Archive for the ‘Cancer Screening’ Category

Skin Cancer Prevention: The Dangers of Tanning Beds

Friday, July 1st, 2011

 

Image from hometanningbed.com

In my last two posts, I have examined the various types of skin cancer, their prevalence and survivability rates, and some prevention methods. Today, I will focus on another major risk factor for skin cancer. The use of tanning beds or “indoor tanning” greatly increases a person’s risk of developing skin cancer. It is a completely voluntary exposure to UV radiation, and yet many people choose to expose themselves despite all of the risks.

Known Dangers of Tanning Beds

Here are just a few statistics about indoor tanning from the Skin Cancer Foundation:

  • “Ultraviolet radiation (UVR) is a proven human carcinogen. Currently tanning beds are regulated by the FDA as Class I medical devices, the same designation given elastic bandages and tongue depressors.
  • The International Agency for Research on Cancer, an affiliate of the World Health Organization, includes ultraviolet (UV) tanning devices in its Group 1, a list of the most dangerous cancer-causing substances. Group 1 also includes agents such as plutonium, cigarettes, and solar UV radiation.
  • Frequent tanners using new high-pressure sunlamps may receive as much as 12 times the annual UVA dose compared to the dose they receive from sun exposure.
  • Ten minutes in a sunbed matches the cancer-causing effects of 10 minutes in the Mediterranean summer sun.
  • Nearly 30 million people tan indoors in the U.S. every year; 2.3 million of them are teens.
  • On an average day, more than one million Americans use tanning salons.
  • Seventy-one percent of tanning salon patrons are girls and women aged 16-29.
  • Indoor ultraviolet (UV) tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.
  • People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma.
  • The indoor tanning industry has an annual estimated revenue of $5 billion.”

Internal references omitted

 

Horrifically, it is mainly young people choosing to use these devices despite the greatly increased risk of melanoma and other skin cancers. Given the enormous financial incentive to service young people – the industry cannot be expected to regulate itself. If they can make $5 billion dollars a year in revenue with a largely young female population, why would they stop? (Aside from morality of course…)

How to Protect the Skin – Even if You Don’t Want To

From a social perspective, there need to be some changes to the value our society places on certain skin color and beauty. This is outside of the realm of this post – but what a shame that in this century, men and woman would still rather expose themselves to harmful radiation than live life with their natural coloring (or lack thereof).

From an education perspective, I think that public awareness and an increased focus on education must continue to be one prong to battle this problem. However, clearly warnings alone are not enough. This is exemplified by a recent news story about a now 23-year-old woman who visited tanning salons three to five times a week starting when she was 16 years old.  This young woman, who despite knowing the risks of tanning continued to use tanning beds until 2009, had to endure surgeries, drug therapies and over a year of painful treatment at the age of twenty-one for the advanced melanoma that had spread to her lymph nodes. Luckily, she is now cancer-free, but living with a greatly increased risk of developing another cancer. This is a cautionary tale, but it is also an example of the invincibility thinking of many young people that makes the risks seem lower than they really are to using tanning beds.

Legal Options – Regulation

So what remains? The tanning salon industry has a financial disincentive towards preventing skin cancers, the young patrons of these establishments may not understand the risks and consequences, yet the individuals and society are going to pay the price of devastating illness, high cost medical treatments and people’s lives if the current use of tanning beds continues. That is where the legal side of this post enters. There are a number of states that have started to regulate the use of these tanning beds – at least for minors. Most states do not regulate these very heavily. The National Conference of State Legislatures has compiled regulations from many states on their website. There are a combination of approaches which generally include either banning the use of tanning beds by very young children and teens (typically under 14 or 16 – but few states have an outright ban) and/or requiring parental consent for the use by children below a certain age (typically 18, occasionally 16). Some of these consent statutes require the parent to be present (in person) to provide consent. Others allow written consent or require the parent to be present only one time in the year. Do you think that these statutes are sufficient? Should the requirements involve vivid pictural warnings like the new requirements for cigarrettes?

In Maryland, Howard County is a leader in regulating this industry. In Howard County, minors under 18 years of age are not permitted to use tanning devices without a doctor’s note stating a medical reason and allowed frequency.  These rules are not subject to a parent’s consent. Many states legislators have proposed tougher legislation in the past few years to increase the regulations on this industry across the country, but few have been successful.

Your Thoughts?

What do you think should happen with the tanning industry? Do you think that there should be an outright ban for any minors using these devises? What about adults? There are still lots of tanning customers who are young adults who are over 18. What can be done to protect them from the increased risks of skin cancer? Is public education sufficient? Could it be done better?

Related Posts:

Skin Cancer: Types, Causes and How to Protect Yourself

Skin Cancer Prevention: Will New FDA Rules Help?

Skin Cancer Videos

 

Cancer: HIV/AIDS Patients At Increased Risk

Monday, June 27th, 2011

It is estimated that there are more than a million people in the U.S. infected with HIV.  In 2009 alone, there were roughly 50 thousand new HIV cases. There are approximately 16-18 thousand AIDS-related deaths in the U.S. each year. Although medical advancements have enabled many HIV/AIDS patients to live a relatively normal life, the truth is that the HIV/AIDS epidemic has been and continues to be a public health disaster of astronomic proportions.

As if life with HIV/AIDS is not difficult enough, researchers have also found that HIV/AIDS patients are also more prone to developing various malignancies when compared with the non-infected population. In fact, cancer is one of the leading causes of mortality in the HIV/AIDS  population. It is estimated that 30%-40% of HIV patients will develop some type of cancer during their life time.

The types of cancer that affect HIV patients can be generally divided into two groups: AIDS defining cancers and opportunistic cancers. An HIV positive patient who develops a cancer defined by the Center for Disease Control and Prevention as AIDS defining is considered to have AIDS.  These AIDS defining cancers include: Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and invasive cervical cancer. Other cancers are generally categorized as opportunistic.

Researchers have found that HIV/AIDS patients have a 2-to-3 fold increase in the overall risk of developing opportunistic cancers. Not only are HIV/AIDS patients more likely to develop cancer but the cancer prognosis is worse when compared with that of non-infected patients. HIV/AIDS patients also present with more advanced cancers at the time of diagnosis and, on average, they develop cancers at a younger age.

So, why is the risk for developing cancer higher in the HIV/AIDS population? It remains unclear whether the actual virus has a direct impact on the development of malignancies. It is believed, however, that the increased incidence of cancer is due to the fact that HIV/AIDS patients have a compromised immune system, which can lead to an impaired ability to produce antibodies or inflammatory responses.

Needless to say, if you are an HIV/AIDS patient or you know someone who is, please be aware of the increased risk for developing cancer. Be proactive and pursue proper and timely cancer screening. If you are experiencing unusual symptoms, don’t automatically attribute them to having HIV/AIDS (e.g., unusual fatigue). Unfortunately, they might just be symptoms of cancer.

 

Related posts:

H.I.V. treatment advances, but what are the implications of terminating research early?

 

 

Living With Cancer: What to Expect After the Diagnosis

Wednesday, May 25th, 2011

Alicia Staley - Cancer Survivor - Visual (Image from her site - awesomecancersurvivor.com

About a million and a half people will be diagnosed with cancer in the U.S. this year. The devastating truth about cancer is that about one-third of these people will die from cancer at some point. For most, the diagnosis is unexpected and completely overwhelming.The cancer does not just affect how one feels, it undermines all sense of security and stability. It changes lifestyles and redefines relationships. So often the emotional trauma is equally shared among family members and loved ones.

Needless to say, the original cancer diagnosis marks the beginning of a difficult, frightening and frustrating experience. For this reason, it is critical not to despair. One must always remain hopeful, adjust, and prepare for the way to recovery. A fundamental step in this process is gaining an understanding and familiarity with the impending medical treatment and associated lifestyle changes. A good deal of stress can be avoided by simply understanding what to expect. While cancer treatment varies depending on the type of cancer and the individual characteristics of the patient, the patient should generally be aware of the following:

Chemotherapy

The vast majority of cancer patients will receive some degree of chemotherapy. This may consist of one or more chemotherapy cycles.  Each cycle can be as long as 3-6 months. Chemotherapy involves the administration of various chemical agents called antineoplastic drugs in order to stop cancerous cells from dividing. Antineoplastic drugs are designed to attack and kill cells that divide in an uncontrolled or rapid matter. Antineoplastic drugs, however, are not able to discriminate between cancerous cells and normal cells. Therefore, cells that divide rapidly as part of their normal life cycle are also attacked. Chemotherapy may cure the cancer entirely or control its growth. Many times, chemotherapy is used in conjunction with other treatments. Some associated complications of chemotherapy include:

  • Anemia
  • Hair Loss
  • Lethargy
  • Nausea and loss of appetite
  • Kidney damage
  • Liver damage
  • Heart damage
  • Deterioration of pre-existing medical conditions such as osteoarthritis, among other things.

Radiation Therapy

In addition to chemotherapy, a patient may also receive radiation therapy. Radiation therapy involves exposing cancerous tissue to ionizing radiation (electromagnetic waves), which tends to destabilize the molecular structure of cancerous cells. In essence, the electromagnetic waves will ionize the atoms of the cancerous cells, by displacing electrons within the inherent structure of the atom. In turn, this process destabilizes the molecules of the cancerous cells, causing them to die.

Surgery

In a number of instances, cancer patients will also require surgery to treat their cancer. Often times, the malignant tumor is identifiable and localized (as opposed to metastasized). In such instances, timely surgery is preferred. Chemotherapy of radiation therapy may follow the surgery. The type of surgery  will vary depending on the type of cancer and how advanced it is. For example, a woman with ovarian cancer will likely undergo a total hysterectomy, including the removal of the ovaries. A patient with intestinal cancer may undergo a laparotomy with dissection of the cancerous tissue. Generally speaking, the sooner the cancer is identified, the less extensive the surgery.

Monitoring

After surgery and chemotherapy/radiation therapy, each cancer patient/cancer survivor should establish a systematic and well developed course of monitoring and supportive care with his/her physician. This will often involve a number of other health care providers such as physicians, nurses, and physical therapists. For example, a patient who has undergone treatment for ovarian cancer may require monitoring by an oncologist, a surgical oncologist, an internist (primary care physician), a gynecologist, and even a urologist. One must then factor in the extent to which the cancer treatment resulted in additional complications or the extent to which pre-existing medical conditions deteriorated as a result of the cancer treatment. As such, the patient may require the involvement of additional specialists to address and monitor the side effects of the cancer treatment. It is very important that the patient maintain a healthy nutrition and exercise regimen, if and as prescribed by the physician.

The bottom line is that cancer patients will invariably have a long and difficult road to recovery, which may take months or even years. Drastic lifestyle changes may be necessary, and patience as well as perseverance are essential. A cancer patient must know what to expect and be proactive to create support structures involving health care providers and family members/loved ones.

Helping Others in Need

If you or someone you know is a cancer patient/survivor, I encourage you to share your story with our readers. What helped you most to cope and persevere on your way to recovery?

Related Posts:

Ovarian Cancer: Five Tips to Get the Medical Care You Need

Ovarian Cancer: Early Intervention is Key – What You Must Know…

Breast Cancer: What You Need to Know About Digital vs. Film Mammograms

Warning to Women of Menopausal Age: HRT Linked to Increase in Death From Breast Cancer

Ovarian Cancer – five tips to make sure you get the medical care you need

Wednesday, May 11th, 2011

Did you know that more than 21,000 women are diagnosed with ovarian cancer in the U.S. each year? An astonishing 15,000 women die from ovarian cancer each year. Despite numerous advances in healthcare, the mortality rate for ovarian cancer has not improved in the last 30 years. Simply put, ovarian cancer is the deadliest of all gynecologic cancers. If the cancer is diagnosed in its early stages (i.e. before it spreads to other organs), the five-year survival rate is about 93.8%. However, if it the cancer is diagnosed in its later stages, the five-year survival rate is about 28.2%.

There is no question that ovarian cancer is quite deadly and that early diagnosis and treatment is key for survival. There is an abundance of information about ovarian cancer online and in other written sources. Simply put, take the time to familiarize yourself with the symptoms of this terrible disease. Let’s share with you some information, which I believe can make a difference. Call it a male lawyer’s perspective, if you will. I’ve seen what happens when early detection should have happened, but tragically did not.

1. Examine Your Medical History

Whenever the possibility for ovarian cancer exists, consider your medical history as you discuss your symptoms with your physician. If you are having symptoms consistent with ovarian cancer, take the initiative and discuss your symptoms and history with a gynecologist as opposed to your primary care physician. Make sure to tell your physician if you have any cancer history. Don’t forget to include information about any family history of cancer (parents, siblings, etc.). Of particular importance is any history of breast or ovarian cancer, although any cancer history is relevant. Unfortunately, women with a personal or family history of ovarian cancer or breast cancer are at a higher risk.

2. Understand and Appreciate Your Symptoms

Although your physician is likely to talk to you about ovarian cancer, it is always a good idea to familiarizer yourself with the signs and symptoms of ovarian cancer before your doctor’s appointment. Many of the symptoms of ovarian cancer overlap with the symptoms of cervical cancer. Therefore, if you are experiencing symptoms of cervical cancer, you and your physician should also discuss the possibility of ovarian cancer. We have seen cases were a physician will consider one or the other but not the possibility of both cancers. Here are some of the more common symptoms of ovarian cancer:

-          Irregular uterine bleeding

-          Abdominal  and/or pelvic pain

-          Abdominal fullness or bloating

-          Fatigue

-          Unexpected weight loss

-          Fatigue

-          Headaches

-          Frequent urination

-          Low back pain

Watch this video for more information about symptoms of ovarian cancer:

httpv://www.youtube.com/watch?v=fH9N4auMblE

 

Watch this video for more information about symptoms of cervical cancer:

httpv://www.youtube.com/watch?v=HHA_0HsjeBI&feature=related

3. Is it a solid mass?

If your radiographic studies reveal a mass, make sure that you get a clear answer as to whether the mass is solid or fluid-filled.  A fluid filled mass will typically turn out to be a cyst. It could also be a blocked fallopian tube (i.e., hydrosalpinx, hematosalpinx, pyosalpinx). Generally speaking, a fluid filled mass is less likely to be malignant. However, if your radiographic studies reveal a solid mass, especially one that arises from an ovary, the possibility of ovarian cancer must be seriously considered. If you are found to have a solid mass, talk to your gynecologist or primary care physician about consulting with a surgical oncologist.

4. Should you have a CA 125 blood test?

CA 125 is a protein. It is a tumor marker or biomarker for ovarian cancer because it is more prominent in ovarian cancer cells. The CA 125 test is a test designed to test the levels of CA 125 in a patient’s blood. Elevated CA 125 levels can be indicative of ovarian cancer. If your CA 125 levels are elevated, you and your physician should seriously consider the possibility of ovarian cancer. An elevated CA125 should prompt your physician to order additional radiographic studies, including a CT of the abdomen and pelvis, an ultrasound of abdomen and pelvis, a PET scan or even a CT pyelogram. You should also consider consulting an oncologist or a surgical oncologist. If you are found to have a solid mass and your CA 125 level is elevated, time is of the essence for further investigation and surgical intervention.  Ask your doctor about other tumor markers that can be tested.

5. Who is reading your ultrasound?

Many patients who present to their gynecologist with symptoms of ovarian cancer will initially undergo an ultrasound. A great number of gynecologists will themselves perform and interpret the ultrasound. Here is the problem. With all due respect to gynecologists, they are not trained ultrasonographers or even radiologists! Ultrasounds can be particularly difficult to read. This can be due to the patient’s position and, more frequently, the size of the patient. In heavier patients, a pelvic ultrasound can be quite limited if one is trying to visualize the ovaries, discern the presence of mass, or determine whether the mass is solid or fluid-filled. So, if your gynecologist is the only person to read your ultrasound, the result is potentially quite devastating. The mass could remain undiagnosed, and you may be told to come back if your symptoms get worse. The ultrasound may be interpreted as limited, and, for whatever reason, your gynecologist may simply neglect to order a more sensitive study (i.e. a CT scan). Instead, he or she may choose to monitor you for any further deterioration of symptoms.

In yet another instance, if the ultrasound is limited, a solid mass may be confused for a fluid-filled mass. Under these circumstances, you may be asked to follow-up in six months. The problem with all of these permutations is delay, and you cannot afford delay with ovarian cancer. Make sure that your radiographic studies, whatever they may be, are read by a skilled specialist in the interpretation of whatever study you undergo.

As we always say, be your own patient advocate and be an informed patient. Be an active participant in your medical care by being informed and by demanding the care you require. Having an understating of the types of mistakes that can be made during medical treatment is simply prudent.

Please share your familiarity or experience with ovarian cancer treatment. What do you think women should watch out for should they find themselves afflicted by this terrible disease?

For more information, see our other blogs:

Ovarian Cancer – Early Intervention is Key, What You Must Know…

New study links gene to ovarian cancer and may assist in early detection 

Ovarian Cancer – The Smear Test Won’t Tell You Much

 

Image from cancersyptomspage.com

Ovarian Cancer – Early Intervention is Key, What You Must Know…

Monday, January 3rd, 2011

According to the American Cancer Society, about 22, 000 women are diagnosed with ovarian cancer in the U.S. each year; about 14,000 of these patients will die as result of their cancer.  It is most noteworthy that the five-year survival rate is 90% when ovarian cancer is diagnosed before it has spread beyond the ovaries.  Yet, only about 20% of ovarian cancers are detected in the early stages.

Screening, more screening, monitoring and an understanding of the signs and symptoms of ovarian cancer are key to early detection.  A myth that must be dispelled is that cervical cancer is the same as ovarian cancer.  Just because a patient has a normal pap smear, does not exclude the possibility of ovarian cancer. Simply put, the pap smear test has nothing to do with the diagnosis of ovarian cancer. Unfortunately, recent studies suggest that many women rely on their normal pap smear result to conclude that they do not have an ovarian problem.

It must also be understood that what some doctors loosely characterize as an ovarian cyst does not necessarily exclude the possibility of ovarian cancer. If your doctor tells you that you have an ovarian cyst because of a mass identified on ultrasound, make sure to inquire about the basis for the conclusion that the mass is”just a cyst.” Sometimes the ultrasound is the only study performed to identify the mass.  As great as ultrasounds are, they are not always the most accurate studies.  This is particularly true for patients who are obese or overweight. Radiologists will often read ultrasounds in such patients as limited because of “body habitus” (the physique of the patient). Keep in mind that most of these ultrasounds are performed in clinics, and they are read by obstetricians, who are not trained radiologists. You must ask your physician if the mass is a solid mass or a mass filled with fluid. If it is a solid mass or your physician cannot answer the question, you may want to consider further studies. Don’t let your physician simply guess that the mass must be a cyst because of its size or because of some general statistical probability. In any event, both cysts and solid masses require further monitoring.

The symptoms of ovarian cancer include but are not limited to:

  • Swollen abdomen
  • Unusual or excessive vaginal bleeding
  • Pelvic and/or abdominal pain and/or heaviness
  • Back pain
  • Unexpected weight gain or loss
  • Increased urinary frequency or urgency
  • Lethargy
  • Constipation
  • Indigestion
  • Nausea and vomiting

If you and your physician suspect ovarian cancer, the following are useful diagnostic modalities:

  • Alpha fetoprotein
  • Blood chemistry
  • CA125 (may be done if ovarian cancer is strongly suspected or has been diagnosed, and to follow the cancer during or after treatment)
  • CBC
  • Quantitative serum HCG (blood pregnancy test)
  • Urinalysis
  • Abdominal CT scan or MRI of abdomen
  • GI series
  • Ultrasound
  • Pelvic laparoscopy
  • Exploratory laparotomy

If you are experiencing these symptoms, you may want to address the possibility of ovarian cancer with your physician.  Some physicians will generally perform an ultrasound. If they are not impressed with the ultrasound, they may not pursue any other diagnostic modalities.  If the ultrasound reveals a mass, some physicians may elect to wait and perform a follow-up ultrasound in a few months.

Notwithstanding how aggressive your physician is to rule out ovarian cancer, remember that physicians rely on your feedback, and you alone truly know the extent and severity of your symptoms.  Depending on your clinical presentation, waiting for 3 or 6 months for a repeat ultrasound may be unacceptable. Ovarian cancer can spread quickly within a matter of a few months from a stage I cancer to a stage IV cancer.  Take the initiative to fully explore all available diagnostic modalities with your physician. Don’t be uncomfortable asking your doctor for additional diagnostic tests or more frequent monitoring.  The worst thing you can do is become a passive participant in a complex and stressful process guided by a physician, who may not fully appreciate the extent and severity of your symptoms.

If you are an ovarian cancer patient, share your story with our readers. How long did it take for you to find out you had ovarian cancer? In retrospect, what would you have done differently as a patient?

Related Blogs:

New study links gene to ovarian cancer and may assist in early detection
Ovarian Cancer – The Smear Test Won’t Tell You Much

CT Scans – Are You Being Properly Protected Against Radiation?

Thursday, December 2nd, 2010

According to new research presented at the annual meeting of the Radiological Society of North America, breast shields should be used for men and women undergoing CT scans of the chest/lungs. According to Terry Healey, M.D., Director of thoracic radiation at Alpert Medical School of Brown University, the breast shield is capable of reducing the level of radiation by about 30%.  This is significant considering that radiation can cause or contribute to the development of various malignancies (e.g. breast cancer, lung cancer, esophageal cancer).

Although some physicians argue that the use of breast shields may impact the quality of the CT scan (i.e., by producing artifacts such as streaks or lines making the interpretation of the study more difficult), this new research suggests that the use of breast shields does not impact the diagnostic quality of the CT scan. A breast shield is nothing more than a thin piece of heavy metal placed in front of the chest during the CT scan procedure.

Researchers studied 50 patients, who needed CT scans of the chest. Most of the patients were undergoing the study to rule-out lung cancer.  For some patient the shield was placed directly on the chest. For other patients, the shield was slightly elevated from the chest surface. Overall, some artifact was present in about 2/3 of the cases. However, in the opinion of the researchers, there were no instances where the artifact interfered with the diagnostic quality of the radiographic study.

According to Judy Yee, M.D., vice chair of radiology at the University of California: ”[T]here’s no good reason not to use breast shields. The cost is relatively low and the benefit large.”

Perhaps a larger patient population is needed for the results of this research to be more widely accepted by the radiology community. We’d appreciate anyone who has experience in this field to share their thoughts on this topic. Do such shields cause artifact that makes the study less accurate and potentially dangerous to a patient? Does the accuracy of the scan, when a shield is used, depend on which type of scanner is used or which generation of scanner is being used? Are there other techniques that can be used to protect a patient yet not run the risk of artifact “mis-read”? We’re not physicians or radiology technicians, so we welcome any insights those who are might have on this topic.

If you are concerned about excessive radiation and need to undergo a chest CT, ask your radiologist if a protective shield can be used during your CT scan. Discuss the issue and – as we always stress – take charge of your own medical care. Be an informed patient and be responsible for your own health and safety. Know what the issues, risks and benefits are and discuss it with your doctor. Then – and only then – make an informed decision.

Image from emedicine.medscape.com

Testicular Cancer – Facts Men Should Know and Do Something About!

Monday, November 1st, 2010

Last week, I posted a brief blog about prostate cancer. One of our Facebook fans pointed out that if a man lives long enough, he will get prostate cancer. She noted that a more concerning cancer is testicular cancer, a condition that affects men at a much younger age when perhaps they are unsuspecting of serious  medical problems. The reader is right on the mark. Did you know that testicular cancer is the most common cancer in men between the ages of 20 and 35? I certainly didn’t.

Testicular cancer is carcinoma of one or both testicles. It is a disease process whereby malignant or cancerous cells invade the healthy tissue of the testicle. The testicles are a set of glands, which produce and store sperm. These gland are a primary source of testosterone in men, a hormone that triggers the development of the male reproductive system as well as other male characteristics (e.g., facial hair).

Here are some other noteworthy facts about testicular cancer that men should know about:

  • There are about 7,500 new cases yearly, with approximately 350 deaths per year in the US.
  • Testicular cancer is more common in white men than black or Asian.
  • Although it accounts for only about 1 percent of all cancers in men, it is the number one cancer killer among men in their 20′s and 30′s.
  • Most testicular cancers are self-discovered by patients as a painless or uncomfortable lump in the testicle. About 1-3% of testicular neoplasms are bilateral.
  • Pure seminomas constitute roughly 40% of all testicular cancer cases. Forty percent of the testicular cancers have mixture of histology.
  • The cancer risk for boys with a history of undescended testicles is about 10-40 times higher than normal individuals. The risk of developing the disease was estimated at 1 out of 20 for a testis retained in the abdomen and 1 out of 80 if it was within the inguinal canal. The risk remains elevated after surgical correction. Both testis are at higher risk, not just the undescended one.
  • If found early, testicular cancer is almost always curable.
  • Early stage testicular cancer can be treated with surgery and radiation therapy. Late stage testicular cancer can be treated with the combination of surgery, radiation therapy and/or chemotherapy.
  • The prognosis for men with testicular cancer is very good, even with late stage disease. The chances of recovery are excellent with surgery and radiotherapy for early stage disease. Combined modality is used for treatment of late stage disease with good results.
  • More than 90% of testicular cancer patients are cured by their initial treatment, and many of those who have recurrent disease can also be cured with chemotherapy or radiation.

There are two basic types of testicular cancer: seminomas and nonseminomas. There are additional sub classifications under each type of testicular cancer. Both types can be present at the same time. Seminoma describes a testicular cancer of the germ cell, which is slow-growing. Germ cells are cells that develop into reproductive cells (e.g., sperm and ova). Nonseminoma describes a more rapidly growing/spreading testicular cancer that originates in the germ cells.

Some of the signs and symptoms of testicular cancer include:

  • A painless lump or swelling in a testicle
  • Pain or discomfort in a testicle or in the scrotum
  • Any enlargement of a testicle or change in the way it feels
  • A feeling of heaviness in the scrotum
  • A dull ache in the lower abdomen, back, or groin
  • A sudden collection of fluid in the scrotum

If you have one or more of the risk factors mentioned above and are manifesting signs and symptoms consistent with testicular cancer, talk to a doctor as soon as possible. Don’t ignore your symptoms and don’t wait for them to simply go away. Talk to your doctor about testicular cancer and the various tests, which can be used to rule it out. These generally include: blood tests, ultrasound, and tissue biopsy.

Again, don’t try to run and hide if you have these symptoms. Remember Lance Armstrong, who was diagnosed with stage 3 testicular cancer, which had spread to his lungs and brain by the time of his diagnosis.

Update:New Painless Test for Colon Cancer Details – Still Experimental but Hope Abounds.

Monday, November 1st, 2010

Two weeks ago, this blog highlighted the issue of doctors not following recommended colon cancer screening guidelines. While the standard tests for colon cancer (primarily colonoscopy and flexible sigmoidoscopy) will likely remain in place for now, new information is coming out on a new test that may one day be used to detect colon cancer – a DNA stool test.  As reported by MedicalNewsToday.com and others, the test uses a stool sample and detects alterations in DNA that are linked to the presence of tumors.  Therefore, actual imaging of the colon is not necessary.

The test has been developed by a Wisconsin company called Exact Sciences.  What is key about this new test is that it is non-invasive, meaning that it does not involve any bodily penetration.  This would be a boon for those patients who put off getting tested because they don’t want to undergo more invasive procedures, or who don’t want to take time away from their busy lives to do it.  This new test can even be done at home.

Researchers at the Mayo Clinic have already tried out this new test on humans with surprisingly good results.  On a test involving 1,100 participants, the DNA test detected 85% of cancers and 65% of pre-cancerous adenomas larger than 1 cm.  87% of Stage I to Stage III cancers were caught by the new test, which is excellent news because the earlier cancer is detected, the better chance there is of a cure.

We must emphasize that this new test is experimental only at this stage.  Additional human trials are expected to get underway in 2011.  There is no word on when this test may become available for wide-spread use.  We will continue to post updates on this exciting new front.

How Much Do You Really Know About Prostate Cancer? Facts you should know!

Monday, October 25th, 2010

According to the American Cancer Society, about 217,730 men will be diagnosed with prostate cancer this year. Another 32,050 men are expected to die from prostate cancer in 2010.  Prostate cancer is the second leading cause of cancer-related deaths among men.

Prostate cancer refers to carcinoma of the prostate gland. The prostate is about the size of a walnut, and it is an integral part of the male reproductive system. This gland secretes and stores an alkaline fluid that makes up about 25-30% of the semen. This alkaline fluid is what prolongs the life of the spermatozoa once secreted. The prostate gland wraps around the urethra, which conducts the urine out of the bladder.  Men diagnosed with prostate cancer experience difficulties with urination as the gland swells up, thus constricting the urethra.

Considering the prevalence of this cancer in the male population, each man should take time to familiarize himself with the signs and symptoms of this disease and how it is diagnosed.  Some of the symptoms of prostate cancer include:

  • Urinary hesitation
  • Urinary dribbling
  • Urinary retention
  • Pain with urination
  • Pain with ejaculation
  • Lower back pain
  • Pain with bowel movements
  • Urinary leakage
  • Bloody urine
  • Anemia
  • Lethargy
  • Weight loss

If you happen to experience some or all of  the above symptoms, make sure to talk to your doctor about the possibility of prostate cancer.  You should ask your physician to explain to you the various diagnostic tests, which could help make an early diagnosis.  These include:

  • PCA test – Prostate-Specific Antigen blood test is designed to examine the level of a substance produced by the prostate gland (i.e., the antigen). An elevated PCA level could be indicative of prostate cancer.
  • AMACR - α-Methylacyl Coenzyme A Racemase (AMACR) is a protein, which tends to be more expressed in patients with prostate cancer.
  • Urine analysis
  • Prostate fluid testing
  • Prostate biopsy

Sure, many men will avoid getting ongoing healthcare and avoid going to their doctors regularly – until it’s too late. If you have any of the symptoms listed above, do yourself a favor and contact your doctor for an appointment.

Most Doctors Don’t follow Colon Cancer Screening Guidelines

Monday, October 18th, 2010

Each year in the United States, colorectal cancer causes over 50,000 deaths.  Despite the obvious seriousness of colorectal cancer, a new study published in the Journal of General Internal Medicine reports that 81 percent of doctors are not following all recommended colon cancer screening guidelines.  While approximately 40% of doctors follow guidelines for some tests, a shocking 40% don’t follow recommended guidelines for any colon cancer screening tests.

First off, what are screening tests?  A screening test is a test for a certain disease that is given to patients who do not have symptoms of the disease.  This is different from a test that a doctor orders in response to a specific symptom, e.g., a finding of blood in the stool that results in a colonoscopy to discover the cause of the bleeding.  The purpose of a screening test is to catch a disease early, before it gets to the point where it starts to cause symptoms.  The earlier colon cancer gets detected, the better chance the patient has for a successful outcome.  Knowing this, it is difficult to understand why doctors are not following recommended guidelines.

One factor that the study’s authors noted was the age of the doctor.  Younger, board-certified doctors were the most likely to properly follow the guidelines.  Older doctors, on the other hand, were less likely to do so.  It appears that older doctors may be following guidelines that were in effect at the time of their training rather than keeping up to date with current guidelines.  This is not to suggest that the non-compliant doctors are all failing to recommend any screening tests.  The study indicates that some doctors are actually over-using the tests.  This, however, can result in additional risk (e.g., risk of injury from a colonoscopy) as well as unnecessary tests and higher medical costs.

From the patient’s perspective, it is wise to know yourself what the recommended guidelines are so that you can have a meaningful discussion with your doctor about what tests you should be getting and when.  As reported in the linked article:

Here are the American Cancer Society’s current guidelines on checking for colorectal cancer and polyps (often precursors to cancer). Starting at age 50, men and women should follow one of these testing schedules:

To detect both polyps and cancer (preferred) :

To primarily detect a cancer:

Some people may require a different screening schedule due to personal or family history; the cancer society recommends that you talk with your doctor to determine which schedule is best for you.