a medical oncologist.

Training requirements:

University (BS or BA)        4 years

Medical school (MD)       4 years*

Internship                          1 year

Internal medicine residency    2 years

Oncology fellowship             or  2 years

Hematology fellowship   or     2 years

Hematology/Oncology            3 years (combined)                                          *Osteopathy degree is also acceptable in place of MD

.

My advice is never be treated by a non-board certified (in medical oncology or only hematology) physicians with few exceptions.( leukemia and lymphoma are often treated expertly by both. The board pass rate is 58-65% with board certification only good for 10 years, as you must re-pass a new exam. As mentioned, many do not sit for the hematology board and remain “board eligible

Specific and related fields

 

Medical oncology involves the management of most cancers in adults and is one of the younger Internal Medicine sub-specialties. The need for a “cancer specialist” did not arise until early 1970’s with the advent of sophisticated chemotherapy regimens. A “quarterback” for cancer care was needed. Patients are usually referred to us after the diagnosis.. Our role has largely evolved to being deeply involved behind the scenes when the diagnosis is suspected but not made.

Pediatric oncology.

Gynecologic oncology

Urology involves the primary surgical approach, but not the chemotherapy, if any, of bladder, kidney, and prostate cancer..

Otolaryngology, also known as (ENT) involves primarily surgery only on cancers of the head and neck and may parent with radiation and chemotherapy.

Surgical oncology largely concentrates on breast, colon, melanoma, and other solid tumors: some have training sufficient to credential them to give chemotherapy.

Neurosurgeons deal largely with the removal and or biopsy of tumors of the brain or spinal cord tumors.

Thoracic surgery concentrates on early stage lung cancers and occasional open biopsies of the lining of the heart or other chest structures.

Orthopedic surgery deals with the primary surgery of bone cancers or metastases, surgical removal and stabilization of bones (rods/ pins) weakened by cancers.

Radiation Oncology they give radiation to different types of cancer as primary treatment such as brain tumors, lung cancers, some lymphomas (cancer of lymphocytes) or treatment after surgery (breast after removal of breast cancer) or treatment along with chemotherapy (synergism)-head and neck, rectal, anal, and lung, or treatment of local painful boney areas of tumor spread.

The Scope Of The Problem

Age is the greatest single factor worldwide for developing malignancy.

Globally, over 13 million people are diagnosed with some form of cancer yearly with 8 million deaths. This represents a global cancer burden doubling in the last 30 years of the 20th century, with doubling again between 2000 and 2020 and nearly tripling by 2030. By 2030, over 25 million people a year may be diagnosed with cancer, with two thirds dying from it..

The most recent figures show that for the first time since records have been kept, less than 20 percent of adults were smokers in 2007. However, cigarette companies are finding new customers in developing countries. About 40 percent of the world’s smokers live in just two nations — China and India.

Cancer treatment facilities are out of reach for many and life-saving treatments are less available. .

Cancer is uncommon in adolescents and children (with only about 150 cases per million in the U.S.), with leukemia the most common. If we put all ages and both sexes together the odds of getting cancer are about 460 per 100,000. This is not rare

Cancer in the first year of life has an incidence of about 230 per million in the U.S. with the most common cancer being nueroblastoma.

In the U.K., cancer is in the lead over cardiovascular disease yet it appears much lower in third world countries most likely owing to much higher deaths from infectious diseases such as malaria and TB and accidents. Nonetheless, cancer remains a major public health problem worldwide with skin, lung, prostate, and breast, lung, colorectal and urinary bladder representing the majority of types

EARLY NUTS AND BOLTS OF ONCOLOGY

Hi DR Ryan here, medical oncologist, PROFESSOR, RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer.
This is largely FROM A BOOK OF THE SAME NAME AS WELL AS ITS WEB SITE www.whentumoristherumorandcanceristheanswer.com WHICH are both  THERAPEUTIC
The goal is not to sell books as much as it is to get out the authentic words about cancer as 2 million people and more, as we age, will have it and 80% of us knew know or will know someone with it .
In terms of family and friends that is more than 20 million people and that too is growing. Visit the web site. The book is available on Amazon as well as the web site but again this is a NON PROFIT endeavor which is all paid for by me so I could control the content and stay away from untruths and sensationalisms which editors often in this field want
THIS is the real deal and take from it what you need when you need it .
After this, our 9th time of meeting. Next week we will do a summary of all we have said. In this section I will try to answer questions as we go along as possible
THIS IS A BROAD OVERVIEW OF NUTS AND BOLTS OF ONCOLOGY
        In this section, I present an overview of the structure of the field of oncology and some critical terms and aspects all patients will encounter. Also as I said since this is a short section I encourage questions on both it and anything regarding cancer and I’ll do my best to answer them as long as a good answer is not too lengthy. This sets the stage by being less in depth than an individual might find in some textbooks for professionals on the matter and covers some material that will appear again in different format later on.
You will also see the tone change just a bit when we get to the direct and dry science. The material is going to be in-depth, for many of you of interest and for others not so and be a bit dry but it is ok and a necessary part of  the big picture and needs to be covered.
We will later. not in this section, discuss some chemotherapy agents somewhat. Nonetheless, I urge you take a good look at it all, even if you only understand it notionally. The reason is this; cancer is damn frightening and profoundly complex. The more you understand, even notionally, of the tools we use to describe it and classify it and its treatments as well as its origin, the more you can control the experience. The more you comprehend its ‘mindset’ physiologically on a cellular level and the tools we have to image it and eradicate it, the more you can engage in outside reading that is focused and appropriate. Facts are your fodder and fuel to go from a leap of faith in your treatment to informed conviction, and I suspect the material is not so dry as to not be worth a run though.
The more you understand putting all the pieces together the more peace you will have. If only it serves as reference for loved ones or perhaps not at all, you still have the comfort of knowing it is there for you to understand more. It is not essential that you know all of this but the more you master the more you will master the anxiety that seeks to direct you rather than you be in the director’s chair.
Thus, the book can serve readily as a reference taking you wherever you need to go to learn more about the journey you are on or are about to undertake. Take advantage of that structure and peruse the table of contents selecting easily what you need and jump right in.
In this section, you will have enough to be familiar with the road and major signposts starting from your first rumor of tumor until you actually begin therapy because cancer was the answer.

 

Overview of Specialty

 

Let us first look at what is required to become a medical oncologist.

 

 

Training requirements:

 

 

 

University (BS or BA)      4 years

Medical school (MD)      4 years*

Internship                1 year

Internal medicine residency      2 years

Oncology fellowship            or  2 years

Hematology fellowship   or     2 years

Hematology/Oncology            3 years (combined)

 

*Osteopathy degree is also acceptable in place of MD

 

The above is needed to sit for the exam for board certification in Hematology or Oncology (separate boards).

Training falls under the auspices of the American Board of Internal Medicine. You must be board certified in Internal Medicine and complete the training of the above fellowships to be eligible to sit for oncology or hematology written exams. Essentially all those completing the fellowships sit for the Medical Oncology exam and about 50% sit for the hematology board. My advice is never be treated by a non-board certified (in medical oncology or only hematology) physicians with few exceptions.( leukemia and lymphoma are often treated expertly by both. The board pass rate is 58-65% with board certification only good for 10 years, as you must re-pass a new exam. As mentioned, many do not sit for the hematology board and remain “board eligible” until first request to sit for the exam, then eligibility is good for six years. This system is under review.

 

Specific and related fields

 

Medical oncology involves the management of most cancers in adults and is one of the younger Internal Medicine sub-specialties. The need for a “cancer specialist” did not arise until early 1970’s with the advent of sophisticated chemotherapy regimens. This required specific training for delivery of drugs and follow-up of unique, life-threatening side effects as well as much more in depth understanding of the natural history of a disease promulgating the need for a “quarterback” for cancer care. Patients are usually referred to us after the diagnosis. There is significant overlap with hematological cancers of the blood system such as leukemia and lymphoma as mentioned above. Our role has largely evolved to being deeply involved behind the scenes when the diagnosis is suspected but not made.

Pediatric oncology involves cancers of children and young adults (up to 18 years old). The above training is similar with a pediatric residency instead of internal medicine.

Gynecologic oncology treats ovarian, cervical, and uterine cancers. An obstetrics and gynecology residency, followed by a 2-year fellowship is required with formalized board certification.

Urology involves the primary surgical approach, but not the chemotherapy, if any, of bladder, kidney, and prostate cancer. There is some significant degree of chemotherapy treatment by the urologist directly into the bladder for the more superficial bladder cancers. There is some extent of treatment of recurrent or even preoperative and immediately postoperative hormonal manipulation of prostate cancer being increasingly done by this field. Training is four years after a one-year surgical internship.

Otolaryngology, also known as (ENT) involves primarily surgery only on cancers of the head and neck. There is a 4-year residency after internship.

Surgical oncology largely concentrates on breast, colon, melanoma, and other solid tumors: some have training sufficient to credential them to give chemotherapy. This entails a 5-year residency followed by 1-2 year fellowship.

Neurosurgeons deal largely with the removal and or biopsy of tumors of the brain or spinal cord tumors. This entails a 7-year residency.

Thoracic surgery concentrates on early stage lung cancers and occasional open biopsies of the lining of the heart or other chest structures. This entails a five-year residency followed by fellowship.

Orthopedic surgery deals with the primary surgery of bone cancers or metastases, surgical removal and stabilization of bones (rods/ pins) weakened by cancers.

Radiation Oncology entails a 1-year general internship. After a 3-4 year residency, they give radiation to different types of cancer as primary treatment such as brain tumors, lung cancers, some lymphomas (cancer of lymphocytes) or treatment after surgery (breast after removal of breast cancer) or treatment along with chemotherapy (synergism)-head and neck, rectal, anal, and lung, or treatment of local painful boney areas of tumor spread.

The Scope Of The Problem

 

Perhaps not obvious to some and certainly not meant to be clever, age is the greatest single factor worldwide for developing malignancy. Think of it. Assaults of whatever nature from the outside are constant (to varying degrees) and continuous. Our own aging argues for how our major mechanisms to fend off the various external causes of cancer are not what they used to be in our youth. Think of sun caused skin changes and cancers.

Cancer may one day replace heart disease as the No. 1 cause of death worldwide with a growing burden in poor countries thanks to more cigarette smoking and other factors. Globally, over 13 million people are diagnosed with some form of cancer yearly with 8 million deaths. This represents a global cancer burden doubling in the last 30 years of the 20th century, with doubling again between 2000 and 2020 and nearly tripling by 2030. By 2030, over 25 million people a year may be diagnosed with cancer, with two thirds dying from it.

In men, lung cancer is the most common form in terms of new cases and deaths, while breast cancer is the most common type among women in new cases and deaths. More men than women get cancer and die from it with cancer currently accounting for about one in eight deaths worldwide.

Trends that will contribute to rising cancer cases and deaths include the aging of populations in many countries, as cancer is more common in the elderly and cigarette smoking rates are increasing in poor countries.  Some countries have made progress in cutting cigarette smoking, which causes most cases of lung cancer as well as many other illnesses. In the United States, the most recent figures show that for the first time since records have been kept, less than 20 percent of adults were smokers in 2007. However, cigarette companies are finding new customers in developing countries. About 40 percent of the world’s smokers live in just two nations — China and India.

Decades ago, cancer was considered largely a problem of westernized, rich, industrialized countries. However, much of the global burden now rests in poor and medium-income countries. Many of these countries have limited health budgets and high rates of communicable diseases, while cancer treatment facilities are out of reach for many and life-saving treatments are less available.

At the same time, progress against cancer is occurring in such places as the United States and Europe. For example, health authorities in the United States report that cancer diagnosis rates are now dropping for the first time in both men and women and previous declines in cancer death rates are accelerating. They attributed the progress to factors such as regular screening for breast and colorectal cancer, declining smoking rates and improved treatments.

Let’s look a little more specifically at the numbers in the United States. Cancer is about 25% of all deaths and appears on track to replace cardiovascular disease as number one. One cancer alone, lung, is 30 % of all deaths. Prostate is second in men responsible for 25% of deaths. Prostate is also the most commonly occurring cancer in men with breast cancer just ahead of lung cancer, in women.

Cancer is uncommon in adolescents and children (with only about 150 cases per million in the U.S.), with leukemia the most common. If we put all ages and both sexes together the odds of getting cancer are about 460 per 100,000. This is not rare

Cancer in the first year of life has an incidence of about 230 per million in the U.S. with the most common cancer being nueroblastoma.

In the U.K. cancer is in the lead over cardiovascular disease yet it appears much lower in third world countries most likely owing to much higher deaths from infectious diseases such as malaria and TB and accidents.

Nonetheless, cancer remains a major public health problem worldwide with skin, lung, prostate, and breast, lung, colorectal and urinary bladder representing the majority of types

 

 

THIS HAS BEEN the first of a series on the nuts and bolts on oncology kept intentionally short to encourage questions. Next week , our 9th week together, will be a summary of all we have covered so this is the first  week on the nuts and bolts of oncology and intentionally kept more mellow

 

Any more questions?????

 

This has ben DR kevin Ryanmd mba facp and hematologist oncologist here, medical oncologist PROFESSOR AND RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer. Modeled after my book of the same name available on thE web site OF THE SAME NAME you can find it on the web site and a lot more, interviews, films excerpts on the site and it is also available on Amazon   IN ALL FORMATS I AM Signing off radio www.w4cs.com the cancer support radio program REMIND YOU THE PROGRAM IS ARCHIVED HERE AND THE iheart RADIO AS WELL AS THE WWW.W4CS BLOG AND MYBLOG ACCESSED EASILY FROM THE WEB SITE

Cancer What is it?

Hi DR Ryan here, medical oncologist AND PROFESSOR AND RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer. Modeled after my book of the same name available on th web site and Amazon

I am sure you are familiar with our opening song   from chariots  of fire. A man has a plan and in a day it is crushed…… so it is when you have been told you have cancer ,thoughts of loss of control, soul sucking anxiety, what about your family and the list goes on as it hits  you like a ton of bricks.

He rose above it in the film  and so you to will be a hero ………I have seen no exception no matter how afraid you are, FIRST OFF WE DID NOT GET TO THE QUESTIONS OF LAST WEEK ALTHOUGH THE TALK DID COVER THEM ALL LET’S JUST QUICKLY TAKE A LOOK WITH MY APOLOGIES

First answer questions J

just how do you know if there is a depressive state in things? Covered this

Can you see the depression in your self or others? Perhaps not little insight

What does depression look like? See list of symptoms

How does depression feel to people? Never and forever lie See list

How can you work with the depressive state? Very difficult

Should you have guilt being depressed? No no no guilt is part of the fisease in many see list especially inelderly

So its all in what you eat? No no no I was just being fair to unfounded claims The blood sugar and binging and starving that may occur ae bad however

Where do the good studies come from? There are none for food there are for depression in general ,meds, the integrative modalities and therapy

. Recently, Mehnert and colleagues reported a 31% prevalence rate for any psychiatric disorder in cancer patients. Rates for depression vary from 11% to 37%,. The rate for depression in the general population is 7%—and thus HIGHER among cancer patients—THE RATE OF SUICIDE IS TWICE THE NORMAL POPULATION

7 Physical Clues You Could Have Depression

 

Many people who suffer from chronic illnesses also suffer from depression. Depression isn’t something that should be overlooked; it should be brought to your doctor’s attention so that it can be treated. But how do you spot depression?  With help from prevention.com, we’ve put together a list of some of the most common physical signs that someone is suffering from depression.

 

Aches and Pains

Although many chronic illnesses have their share of aches and pains, depression can also make muscles and joints feel sore or exacerbate the problem. People who are happy or content generally feel pain less than those who have depression.

 

Difficulty Sleeping or Waking Through the Night

Not being able to relax enough to fall asleep or frequently waking up during the night and finding it difficult to go back to sleep could both be signs of depression. Lack of sleep or disturbed sleep can have a profound effect on mood and the ability to concentrate.

 

Changes in Weight

Loss of appetite or comfort eating are both associated with depression, but you may not realize you have either until you step on the scale and notice a difference. In addition, if you’re not sleeping well because you’re anxious or depressed, this can also mess with your appetite leading to weight loss or gain.

 

Skin Complaints

Because depression affects hormones, this often becomes apparent in our skin. Depression can lead to skin complaints like acne, psoriasis, and eczema and treating the depression can help with the skin complaint.

 

Stomach Problems

Mood definitely affects the gut, and people with depression may suffer from symptoms like nausea, constipation, diarrhea, heartburn and indigestion.

 

Headaches and Migraines

People with depression are more likely to experience frequent headaches or migraines. Although this could also be a side effect of medication or treatments you take for your chronic illness.

 

Oral Problems

Dentists in Australia have found people with depression are more likely to need dental work such as tooth extractions and cavities than those who don’t. The thought behind this is that if you’re depressed, you’re less likely to be as diligent about oral health.

 

Depression questionqaire IS KEY

 

Suicide

growing body of evidence that mental and physical health do not function on separate planes, and that one can influence the other.

 

Since most cancer occur is the elderly and cancer is proportional with age and depression may look different than just those simple 7 symptoms Diagnosing Depression IN THE ELDERLY is somewhat different

Common symptoms of depression—fatigue, diminished concentration, thoughts of death/suicide, weight loss/gain—are confounded with side effects from cancer treatments or, potentially, the cancer itself.

 

The literature suggests that two gateway symptoms—depressed mood and loss of interest—are most valuable in diagnosing depression in cancer, but identifying these symptoms is not necessarily useful in older adults.

“The gateway questions come off the table as less than useful diagnostic criteria when we combine cancer and aging. “

Major and Minor Themes

anhedonia depressed mood without sadness , reduction in social relationships/loneliness, loss of meaning and purpose, and lack of usefulness and sense of being a burden. These are big and also seen somewhat in younger patients

Four minor themes also emerge: attitude toward treatment, mood, regret and guilt, and physical symptoms and limitations.

Another central issue was loneliness, depressed patients tended to have limited meaningful relationships and were socially isolated and withdrawn.

 

Loss of meaning and purpose in life was STRONGLY PRESENT and they display an inability to adjust to their new limitations. “rumination THIS IS CRITICAL AND PATIENTS GO BACK TO IT (WHAT THEY DID IN THE PAST) OVER AND OVER AGAIN Lack of usefulness and sense of being a burden is also displayed in all depressed.

There was no difference between depressed and non depressed participants in terms of their willingness to engage in treatment, but attitude toward treatment different“

 

The non depressed are much more proactive regarding their treatment, whereas the depressed are resentful, angry, and upset about their treatment,”

Both depressed and non depressed look back at their lives and experience some level of regret, but the amount of guilt experienced the differentiating factor between the non depressed and the depressed. “The depressed patients seemed to ruminate on their regrets, whereas the non depressed are able to put their regrets in a tolerable perspective,”

 

No actual difference in physical limitations is observed between the two groups, but a difference is noted in how they cope with those limitations. Depressed do not adapt.

 

LECTURE 6 PART 1  BLOG IT AND SUBMIT IHEART FORM

 

BUT WE MUST KNOW THAT WHICH WE ARE AFRAID OF WE MUST KNOW THE ERSONALITY OF THE BEAST TO BE BETTER ABLE TO FIGHT IT , WE MUST KNOW THE ENEMY AND THAT IS WHAT WE ARE GOING TO TALK ABOUT TODAY AND  NEXT WEEK

THE ENEMY

 

 

THE ENEMY

 

First, a Parable

 

 

Winter was coming early to the western Cordillera range of the Sierra Nevada and the mountain man knew it was time to head down to safer ground. Packing his mule, he heard from behind a cold craggy granite precipice the unmistakable hissing and eerie rattle of the deadly western diamond back. Then, as strange as it seems, the snake spoke and began pleading with the rugged frontiersman. “Pleasssse, oh Pleassse.”, it begged while hissing, “Winter has come early and I will ssssurely freesssse if you do not put me in your pack and take me down to ssssafer warmer ground

Hard won experience had told the mountain man to be wary. He declined, stating firmly, “You will surely bite me before the trail is through”. The snake assured him he would never do such a thing if the man would save him. Thus, reckoning back to lessons from his ma and pa long since dead after hard laboring the rocky western Kentucky soil, the cautious but kindly outdoorsman took pity on one of God’s creatures. Carefully, against his gut instincts, he placed the viper in his pack and headed to lower, warmer ground.

At the end of the journey, as promised, he reached into the pack to release the viper. Of course the snake struck, injecting the outdoorsman with blindingly painful venom and the near certainty of an ugly and lonely demise. The Good Samaritan of the frontier was enraged and while still lucid reminded the snake of his promise.

The snake replied, slowly and sincerely, “but you knew I wassss a sssnake when you helped me, I just did what sssnakes do”

 

…. and so it is with the enemy, cancer.

 

“They’re toast”. That is not a rare expression uttered by some physicians in private when hearing of a severely threatening diagnosis. I have heard this common irreverent comment and similar ones uttered by my colleagues and young residents when referring to those newly diagnosed with cancer. Curiously, these flippant declarations do not always follow a diagnosis of advanced or terminal disease. These insensitive quips have even popped out at the mere confirmation of the mere diagnosis before any determination of stage or degree of severity. Why? It is because cancer is the ultimate terrorist, the perfect enemy.

Cancer, the anathema, the incubus; nothing evokes more fear. There is no greater pariah to caretaker, clinician or patient. Indeed the very origin of the word “cancer,” from “crab” speaks legions regarding the dread with which we regard the word. Why is this?

Perhaps we fear cancers’ amazing talent for infernal mimicry of the norm. Cancer cells imitate normal cells, but perversely. Perhaps we detest the macabre brilliance by which cancer cells systematically unravel the elegant mysteries of normal cells. Cancer cells, regarded by some scientists intellectually as little medical miracles, take their cue from normalcy but with a deviant twist. They grow; constantly, irrepressibly.

Their mere presence conjures up visions of evil humors reminiscent of those alluded to by Galen, the ancient Greek founding father of medicine, as they swarm over the unsuspecting patient. They are admirably ingenious rogues with innumerable deceptions cloaking them from our immune systems’ elegant surveillance and intelligence network. They have amazing techniques that protect them from detection and eradication.

Cancer cells will also not stay put. They marshal innocent patients’ wondrous blood vessel factories and command those factories to build an evil network of canals and thoroughfares of new vessels which bring the malignant little monsters nourishment and usher them on journeys to distant organs to wreak havoc. These princes of parasitism suck essential nutrients from us, decimating our defenses. Some cause local mayhem, blocking critical passageways, bowel and bladder alike. Some make us weep blood. Some sneak off to the otherwise pristine recesses of the brain confounding movement and sensation while causing neurological crises. Malignant and malevolent, it is no wonder we hate cancer with unbridled passion.

It is so poignant that in our battle against cancer we employ potent poisons in a sort of chemical and biological warfare. These therapies frequently count on the “good guys”, our normal tissues, to hang in there despite the sometimes enormous toll therapy exacts on the body. The quest is rather daunting; to kill a cancer cell and still leave normal cells and tissues largely undisturbed and surviving normally. For some, successful surgical removal of the cancer holds a pivotal place in the armamentarium. For others, blasting away with radiation is the treatment. Others receive chemical, biological or combined assaults.

Cancer can be and is often killed. However,  biologically resistant and insolent to the last, this enemy will not die without a fight and without a fight, the patient often will

Some CANCER BASICS

 

PONDER THIS

HOW DO LIVER CELLS KNOW WHEN IT IS TIME TO STOP GROWING BECAUSE THEY HAVE REACHED LIVER NESS

 

And so it goes for every other organ

in cancer the cells do not stop , they escape or impair immune detection or fool it , They simplY do not stop having children. They do not stop growing .

they have ways of turning off natural timing of cells death or making vascular highways for themselves to feed themselves as well as have highways to travel on and spread either by direct extension or through the blood

What Is Cancer?

Cancer can start any place in the body. It starts when cells grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.

Cancer can be treated very well for many people. In fact, more people than ever before lead full lives after cancer treatment. 65% The numbers used to be opposite

Here we will explain what cancer is and how it’s treated. You’ll find a list of words about cancer and what they mean at the end of this booklet.

Cancer basics

Causes

 

How cancer begins

Cells are the basic units that make up the human body. Cells grow and divide to make new cells as the body needs them. Usually, when cells get too old or damaged, they die. Then new cells take their place. AT A NORMAL HEALTHY PACE

Cancer begins when genetic changes impair this orderly process. Cells start to grow uncontrollably. These cells may form a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

 

Some types of cancer do not form a tumor. These include leukemias, most types of lymphoma, and myeloma.

Cancer is caused by changes (mutations) to the DNA within cancer cells. The DNA inside a cell is packaged into a large number of individual genes, each of which contains a set of instructions telling the cell what functions to perform, as well as how to grow and divide. Errors in the instructions can cause the cell to stop its normal function and may allow a cell to become cancerous.

What do gene mutations do?

A gene mutation can instruct a healthy cell to:

  • Allow rapid growth. A gene mutation can tell a cell to grow and divide more rapidly. This creates many new cells that all have that same mutation.
  • Fail to stop uncontrolled cell growth. Normal cells know when to stop growing so that you have just the right number of each type of cell. Cancer cells lose the controls (tumor suppressor genes) that tell them when to stop growing. A mutation in a tumor suppressor gene allows cancer cells to continue growing and accumulating.
  • Gene mutations can cause normal cells to Make mistakes when repairing DNA errors. DNA repair genes look for errors in a cell’s DNA and make corrections. A mutation in a DNA repair gene may mean that other errors aren’t corrected, leading cells to become cancerous.

Those mutations are the most common ones found in cancer. But many other gene mutations can contribute to causing cancer.

What causes gene mutations?

Gene mutations can occur for several reasons, for instance:

  • Gene mutations you’re born with. You may be born with a genetic mutation that you inherited from your parents. This type of mutation accounts for a small percentage of cancers. Perhaps 5-8%
  • Gene mutations that occur after birth. Most gene mutations occur after you’re born and aren’t inherited. A number of forces can cause gene mutations, such as smoking, radiation, viruses, cancer-causing chemicals (carcinogens), obesity, hormones, chronic inflammation and a lack of exercise.

Gene mutations occur frequently during normal cell growth. However, cells and especially those in our immune system when it works correctly contain a mechanism that recognizes when a mistake occurs and repairs the mistake. Occasionally, a mistake is missed. This could cause a cell to become cancerous.

How do gene mutations interact with each other?

The gene mutations you’re born with and those that you acquire throughout your life work together to cause cancer.

For instance, if you’ve inherited a genetic mutation that predisposes you to cancer, that doesn’t mean you’re certain to get cancer. Instead, you may need one or more other gene mutations to cause cancer. Your inherited gene mutation could make you more likely than other people to develop cancer when exposed to a certain cancer-causing substance.

It’s not clear just how many mutations must accumulate for cancer to form. It’s likely that this varies among cancer types

 

While doctors have an idea of what may increase your risk of cancer, MANY of cancers occur in people who don’t have any known risk factors. Factors known to increase your risk of cancer include:

Your age

A big factor Cancer can take decades to develop. That’s why most people diagnosed with cancer are 65 or older. While it’s more common in older adults, cancer isn’t exclusively an adult disease — cancer can be diagnosed at any age.

 

Your habits

Certain lifestyle choices are known to increase your risk of cancer. Smoking, drinking more than one alcoholic drink a day (for women of all ages and men older than age 65) or two drinks a day (for men age 65 and younger), excessive exposure to the sun or frequent blistering sunburns, being obese, and having unsafe sex can contribute to cancer.

You can change these habits to lower your risk of cancer — though some habits are easier to change than others.

 

Your family history

Only a small portion of cancers are due to an inherited condition. If cancer is common in your family, it’s possible that mutations are being passed from one generation to the next. You might be a candidate for genetic testing to see whether you have inherited mutations that might increase your risk of certain cancers. Keep in mind that having an inherited genetic mutation doesn’t necessarily mean you’ll get cancer.

 

Your health conditions

Some chronic health conditions, such as ulcerative colitis, can markedly increase your risk of developing certain cancers. Talk to your doctor about your risk. Chronic inflammatory states

 

Your environment

The environment around you may contain harmful chemicals that can increase your risk of cancer. Even if you don’t smoke, you might inhale secondhand smoke if you go where people are smoking or if you live with someone who smokes. Chemicals in your home or workplace, such as asbestos and benzene, also are associated with an increased risk of cancer

 

Cancer is a scary and complex disease. Even when it’s caught early and with good odds for surviving and living a long, healthy life, there are a lot of people who develop cancer each year—and, sadly, not everyone survives it. Most cancers develop depending on several factors, but research has identified many contributing causes of cancer. Some are obvious and preventable, while others are the simple yet unfortunate result of genetics. And although many cancers have a high probability of being beat, the lack of proper or available medical care in certain areas, and even whole countries, can greatly impact the survival rate.

 

 

Taking into account the complexity of the disease and recognizing that many factors usually contribute to developing it, here’s again the wide range of what causes cancer— a little more in depth and some tips to change what you can to prevent the disease…

 

1. The Sun

The damage caused by ultraviolet (UV) rays from the sun have been studied immensely over the years. According to the Skin Cancer Foundation, UV is a proven carcinogen that in excess, can lead to skin cancer as a result of gene mutations from exposure to these harmful rays. There are various types of skin cancer that UV rays can cause or contribute to the risk of, with melanoma being the most serious and often deadly type. There’s a reason many health experts don’t approve of the use of tanning beds, and at least one developed country has completely banned the use of them (hint: it’s Australia).

 

Although people frequently flock to warm, sunny, vacation destinations to soak up the rays, it doesn’t need to be hot outside to damage your skin and potentially increase your risk of skin cancer. A cooler, cloudy day can still be risky, so you shouldn’t only wear sunscreen when you’re somewhere hot and sunny. You often see parents lathering their children in sunscreen, and while kids have sensitive skin and would be in a lot of pain if they were seriously burned from the sun, adults need protection too.

 

Genes

As we stated People can be at a higher risk of developing cancer from their genetic makeup, or DNA. More specifically, certain mutated genes can be passed onto children from generation to generation, something you can’t prevent or control the effect of. The American Cancer Society explains that cancer is believed to be formed from more than one gene mutation, so you aren’t likely to develop cancer just from one mutated gene inherited through DNA. However, people who inherit these faulty genes are then at a disadvantage because they’re automatically starting off with one mutated gene.

 

Breast cancer is a prime example of this—there are two genes that can be inherited, which can greatly increase the risk of breast cancer within families or lineages. There’s testing that can be done to find out if you have one of these risky genes, and it’s believed that around 5- to 10-percent of breast cancer cases are caused by them. Although many women and some men are diagnosed with breast cancer each year, it’s something that is often caught early enough to treat and overcome.

 

. Smoking

No list of factors that cause cancer would be complete without smoking. Cigarettes kill a staggering amount of people each year because of various types of cancer, many of which develop in the lung, esophagus, mouth, throat, and stomach. More and more cities are banning the use of cigarettes inside public establishments, on patios, and in vehicles as research has shown that second hand smoke is harmful and even deadly for those who don’t smoke. It seriously increases the risk of developing several types of cancer, as well as harmful diseases in other organs.

 

 

With all the advertisements about how dangerous smoking is to your health and its ability to greatly increase your risk of cancer, you might wonder how and why it’s legal. The good news is, the U.S. Centers for Disease Control (CDC) has tracked smoking trends since 1965, and the amount of adult smokers has decreased by over 20-percent in that time frame. If you need help quitting smoking, take advantage of the many helpful online tools available, join a support group, and talk to your doctor about kicking the habit for good.

Eating Habits and (Lack of) Physical Activity

There are many things that increase the risk of or cause cancer that can’t be prevented. But there are some lifestyle choices that contribute to the risk of developing it, and poor eating habits and little physical activity are two of them. The research relating to diet and cancer is still ongoing, but what we currently know is that a poor diet could increase the risk of cancer. More recent research has shown that the food we eat can not only influence developing the disease, but certain healthy foods may decrease or even help prevent cancer from developing. SUCH AS LEAN MEATS VEGGIES

 

How we treat our bodies is a major factor in being healthy—including limiting and reducing the risk of diseases like cancer, obesity, heart disease, diabetes, and others that vary in severity. Exercising and getting regular physical activity play a role in this too. Being active not only reduces the risk of cardiovascular disease, but also lowers the chance of obesity, hormone fluctuations, and immune system function. These factors have all been connected to cancer, so taking care of your body in every way is important. Being overweight TRIPLES your risk of UTERINE cancer: HWEW IA AOMW MOEW ABOUT IT

Fatty tissue produces the hormone oestrogen, which regulates a woman’s reproduction and is linked to the cancer when levels in the body are excessive

  • Obesity increases a woman’s chance of the disease by a massive six times
  • Other risk factors are diabetes, being postmenopause and not having children
  • Women should look out for abnormal vaginal bleeding, as well as pain during sex
  • If detected early, a sufferer’s survival chances beyond one year are 95 per cent

 

AGE Age

It’s a common fact that as you grow older, your chance of developing cancer increases. This isn’t surprising because many types of cancer are more common amongst older age groups. According to the Mayo Clinic, since cancer can take decades to develop it’s most common for people 65 and older to develop cancer. Cells don’t mutate into cancerous cells overnight, so slow changes can happen over a healthy person’s lifetime without them knowing. Sometimes it happens naturally,IS DETECTED AND DEALT WUTH BECAUSE OF EARLY SCREENING OR A HEALTHY IMMUNE SYSTEM while in some cases the cell mutates from the person being exposed to carcinogens, like cigarettes or environmental hazards.

No one can prevent cancer completely but there are steps that can be taken to help lower the risk of developing cancer. You can’t stop the aging process, but eating healthy, exercising, limiting exposure to carcinogens, and seeing your doctor for regular physicals, GETTING SCREENS are all important for your future—what you do now and how you treat your body as you grow older can have a long-term impact, and being as healthy as possible is the best way to avoid certain preventable diseases, including contributing to your risk of certain cancers.

 

Asbestos

Asbestos exposure, and mesothelioma as a result of this exposure, might be rare these days, but you’d be surprised by the amount of people suffering from cancer and other complications associated with asbestos. Over the years, the use of asbestos in buildings and materials has dramatically decreased, but it’s still possible to be exposed to these deadly minerals, especially in older buildings. And it’s still used frequently in some countries, so the dangers are still there.

Asbestos comes in the form of tiny fibers that are inhaled and cause damage to the lungs. It can also be ingested through water that gets contaminated from the pipes it runs through. In addition to lung cancer and mesothelioma, asbestos has shown to increase the risk of cancer in the larynx and ovaries. It’s also been linked to other forms of cancer, making asbestos exposure a very real and serious threat to the health of anyone exposed to it. People working in construction are most at risk because of the materials used and potential for mishandling and other ways of exposure

Excessive Alcohol Consumption

The impact of alcohol consumption on our health has been widely studied. Many experts believe a drink a day, or specifically a glass of wine a day, could be good for your health. Others believe there are too many potential harmful effects and that alcohol should be completely avoided. Regardless of these two sides, it’s agreed that excessive alcohol consumption can lead to numerous serious medical conditions, including cancer, cardiovascular disease, and mental health problems. Then there’s the effect on your personal and professional life, which can cause serious problems.

 

Some of the most common cancers linked to drinking too much over a long period of time are liver, colon, throat and breast cancer. In the case of breast cancer, it could increase your risk by around 10-percent. It’s important to note that drinking excessively doesn’t equate to being addicted to alcohol. There are many people who binge drink or regularly have 10 or more drinks per week but aren’t considered alcoholics or have a risky dependence on alcohol. But there is both short and long-term damage associated with drinking, so most experts agree that moderation is key.

 

Sex HPV

Conditions Affecting the Immune System

The immune system is your body’s way to defend and prevent infections and diseases. Weakened immune systems or those that don’t function properly are at risk of allowing harmful cells to hurt the body. An unfortunate cause of cancer stems from immune systems that are already affected by another medical condition or syndrome. This makes it especially difficult on the person with the existing condition, as oftentimes the problems they currently face cause them to struggle even more and cause additional complications once cancer has also been diagnosed.

 

Since viruses weaken the immune system, there are certain types of viruses that could cause cancer or put the person at a higher risk of developing it in their lifetime. According to the American Cancer Society, some of these viruses include hepatitis B and C, human immunodeficiency virus (HIV), human papilloma viruses (HPVs), and human herpes virus 8 (HHV-8). Several other viruses have been linked to causing cancer but there isn’t enough evidence yet to prove the connection

 

AGENT ORANGE OTHER TOXINS

 

Types of cancer

Doctors divide cancer into types based on where it began. Four main types of cancer are:

 

There are many other types of cancer. These are the main groups

 

 

How cancer spreads

As a cancerous tumor grows, the bloodstream or lymphatic system may carry cancer cells to other parts of the body. During this process, known as metastasis, the cancer cells grow and may develop into new tumors.

One of the first places a cancer often spreads is to regional lymph nodes draining the area. Lymph nodes are tiny, bean-shaped organs that help fight infection. They are located in clusters in different parts of the body, such as the neck, groin area, and under the arms.

Cancer may also spread through the bloodstream to distant parts of the body. These parts may include the bones, liver, lungs, or brain. Even if the cancer spreads, it is still named for the area where it began. For example, if breast cancer spreads to the lungs, it is called metastatic breast cancer, not lung cancer.a very very common mistake and not just grammar

.

Diagnosing cancer

Often, a diagnosis begins when a person visits a doctor about an unusual symptom. The doctor will talk with the person about his or her medical history and symptoms. Then the doctor will perform various tests to find out the cause of these symptoms. Many people with cancer have no symptoms, though. For these people, cancer is diagnosed during a medical test for another issue or condition.

Sometimes a doctor diagnoses cancer after a cancer screening test in an otherwise healthy person. Examples of screening tests include colonoscopy, mammography, and a Pap test. A person may need additional tests to confirm or disprove the result of the screening test.

 

For most cancers, a biopsy is the only way to make a definite diagnosis. A biopsy is the removal of a small amount of tissue for further study.

 

Cancer and its treatment can cause several complications, including:

  • Pain. Pain can be caused by cancer or by cancer treatment, though not all cancer is painful. Medications and other approaches can effectively treat cancer-related pain
  • .
  • Fatigue. Fatigue in people with cancer has many causes, but it can often be managed. Fatigue associated with chemotherapy or radiation therapy treatments is common, but it’s usually temporary.
  • Difficulty breathing. Cancer or cancer treatment may cause a feeling of being short of breath. Treatments may bring relief.
  • Nausea. Certain cancers and cancer treatments can cause nausea. Your doctor can sometimes predict if your treatment is likely to cause nausea. Medications and other treatments may help you prevent or decrease nausea.
  • Diarrhea or constipation. Cancer and cancer treatment can affect your bowels and cause diarrhea or constipation.
  • Weight loss. Cancer and cancer treatment may cause weight loss. Cancer steals food from normal cells and deprives them of nutrients. This is often not affected by how many calories or what kind of food is eaten; it’s difficult to treat. In most cases, using artificial nutrition through tubes into the stomach or vein does not help change the weight loss.
  • Chemical changes in your body. Cancer can upset the normal chemical balance in your body and increase your risk of serious complications. Signs and symptoms of chemical imbalances might include excessive thirst, frequent urination, constipation and confusion.
  • Brain and nervous system problems. Cancer can press on nearby nerves and cause pain and loss of function of one part of your body. Cancer that involves the brain can cause headaches and stroke-like signs and symptoms, such as weakness on one side of your body.
  • Unusual immune system reactions to cancer. In some cases the body’s immune system may react to the presence of cancer by attacking healthy cells. Called paraneoplastic syndrome, these very rare reactions can lead to a variety of signs and symptoms, such as difficulty walking and seizures.
  • Cancer that spreads. As cancer advances, it may spread (metastasize) to other parts of the body. Where cancer spreads depends on the type of cancer.
  • Cancer that returns. Cancer survivors have a risk of cancer recurrence. Some cancers are more likely to recur than others. Ask your doctor about what you can do to reduce your risk of cancer recurrence. Your doctor may devise a follow-up care plan for you after treatment. This plan may include periodic scans and exams in the months and years after your treatment, to look for cancer recurrence.
  • We will do more next weekLet’s see if there are any questions See you Next Tuesday at noon PST when we will look at PART 2 OF WHAT IS CANCER WITH A LOT OF REINFORCEMENT AND NEEDED REPEPTITION AND SOME NEW INFORMATION    I am sure you are familiar with our opening song   from chariots of fire. A man has a plan and in a day it is crushed…… so it is when you have been told you have cancer ,thoughts of loss of control, soul sucking anxiety, what about your family and the list goes on as it hits you like a ton of bricks.
  • He rose above it in the film and so you to will be a hero ………I have seen no exception no matter how afraid you are, BUT WE MUST KNOW THAT WHICH WE ARE AFRAID OF WE MUST KNOW THE ERSONALITY OF THE BEAST TO BE BETTER ABLE TO FIGHT IT , WE MUST KNOW THE ENEMY AND THAT IS WHAT WE ARE GOING TO TALK ABOUT TODAY
  • Hi DR Ryan here, medical oncologist AND PROFESSOR AND RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer. Modeled after my book of the same name available on th web site and Amazon
  • WHAT IS CANCER WITH A LOT OF REINFORCEMENT FROM LAST WEEK AND SOME NEW NEEDED INFORMATION
  • PART 2
  •  This is Dr Kevin Ryan author of the book when tumor is the rumor and cancer is the answer, a comprehensive text for newly diagnosed patients and their families available on the website of the same name and Amazon signing off radio www.w4cs.com the cancer support radio program   and ARCHIVED AUDIO FILES ON iheart RADIO
  • ANY QUESTION S

Remember Cancer is not just one disease.

There are many types of cancer. It’s not just one disease. Cancer can start in the lungs, the breast, the colon, or even in the blood. Cancers are alike in some ways, but they are different in the ways they grow and spread.

 

How are cancers alike?

The cells in our bodies all have certain jobs to do. Normal cells divide in an orderly way. They die when they are worn out or damaged, and new cells take their place. Cancer is when the cells start to grow out of control. The cancer cells keep on growing and making new cells. They crowd out normal cells. This causes problems in the part of the body where the cancer started.

 

Cancer cells can also spread to other parts of the body. For instance, cancer cells in the lung can travel to the bones and grow there. When cancer cells spread, it’s called metastasis (meh-TAS-tuh-sis). When lung cancer spreads to the bones, it’s still called lung cancer. And folks often confuse this The distinction is not academic as the original cancer behaves like the behavior of the orginal cancer not like the place is spread to. To doctors, the cancer cells in the bones look just like the ones from the lung. It’s not called bone cancer unless it started in the bones.

 

How are cancers different?

Some cancers grow and spread fast. Others grow more slowly. They also respond to treatment in different ways. Some types of cancer are best treated with surgery; others respond better to drugs called chemotherapy (key-mo-THER-uh-pee). Often 2 or more treatments are used to get the best results.

When someone has cancer, the doctor will want to find out what kind of cancer it is. People with cancer need treatment that works for their type of cancer.

 

What are tumors?

Most cancers form a lump called a tumor or a growth. But not all lumps are cancer. Doctors take out a piece of the lump and look at it to find out if it’s cancer. Lumps that are not cancer are called benign (be-NINE). Lumps that are cancer are called malignant (muh-LIG-nunt).

There are some cancers, like leukemia (cancer of the blood), that don’t form tumors. They grow in the blood cells or other cells of the body such as the bone marrow and or lymphnodes.

What stage is the cancer? We will talk more about that later

The doctor also needs to know if and how far the cancer has spread from where it started. This is called the cancer stage. You may have heard other people say that their cancer was stage 1 or stage 2. Knowing the stage of the cancer helps the doctor decide what type of treatment is best.

For each type of cancer there are tests that can be done to figure out the stage of the cancer. As a rule, a lower stage (such as a stage 1 or 2) means that the cancer has not spread very much. A higher number (such as a stage 3 or 4) means it has spread more. Stage 4 is the highest stage.

Ask your doctor to explain the stage of your cancer and what it means for you.

 

How is cancer treated?

The most common treatments for cancer are surgery, chemotherapy, and radiation (ray-dee-A- shun). Although immuno therapy and a number of precision and targeted medicines  and techniques are exciting , on the rise in treatment , early detection, screening finding early relapse  with some in previously hopeless situations. We are on the edge of a brave new world and much later we will cover future treatments

Surgery can be used to take out the cancer. The doctor might also take out some or all of the body part the cancer affects. For breast cancer, part (or all) of the breast might be removed. For prostate cancer, the prostate gland might be taken out. Surgery is not used for all types of cancer. For example, blood cancers like leukemia are best treated with drugs.

 

Chemo (short for chemotherapy) is the use of drugs to kill cancer cells or slow their growth. Some chemo can be given by IV (into a vein through a needle), and others are a pill you swallow. Because chemo drugs travel to nearly all parts of the body, they are useful for cancer that has spread.

 

Radiation is also used to kill or slow the growth of cancer cells. It can be used alone or with surgery or chemo. Radiation treatment is like getting an x-ray. Sometimes it’s given by putting a “seed” inside the cancer to give off the radiation.

 

What treatment is best for me?

Your cancer treatment will depend on what’s best for you. Some cancers respond better to surgery; others respond better to chemo or radiation. Knowing the type of cancer you have is the first step toward knowing which treatments will work best for you.

The stage of your cancer will also help the doctor decide on the best treatment for you. A stage 3 or 4 cancer is likely to respond better to treatments that treat the whole body, like chemo.

Your health and the treatment you prefer will also play a part in deciding about cancer treatment. Not all types of treatment will work for your cancer, so ask what options you have. And treatments do have side effects, so ask about what to expect with each treatment.

Don’t be afraid to ask questions. It’s your right to know what treatments are most likely to help and what their side effects may be.

 

Why did this happen to me?

People with cancer often ask, “What did I do wrong?” or “Why me?” Doctors don’t know for sure what causes cancer. But we covered a lot of reasons When doctors can’t give a cause, people may come up with their own ideas about why it happened and many are wrong and suffer from guilt Nonetheless lifestyle choices have a major role.

Some people think they’re being punished for something they did or didn’t do in the past. Most people wonder if they did something to cause the cancer. In many cases they did but the guilt has no role and stopping the behavior and starting healthy ones even after diagnosis can actually be beneficial but in terms of the cancer, quality of life and psycho emotional status and sense of control and fighting back

If you’re having these feelings, you’re not alone. Thoughts and beliefs like this are common for people with cancer. You need to know that cancer is not a punishment for your past actions..It may be a consequence though. Try to not blame yourself or focus on looking for ways you might have prevented cancer. It does no good other than what I said

 

How to talk to your loved ones about cancer I cover this in the section called But What Do I say and we will repeat them then but here are some tips..

It can be hard to talk about cancer, even with the people you love. Learning you have cancer can stir many feelings, such as sadness, anger, and fear. Sometimes it’s hard to know how you’re feeling, much less talk to others about it.

Your loved ones may also have a hard time talking about cancer. It’s not easy for them to know what to say to help you or make you feel better.

Here are some tips to help you and your loved ones deal with cancer:

  • Tell your family and friends about your cancer as soon as you feel up to it. Sooner or later, they’ll all know you have cancer. They might feel hurt or left out if they haven’t heard about it from you.
  • When you talk to them, explain what kind of cancer you have and how it will be treated. Let them know that no one can catch it from you.
  • Allow friends and family to help you, and tell them what kind of help you need. If you need a ride to the doctor’s office or hospital, let them know. If you need help around the house, let them know that, too. There may be times when you’re not sure what you need. That’s OK. Just let them know you aren’t sure, but you’ll let them know when you are.
  • Tell the people who are closest to you how you feel. This may not be easy, but it can be a very important way to get the support you need when you need it most. If you have trouble talking about your feelings, you might find a support group or a mental health counselor to help you.
  • If you have friends or family who tell you to “cheer up” when you’re not feeling good, it’s OK to ask them to just listen, and not tell you what to do. Sometimes you need to talk about what’s going on without getting advice in return.
  • If some people are not OK with talking about your feelings, don’t be upset. Try talking to others who might listen.
  • You may not be able to do things you were doing before you got cancer. If that’s true, let your family and friends know.
  • It’s best for your family and friends to keep doing the things they did before you had cancer. They should not feel guilty about doing this.
  • If you’re feeling sad or depressed, talk to your doctor, nurse, or religious leader. You can also call the American Cancer Society at 1-800-227-2345.

Cancer words you may hear A new vocabulary

These are words that you may hear your cancer care team use.

Benign (be-NINE): a tumor that’s not cancer

Biopsy (BY-op-see): taking out a piece of tissue to see if cancer cells are in it

Cancer (CAN-sur): a word used to describe more than 100 diseases in which cells grow out of control; or a tumor with cancer in it

Chemotherapy (key-mo-THER-uh-pee): the use of drugs to treat disease. The word most often refers to drugs used to treat cancer. Sometimes it’s just called “chemo.”

Malignant (muh-LIG-nunt): having cancer in it

Metastasis/Metastasized (meh-TAS-tuh-sis/meh-TAS-tuh-sized): the spread of cancer cells to distant parts of the body through the lymph system or bloodstream

Oncologist (on-KAHL-uh-jist): a doctor who treats people who have cancer

Radiation therapy (ray-dee-A-shun THER-uh-pee): the use of high-energy rays, like x-rays, to treat cancer

Remission (re-MISH-un): when signs or symptoms of cancer are all or partly gone

Stage: a word that tells whether a cancer has spread, and if so, how far

How can I learn more about my cancer?

If you have questions about cancer or need help finding resources in your area, please call the American Cancer Society at 1-800-227-2345. We’re there when you need us – 24 hours a day, 7 days a week.

PART 2 A REVIEW

Cancer is the uncontrolled growth of abnormal cells in the body. Cancer develops when the body’s normal control mechanism stops working. Old cells do not die and instead grow out of control, forming new, abnormal cells. These extra cells may form a mass of tissue, called a tumor. Some cancers, such as leukemia, do not form tumors.

What are the most common forms of cancer?

Cancer may occur anywhere in the body. In women, breast cancer is one of the most common. In men, it’s prostate cancer. Lung cancer and colorectal cancer affect both men and women in high numbers.

There are five main categories of cancer:

  • Carcinomas begin in the skin or tissues that line the internal organs.
  • Sarcomas develop in the bone, cartilage, fat, muscle or other connective tissues.
  • Leukemia begins in the blood and bone marrow.
  • Lymphomas start in the immune system.
  • Central nervous system cancers develop in the brain and spinal cord.Treatment options depend on the type of cancer, its stage, if the cancer has spread and your general health. The goal of treatment is to kill as many cancerous cells while reducing damage to normal cells nearby. Advances in technology make this possible.
  • The three main treatments are:
  • How is cancer treated?
  • Surgery: directly removing the tumor
  • Chemotherapy: using chemicals to kill cancer cells
  • Radiation therapy: using X-rays to kill cancer cells
  • AND NOW TARGETED PRECISION AND MOELCULAR
  • gentic THERAPY AND IMUNO AND BIOLOGIGAL THERAPYWhat can you do to manage the side effects of cancer treatment? AND I COVER THAT LATER WHEN WE DEAL WITH SIDE EFFECTS
  • Supportive care services describe a broad range of therapies designed to combat side effects and maintain well-being. Treating cancer requires focusing on more than the disease alone; it must also address the pain, fatigue, depression and other side effects that come with it.
  • The same cancer type in one individual is very different from that cancer in another individual. Within a single type of cancer, such as breast cancer, researchers are discovering subtypes that each requires a different treatment approach.
  •  The future of cancer treatment lies in providing patients with an even greater level of personalization. Doctors are beginning to offer treatment options based on the genetic changes occurring in a specific tumor.
  • An innovative new diagnostic tool, the genomic tumor assessment, examines a patient’s tumor genetically to identify the mechanism that caused the cancer. Genomic tumor assessment may result in a more personalized approach to cancer treatment
  • What does the future hold for cancer treatment?

THUS CANCER IS A Collection of Related Diseases

Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

 

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

 

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

 

Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.

 

Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system

 

Unlike malignant tumors, benign tumors do not spread into, or invade, nearby tissues. Benign tumors can sometimes be quite large, however. When removed, they usually don’t grow back, whereas malignant tumors sometimes do. Unlike most benign tumors elsewhere in the body, benign brain tumors can be life threatening.

 

Differences between Cancer Cells and Normal Cells

Cancer cells differ from normal cells in many ways that allow them to grow out of control and become invasive. One important difference is that cancer cells are less specialized than normal cells. That is, whereas normal cells mature into very distinct cell types with specific functions, cancer cells do not. This is one reason that, unlike normal cells, cancer cells continue to divide without stopping.

 

In addition, cancer cells are able to ignore signals that normally tell cells to stop dividing or that begin a process known as programmed cell death, or apoptosis, which the body uses to get rid of unneeded cells.

 

Cancer cells may be able to influence the normal cells, molecules, and blood vessels that surround and feed a tumor—an area known as the microenvironment. For instance, cancer cells can induce nearby normal cells to form blood vessels that supply tumors with oxygen and nutrients, which they need to grow. These blood vessels also remove waste products from tumors.

 

Cancer cells are also often able to evade the immune system, a network of organs, tissues, and specialized cells that protects the body from infections and other conditions. Although the immune system normally removes damaged or abnormal cells from the body, some cancer cells are able to “hide” from the immune system.

Tumors can also use the immune system to stay alive and grow. For example, with the help of certain immune system cells that normally prevent a runaway immune response, cancer cells can actually keep the immune system from killing cancer cells.

How Cancer Arises

Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.

Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun. Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.

In general, cancer cells have more genetic changes, such as mutations in DNA, than normal cells. Some of these changes may have nothing to do with the cancer; they may be the result of the cancer, rather than its cause.

“Drivers” of Cancer

The genetic changes that contribute to cancer tend to affect three main types of genes—proto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.

Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes), allowing cells to grow and survive when they should not.

Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.

DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes. Together, these mutations may cause the cells to become cancerous.

As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Because of this, cancers are sometimes characterized by the types of genetic alterations that are believed to be driving them, not just by where they develop in the body and how the cancer cells look under the microscope.

DNA IS LIKE A LADDER WITH TWO IDENTICAL LONG LEGS AND RUNGS THAT ALWAYS MATCH IN A CERTAIN WAY THE LADDER AND RUNGS ARE MADE OF BUILDUBG BKICJS CAKKED NUCKEITIDES

The fidelity of the human genome is maintained by multiple pathways of DNA repair that respond to DNA damage or errors in replication.1 Mismatch repair (MMR) proteins proofread newly replicated DNA strands for mistakes. When an error is found, the MMR protein complex excises the incorrect building block in the DNA and the resulting gap is repaired.4 It is estimated that MMR proteins improve the accuracy of DNA replication by several orders of magnitude.5

Mutations of a principal MMR protein can result in the accumulation of DNA errors, which are compounded by subsequent cycles of DNA replication.6 Repetitive elements within the DNA are especially sensitive to MMR protein dysfunction and the gain or loss of nucleotide repeats within these repetitive elements is termed microsatellite instability (MSI).7 As the burden of pointS OF mutations and MSI increases, DNA stability is lost and cells accumulate malignant properties.8 The consequences of this cellular dysregulation are most clearly observed in patients with Lynch syndrome who carry germline mutations in one of the MMR proteins.9 Most commonly, these patients develop colorectal cancer and women who carry these mutations are also at significant risk for endometrial and ovarian cancer.10 Patients with Lynch syndrome are also at increased risk for gastric, pancreatic, small bowel, urothelial cancers, and gliomas in the brain.10

When Cancer Spreads

 

In metastasis, cancer cells break away from where they first formed (primary cancer), travel through the blood or lymph system, and form new tumors (metastatic tumors) in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor.

A cancer that has spread from the place where it first started to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to and forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.

Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

Treatment may help prolong the lives of some people with metastatic cancer. In general, though, the primary goal of treatments for metastatic cancer is to control the growth of the cancer or to relieve symptoms caused by it. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.

Tissue Changes that Are Not Cancer

Not every change in the body’s tissues is cancer. Some tissue changes may develop into cancer if they are not treated, however. Here are some examples of tissue changes that are not cancer but, in some cases, are monitored:

Hyperplasia occurs when cells within a tissue divide faster than normal and extra cells build up, or proliferate. However, the cells and the way the tissue is organized look normal under a microscope. Hyperplasia can be caused by several factors or conditions, including chronic irritation.

Dysplasia is a more serious condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form.

Some types of dysplasia may need to be monitored or treated. An example of dysplasia is an abnormal mole (called a dysplastic nevus) that forms on the skin. A dysplastic nevus can turn into melanoma, although most do not.

An even more serious condition is carcinoma in situ. Although it is sometimes called cancer, carcinoma in situ is not cancer because the abnormal cells do not spread beyond the original tissue. That is, they do not invade nearby tissue the way that cancer cells do. But, because some carcinomas in situ may become cancer, they are usually treated.

 

Normal cells may become cancer cells. Before cancer cells form in tissues of the body, the cells go through HYPERPASIA AND DYSPLASIA

Types of Cancer

There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in cells of the lung, and brain cancer starts in cells of the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

You can search NCI’s website for information on specific types of cancer based on the cancer’s location in the body or by using THEIR A to Z List of Cancers. THEY also have collections of information on childhood cancers and cancers in adolescents and young adults.

Here are some categories of cancers that begin in specific types of cells:

Carcinoma

Carcinomas are the most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. There are many types of epithelial cells, which often have a column-like shape when viewed under a microscope.

Carcinomas that begin in different epithelial cell types have specific names:

Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas.

Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin.

Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.

 

Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.

Sarcoma

Soft tissue sarcoma forms in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints.

Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).

Osteosarcoma is the most common cancer of bone. The most common types of soft tissue sarcoma are leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, liposarcoma, and dermatofibrosarcoma protuberans.

FINALLY.

Blood Cancers

Blood cancers such as multiple myeloma affect the function and production of blood cells. In most MYELOMA blood cancers, normal blood cell development is interrupted by uncontrolled growth of abnormal blood cells called plasma cells which make anribodies. The abnormal blood cells can prevent blood from fighting off infection or preventing uncontrolled bleeding. In rare cases myeloma is found in one place in the body, and is called solitary myeloma. Myeloma blood cancer treatment may include chemotherapy, radiation and stem cell transplant.

 

There are three main blood cancer types:

HUGE PROGRESS IN MULTIPLE RELAPSES

Leukemia

 

And lymphoma

Multiple Myeloma

Leukemia is a blood cancer in both the bone marrow and in blood itself. Both types of leukemia involve an over-production of white blood cells. Lymphocytic leukemia involves over-production of lymphocytes, and myelogenous leukemia involves over-production of white blood cells called granulocytes. Over time, leukemia cells crowd out normal blood cells leading to serious bleeding and infection.

Lymphoma

Lymphoma is a blood cancer that develops in the lymphatic system. The lymphatic system is made up of groups of lymph nodes which keep body fluids free from infection. The blood cancer may spread from one group of lymph nodes to another in order (Hodgkin lymphoma) or spread randomly (non-Hodgkin lymphoma).

Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.

There are two main types of lymphoma:

Hodgkin lymphoma – People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells.

Non-Hodgkin lymphoma – This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

 

Leukemia

Cancers that begin in the blood-forming tissue of the bone marrow are called leukemias. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to its tissues, control bleeding, or fight infections.

There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid).

.

Multiple Myeloma

AS WE DISCUSSED Multiple myeloma is cancer that begins in plasma cells, another type of immune cell. The abnormal plasma cells, called myeloma cells, build up in the bone marrow and form tumors in bones all through the body. Multiple myeloma is also called plasma cell myeloma.

.

Melanoma

Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.

.

Brain and Spinal Cord Tumors

There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Other Types of Tumors

Germ Cell Tumors

Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.

.

Neuroendocrine Tumors

Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.

.

Carcinoid Tumors

Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine). Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

Let’s see if there are any questions

 

 

This is Dr Kevin Ryan author of the book when tumor is the rumor and cancer is the answer, a comprehensive text for newly diagnosed patients and their families available on the website of the same name and Amazon signing off radio www.w4cs.com the cancer support radio program   and ARCHIVED AUDIO FILES ON iheart RADIO 

See you Next Tuesday at noon PST when we will look MORE OF THE NUTS AND BOLTS OF THE OVERVIEW OF CANCER

 

 

WHAT IS CANCER PART 1

Hi DR Ryan here, medical oncologist AND PROFESSOR AND RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer. EVERYTHING IS NON PROFIT THIS SHOW IS Modeled after my book of the same name available on thE THERAPEUTIC web site, TWITTER ABOUT 450 BLOGS AND FACEBOOK and IS AVAILABLE ON BOTH THE WEB SITE AND Amazon, Take a look around lots of films and interviews and excerpts

I am sure you are familiar with our opening song   from chariots  of fire. A man has a plan and in a day it is crushed…… so it is when you have been told you have cancer ,thoughts of loss of control, soul sucking anxiety, what about your family and the list goes on as it hits  you like a ton of bricks.

He rose above it in the film  and so you to will be a hero ………I have seen no exception no matter how afraid you are, FIRST OFF WE DID NOT GET TO THE QUESTIONS OF LAST WEEK ALTHOUGH THE TALK DID COVER THEM ALL LET’S JUST QUICKLY TAKE A LOOK WITH MY APOLOGIES

First lets answer questions which tend to repeat

just how do you know if there is a depressive state in things? Covered this

Can you see the depression in your self or others? Perhaps not little insight

What does depression look like? See list of symptoms

How does depression feel to people? Never and forever lie See list

How can you work with the depressive state? Very difficult

Should you have guilt being depressed? No no no guilt is part of the fisease in many see list especially in elderly

So its all in what you eat? No no no I was just being fair to unfounded claims The blood sugar and binging and starving that may occur are bad however

Where do the good studies come from? There are none for food there are for depression in general ,meds, the integrative modalities and therapy

. Recently, Mehnert and colleagues reported a 31% prevalence rate for any psychiatric disorder in cancer patients. Rates for depression vary from 11% to 37%,. The rate for depression in the general population is 7%—and thus HIGHER among cancer patients—THE RATE OF SUICIDE IS TWICE THE NORMAL POPULATION

7 Physical Clues You Could Have Depression

 

Many people who suffer from chronic illnesses also suffer from depression. Depression isn’t something that should be overlooked; it should be brought to your doctor’s attention so that it can be treated. But how do you spot depression?  With help from prevention.com, we’ve put together a list of some of the most common physical signs that someone is suffering from depression.

 

Aches and Pains

Although many chronic illnesses have their share of aches and pains, depression can also make muscles and joints feel sore or exacerbate the problem. People who are happy or content generally feel pain less than those who have depression.

 

Difficulty Sleeping or Waking Through the Night

Not being able to relax enough to fall asleep or frequently waking up during the night and finding it difficult to go back to sleep could both be signs of depression. Lack of sleep or disturbed sleep can have a profound effect on mood and the ability to concentrate.

 

Changes in Weight

Loss of appetite or comfort eating are both associated with depression, but you may not realize you have either until you step on the scale and notice a difference. In addition, if you’re not sleeping well because you’re anxious or depressed, this can also mess with your appetite leading to weight loss or gain.

 

Skin Complaints

Because depression affects hormones, this often becomes apparent in our skin. Depression can lead to skin complaints like acne, psoriasis, and eczema and treating the depression can help with the skin complaint.

 

Stomach Problems

Mood definitely affects the gut, and people with depression may suffer from symptoms like nausea, constipation, diarrhea, heartburn and indigestion.

 

Headaches and Migraines

People with depression are more likely to experience frequent headaches or migraines. Although this could also be a side effect of medication or treatments you take for your chronic illness.

 

Oral Problems

Dentists in Australia have found people with depression are more likely to need dental work such as tooth extractions and cavities than those who don’t. The thought behind this is that if you’re depressed, you’re less likely to be as diligent about oral health.

 

Depression questionqaire IS KEY

 

Suicide

growing body of evidence that mental and physical health do not function on separate planes, and that one can influence the other.

 

Since most cancer occur is the elderly and cancer is proportional with age and depression may look different than just those simple 7 symptoms Diagnosing Depression IN THE ELDERLY is somewhat different

Common symptoms of depression—fatigue, diminished concentration, thoughts of death/suicide, weight loss/gain—are confounded with side effects from cancer treatments or, potentially, the cancer itself.

 

The literature suggests that two gateway symptoms—depressed mood and loss of interest—are most valuable in diagnosing depression in cancer, but identifying these symptoms is not necessarily useful in older adults.

“The gateway questions come off the table as less than useful diagnostic criteria when we combine cancer and aging. “

Major and Minor Themes

anhedonia depressed mood without sadness , reduction in social relationships/loneliness, loss of meaning and purpose, and lack of usefulness and sense of being a burden. These are big and also seen somewhat in younger patients

Four minor themes also emerge: attitude toward treatment, mood, regret and guilt, and physical symptoms and limitations.

Another central issue was loneliness, depressed patients tended to have limited meaningful relationships and were socially isolated and withdrawn.

 

Loss of meaning and purpose in life was STRONGLY PRESENT and they display an inability to adjust to their new limitations. “rumination THIS IS CRITICAL AND PATIENTS GO BACK TO IT (WHAT THEY DID IN THE PAST) OVER AND OVER AGAIN Lack of usefulness and sense of being a burden is also displayed in all depressed.

There was no difference between depressed and non depressed participants in terms of their willingness to engage in treatment, but attitude toward treatment different“

 

The non depressed are much more proactive regarding their treatment, whereas the depressed are resentful, angry, and upset about their treatment,”

Both depressed and non depressed look back at their lives and experience some level of regret, but the amount of guilt experienced the differentiating factor between the non depressed and the depressed. “The depressed patients seemed to ruminate on their regrets, whereas the non depressed are able to put their regrets in a tolerable perspective,”

 

No actual difference in physical limitations is observed between the two groups, but a difference is noted in how they cope with those limitations. Depressed do not adapt.

 

LECTURE 6 PART 1  BLOG IT AND SUBMIT IHEART FORM

 

BUT WE MUST KNOW THAT WHICH WE ARE AFRAID OF WE MUST KNOW THE ERSONALITY OF THE BEAST TO BE BETTER ABLE TO FIGHT IT , WE MUST KNOW THE ENEMY AND THAT IS WHAT WE ARE GOING TO TALK ABOUT TODAY AND  NEXT WEEK AND THEN AFTER WE FINISH THE TWO WEEKS ON WHAT IS CANCER WE ARE GOING TO OPEN THE WHOLE SHOW UP TO PERTINEINT QUESTIONS

BY THAT TIME IT IS A PERFECT TIME GOR A BREAK We will Have COBERRED ATTITUDE, autonomy, anxiety, depression and what is cancer and that is a perfect time to STOP AND TAKE STOCK of what did we learn and ask anything you WAMT  the oNly stupid question is the one you diD not ask

 

I MAY HAVE SOME QUESTIONS FOR YOU

NOW LETS SINK OUR TEETH INTO THE BEAST..THE ENEMY ..WHAT IS CANCER

 

 

THE ENEMY

 

First, a Parable

 

 

Winter was coming early to the western Cordillera range of the Sierra Nevada and the mountain man knew it was time to head down to safer ground. Packing his mule, he heard from behind a cold craggy granite precipice the unmistakable hissing and eerie rattle of the deadly western diamond back. Then, as strange as it seems, the snake spoke and began pleading with the rugged frontiersman. “Pleasssse, oh Pleassse.”, it begged while hissing, “Winter has come early and I will ssssurely freesssse if you do not put me in your pack and take me down to ssssafer warmer ground

Hard won experience had told the mountain man to be wary. He declined, stating firmly, “You will surely bite me before the trail is through”. The snake assured him he would never do such a thing if the man would save him. Thus, reckoning back to lessons from his ma and pa long since dead after hard laboring the rocky western Kentucky soil, the cautious but kindly outdoorsman took pity on one of God’s creatures. Carefully, against his gut instincts, he placed the viper in his pack and headed to lower, warmer ground.

At the end of the journey, as promised, he reached into the pack to release the viper. Of course the snake struck, injecting the outdoorsman with blindingly painful venom and the near certainty of an ugly and lonely demise. The Good Samaritan of the frontier was enraged and while still lucid reminded the snake of his promise.

The snake replied, slowly and sincerely, “but you knew I wassss a sssnake when you helped me, I just did what sssnakes do”

 

…. and so it is with the enemy, cancer.

 

“They’re toast”. That is not a rare expression uttered by some physicians in private when hearing of a severely threatening diagnosis. I have heard this common irreverent comment and similar ones uttered by my colleagues and young residents when referring to those newly diagnosed with cancer. Curiously, these flippant declarations do not always follow a diagnosis of advanced or terminal disease. These insensitive quips have even popped out at the mere confirmation of the mere diagnosis before any determination of stage or degree of severity. Why? It is because cancer is the ultimate terrorist, the perfect enemy.

Cancer, the anathema, the incubus; nothing evokes more fear. There is no greater pariah to caretaker, clinician or patient. Indeed the very origin of the word “cancer,” from “crab” speaks legions regarding the dread with which we regard the word. Why is this?

Perhaps we fear cancers’ amazing talent for infernal mimicry of the norm. Cancer cells imitate normal cells, but perversely. Perhaps we detest the macabre brilliance by which cancer cells systematically unravel the elegant mysteries of normal cells. Cancer cells, regarded by some scientists intellectually as little medical miracles, take their cue from normalcy but with a deviant twist. They grow; constantly, irrepressibly.

Their mere presence conjures up visions of evil humors reminiscent of those alluded to by Galen, the ancient Greek founding father of medicine, as they swarm over the unsuspecting patient. They are admirably ingenious rogues with innumerable deceptions cloaking them from our immune systems’ elegant surveillance and intelligence network. They have amazing techniques that protect them from detection and eradication.

Cancer cells will also not stay put. They marshal innocent patients’ wondrous blood vessel factories and command those factories to build an evil network of canals and thoroughfares of new vessels which bring the malignant little monsters nourishment and usher them on journeys to distant organs to wreak havoc. These princes of parasitism suck essential nutrients from us, decimating our defenses. Some cause local mayhem, blocking critical passageways, bowel and bladder alike. Some make us weep blood. Some sneak off to the otherwise pristine recesses of the brain confounding movement and sensation while causing neurological crises. Malignant and malevolent, it is no wonder we hate cancer with unbridled passion.

It is so poignant that in our battle against cancer we employ potent poisons in a sort of chemical and biological warfare. These therapies frequently count on the “good guys”, our normal tissues, to hang in there despite the sometimes enormous toll therapy exacts on the body. The quest is rather daunting; to kill a cancer cell and still leave normal cells and tissues largely undisturbed and surviving normally. For some, successful surgical removal of the cancer holds a pivotal place in the armamentarium. For others, blasting away with radiation is the treatment. Others receive chemical, biological or combined assaults.

Cancer can be and is often killed. However,  biologically resistant and insolent to the last, this enemy will not die without a fight and without a fight, the patient often will

Some CANCER BASICS

 

PONDER THIS

HOW DO LIVER CELLS KNOW WHEN IT IS TIME TO STOP GROWING BECAUSE THEY HAVE REACHED LIVER NESS

 

And so it goes for every other organ

in cancer the cells do not stop , they escape or impair immune detection or fool it , They simplY do not stop having children. They do not stop growing .

they have ways of turning off natural timing of A cells death or making vascular highways for themselves to feed themselves as well as have highways to travel on and spread either by direct extension or through the blood

What Is Cancer?

Cancer can start any place in the body. It starts when cells grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.

Cancer can be treated very well for many people. In fact, more people than ever before lead full lives after cancer treatment. 65% The numbers used to be opposite

Here we will explain what cancer is and how it’s treated IN VERY general terms. You’ll find a list of words about cancer and what they mean at the end of this booklet.

Cancer basics

Causes

 

How cancer begins

Cells are the basic units that make up the human body. Cells grow and divide to make new cells as the body needs them. Usually, when cells get too old or damaged, they die. Then new cells take their place. AT A NORMAL HEALTHY PACE

Cancer begins when genetic changes impair this orderly process. Cells start to grow uncontrollably. These cells may form a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

 

Some types of cancer do not form a tumor. These include leukemias, most types of lymphoma, and myeloma.

Cancer is caused by changes (mutations) to the DNA within cancer cells. The DNA inside a cell is packaged into a large number of individual genes, each of which contains a set of instructions telling the cell what functions to perform, as well as how to grow and divide.it tells it what proteins to make that might blck the immune systems Errors in the instructions can cause the cell to stop its normal function and may allow a cell to become cancerous.

What do gene mutations do?

A gene mutation can instruct a healthy cell to:

  • Allow rapid growth. A gene mutation can tell a cell to grow and divide more rapidly. This creates many new cells that all have that same mutation.
  • Fail to stop uncontrolled cell growth. Normal cells know when to stop growing so that you have just the right number of each type of cell. Cancer cells lose the controls (tumor suppressor genes) that tell them when to stop growing. A mutation in a tumor suppressor gene allows cancer cells to continue growing and accumulating.
  • Gene mutations can cause normal cells to Make mistakes when repairing DNA errors. DNA repair genes look for errors in a cell’s DNA and make corrections. A mutation in a DNA repair gene may mean that other errors aren’t corrected, leading cells to become cancerous.

Those mutations are the most common ones found in cancer. But many other gene mutations can contribute to causing cancer.

What causes gene mutations?

Gene mutations can occur for several reasons, for instance:

  • Gene mutations you’re born with. You may be born with a genetic mutation that you inherited from your parents. This type of mutation accounts for a small percentage of cancers. Perhaps 5-8%
  • Gene mutations that occur after birth. Most gene mutations occur after you’re born and aren’t inherited. A number of forces can cause gene mutations, such as smoking, radiation, viruses, cancer-causing chemicals (carcinogens), obesity, hormones, chronic inflammation and a lack of exercise.

Gene mutations occur frequently during normal cell growth. However, cells and especially those in our immune system when it works correctly contain a mechanism that recognizes when a mistake occurs and repairs the mistake. Occasionally, a mistake is missed. This could cause a cell to become cancerous.

How do gene mutations interact with each other?

The gene mutations you’re born with and those that you acquire throughout your life work together to cause cancer.

For instance, if you’ve inherited a genetic mutation that predisposes you to cancer, that doesn’t mean you’re certain to get cancer. Instead, you may need one or more other gene mutations to cause cancer. Your inherited gene mutation could make you more likely than other people to develop cancer when exposed to a certain cancer-causing substance.

It’s not clear just how many mutations must accumulate for cancer to form. It’s likely that this varies among cancer types

 

While doctors have an idea of what may increase your risk of cancer, MANY of cancers occur in people who don’t have any known risk factors. Factors known to increase your risk of cancer include:

Your age

A big factor Cancer can take decades to develop. That’s why most people diagnosed with cancer are 65 or older. While it’s more common in older adults, cancer isn’t exclusively an adult disease — cancer can be diagnosed at any age.

 

Your habits

Certain lifestyle choices are known to increase your risk of cancer. Smoking, drinking more than one alcoholic drink a day (for women of all ages and men older than age 65) or two drinks a day (for men age 65 and younger), excessive exposure to the sun or frequent blistering sunburns, being obese, and having unsafe sex can contribute to cancer.

You can change these habits to lower your risk of cancer — though some habits are easier to change than others.

 

Your family history

Only a small portion of cancers are due to an inherited condition. If cancer is common in your family, it’s possible that mutations are being passed from one generation to the next. You might be a candidate for genetic testing to see whether you have inherited mutations that might increase your risk of certain cancers. Keep in mind that having an inherited genetic mutation doesn’t necessarily mean you’ll get cancer.

 

Your health conditions

Some chronic health conditions, such as ulcerative colitis, can markedly increase your risk of developing certain cancers. Talk to your doctor about your risk. Chronic inflammatory states

 

Your environment

The environment around you may contain harmful chemicals that can increase your risk of cancer. Even if you don’t smoke, you might inhale secondhand smoke if you go where people are smoking or if you live with someone who smokes. Chemicals in your home or workplace, such as asbestos and benzene, also are associated with an increased risk of cancer

 

Cancer is a scary and complex disease. Even when it’s caught early and with good odds for surviving and living a long, healthy life, there are a lot of people who develop cancer each year—and, sadly, not everyone survives it. Most cancers develop depending on several factors, but research has identified many contributing causes of cancer. Some are obvious and preventable, while others are the simple yet unfortunate result of genetics. And although many cancers have a high probability of being beat, the lack of proper or available medical care in certain areas, and even whole countries, can greatly impact the survival rate.

 

 

Taking into account the complexity of the disease and recognizing that many factors usually contribute to developing it, here’s again the wide range of what causes cancer— a little more in depth and some tips to change what you can to prevent the disease…

 

1. The Sun

The damage caused by ultraviolet (UV) rays from the sun have been studied immensely over the years. According to the Skin Cancer Foundation, UV is a proven carcinogen that in excess, can lead to skin cancer as a result of gene mutations from exposure to these harmful rays. There are various types of skin cancer that UV rays can cause or contribute to the risk of, with melanoma being the most serious and often deadly type. There’s a reason many health experts don’t approve of the use of tanning beds, and at least one developed country has completely banned the use of them (hint: it’s Australia).

 

Although people frequently flock to warm, sunny, vacation destinations to soak up the rays, it doesn’t need to be hot outside to damage your skin and potentially increase your risk of skin cancer. A cooler, cloudy day can still be risky, so you shouldn’t only wear sunscreen when you’re somewhere hot and sunny. You often see parents lathering their children in sunscreen, and while kids have sensitive skin and would be in a lot of pain if they were seriously burned from the sun, adults need protection too.

 

Genes

As we stated People can be at a higher risk of developing cancer from their genetic makeup, or DNA. More specifically, certain mutated genes can be passed onto children from generation to generation, something you can’t prevent or control the effect of. The American Cancer Society explains that cancer is believed to be formed from more than one gene mutation, so you aren’t likely to develop cancer just from one mutated gene inherited through DNA. However, people who inherit these faulty genes are then at a disadvantage because they’re automatically starting off with one mutated gene.

 

Breast cancer is a prime example of this—there are two genes that can be inherited, which can greatly increase the risk of breast cancer within families or lineages. There’s testing that can be done to find out if you have one of these risky genes, and it’s believed that around 5- to 10-percent of breast cancer cases are caused by them. Although many women and some men are diagnosed with breast cancer each year, it’s something that is often caught early enough to treat and overcome.

 

. Smoking

No list of factors that cause cancer would be complete without smoking. Cigarettes kill a staggering amount of people each year because of various types of cancer, many of which develop in the lung, esophagus, mouth, throat, and stomach. More and more cities are banning the use of cigarettes inside public establishments, on patios, and in vehicles as research has shown that second hand smoke is harmful and even deadly for those who don’t smoke. It seriously increases the risk of developing several types of cancer, as well as harmful diseases in other organs.

 

 

With all the advertisements about how dangerous smoking is to your health and its ability to greatly increase your risk of cancer, you might wonder how and why it’s legal. The good news is, the U.S. Centers for Disease Control (CDC) has tracked smoking trends since 1965, and the amount of adult smokers has decreased by over 20-percent in that time frame. If you need help quitting smoking, take advantage of the many helpful online tools available, join a support group, and talk to your doctor about kicking the habit for good.

Eating Habits and (Lack of) Physical Activity

There are many things that increase the risk of or cause cancer that can’t be prevented. But there are some lifestyle choices that contribute to the risk of developing it, and poor eating habits and little physical activity are two of them. The research relating to diet and cancer is still ongoing, but what we currently know is that a poor diet could increase the risk of cancer. More recent research has shown that the food we eat can not only influence developing the disease, but certain healthy foods may decrease or even help prevent cancer from developing. SUCH AS LEAN MEATS VEGGIES

 

How we treat our bodies is a major factor in being healthy—including limiting and reducing the risk of diseases like cancer, obesity, heart disease, diabetes, and others that vary in severity. Exercising and getting regular physical activity play a role in this too. Being active not only reduces the risk of cardiovascular disease, but also lowers the chance of obesity, hormone fluctuations, and immune system function. These factors have all been connected to cancer, so taking care of your body in every way is important. Being overweight TRIPLES your risk of UTERINE cancer: here is a breakdown of how

Fatty tissue produces the hormone oestrogen, which regulates a woman’s reproduction and is linked to the cancer when levels in the body are excessive

  • Obesity increases a woman’s chance of the disease by a massive six times
  • Other risk factors are diabetes, being postmenopause and not having children
  • Women should look out for abnormal vaginal bleeding, as well as pain during sex
  • If detected early, a sufferer’s survival chances beyond one year are 95 per cent

 

AGE Age

It’s a common fact that as you grow older, your chance of developing cancer increases. This isn’t surprising because many types of cancer are more common amongst older age groups. According to the Mayo Clinic, since cancer can take decades to develop it’s most common for people 65 and older to develop cancer. Cells don’t mutate into cancerous cells overnight, so slow changes can happen over a healthy person’s lifetime without them knowing. Sometimes it happens naturally,IS DETECTED AND DEALT WiTH BECAUSE OF EARLY SCREENING OR A HEALTHY IMMUNE SYSTEM while in some cases the cell mutates from the person being exposed to carcinogens, like cigarettes or environmental hazards.

No one can prevent cancer completely but there are steps that can be taken to help lower the risk of developing cancer. You can’t stop the aging process, but eating healthy, exercising, limiting exposure to carcinogens, and seeing your doctor for regular physicals, GETTING SCREENS are all important for your future—what you do now and how you treat your body as you grow older can have a long-term impact, and being as healthy as possible is the best way to avoid certain preventable diseases, including contributing to your risk of certain cancers.

 

Asbestos

Asbestos exposure, and mesothelioma as a result of this exposure, might be rare these days, but you’d be surprised by the amount of people suffering from cancer and other complications associated with asbestos. Over the years, the use of asbestos in buildings and materials has dramatically decreased, but it’s still possible to be exposed to these deadly minerals, especially in older buildings. And it’s still used frequently in some countries, so the dangers are still there.

Asbestos comes in the form of tiny fibers that are inhaled and cause damage to the lungs. It can also be ingested through water that gets contaminated from the pipes it runs through. In addition to lung cancer and mesothelioma, asbestos has shown to increase the risk of cancer in the larynx and ovaries. It’s also been linked to other forms of cancer, making asbestos exposure a very real and serious threat to the health of anyone exposed to it. People working in construction are most at risk because of the materials used and potential for mishandling and other ways of exposure

Excessive Alcohol Consumption

The impact of alcohol consumption on our health has been widely studied. Many experts believe a drink a day, or specifically a glass of wine a day, could be good for your health. Others believe there are too many potential harmful effects and that alcohol should be completely avoided. Regardless of these two sides, it’s agreed that excessive alcohol consumption can lead to numerous serious medical conditions, including cancer, cardiovascular disease, and mental health problems. Then there’s the effect on your personal and professional life, which can cause serious problems.

 

Some of the most common cancers linked to drinking too much over a long period of time are liver, colon, throat and breast cancer. In the case of breast cancer, it could increase your risk by around 10-percent. It’s important to note that drinking excessively doesn’t equate to being addicted to alcohol. There are many people who binge drink or regularly have 10 or more drinks per week but aren’t considered alcoholics or have a risky dependence on alcohol. But there is both short and long-term damage associated with drinking, so most experts agree that moderation is key.

 

Sex HPV

Conditions Affecting the Immune System

The immune system is your body’s way to defend and prevent infections and diseases. Weakened immune systems or those that don’t function properly are at risk of allowing harmful cells to hurt the body. An unfortunate cause of cancer stems from immune systems that are already affected by another medical condition or syndrome. This makes it especially difficult on the person with the existing condition, as oftentimes the problems they currently face cause them to struggle even more and cause additional complications once cancer has also been diagnosed.

 

Since viruses weaken the immune system, there are certain types of viruses that could cause cancer or put the person at a higher risk of developing it in their lifetime. According to the American Cancer Society, some of these viruses include hepatitis B and C, human immunodeficiency virus (HIV), human papilloma viruses (HPVs), and human herpes virus 8 (HHV-8). Several other viruses have been linked to causing cancer but there isn’t enough evidence yet to prove the connection

 

AGENT ORANGE OTHER TOXINS

Types of cancer

Doctors divide cancer into types based on where it began. Four main types of cancer are:

  • Carcinomas. A carcinoma begins in the skin or the tissue that covers the surface of internal organs and glands. Carcinomas usually form solid tumors. They are the most common type of cancer. Examples of carcinomas include prostate cancer, breast cancer, lung cancer, and colorectal cancer.
  • Sarcomas. A sarcoma begins in the tissues that support and connect the body. A sarcoma can develop in fat, muscles, nerves, tendons, joints, blood or lymph vessels, cartilage, or bone.
  • Leukemias. Leukemia is a cancer of the blood. Leukemia begins when healthy blood cells change and grow uncontrollably. The four main types of leukemia are acute lymphocytic and myeloid leukemia, chronic lymphocytic leukemia, , and chronic myeloid leukemia.
  • Lymphomas. Lymphoma is a cancer that begins in the lymphatic system. The lymphatic system is a network of vessels and glands that help fight infection. There are two main types of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphoma.

 

There are many other types of cancer. These above are the main groups

 

 

How cancer spreads

As a cancerous tumor grows, the bloodstream or lymphatic system may carry cancer cells to other parts of the body. During this process, known as metastasis, the cancer cells grow and may develop into new tumors.

One of the first places a cancer often spreads is to regional lymph nodes draining the area. Lymph nodes are tiny, bean-shaped organs that help fight infection. They are located in clusters in different parts of the body, such as the neck, groin area, and under the arms.

Cancer may also spread through the bloodstream to distant parts of the body. These parts may include the bones, liver, lungs, or brain. Even if the cancer spreads, it is still named for the area where it began. For example, if breast cancer spreads to the lungs, it is called metastatic breast cancer, not lung cancer.a very very common mistake and not just grammar

.

Diagnosing cancer

Often, a diagnosis begins when a person visits a doctor about an unusual symptom. The doctor will talk with the person about his or her medical history and symptoms. Then the doctor will perform various tests to find out the cause of these symptoms. Many people with cancer have no symptoms, though. For these people, cancer is diagnosed during a medical test for another issue or condition.

Sometimes a doctor diagnoses cancer after a cancer screening test in an otherwise healthy person. Examples of screening tests include colonoscopy, mammography, and a Pap test amd soon genetic b;ood tests. A person may need additional tests to confirm or disprove the result of the screening test.

 

For most cancers, a biopsy is the only way to make a definite diagnosis. A biopsy is the removal of a small amount of tissue for further study. The following expression is crude but memorable no meat no treat. You must know the tissue diagnosis not guess

 

Cancer and its treatment can cause several complications, including:

  • Pain. Pain can be caused by cancer or by cancer treatment, though not all cancer is painful. Medications and other approaches can effectively treat cancer-related pain
  • .
  • Fatigue. Fatigue in people with cancer has many causes, but it can often be managed. Fatigue associated with chemotherapy or radiation therapy treatments is common, but it’s usually temporary.
  • Difficulty breathing. Cancer or cancer treatment may cause a feeling of being short of breath. Treatments may bring relief.
  • Nausea. Certain cancers and cancer treatments can cause nausea. Your doctor can sometimes predict if your treatment is likely to cause nausea. Medications and other treatments may help you prevent or decrease nausea. Mj is once again like the 1980’s showing a possible role as is hypnosis, meditation acupunture and acupressure
  • Diarrhea or constipation. Cancer and cancer treatment can affect your bowels and cause diarrhea or constipation.
  • Weight loss. Cancer and cancer treatment may cause weight loss. Cancer steals food from normal cells and deprives them of nutrients. This is often not affected by how many calories or what kind of food is eaten; it’s difficult to treat. In most cases, using artificial nutrition through tubes into the stomach or vein does not help change the weight loss. But it is tired Medical therapy is tried and once age the cannabanoids- the munchies may have a role research is really and difficult to do as MJ is still stupidly classified as a stage 1 drug up there with opium and heroin
  • Chemical changes in your body. Cancer can upset the normal chemical balance in your body and increase your risk of serious complications. Signs and symptoms of chemical imbalances might include excessive thirst, frequent urination, constipation and confusion. Some times it can be very severe
  • Brain and nervous system problems. Cancer can press on nearby nerves and cause pain and loss of function of one part of your body. Cancer that involves the brain can cause headaches and stroke-like signs and symptoms, such as weakness on one side of your body. There is also a lot of research into so called chemo brain especially in breast cancer.
  • Unusual immune system reactions to cancer. In some cases the body’s immune system may react to the presence of cancer by attacking healthy cells. Called paraneoplastic syndrome, these very rare reactions can lead to a variety of signs and symptoms, such as difficulty walking and seizures. High and low calciums, increased clotting and many more
  • Cancer that spreads. As cancer advances, it may spread (metastasize) to other parts of the body. Where cancer spreads depends on the type of cancer. And cancers of a particular type typically spread to the same list of sites for that cancer
  • Cancer that returns. Cancer survivors have a risk of cancer recurrence. Some cancers are more likely to recur than others. Ask your doctor about what you can do to reduce your risk of cancer recurrence. Your doctor may devise a follow-up care plan for you after treatment. This plan may include periodic scans and exams in the months and years after your treatment, to look for cancer recurrence.This is Dr Kevin Ryan author of the book when tumor is the rumor and cancer is the answer, a comprehensive text for newly diagnosed patients and their families available on the website of the same name and Amazon signing off radio www.w4cs.com the cancer support radio program   and ARCHIVED AUDIO FILES ON iheart RADIO END PART 1
  • See you Next Tuesday at noon PST when we will look at PART 2 OF WHAT IS CANCER WITH A LOT OF REINFORCEMENT AND NEEDED REPEPTITION AND SOME NEW INFORMATION
  • Lets see if we have time for questions

DEPRESSION AND CANCER

Hi DR Ryan here, medical oncologist AND PROFESSOR AND RETIRED COLONEL AND CANCER SURVIVOR and this is when tumor is the rumor and cancer is the answer.

I am sure you are familiar with our opening song   from chariots  of fire. A man has a plan and in a day it is crushed…… so it is when you have been told you have cancer ,thoughts of loss of control, soul sucking anxiety, what about your family and the list goes on as it hits  you like a ton of bricks.

He rose above it in the film  and so you to will be a hero ………I have seen no exception no matter how afraid you are, and that is what we are going to talk about today …your attitude when first diagnosed and through your course of therapy.. What about Depression

 

. We will take our time so feel free to write in your questions or comments at www.w4cs.com and i will try to get to them

Depression and Anxiety Disorders in Patients With Cancer

 

OVERVIEW

Over 15.5 million cancer survivors are alive today in the US, which is similar to the populations of New York City, Los Angeles, and Chicago combined.

 

The number of survivors continues to grow, not just because of earlier detection and treatment AND AGING OF THE POPULATION , but because of revolutionary new therapies that have been emerging over the past decade.

Now, patients with poor-prognosis metastatic cancers such as lung cancer and melanoma can live many years with good quality of life while on active treatment. For many individuals, this changes the landscape from a terminal illness to more of a chronic illness.

 

Concurrent with advances in cancer treatment, the importance of psychosocial care of individuals with cancer is being increasingly recognized. In 2008, the Institute of Medicine published Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, which documented under-detection and failure to optimally manage psychiatric disorders and psychosocial needs in patients with cancer and their families.

 

Unmet needs can have negative consequences for quality of life, treatment adherence, and survival. Subsequently, the American College of Surgeons Commission on Cancer started requiring cancer centers to screen patients for psychosocial distress as part of accreditation, and the American Society of Clinical Oncology developed practice guidelines for managing depression and anxiety.

 

THEY ARE NOT ALWAYS FOLLOWED OR SCREENING DONE SORRY BUT THAT IS REALITY AND RESEARCH SUPPORTS THAT

 

 

Although most cancer centers provide some psychosocial services, increased attention to the psychosocial needs of patients with cancer may result in increased referrals to mental health professionals . Some basic knowledge about a patient’s cancer and treatment are essential for psychiatric management.

 

Studies have documented that a cancer diagnosis results in high levels of emotional distress. Patients go through an adjustment period for about 4 to 6 weeks after diagnosis. SOME LONGER AND EXPECT THAT Cancer for many patients is synonymous with death and debilitating treatments, with images of a prolonged painful dying process. Patients often say they feel overwhelmed trying to assimilate medical information and make treatment decisions—all while continuing to manage family, work, and other responsibilities.

 

However, for the majority of patients, once they receive a plan of action and begin treatment, their emotions tend to level out. Yet, cancer should not be considered as one discrete crisis, but rather as a series of crises that may occur at any time in the disease trajectory from diagnosis, treatment, cycles of recurrences and remissions, post-treatment, and sometimes palliative care.

 

In terms of psychiatric disorders among cancer patients, there is significant variability in the prevalence rates reported due to different assessment methods (clinical interview versus standardized measures), diagnostic criteria, type of cancer, and stage of disease among other variables. Recently, Mehnert and colleagues reported a 31% prevalence rate for any psychiatric disorder in cancer patients. Adjustment disorders tend to be the most commonly diagnosed, with the rates ranging from 11% to 35%. Rates for depression vary from 11% to 37%, and anxiety disorders show rates from 2.6% to 19.4%. The rate for depression in the general population is 7%—and thus lower than among cancer patients—but the rates for overall anxiety disorders seem to be comparable WHICH I DO NOT BELIEVE IT IS UNDER REPORTED.

 

 

Assessment and treatment

The Case Vignette presents specific issues important for psychiatrists to consider when treating patients with cancer.

CASE VIGNETTE

Mrs. T is a 53-year-old postmenopausal married woman with 2 teenage daughters who recently received a diagnosis of stage IV breast cancer metastatic to pelvic bone. Up until 2 months ago, she had been working full-time as an attorney but had to stop because of severe pain that progressively worsened. A medical workup showed an HIGHLY TREATABLE BUT INCURABLE LONG TEERM POSSIBLE SURVIVAL CANCER.

She does not have a psychiatric history or comorbid illnesses. Soon after starting THERAPY, she began to feel very sad, anxious, irritable, and fatigued; cried easily; and had trouble sleeping because of hot flashes. She ruminates on dying and leaving her daughters. She denies hopelessness and suicidal ideation, and quite the contrary she very much wants to live.

 

Depression and Anxiety Disorders in Patients With Cancer: Page 2 of 3

SIGNIFICANCE FOR THE PRACTICING PSYCHIATRIST

 

Coordinating with the oncology team. With the patient’s permission, consulting and informing the oncology team of your involvement is critical. As mentioned earlier, psychiatrists need to understand the patient’s cancer diagnosis, staging, treatments, adverse effects of treatment, and prognosis to appreciate the challenges the patient is coping with throughout treatment as well as survivorship or end-of-life. Medical concerns can cause or exacerbate depression and anxiety.

 

For example, in this case, knowing that survival with metastatic breast cancer can be years is critical in providing psychiatric care for the patient. Remaining silent as the patient expresses fear of death within the next few months can be taken by the patient as agreement and can exacerbate anxiety. Psychiatrists contribute to oncology care by providing information to the oncology team regarding the patient’s emotional status and potential barriers to care and treatment adherence.

 

 

Pharmacotherapy. While there may be overlap between symptoms of depression and anxiety and cancer- and treatment-related adverse effects (fatigue, changes in sleep and appetite), treatment of the psychiatric disorder is primary rather than a focus on differentiating the causes of the symptoms. The most prescribed antide­pressants in cancer patients are SSRIs, At times the choice of an antidepressant is made based on the antidepressant adverse-effect profile.

 

.

Some psychiatric medications may adversely affect the efficacy of commonly used systemic cancer therapies.

.

Be aware that some systemic cancer treatments are associated with psychiatric adverse effects. DRUGS TO TREAT leukemia and some lymphomas, may cause depression. Interferon at high doses can cause depression and even suicidal ideation. SOME CAN CAUSE can cause lethargy, depression, mania, confusion, and hallucinations. THEY can potentiate the effects of alcohol, opioids, and tricyclic antidepressants.

 

Glucocorticosteroids such as prednisone and dexamethasone are widely used in cancer care. They can cause a range of psychiatric symptoms, from emotional lability, depression, anxiety, restlessness, irritability, and insomnia to paranoia, delusions, and hallucinations. Symptoms may develop within a couple of days of the start of treatment and are also common if the dose is rapidly tapered off. But psychiatric symptoms can develop even on a stable dose.

Mindfulness Practice Reduces Cortisol Blunting During Chemo

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Mindfulness practice during chemotherapy can reduce the blunting of neuroendocrine profiles typically observed in cancer patients, according to a study published online April 7 in Cancer.

) — Mindfulness practice during chemotherapy can reduce the blunting of neuroendocrine profiles typically observed in cancer patients, according to a study published online April 7 in Cancer.

David S. Black, Ph.D., M.P.H., from University of Southern California in Los Angeles, and colleagues assigned 57 English- or Spanish-speaking colorectal cancer patients to either mindfulness, attention-control, or resting exposure at the start of chemotherapy. Four saliva samples were collected at the start of chemotherapy and at 20-minute intervals during the first 60 minutes of chemotherapy. Self-reported biobehavioral assessments after chemotherapy included distress, fatigue, and mindfulness

An area-under-the-curve analysis showed a relative increase in cortisol reactivity in the mindfulness group, after adjustments for biological and clinical measures (P = 0.03). From baseline to 20 minutes, more than twice as many patients in the mindfulness group displayed a cortisol rise, compared to controls (69 versus 34 percent; P = 0.02). Mindfulness scores were inversely correlated with fatigue and DEPRESSION (P < 0.01) and distress scores (P < 0.01).

 

 

 

 

Pain management. Suffering from uncontrollable pain is one of the most common fears of cancer patients. Unfortunately, pain is under-recognized and undertreated in patients with cancer. Bone pain experienced by cancer patients can be excruciating, and explaining to the patient that at times she may need to use opioids under the care of her oncologist without fearing addiction can prevent the patient from suffering unnecessarily. Poorly managed pain can lead to depression and anxiety. Once pain is appropriately managed, depressive and anxiety symptoms often diminish or resolve.

While some psychiatrists and oncologists have expertise in pain management, others may not and are reluctant to prescribe the necessary medications at the appropriate doses. AND SOME OVERPRESCRIBE Speaking with the oncology team and helping to get appropriate referral to a cancer pain specialist or palliative care team is crucial to the quality of life of cancer patients, especially those with advanced disease.

 

 

Before the patient’s visit with the pain specialist, it is helpful for the psychiatrist to provide education and correct some common misconceptions. The following 3 key issues should be considered regarding referral for pain management:

1) A majority of cancer patients do not have a history of addiction and actually fear becoming addicted to pain medications

2) Patients view the taking of pain medications as associated with death and dying: “Only a patient who is dying takes morphine”

3) Patients may need education on the difference between addiction and tolerance, in order to comply with prescribed pain medications

 

Psychiatry appointments

The traditional paradigm for psychiatric treatment may require a more flexible approach to scheduling to adjust to the reality of the patient’s needs during treatment. Patients may initially need more frequent appointments as they are adjusting to the diagnosis. New patients may be unsure when to make follow-up appointments because they have many upcoming oncology visits. Letting the patient know that scheduling psychiatry visits shortly after the oncology visits provides an opportunity to review the new medical information during the session.

 

 

During treatment, patients may need to cancel or reschedule appointments because of the adverse effects of treatment. Depending on the specific patient’s clinical situation, exceptions may need to be made to policies about late cancellations and no-shows. As the disease advances, patients may become hospitalized and are too weak to make office visits. Accommodating shorter inpatient visits may be indicated for continuity of care.

 

Patients often include their family in oncology visits, and some assume that this practice also occurs in psychiatric visits. Psychiatrists in cancer centers frequently see patients with their family members in the room. It would not have been out of the ordinary for Mrs. T to have her husband or another family member join her for her psychiatric evaluation. Providing effective support and treatment of patients with cancer will often entail providing support and education to their spouses, children, and significant others. Family members may need support in coping with their own concerns and often need education in how best to support the cancer patient.

 

 

Concluding OVERVIEW thoughts

 

Cancer care will continue to change over the next several years, sometimes rapidly. While psychiatrists cannot be expected to stay up to date with all of the emerging cancer treatments, they do need to learn about the ones that their patients might be receiving. Many resources are available for learning more about the psychiatric care of individuals with cancer. The American Psychosocial Oncology Society (www.apos-society.org) has published quick reference handbooks on psychosocial care for adults, children, and elderly adults with cancer and produces webinars on particular topics, such as sexual health and cancer.

 

7 Physical Clues You Could Have Depression

 

Many people who suffer from chronic illnesses also suffer from depression. Depression isn’t something that should be overlooked; it should be brought to your doctor’s attention so that it can be treated. But how do you spot depression?  With help from prevention.com, we’ve put together a list of some of the most common physical signs that someone is suffering from depression.

 

Aches and Pains

Although many chronic illnesses have their share of aches and pains, depression can also make muscles and joints feel sore or exacerbate the problem. People who are happy or content generally feel pain less than those who have depression.

 

Difficulty Sleeping or Waking Through the Night

Not being able to relax enough to fall asleep or frequently waking up during the night and finding it difficult to go back to sleep could both be signs of depression. Lack of sleep or disturbed sleep can have a profound effect on mood and the ability to concentrate.

 

Changes in Weight

Loss of appetite or comfort eating are both associated with depression, but you may not realize you have either until you step on the scale and notice a difference. In addition, if you’re not sleeping well because you’re anxious or depressed, this can also mess with your appetite leading to weight loss or gain.

 

Skin Complaints

Because depression affects hormones, this often becomes apparent in our skin. Depression can lead to skin complaints like acne, psoriasis, and eczema and treating the depression can help with the skin complaint.

 

Stomach Problems

Mood definitely affects the gut, and people with depression may suffer from symptoms like nausea, constipation, diarrhea, heartburn and indigestion.

 

Headaches and Migraines

People with depression are more likely to experience frequent headaches or migraines. Although this could also be a side effect of medication or treatments you take for your chronic illness.

 

Oral Problems

Dentists in Australia have found people with depression are more likely to need dental work such as tooth extractions and cavities than those who don’t. The thought behind this is that if you’re depressed, you’re less likely to be as diligent about oral health.

 

Depression questionqaire IS KEY

 

Suicide

 

 

LONDON, England, AND I MENTIONED THIS BEFORE – British researchers have found that people who are frequently depressed or anxious may run a higher risk of dying from certain types of cancer. THERE ARE SEVERE PROBLEMS WITHIS STUDY AND IT HAS NOT BEEN REPLICATED LOOK AT COMLIANCE, SYMTOM COMPLAINING, ALCOHOL, QUALITY OF LIFE ISSUES, AND SUCH

In THIS study published in the BMJ medical journal, the scientists were cautious in their conclusions, pointing out that a statistical link does not necessarily signify a cause-and-effect relationship between mood and cancer.

Their findings nevertheless added to the growing body of evidence that mental and physical health do not function on separate planes, and that one can influence the other.

While earlier research had shown that chronic depression and anxiety could help trigger heart disease and stroke, attempts to forge similar links between states of mind and cancer have yielded mixed results.

 

It has already been established that depression can disrupt hormonal balance to the extent of boosting natural cortisone concentrations and inhibiting DNA repair mechanisms – both of which weaken defences to cancer.

 

It is also well known that emotionally distressed people are more likely to smoke, drink and become obese – all of which are associated with a higher cancer risk.

 

.

The scientists could not discount the possibility that depression could be a result, rather than the cause of cancer, however.

 

“Distress might be a consequence of the early stages of the malignancy rather than a potential predictor,” they said.

 

THE AUTHORS noted that further research was needed to confirm the link and tease out the causal connections.

 

 

 

Seeing Cancer Through a Sibling’s Eyes: What We Don’t Know Can Hurt Them

SO LETS DRILL DOWN TO WHAT WE HAVE LEARNED

 

Depression and Anxiety Disorders in Patients With Cancer

AGAIN

7 Physical Clues You Could Have Depression

 

Many people who suffer from chronic illnesses also suffer from depression. Depression isn’t something that should be overlooked; it should be brought to your doctor’s attention so that it can be treated. But how do you spot depression?  With help from prevention.com, we’ve put together a list of some of the most common physical signs that someone is suffering from depression.

 

Aches and Pains

Although many chronic illnesses have their share of aches and pains, depression can also make muscles and joints feel sore or exacerbate the problem. People who are happy or content generally feel pain less than those who have depression.

 

Difficulty Sleeping or Waking Through the Night

Not being able to relax enough to fall asleep or frequently waking up during the night and finding it difficult to go back to sleep could both be signs of depression. Lack of sleep or disturbed sleep can have a profound effect on mood and the ability to concentrate.

 

Changes in Weight

Loss of appetite or comfort eating are both associated with depression, but you may not realize you have either until you step on the scale and notice a difference. In addition, if you’re not sleeping well because you’re anxious or depressed, this can also mess with your appetite leading to weight loss or gain.

 

Skin Complaints

Because depression affects hormones, this often becomes apparent in our skin. Depression can lead to skin complaints like acne, psoriasis, and eczema and treating the depression can help with the skin complaint.

 

Stomach Problems

Mood definitely affects the gut, and people with depression may suffer from symptoms like nausea, constipation, diarrhea, heartburn and indigestion.

 

Headaches and Migraines

People with depression are more likely to experience frequent headaches or migraines. Although this could also be a side effect of medication or treatments you take for your chronic illness.

 

Oral Problems

Dentists in Australia have found people with depression are more likely to need dental work such as tooth extractions and cavities than those who don’t. The thought behind this is that if you’re depressed, you’re less likely to be as diligent about oral health.

 

Depression questionqaire IS CRUCIAL

 

Suicide TWICE THE RATE

Elderly patients with cancer

 

are far less likely to be diagnosed with depression than patients in any other age group for two primary reasons: There is an overlap between cancer symptoms/treatment side effects and the diagnostic criteria for depression, and older adults are more likely to present with anhedonic “depression without sadness,” according to Chris Nelson, PhD, Associate Attending Psychologist at Memorial Sloan Kettering Cancer Center in New York.

 

 

According to Dr. Nelson, self-report instruments tend to underestimate the severity of depressive symptoms, and many depressed older patients with cancer are completely overlooked. “There is clearly a need to better understand, quantify, and treat depression in older cancer patients,” he said at the 2017 American Psychosocial Oncology Society (APOS) Annual Conference in Orlando, Florida.1 “This represents a significant public health concern that will grow in importance as the U.S. population continues to age.”

 

Diagnosing Depression

Common symptoms of depression—fatigue, diminished concentration, thoughts of death/suicide, weight loss/gain—are confounded with side effects from cancer treatments or, potentially, the cancer itself.

 

The literature suggests that two gateway symptoms—depressed mood and loss of interest—are most valuable in diagnosing depression in cancer, but according to Dr. Nelson, identifying these symptoms is not necessarily useful in older adults.

“The gateway questions come off the table as less than usefull useful diagnostic criteria when we combine cancer and aging,” he said. “So we’ve been trying to identify additional symptoms that are useful for diagnosing depression in older adults with cancer.”

 

He and his colleagues conducted a study aimed at identifying the phenomenology of depression in older cancer patients and developing a set of indicators to identify, assess, and treat depression in this population. They performed a literature review and interviewed eight experts in the fields of oncology, social work, psychiatry, and psychology to assist in identifying important constructs.

 

Based on input from the experts and findings from the literature review, the researchers conducted qualitative interviews with 12 depressed and 12 nondepressed cancer patients older than age 70. Depressed patients were identified by referral and subsequently interviewed by the panel of experts to confirm their depression.

 

Major and Minor Themes

The researchers identified four major themes in distinguishing depression in older cancer patients: anhedonia depressed mood without sadness , reduction in social relationships/loneliness, loss of meaning and purpose, and lack of usefulness and sense of being a burden.

 

Four minor themes also emerged: attitude toward treatment, mood, regret and guilt, and physical symptoms and limitations.

 

 

In the patient interviews, the experience of anhedonia was nuanced and involved a lack of initiation of new activities in addition to difficulty maintaining existing activities, he reported.

 

Another central issue was, reduction in social relationships and loneliness, varied based on the range and depth of patients’ social engagement, but depressed patients tended to have limited meaningful relationships and were socially isolated and withdrawn.

 

Loss of meaning and purpose in life was salient in the depressed group, and they displayed an inability to adjust to their new limitations. “Patients in the nondepressed group didn’t need to be engaging in anything particularly purposeful, but what they did in the past carried over and was still important to them,” he noted. THIS IS CRITICAL AND THEY GO BACK TO IT OVER AND OBVER AGAIN Lack of usefulness and sense of being a burden was also displayed in all depressed participants.

There was no difference between depressed and nondepressed participants in terms of their willingness to engage in treatment, but their attitude toward treatment was the nuanced difference. “

 

The nondepressed were much more proactive regarding their treatment, whereas the depressed were resentful, angry, and upset about their treatment,” he said. Mood also varied more in the depressed group, with some patients citing worse mood in the morning, when the demands of the day were in front of them.

 

Both groups looked back at their lives and experienced some level of regret, but the amount of guilt experienced was the differentiating factor between the nondepressed and the depressed. “The depressed patients seemed to ruminate on their regrets, whereas the nondepressed were able to put their regrets in a tolerable perspective,” he said.

 

No actual difference in physical limitations was observed between the two groups, but a difference was noted in how they coped with those limitations. Two aspects of coping were deemed to be specifically useful to older cancer patients: acceptance of the limitations associated with aging; and adaptation—changing and modifying one’s lifestyle and activities—to adjust to those limitations.

 

Of the four major and four minor themes recognized by the researchers, only two—the major theme of anhedonia DEPRESSION WITHOUT SADNESS and the minor theme of mood—are identified in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria for depression. Based on their findings, the researchers conclude that the DSM-5 criteria might not apply in identification of depression in older patients with cancer. We missed the boat perhaps According to Dr. Nelson, a new patient-reported outcome based on these symptoms we have talked about may be beneficial in identifying depression. ■

 

Cancer survivors show patients how to overcome the ordeal WITH COMPEMATRY AND ALTERNATIVE MEDICINE FOR WHICH THERE IS SCANT TO NO PROOF REMEMBER ANECDOTE DOES NOT MEAN ANTIDOTE

THESE ARE CLAIMED HEAD FOODS

Diet may a huge role in Depression. There are a number of lifestyle factors that contribute to Depression but one cannot overlook what you put in your mouth. The following foods are THOUGHT to lift the mood by working at the cellular level:

Chamomile Tea: One of the most recommended bedtime soothers. Pennsylvania university tested chamomile supplements on 57 participants suffering from Depression for eight weeks and found that it led to a significant drop in symptoms. Pour a cup of boiling water over 2 to 3 heaping tablespoons of the dried flowers (you can buy chamomile either loose or in tea bags at health food stores) and steep for 10 minutes. Try having a cup every night: Turn off the TV, computer, and phone and settle down for a peaceful end to the day. It’s nice iced, too.THIS WAS POOORLY DONE STUDY AND NOT CORROBORATED

 

Chocolate: Therapy for Depression, especially if it is dark chocolate. The antioxidants boost up not just the heart health but PERHAPS the mood. Dark chocolate is known to lower blood pressure, adding calmness. It contains MORE polyphenols and flavonols than some fruit juices. WHAT THAT MEANS IS UNCLEAR

 

Garlic: Surprised?. But garlic is packed with antioxidants which neutralise free radicals (particles that damage cells). It has allicin, said to fend off heart disease, cancer and common cold.AGAIN NOT PROVEN Depression weakens our immune system, but garlic IS CLAIMED TO mend it back. Have raw in the morning, saute it in broth, or add to all the meals, it is an enemy of depression.

Green Tea: Yes there’s caffeine but green tea also has theanine, an important amino acid IS THOUGHT TO fights Depression. in addition to ALLEGEDLY protecting against cancer, this slimming food is a brain booster as well, enhancing mental performance. Have two cups a day.

 

Oatmeal: The humble oat is actually a complex carbohydrate which compels the brain to produce serotonin, a feel-good chemical. Children on oatmeal breakfast stay sharper through the morning. AGAIN NOT FULLY CORROBORATED IN CONTROLLED STUDIES Beta-glucan, a soluble fibre in oatmeal, promotes satiety. THAT IS TRUE The whole grains release the glucose slowly in the blood stream hence keeping the blood sugars levels optimum. Stabilised blood sugar help the person to have a stable mood too PERHAPS BUT NO [ROVEN ROLE IN DEPRESSION.

 

Tomatoes: Contain folic acid and alpha-lipoic acid, both of which are good for fighting Depression. AGAIN SAME ANSWER NOT PROVEN

According to a paper in the Journal of Psychiatry and Neuroscience, an elevated incidence of folate deficiency is shown in patients suffering from Depression. About one-third Depression patients are deficient in folate. AGAIN NOT PROVEN TO HAVE ANY CAUSE AND AFFECT

 

Fatty Fish: When it comes to omega-3 fatty acids, no food source is better than fatty fish like mackerel, bluefish, wild salmon and tuna. The fatty acids found in these fish not only have ALLEGED UN PROVEN specific brain-boosting properties AND WHAT DOES THAT MEAN to fight depression, but also are good for overall health TRUE. They REDUCErisk of heart disease. For those who cannot or do not consume fish should have dietary supplements of fatty fish of high quality.

Berries: All the berries like strawberries, raspberries and blackberries BUT ESPECIALLY DARK BERRIES are the high antioxidants sources. These antioxidants are also called as DNA repairmen AGAIN UNPROVEN. They ward off the free radicals which are toxic and affect our mood UNPROVEN and the sense of well-being THEY TASTE GOOD AS WELL. These food products go around fixing your cells and prevent them from getting illnesses. AGAIN NOT REALLY PROVEN BEYOND GENERAL HEALTH

Mushrooms & Onions: ARE ALLEGED AND AGAIN UNSTUDIED REPOSIBLY AND UNPROVEN TO promote healthy gut bacterium. Nerve cells in our gut manufacture 80-90% of our body’s serotonin the neurotransmitter NOT REALLY which keeps us sane & happy.A WHOE BUNCH OF INTERACTIONS AND TRANSMITTERS ARE U INVOLVED AND SEROTONIN ALONE IS NOT ENOUGH

Dark Green leafy vegetables ARE HEA;THY FOR YOU Spinach and kale are THOUGHT TO FIGHT DEPRESSION Depression and cancer. GBOMBS stands for greens, berries, onion, mushroom, beans & seeds.

Apple: Is a rich source of antioxidants NOT THAT RICH and helps prevent and repair oxidation damage NOT PROVEN and cellular inflammation WHAT DOES THAT MEAN

 

THE KEY IS DO NOT BELIEVE ALL YOU HEAR. YES DIET HAS VARIOUS ROLES BUT DO NOT DO NOT DO NOT DEPEND ON THEM FOR TREATMENT OF SEVERE DEPRESSION IT CAN END WITH SUICIDE IT MAY NEED COUNSELING AND MANY OTHER PROVEN MODALITIES [PEOPLE WANT THIS TO WORK BUT STUDIES TO PROVE THEY HELP IGNORE THE 13& PPLACEBO EFFECT AND TREATING MILD TRANSIENT MOOD DEPRESSION NOT CLINICAL DEPRESSION. CALIMS ABOUT MEDICAL SPECIFIC MECHANISMS OF ACTION ARE ALMOST ALWAYS CA CA AND UNPROVEN CRITICALLY

 

I promised you stories and this one is filled with depression, hope and my only miracle—believing in miracles is miraculous enough for me

The Gift

 

 

It was as if her soul was branded cruelly at birth, “Kick Here”. It was not that she was dealt bad cards so much as she never had much of a prayer to be in the game of life. Alcoholic and abusive parents spawned this only child almost three decades ago and rendered havoc on her congenitally frail spirit and teetering health. Not surprisingly, she was cursed from the beginning as a severe diabetic. This had withered away her adolescence in angry diabetic comas  and multiple illnesses  as her family rambled helter-skelter across the country lashed to the whims of a drunken, oft-unemployed father.

Now a mother herself, Maria was at most a trembling waif of a young woman. She was murderously robbed of childhood innocence, weaned on despair, suckled on disappointment. Against the odds for severe diabetics she had amazingly survived pregnancy with very healthy twins.

She had escaped her hell of a family only to find herself in a ramshackle marriage to a pestilence, not a man. Wife beater and child abuser, her enlisted military husband was a belligerent brooding hulk for which fatherhood was a grave inconvenience and blot on his life.

I have come to believe that it was not by chance that one of our sage senior physicians happened to pull E.R. duty the day she walked the miles to our hospital carrying her precious cargo shivering in her arms. Both of her babies had fevers and to the discerning eye, it was clear that evil had pitched its tent in their home. Incessant apologies from a terrified tearful mother, scarred blistered skin from burning cigarettes pressed into innocent skin and classic fractures wailed as a wounded plaintiff cry for a savior, for justice.  Clearly both she and her children had been abused. She collapsed out of catharsis and  at least a momentary reprieve from fear and overwhelming grief when the emergency room team were marshaled to gather them all into our protective bosom. Simultaneously the search was set for her stain of a husband.

In short order, it was painfully clear that the tragedy had no bounds. It was soon obvious that Maria was ill. Evaluation in the emergency room showed that she had rapidly worsening kidney failure from what was soon learned to be malignant masses in her abdomen choking off her kidneys and eating voraciously through her pelvis.

I was drawn to this wounded pup. The ache of seeing such unfairness from a world which offers no guarantee of freedom from suffering  was a constant companion for many of us tending to her care. Our clinical bond and trust falteringly evolved. Leveraging the lifeboat of her children, I painstakingly strained to encourage in her a glimmer of hope and perhaps flame the fading flicker of fighting for her life, for her children.

We all have bucket lists of dreams unfulfilled and longed for. Her dream was common enough. She longed to have simply played with her children, to frolic with fantasy, unburdened by dread. Now she was resigned to a painful death; it was all she expected. Only the irrepressible devotion to her babies and the possibility of their future being so uncertain carried her on. However, it quickly became clear that the cancer would agonizingly strain the last beats of life from her.

We had raced through the diagnostic evaluation and the hurried dash to save her kidneys and numb what had to be blinding pain. There was never the slightest whimper, the faintest flinch from her. Through wounded eyes she watched disaffected, rallying only when her babies were safe and near. It was for them she allowed the tubes into her kidneys, for them she tolerated the invasion of her belly to knit together her perforated strangulated bowels, for them she bloodlessly whispered a vacant “yes” to chemotherapy. If only she could have just a moments peace.

A few years ago, I suffered through the disaster of a rental condominium in Orlando while visiting the magical mouse that only Irma Bombeck could rightly do justice. It was absolute architectural anarchy. If water should have passed through it, it did not, if designed to support weight, it would not, if it controlled the environment, it could not. It was simply a massive disappoint and grand inconvenience.

Therefore, one day the stuff of fairy tales landed in my mind. I fashioned a story and made the calls. Perhaps I was serving my need to somehow save her, perhaps not. By the time the smoke cleared, it was all arranged, clearly by the hand of a force far greater than mine; Airfare, a rental car, lodging and Disney World admission was waiting, free of charge for Maria and her babes.

Yet she was  giving up and dying. I eagerly told her of the scheme to whisk her away to fantasyland. I was stupefied by her visceral response. Life beamed in her eyes and for the first time of what was to become an adorable habit, Maria smiled. I could almost hear her soul snap into action barking orders to finally fight the beast eating her body. Her husband safely spirited away, a battered and bruised young, very alive mommy made it home for a long weekend for the first time. Irrespective of my personal faith, I was ill prepared for what lay ahead for Maria and her children.

A few Mondays later my nurse hovered in my doorway, seemingly buoyed by joy, wet eyed and spiritually transfigured. Stammering, she parsed out “It is Maria, Maria, she, ah, she is so alive “. I am sure I fumbled out something only to have my nurse return, “No, it’s Maria, You don’t understand what’s happened.” In an instant, she was gone and I was confused.

Then I saw the glow of life as never I have seen before. Guided by grace this beautiful woman glided into my office and settled into the chair. I was steeped in the warmth issuing from this vision. It looked like the Maria God would have fashioned were he to meddle mercifully in her miseries. She spoke serenely, “I stopped taking the narcotics, they made me sleepy and I have no more pain. I am eating everything in sight and my sugars seem okay. Dr.? Dr.? Are you okay?” Aghast and afraid that I might burst the bubble I beckoned her in to the exam room. It was normal, unbelievably normal.

A lump was growing in my throat and my voice grew strangely hushed. I vaguely remember calling the chief of radiology for the urgent CAT scan but I do remember his return call after it was done He was incredulous, questioning me. “I do not know what you pulled, but the scan I have here, well its normal – no tumor, and healing bone”. Gone too was the bowel obstruction, the blocked kidneys, all of it gone. The physical exams, CAT scan, blood tests; all were normal. Softly, before I could gather myself, she spoke as if the hand of God was gently stroking my disbelief, “I know”, and then silence. I was in the presence of grace.

I had no problem getting through on the phone to make all the arrangements final and in moments, it was done. She would leave for Orlando that weekend. The sweat of my soul slid down my face to  as my nurse handed me a tissue and floated out with our miracle.

On a Monday, some weeks after the joy of a lifetime with her children in Orlando, she appeared in my office. She was gaunt, wasted and desperately pleading “Tell me my babies will be OK; tell me what will happen to them. Tell me.” We spoke until the ache lifted from her spirit and she reached some manner of closure with the cancer that had so quickly returned to ravage her body. Abruptly she stopped, rose to face me  and gently put her arms around my neck without a word. I saw that she knew it was over and her children would be safe.

There was no sorrow that Friday in the hospital. Her babies lay besides her in her arms, sleeping, as God called his angel home.

 

This is Dr Kevin Ryan author of the book when tumor is the rumor and cancer is the answer, a comprehensive text for newly diagnosed patients and their families signing off radio www.w4cs.com and iheart  the cancer support radio program

See you Next Tuesday at noon PST when we will look at depression and cancer

 

Now for any questions