Wednesday 20 May 2015
Cervical Cancer
What is cervical cancer?
Cervical cancer begins in the cells lining the cervix - the lower part of the uterus (womb). This is sometimes called the cervix. The fetus grows in the body of the uterus (the top). The cervix connects the body of the uterus to the vagina (birth canal). The part of the cervix closest to the body of the uterus is called the endocervix. The next part of the vagina is the ectocervix (or ectocervix). The 2 main types of cells lining the cervix are squamous cell (the ectocervix) and glandular cells (the endocervix). These types of cells 2 are in a place that is called the transformation zone. The exact location of the transformation zone changes as you get older and if you give birth.
Most cervical cancers begin in cells in the transformation zone. These cells do not suddenly change into cancer. In contrast, normal cells of the cervix first precancerous changes that become cancer develop gradually. Doctors use several terms to describe these pre-cancerous changes, including cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia. These changes can be detected by the Pap test and treated to prevent the development of cancer (see "Can you prevent cervical cancer?").
Cervical pre-cancers and cervical cancers are classified by their appearance under the microscope. The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma.
Most (up to 9 in 10) cervical cancers are squamous cell carcinomas. These cancers form cells from the ectocervix and cancer cells are squamous cell characteristics under the microscope. Squamous cell carcinomas most often begin in the transformation zone (where the ectocervix joins the endocervix).
Most other types of cervical cancers are adenocarcinomas. Adenocarcinomas are cancers that develop from gland cells. Cervical adenocarcinoma develops from the cells of mucus-producing glands of the endocervix. Cervical adenocarcinomas seem to have become more common in the last 20-30 years.
Less commonly, cervical cancer have features of both squamous and adenocarcinoma cells. These are called adenosquamous carcinomas or mixed carcinomas.
Although cervical cancers start from cells with pre-cancerous changes (pre-cancers), only some women with precancerous lesions of the cervix will develop cancer. It usually takes several years for cervical pre-cancer to change for cervical cancer, but it can happen in less than a year. For most women, precancerous cells disappear without treatment. However, in some women pre-cancers become true cancers (invasive). Treatment of all cervical pre-cancers can prevent almost all true cancers of the cervix. Precancerous changes and specific types of treatment for pre-cancers are discussed in our document on Prevention of Cervical Cancer and early detection.
Although almost all cervical cancers are squamous cell carcinomas or adenocarcinomas, other types of cancer can also develop in the cervix. These other types such as melanoma, sarcoma, lymphoma, and most commonly occur in other body parts.
Endometrial (uterine) cancer
What is endometrial cancer?
Endometrial cancer begins in the endometrium, the inner lining of the uterus (womb). The picture below shows where the uterus removed.
About the uterus and endometrium
The uterus is a hollow body, which is normally about the size and shape of a medium sized bulb. The uterus is where a fetus grows and develops when a woman is pregnant. The uterus has 2 main parts (see picture below):
The cervix of the uterus, the lower end extending into the vagina.
The upper part of the uterus is called the body or corpus. (Corpus is the Latin word for body.)
Even if the cervix is technically part of the uterus, when people talk about cancer of the uterus, they usually mean the body, not the cervix.
The body of the uterus has 2 main layers. The inner layer or lining is called the endometrium. Known, the outer layer of the muscle as the myometrium. This thick layer of muscle is needed to push out the baby during birth. The coating of the outside of the uterine tissue is the serosa.
During the female menstrual cycle, hormones cause the endometrium to change. During the first half of the cycle, before the ovaries an egg (ovulation), the ovaries produce hormones called estrogens. Estrogen causes the uterine lining to thicken, making it to nourish an embryo if pregnancy occurs. If it has produced no pregnancy, estrogen in a small amount and the hormone progesterone after ovulation. This prepares the innermost layer of the lining to shed. By the end of the cycle, the endometrium is shed from the uterus and menstruation (period). This cycle repeats itself until the woman goes through the menopause (menopause).
Cancer of the uterus and endometrium
The 2 main types of cancer of the uterus, are:
Uterine sarcomas, the start of the uterus in the muscular layer (myometrium) or supportive tissue. These include uterine leiomyosarcoma and endometrial stromal sarcomas. These cancers are not covered here, but are described in detail in the uterine sarcomas discussed.
Endometrial carcinomas, which in the cells of the inner lining of the uterus (the endometrium). Almost all cancers of the uterus are this type. These cancers are the focus of the rest of this information.
Endometrial can be divided into several types, depending on how the cells look under a microscope (histologic types). This includes:
Adenocarcinoma, (most endometrial cancers are adenocarcinomas)
Carcinosarcoma (more below)
Squamous
Undifferentiated carcinoma
Small cell carcinoma
Transitional carcinoma
The most common type known as endometrioid adenocarcinoma cancer. Endometrioid cancers consist of cells in glands that are similar to the normal uterine lining (endometrium) made her look. Some of these cancers include squamous cells (squamous cells are flat, thin cells that can be found on the outer surface of the cervix), and glandular cells. A cancer with both types of cells is called an adenocarcinoma with squamous differentiation. If, under the microscope, the glandular cells look cancer but the squamous cells do not, the tumor can be called a adenoacanthoma. If both the squamous cells and glandular cells look malignant (cancerous), these tumors adenosquamous (or mixed cell) carcinomas are called. There are other variants (or subtypes) endometrioid cancers, such as secretory carcinoma, ciliated carcinoma and adenocarcinoma villoglandular.
Clear-cell carcinoma, mucinous adenocarcinoma and papillary serous adenocarcinoma. are rare types of endometrial adenocarcinomas. These types are more aggressive than most endometrial cancers generally. They tend to grow quickly, and often spread outside the uterus at the time of diagnosis.
Classification endometrial
Doctors sometimes classify endometrial based on their perspectives and the underlying causes.
The grade of endometrial cancer is, how much the cancer forms glands that look is based found similar in normal healthy endometrium. In low-grade cancers, more of the cancerous tissue forming glands. In more significant cancers, more of the cancer cells in a random or arranged so disorganized and not form glands.
Grade 1 tumors have 95% or more of the cancerous tissue forming glands.
Grade 2 tumors between 50% and 94% of the cancerous tissue forming glands.
Grade 3 tumors have less than half of the forming gland cancer tissue. Grade 3 cancers are "high-grade" means. They tend to be aggressive and have a poorer outlook than lower grade cancers (grades 1 and 2).
Type 1 endometrial cancers are thought to be caused by excess estrogen. Sometimes they develop from atypical hyperplasia, an abnormal overgrowth of cells in the endometrium (see section Factors Risk). Type 1 cancers are usually not very aggressive and are slow to other tissues. Grades 1 and 2 endometrioid cancers are "Type 1" endometrial cancers.
Type 2 endometrial form a small number of endometrial cancers. Experts are not sure what causes type 2 cancers, but they do not seem to be caused by too much estrogen. Type 2 cancers include all endometrial carcinomas, which are not of type 1, papillary serous carcinoma such as, clear cell carcinoma, undifferentiated carcinoma, and endometrioid carcinoma grade 3. These cancers do not look at all like normal endometrium and so are "poorly differentiated" or "high-grade". Since type 2 tumors are more likely to grow and spread outside the uterus, a poorer outlook (than type 1 they have cancer). Doctors tend to treat these cancers more aggressive.
Uterine carcinosarcoma (CS) starts in the endometrium and has features of both endometrial carcinoma and sarcoma. In the past, CS was considered a type of uterine sarcoma, but doctors now believe that CS is a cancer that is abnormal and so no longer looks much like the cells (poorly differentiated) came.
Uterine CS is considered a type 2 endometrial cancer. CS tumors known as malignant tumors or malignant mixed mesodermal mixed tumors Müller (MMMTs). They make up about 4% of uterine cancer.
Leukemia - Acute Lymphocytic
What is acute lymphoblastic leukemia?
Acute lymphoblastic leukemia (ALL), which is also known as acute lymphoblastic leukemia, a cancer that starts in the bone marrow lymphocytes called by the early release of white blood cells (the soft inner part of bones, are formed in the new blood cells).
Leukemia cells invade usually the blood relatively quickly. You can then spread to other parts of the body including lymph nodes, liver, spleen, central nervous system (brain and spinal cord), and testes (in men). Other cancers can start in these organs and then spread to the bone marrow, but these cancers are not leukemia.
The term "acute" means that the leukemia progress rapidly, and if it is not treated, would probably be fatal within a few months. Lymphatic means developed by early (immature) forms of lymphocytes, a type of white blood cells. This is different from acute myeloid leukemia (AML), which develops in other types of blood cells in the bone marrow. For more information about AML, see document Leukemia - Acute Myeloid.
Other types of cancer that start in lymphocytes are known as lymphomas (non-Hodgkin's lymphoma or Hodgkin's disease). The main difference between these types of cancer is that leukemias as all mainly affects the bone marrow and the blood, and can spread to other places, while lymphoma primarily affect the lymph nodes or other organs, but can affect the bone marrow. Sometimes cancer lymphocytes are found in both the bone marrow and lymph nodes, if the cancer is diagnosed for the first time, making it hard to tell whether the cancer leukemia or lymphoma. If more than 25% of the bone marrow is replaced by cancer lymphocytes, the disease usually as leukemia. The size of the lymph nodes is also important. The bigger they are, the more likely the disease will be as a lymphoma. For more information about lymphoma, please see documents Non-Hodgkin lymphoma and Hodgkin's disease.
In fact, there are many types of leukemia. They differ, what types of cells, they start in, how fast they grow, the people they affect based, and how they are treated. Leukemia to understand, it helps to know about the blood and lymph systems.
Normal bone marrow, blood and lymphatic
Bone marrow
Bone marrow is the soft inner part of some bones such as the skull, shoulder blades, ribs, pelvis and bones in the spine. The bone marrow is made up of a small number of blood stem cells, more mature blood-forming cells, fat cells and supporting tissue made to help the cells grow.
Blood stem cells go through a series of changes to make new blood cells. Here, the cells develop into 1 of the 3 types of blood cell components:
Red Blood Cells
Platelets
White blood cells (lymphocytes, granulocytes and monocytes are)
Red Blood Cells
Red blood cells carry oxygen from the lungs to all other tissues in the body and take carbon dioxide back to the lungs to be removed.
Platelets
Platelets are cell fragments called actually made by a type of bone marrow cells megakaryocytes. Platelets are in plugging holes in blood vessels caused by cuts or bruises important.
White Blood Cells
White blood cells help the body fight infections.
Lymphocytes
These are the main cells, lymph tissue, form a major part of the immune system. Lymphoid tissues in lymph nodes, thymus, spleen, tonsils and adenoids, and is scattered throughout the digestive and respiratory systems and the bone marrow.
Lymphocytes develop from cells called lymphoblasts to mature, infection-fighting cells to be. The two types of lymphocytes B lymphocytes (B cells) and T lymphocytes (T-cells).
B lymphocytes: B lymphocytes protect the body from invading germs by maturing into plasma cells which proteins to make so-called antibodies. The antibody binds to the germs (bacteria, viruses and fungi), which helps to destroy the immune system.
T-lymphocytes: There are various types of T-cells, each with a special task. Some T cells can directly destroy bacteria, while others play a role either increase or slowing the activity of other immune system cells.
Acute lymphoblastic leukemia develops from early forms of lymphocytes. It can either start in early B-cells or T-cells in different stages of ripeness. This is described in the section: "How is acute lymphocytic leukemia classified?"
Granulocytes
These are white blood cells that granules in them, the spots that can be seen under the microscope, can be had. These granules contain enzymes and other substances that can destroy germs, such as bacteria. The 3 types of granulocytes - neutrophils, basophils and eosinophils - are characterized by the size and color of their granules.
Monocytes
These white blood cells, granulocytes are used, also help the body against bacteria. After typing in the bloodstream for about a day, monocytes body tissue macrophages that destroy some germs by surrounding and digesting them, can be.
Development of leukemia
Any kind of early hematopoietic cells of the bone marrow to turn into a leukemia cell. Once this change takes place, the leukemia cells do not mature normally. Could reproduce the leukemia cells quickly, and perhaps do not die when they should. Instead, they will survive and build up in the bone marrow. Over time, these cells spill into the bloodstream and other organs, where they spread keep other cells of normal functioning.
Leukemias
There are 4 types of leukemia:
Acute myeloid (or myelogenous) leukemia (AML)
Chronic myeloid (or myelogenous) leukemia (CML)
Acute Lymphocytic (or lymphoblastic) leukemia (ALL)
Chronic lymphocytic leukemia (CLL)
Acute leukemia versus chronic leukemia
The first factor in classifying leukemia is whether most of the abnormal cells mature (look like normal white blood cells) or immature (more like stem cells) are.
Acute leukemia: In acute leukemia, the bone marrow cells can not mature properly. Immature leukemia cells continue to reproduce and build. Without treatment, most people would live with acute leukemia only a few months. Some types of acute leukemia respond well to treatment, and many patients can be cured. Other types of acute leukemia have a less favorable outlook.
Chronic leukemia: In chronic leukemia, the cells in part, but can not fully mature. These cells may look fairly normal, but they are usually not fight infection as well as do normal white blood cells. They also live longer, build up, and crowd out normal cells. Chronic leukemias are progressing normally over a longer period, and most people can live for many years. But chronic leukemias are generally harder to cure than acute leukemias.
Myeloid leukemia compared lymphocytic leukemia
The second factor in the classification of leukemias is the type of bone marrow cells that are affected.
Myeloid leukemia: leukemia, beginning in early forms of myeloid cells - the cells, the white blood cells (other than lymphocytes), red blood cells or platelets makes cells (megakaryocytes) - are myeloid leukemias (also called myelocytic, myelogenous known, or non-lymphoid leukemia).
Lymphoblastic leukemia: leukemia that will begin in immature forms of lymphocytes lymphatic leukemias (also known as lymphoid or lymphoblastic leukemia).
Cancer in Adolescents
What are the types of cancer in teenagers?
There is no strict definition of what separates "childhood cancer" of cancers in adolescents, or when exactly a person with cancer is considered an adult. However, for statistical purposes, cancers in adolescents are often considered the beginning between the ages of 15 and 19.
Cancer is not common in teenagers, but a wide variety of cancers can occur in this age group, and treatment of these cancers can be challenging for a number of reasons.
The vast majority of cancers occur in older adults. The most common types of cancer in adults are skin, lung, colorectal, breast (in women), and prostate (in men). Many adult cancers are related to risk factors related to lifestyle (such as smoking, being overweight or obese, or lack of physical activity) or other environmental factors. A small part are strongly influenced by changes in the DNA (genetic mutations) of a person who inherit from their parents.
Cancers that begin in childhood (before age 15) are much less common. Cancers that develop in children are often different from the types that develop in adults. Childhood cancers are often the result of changes in the DNA of cells that develop very early in life, sometimes even before birth. Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors.
The types of cancer that occur in adolescents are a mixture of many types that can develop in children and adults.
The most common cancers in adolescents
The types of cancers seen in adolescents (ages 15-19) are not unique to this age group, but the most common types are different from those of small children or adults.
The most common cancers in adolescents are:
Lymphomas (Hodgkin's and non-Hodgkin lymphoma)
Leukemia (acute lymphocytic leukemia majority [ALL] and acute myeloid leukemia [AML])
Thyroid cancer
Brain and spinal cord tumors
Testicular cancer
Bone tumors (osteosarcoma and Ewing)
Soft tissue tumors (sarcomas)
Melanoma
Ovarian cancer
Many other types of cancer can occur in adolescents as well - these are only the most common types.
Lymphomas
Lymphomas start in certain immune system cells called lymphocytes. These cancers most often affect the lymph nodes and other lymphoid tissues such as the tonsils, or thymus (a small organ in front of the heart). They can also affect the bone marrow and other organs. They cause different symptoms depending on the location of the cancer. The most common symptoms include weight loss, fever, sweating, fatigue and projections (swollen lymph nodes) under the skin in the neck, armpit or groin.
There are two main types of lymphoma:
Hodgkin lymphoma (Hodgkin's disease)
NHL
Both types can occur in adolescents.
Hodgkin's lymphoma is more common in two age groups: adult (aged 15-40, usually people in their 20s) and late adulthood (after 55 years). This type of cancer is similar in all age groups, including what types of treatment work better.
Non-Hodgkin lymphoma (NHL) is less common than Hodgkin disease in adolescents, but the risk of NHL increases as people age. There are many types of NHL. Some of the types most frequently observed in adolescents tend to grow rapidly and require intensive treatment, but also tend to respond better to treatment than older adults NHL.
For more information on these cancers, see our documents Hodgkin's disease, non-Hodgkin lymphoma and non-Hodgkin lymphoma in children.
Leukemias
Leukemias are cancers of the bone marrow and blood. They are the most common cancers in children, but can occur at any age, and in fact, most of leukemia occur in older adults.
Most teenagers are leukemias types (fast-growing) acute and acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML). Leukemia can cause tiredness, weakness, pale skin, bruising or bleeding, fever, weight loss, bone and joint pain, and other symptoms.
The outlook for the most acute leukemia tends to be better the younger the patient.
For more information, see our documents Childhood Leukemia - Acute Lymphocytic Leukemia and - acute myeloid (myelogenous).
Thyroid cancer
The risk of thyroid cancer tends to increase as people age, but is often at a younger age than most adult cancers age. It is much more common in young women than young men.
The most common symptom of thyroid cancer is a lump in the front of the neck. Most thyroid tumors are not cancerous, but it is important to have them checked to be sure. Other symptoms of thyroid cancer may include pain or swelling in the neck, difficulty swallowing or breathing and voice changes.
The possibility of curing these cancers is usually very good.
For more information, see our document Thyroid Cancer.
Brain and spinal cord tumors
There are many types of brain tumors and spinal cord, and treatment and prospects of each is different. In children, most brain tumors begin in the lower parts of the brain such as the cerebellum (which coordinates movement) or brainstem (which connects the brain to the spinal cord). Adults are more likely to develop tumors in the upper parts of the brain. Tumors in adolescents may occur in any area. Spinal cord tumors are less common than brain tumors in all age groups.
Brain tumors can cause headaches, nausea, vomiting, blurred or double vision, dizziness, seizures, trouble walking or handling objects, and other symptoms.
For more information, see our documents brain and spinal cord tumors in children and brain and spinal cord tumors in adults.
Testicular cancer
Testicular cancer occurs most often in young men. About half of testicular cancers occur in men between the ages of 20 and 34, but can occur at any age, even in adolescence.
Very often, the first symptom of testicular cancer is a lump in the testicle or testicles inflamed or larger. Some testicular tumors can be painful, but most often they are not. It is important to lumps checked by a doctor as soon as possible so that the cause can be found.
Overall, the outlook for testicular cancers is very good, and most of these cancers can be cured.
For more information, see our document, Testicular Cancer.
Bone and soft tissue tumors (sarcomas)
Sarcomas are cancers that begin in the connective tissues such as muscle, bone or fat cells. There are 2 main types of sarcoma: bone sarcomas and soft tissue sarcomas (starting in the muscles, fat, blood vessels or some other body tissues). Sarcomas can occur at any age, but some types occur more often in older children and adolescents.
Bone sarcomas: The 2 most common types of bone cancer, osteosarcoma and Ewing's sarcoma are more common in adolescents. They often cause bone pain that worsens at night or with activity. They can also cause swelling in the area around the bone.
Osteosarcoma usually starts in areas where the bone is growing rapidly, as near the ends of long bones of the legs or arms. The most common Ewing sarcoma places to start are the bones of the pelvis, chest wall (such as the ribs or shoulder blades), or in the middle of the long bones of the leg.
For more information, see our documents osteosarcoma and Ewing family of tumors.
Soft tissue sarcomas: These cancers can start anywhere in the body, but often develop in the arms or legs. Rhabdomyosarcoma, a cancer that begins in cells that normally develop into skeletal muscles, is more common in children under 10, but it also can develop in adolescents and adults. Most other types of soft tissue sarcomas become more common as people age. Symptoms depend on where the sarcoma starts, and may include packages (which may or may not cause pain), bloating or intestinal problems.
For more information, see our documents and rhabdomyosarcoma sarcoma - soft tissue cancer in adults.
Melanoma
Although melanoma is more likely to occur in older adults, it is a cancer that is also found in younger people, including adolescents. In fact, melanoma is one of the most common cancers in people under 30 (especially younger women). Melanoma that runs in families may occur at an earlier age.
The most important signal warning for melanoma is a new spot on the skin or a spot that is changing in size, shape or color. One point that is different from everyone else in the skin can also be a warning and should be checked by a doctor.
The ability to cure a melanoma is usually very good if discovered and treated early. But if left alone, it can grow and spread quickly, which can make it much more difficult to treat.
For more information, see our document, Skin Cancer - melanoma.
Ovarian cancer
General cancer, ovarian cancer is much more common in older women. However, some types of ovarian cancer, known as germ cell tumors are more common in adolescents and young women.
Early ovarian cancer usually causes no symptoms, but some adolescents and young women may feel full quickly when eating or having abnormal swelling, belly pain, or urinary symptoms. If these symptoms last longer than a few weeks, they should be checked by a doctor.
There is no strict definition of what separates "childhood cancer" of cancers in adolescents, or when exactly a person with cancer is considered an adult. However, for statistical purposes, cancers in adolescents are often considered the beginning between the ages of 15 and 19.
Cancer is not common in teenagers, but a wide variety of cancers can occur in this age group, and treatment of these cancers can be challenging for a number of reasons.
The vast majority of cancers occur in older adults. The most common types of cancer in adults are skin, lung, colorectal, breast (in women), and prostate (in men). Many adult cancers are related to risk factors related to lifestyle (such as smoking, being overweight or obese, or lack of physical activity) or other environmental factors. A small part are strongly influenced by changes in the DNA (genetic mutations) of a person who inherit from their parents.
Cancers that begin in childhood (before age 15) are much less common. Cancers that develop in children are often different from the types that develop in adults. Childhood cancers are often the result of changes in the DNA of cells that develop very early in life, sometimes even before birth. Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors.
The types of cancer that occur in adolescents are a mixture of many types that can develop in children and adults.
The most common cancers in adolescents
The types of cancers seen in adolescents (ages 15-19) are not unique to this age group, but the most common types are different from those of small children or adults.
The most common cancers in adolescents are:
Lymphomas (Hodgkin's and non-Hodgkin lymphoma)
Leukemia (acute lymphocytic leukemia majority [ALL] and acute myeloid leukemia [AML])
Thyroid cancer
Brain and spinal cord tumors
Testicular cancer
Bone tumors (osteosarcoma and Ewing)
Soft tissue tumors (sarcomas)
Melanoma
Ovarian cancer
Many other types of cancer can occur in adolescents as well - these are only the most common types.
Lymphomas
Lymphomas start in certain immune system cells called lymphocytes. These cancers most often affect the lymph nodes and other lymphoid tissues such as the tonsils, or thymus (a small organ in front of the heart). They can also affect the bone marrow and other organs. They cause different symptoms depending on the location of the cancer. The most common symptoms include weight loss, fever, sweating, fatigue and projections (swollen lymph nodes) under the skin in the neck, armpit or groin.
There are two main types of lymphoma:
Hodgkin lymphoma (Hodgkin's disease)
NHL
Both types can occur in adolescents.
Hodgkin's lymphoma is more common in two age groups: adult (aged 15-40, usually people in their 20s) and late adulthood (after 55 years). This type of cancer is similar in all age groups, including what types of treatment work better.
Non-Hodgkin lymphoma (NHL) is less common than Hodgkin disease in adolescents, but the risk of NHL increases as people age. There are many types of NHL. Some of the types most frequently observed in adolescents tend to grow rapidly and require intensive treatment, but also tend to respond better to treatment than older adults NHL.
For more information on these cancers, see our documents Hodgkin's disease, non-Hodgkin lymphoma and non-Hodgkin lymphoma in children.
Leukemias
Leukemias are cancers of the bone marrow and blood. They are the most common cancers in children, but can occur at any age, and in fact, most of leukemia occur in older adults.
Most teenagers are leukemias types (fast-growing) acute and acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML). Leukemia can cause tiredness, weakness, pale skin, bruising or bleeding, fever, weight loss, bone and joint pain, and other symptoms.
The outlook for the most acute leukemia tends to be better the younger the patient.
For more information, see our documents Childhood Leukemia - Acute Lymphocytic Leukemia and - acute myeloid (myelogenous).
Thyroid cancer
The risk of thyroid cancer tends to increase as people age, but is often at a younger age than most adult cancers age. It is much more common in young women than young men.
The most common symptom of thyroid cancer is a lump in the front of the neck. Most thyroid tumors are not cancerous, but it is important to have them checked to be sure. Other symptoms of thyroid cancer may include pain or swelling in the neck, difficulty swallowing or breathing and voice changes.
The possibility of curing these cancers is usually very good.
For more information, see our document Thyroid Cancer.
Brain and spinal cord tumors
There are many types of brain tumors and spinal cord, and treatment and prospects of each is different. In children, most brain tumors begin in the lower parts of the brain such as the cerebellum (which coordinates movement) or brainstem (which connects the brain to the spinal cord). Adults are more likely to develop tumors in the upper parts of the brain. Tumors in adolescents may occur in any area. Spinal cord tumors are less common than brain tumors in all age groups.
Brain tumors can cause headaches, nausea, vomiting, blurred or double vision, dizziness, seizures, trouble walking or handling objects, and other symptoms.
For more information, see our documents brain and spinal cord tumors in children and brain and spinal cord tumors in adults.
Testicular cancer
Testicular cancer occurs most often in young men. About half of testicular cancers occur in men between the ages of 20 and 34, but can occur at any age, even in adolescence.
Very often, the first symptom of testicular cancer is a lump in the testicle or testicles inflamed or larger. Some testicular tumors can be painful, but most often they are not. It is important to lumps checked by a doctor as soon as possible so that the cause can be found.
Overall, the outlook for testicular cancers is very good, and most of these cancers can be cured.
For more information, see our document, Testicular Cancer.
Bone and soft tissue tumors (sarcomas)
Sarcomas are cancers that begin in the connective tissues such as muscle, bone or fat cells. There are 2 main types of sarcoma: bone sarcomas and soft tissue sarcomas (starting in the muscles, fat, blood vessels or some other body tissues). Sarcomas can occur at any age, but some types occur more often in older children and adolescents.
Bone sarcomas: The 2 most common types of bone cancer, osteosarcoma and Ewing's sarcoma are more common in adolescents. They often cause bone pain that worsens at night or with activity. They can also cause swelling in the area around the bone.
Osteosarcoma usually starts in areas where the bone is growing rapidly, as near the ends of long bones of the legs or arms. The most common Ewing sarcoma places to start are the bones of the pelvis, chest wall (such as the ribs or shoulder blades), or in the middle of the long bones of the leg.
For more information, see our documents osteosarcoma and Ewing family of tumors.
Soft tissue sarcomas: These cancers can start anywhere in the body, but often develop in the arms or legs. Rhabdomyosarcoma, a cancer that begins in cells that normally develop into skeletal muscles, is more common in children under 10, but it also can develop in adolescents and adults. Most other types of soft tissue sarcomas become more common as people age. Symptoms depend on where the sarcoma starts, and may include packages (which may or may not cause pain), bloating or intestinal problems.
For more information, see our documents and rhabdomyosarcoma sarcoma - soft tissue cancer in adults.
Melanoma
Although melanoma is more likely to occur in older adults, it is a cancer that is also found in younger people, including adolescents. In fact, melanoma is one of the most common cancers in people under 30 (especially younger women). Melanoma that runs in families may occur at an earlier age.
The most important signal warning for melanoma is a new spot on the skin or a spot that is changing in size, shape or color. One point that is different from everyone else in the skin can also be a warning and should be checked by a doctor.
The ability to cure a melanoma is usually very good if discovered and treated early. But if left alone, it can grow and spread quickly, which can make it much more difficult to treat.
For more information, see our document, Skin Cancer - melanoma.
Ovarian cancer
General cancer, ovarian cancer is much more common in older women. However, some types of ovarian cancer, known as germ cell tumors are more common in adolescents and young women.
Early ovarian cancer usually causes no symptoms, but some adolescents and young women may feel full quickly when eating or having abnormal swelling, belly pain, or urinary symptoms. If these symptoms last longer than a few weeks, they should be checked by a doctor.
Brain and spinal cord tumors in children
What are brain and spinal cord tumors in children?
Tumors of the brain and spinal cord are masses of abnormal cells in the brain or spinal cord that have grown out of control.
In most other parts of the body, it is very important to distinguish between benign (non-cancerous) and malignant (cancerous). Benign tumors do not invade nearby tissue or spread to distant areas, so in other parts of the body are almost never life threatening. One of the main reasons malignant tumors (cancers) are so dangerous is because they can spread throughout the body.
Although brain tumors rarely spread to other parts of the body, most of them can spread through the brain and spinal cord tissue. Even so-called benign tumors can, as they grow, press and destroy normal brain tissue, causing damage that often disabling and can sometimes cause death. That is why doctors usually speak of "brain tumors" rather than "brain cancers." The main concerns with brain tumors and spinal cord are how fast they grow, how easily spread through the rest of the brain or spinal cord, and if it can be removed or treated and did not return. But both benign and malignant tumors can be life threatening.
Brain and spinal cord tumors in children tend to be different from those of adults. Often they form in different places, develop from different cell types, and may have a different treatment and prognosis (outlook). This document only refers to the brain and spinal cord tumors in children. Tumors in adults are discussed in our brain tumors document and adult spinal cord.
The central nervous system
To understand the brain and spinal cord tumors, it helps to know about the normal structure and function of the central nervous system (CNS), which is the medical name for the brain and spinal cord.
The brain is the center of thought, feeling, memory, speech, vision, hearing, movement, and more. The spinal cord and special nerves in the head called cranial nerves carry messages between the brain and the rest of the body. These messages tell our muscles how to move, transmit information gathered by our senses, and help coordinate the functions of our internal organs.
The brain is protected by the skull. Also, the spinal cord is protected by the bones (vertebrae) of the spine.
The brain and spinal cord are surrounded and cushioned by a fluid called cerebrospinal fluid (CSF). CSF is made by the choroid plexus, found in the spaces in the brain called ventricles. The ventricles and the spaces around the brain and spinal cord are filled with cerebrospinal fluid.
Parts of the brain and spinal cord
The main areas of the brain include the cerebrum, cerebellum and brain stem. Each area has a special function.
Brain: The brain is the largest, outside of the brain. It consists of two hemisferios (halves) and reasoning, thinking, emotion and language controls. It is also responsible for planned muscle movements (voluntary) (throw a ball, walking, chewing, etc.) and to take and interpret sensory information such as vision, hearing, smell, touch and pain.
The symptoms caused by a tumor in a cerebral hemisphere depend on the location of the tumor. Common symptoms include:
Seizures
Slurred speech
A change of mood such as depression
A change in personality
Weakness or paralysis on one side of the body
Changes in vision, hearing or other senses
Cerebellum: The cerebellum is located below the brain at the back of the brain. It helps to coordinate movement.
Cerebellar tumors can cause problems with coordination in walking; problems with the precise movements of the hands, arms, feet and legs; trouble swallowing or synchronized eye movements; and changes in the rate of speech.
Brainstem: The brainstem is the lower part of the brain that is connected to the spinal cord. It has bundles of very long nerve fibers that carry signals controlling muscles and sensation or feeling between the brain and the rest of the body. Special centers in the brain stem also help control breathing and heartbeat. Moreover, most of the cranial nerves (described below) starting at the brainstem.
The brain stem is divided into 3 main parts: the midbrain, pons and medulla.
Tumors in this critical area of the brain may cause weakness, muscle stiffness, or problems with sensation, facial movement or eye, ear, or swallowing. Double vision is a common early symptom of brain stem tumors, as are problems with coordination in walking. Because the brain stem is a small area that is so essential for life, it may not be possible to surgically remove tumors in this area.
Spinal cord: The spinal cord has bundles of very long nerve fibers that carry signals controlling muscles, sensation or feeling, and bladder and bowel control.
Tumors of the spinal cord can cause weakness, paralysis or numbness. The spinal cord is a narrow structure, so that develop tumors usually do not cause symptoms on both sides of the body (for example, weakness or numbness in the legs). This is different from the symptoms of most brain tumors, which often affect only one side of the body.
The nerves supplying arms leave the spinal cord in the neck (cervical spine). Nerves to the legs, intestines, bladder and spinal cord branch back (thoracic and lumbar spine). Tumors of the spinal cord in the neck (cervical spine) can cause symptoms in the arms and legs, as well as affect the function of the bowel and bladder. Tumors of the spinal cord below the neck only affect the legs and bowel and bladder function.
Cranial nerves: The cranial nerves extend directly from the base of the brain (as opposed to the output of the spinal cord). These nerves carry signals directly between the brain and face, eyes, tongue, mouth, and some other areas.
The most common tumors of the cranial nerves in children are called optical gliomas, which are tumors of the optic nerve (the largest nerve that runs between the brain and each eye). These tumors cause vision problems. Tumors that start in other cranial nerves can cause double vision; difficulty swallowing; loss of hearing in one or both ears; or facial paralysis, numbness or pain.
Types of cells and tissues in the brain and spinal cord
The brain and spinal cord are many types of tissues and cells that can develop into different types of tumors.
The neurons (nerve cells): These are the most important cells in the brain. Transmit chemical and electrical signals that determine thought, memory, emotion, speech, muscle movement, sensation, and almost everything else that the brain and spinal cord do. Neurons send these signals through their nerve fibers (axons). The axons in the brain tend to be short, while the spinal cord can be as long as several feet.
Unlike many other types of cells that can grow and divide to repair damage caused by injury or disease, neurons in the brain and spinal cord largely stop dividing about a year after birth (with some exceptions). Neurons do not usually form tumors, but can be damaged by tumors that start nearby.
Glial cells: Glial cells are supporting cells of the brain. Most brain tumors and spinal cord develop from glial cells. These tumors are known as a group called gliomas times.
There are 3 types of glial cells - astrocytes, oligodendrocytes, and ependymal cells. A fourth cell type called microglia is part of the immune system and is not really a glial cell.
Astrocytes help support and nourish neurons. When the brain is injured, astrocytes form scar tissue that helps repair the damage. Main tumors from these cells are called astrocytomas or glioblastomas.
Oligodendrocytes make myelin, a fatty substance that surrounds and insulates the axons of nerve cells in the brain and spinal cord. This helps neurons send electrical signals through axons. Tumors starting in these cells are called oligodendrogliomas.
Ependymal cells lining the ventricles (fluid-filled areas) in the central part of the brain and the shape of the pathway through which the cerebrospinal fluid (CSF) flows. Tumors that begin in these cells are called ependymomas.
Microglia are the immune cells (fight infection) CNS.
Neuroectodermal cells: They are very early forms of nervous system cells, which are probably involved in the development of brain cells. They are found throughout the brain. The most common tumors that come from these cells are called medulloblastomas, which begin in the cerebellum.
Meninges: These are layers of tissue that cover and protect the brain and spinal cord. The meninges help form the spaces through which CSF travels. The most common tumors that start in these tissues are called meningiomas.
Choroid plexus: The choroid plexus is the area of the brain within the ventricles that makes CSF, which nourishes and protects the brain. Tumors that start here include choroid plexus papillomas and carcinomas of the choroid plexus.
The pituitary gland and the hypothalamus: The pituitary gland is a small gland at the base of the brain. It is connected to a part of the brain called the hypothalamus. Both produce hormones that help regulate the activity of several other glands in the body.
Tumors of the brain and spinal cord are masses of abnormal cells in the brain or spinal cord that have grown out of control.
In most other parts of the body, it is very important to distinguish between benign (non-cancerous) and malignant (cancerous). Benign tumors do not invade nearby tissue or spread to distant areas, so in other parts of the body are almost never life threatening. One of the main reasons malignant tumors (cancers) are so dangerous is because they can spread throughout the body.
Although brain tumors rarely spread to other parts of the body, most of them can spread through the brain and spinal cord tissue. Even so-called benign tumors can, as they grow, press and destroy normal brain tissue, causing damage that often disabling and can sometimes cause death. That is why doctors usually speak of "brain tumors" rather than "brain cancers." The main concerns with brain tumors and spinal cord are how fast they grow, how easily spread through the rest of the brain or spinal cord, and if it can be removed or treated and did not return. But both benign and malignant tumors can be life threatening.
Brain and spinal cord tumors in children tend to be different from those of adults. Often they form in different places, develop from different cell types, and may have a different treatment and prognosis (outlook). This document only refers to the brain and spinal cord tumors in children. Tumors in adults are discussed in our brain tumors document and adult spinal cord.
The central nervous system
To understand the brain and spinal cord tumors, it helps to know about the normal structure and function of the central nervous system (CNS), which is the medical name for the brain and spinal cord.
The brain is the center of thought, feeling, memory, speech, vision, hearing, movement, and more. The spinal cord and special nerves in the head called cranial nerves carry messages between the brain and the rest of the body. These messages tell our muscles how to move, transmit information gathered by our senses, and help coordinate the functions of our internal organs.
The brain is protected by the skull. Also, the spinal cord is protected by the bones (vertebrae) of the spine.
The brain and spinal cord are surrounded and cushioned by a fluid called cerebrospinal fluid (CSF). CSF is made by the choroid plexus, found in the spaces in the brain called ventricles. The ventricles and the spaces around the brain and spinal cord are filled with cerebrospinal fluid.
Parts of the brain and spinal cord
The main areas of the brain include the cerebrum, cerebellum and brain stem. Each area has a special function.
Brain: The brain is the largest, outside of the brain. It consists of two hemisferios (halves) and reasoning, thinking, emotion and language controls. It is also responsible for planned muscle movements (voluntary) (throw a ball, walking, chewing, etc.) and to take and interpret sensory information such as vision, hearing, smell, touch and pain.
The symptoms caused by a tumor in a cerebral hemisphere depend on the location of the tumor. Common symptoms include:
Seizures
Slurred speech
A change of mood such as depression
A change in personality
Weakness or paralysis on one side of the body
Changes in vision, hearing or other senses
Cerebellum: The cerebellum is located below the brain at the back of the brain. It helps to coordinate movement.
Cerebellar tumors can cause problems with coordination in walking; problems with the precise movements of the hands, arms, feet and legs; trouble swallowing or synchronized eye movements; and changes in the rate of speech.
Brainstem: The brainstem is the lower part of the brain that is connected to the spinal cord. It has bundles of very long nerve fibers that carry signals controlling muscles and sensation or feeling between the brain and the rest of the body. Special centers in the brain stem also help control breathing and heartbeat. Moreover, most of the cranial nerves (described below) starting at the brainstem.
The brain stem is divided into 3 main parts: the midbrain, pons and medulla.
Tumors in this critical area of the brain may cause weakness, muscle stiffness, or problems with sensation, facial movement or eye, ear, or swallowing. Double vision is a common early symptom of brain stem tumors, as are problems with coordination in walking. Because the brain stem is a small area that is so essential for life, it may not be possible to surgically remove tumors in this area.
Spinal cord: The spinal cord has bundles of very long nerve fibers that carry signals controlling muscles, sensation or feeling, and bladder and bowel control.
Tumors of the spinal cord can cause weakness, paralysis or numbness. The spinal cord is a narrow structure, so that develop tumors usually do not cause symptoms on both sides of the body (for example, weakness or numbness in the legs). This is different from the symptoms of most brain tumors, which often affect only one side of the body.
The nerves supplying arms leave the spinal cord in the neck (cervical spine). Nerves to the legs, intestines, bladder and spinal cord branch back (thoracic and lumbar spine). Tumors of the spinal cord in the neck (cervical spine) can cause symptoms in the arms and legs, as well as affect the function of the bowel and bladder. Tumors of the spinal cord below the neck only affect the legs and bowel and bladder function.
Cranial nerves: The cranial nerves extend directly from the base of the brain (as opposed to the output of the spinal cord). These nerves carry signals directly between the brain and face, eyes, tongue, mouth, and some other areas.
The most common tumors of the cranial nerves in children are called optical gliomas, which are tumors of the optic nerve (the largest nerve that runs between the brain and each eye). These tumors cause vision problems. Tumors that start in other cranial nerves can cause double vision; difficulty swallowing; loss of hearing in one or both ears; or facial paralysis, numbness or pain.
Types of cells and tissues in the brain and spinal cord
The brain and spinal cord are many types of tissues and cells that can develop into different types of tumors.
The neurons (nerve cells): These are the most important cells in the brain. Transmit chemical and electrical signals that determine thought, memory, emotion, speech, muscle movement, sensation, and almost everything else that the brain and spinal cord do. Neurons send these signals through their nerve fibers (axons). The axons in the brain tend to be short, while the spinal cord can be as long as several feet.
Unlike many other types of cells that can grow and divide to repair damage caused by injury or disease, neurons in the brain and spinal cord largely stop dividing about a year after birth (with some exceptions). Neurons do not usually form tumors, but can be damaged by tumors that start nearby.
Glial cells: Glial cells are supporting cells of the brain. Most brain tumors and spinal cord develop from glial cells. These tumors are known as a group called gliomas times.
There are 3 types of glial cells - astrocytes, oligodendrocytes, and ependymal cells. A fourth cell type called microglia is part of the immune system and is not really a glial cell.
Astrocytes help support and nourish neurons. When the brain is injured, astrocytes form scar tissue that helps repair the damage. Main tumors from these cells are called astrocytomas or glioblastomas.
Oligodendrocytes make myelin, a fatty substance that surrounds and insulates the axons of nerve cells in the brain and spinal cord. This helps neurons send electrical signals through axons. Tumors starting in these cells are called oligodendrogliomas.
Ependymal cells lining the ventricles (fluid-filled areas) in the central part of the brain and the shape of the pathway through which the cerebrospinal fluid (CSF) flows. Tumors that begin in these cells are called ependymomas.
Microglia are the immune cells (fight infection) CNS.
Neuroectodermal cells: They are very early forms of nervous system cells, which are probably involved in the development of brain cells. They are found throughout the brain. The most common tumors that come from these cells are called medulloblastomas, which begin in the cerebellum.
Meninges: These are layers of tissue that cover and protect the brain and spinal cord. The meninges help form the spaces through which CSF travels. The most common tumors that start in these tissues are called meningiomas.
Choroid plexus: The choroid plexus is the area of the brain within the ventricles that makes CSF, which nourishes and protects the brain. Tumors that start here include choroid plexus papillomas and carcinomas of the choroid plexus.
The pituitary gland and the hypothalamus: The pituitary gland is a small gland at the base of the brain. It is connected to a part of the brain called the hypothalamus. Both produce hormones that help regulate the activity of several other glands in the body.
Brain and spinal cord tumors in adults
What are brain and spinal cord tumors?
Tumors of the brain and spinal cord are masses of abnormal cells in the brain or spinal cord that have grown out of control.
In most other parts of the body, it is very important to distinguish between benign (non-cancerous) and malignant (cancerous). Benign tumors do not grow into nearby tissues or spread to distant areas, so in other parts of the body are almost never life threatening. One of the main reasons of malignant tumors are so dangerous is because they can spread throughout the body.
Although brain tumors rarely spread to other parts of the body, most of them can spread through the brain tissue. Even so-called benign tumors can, as they grow, press and destroy normal brain tissue, causing damage that often disabling and sometimes fatal. For this reason, doctors usually speak of "brain tumors" rather than "brain cancers." The main concerns with brain tumors and spinal cord are easily propagated through the rest of the brain or spinal cord and can be removed if not return.
Tumors of the brain and spinal cord tend to be different in adults and children. They often form in different areas, develop from different cell types, and may have a perspective and a different treatment.
This document refers only to brain tumors and spinal cord. Tumors in children are discussed in our document brain and spinal cord tumors in children.
The central nervous system
To understand the brain and spinal cord tumors, it helps to know about the normal structure and function of the central nervous system (CNS), which is the medical name for the brain and spinal cord.
The brain is the center of thought, feeling, memory, speech, vision, hearing, movement, and more. The spinal cord and special nerves in the head called cranial nerves help carry messages between the brain and the rest of the body. These messages tell our muscles how to move, transmit information gathered by our senses, and help coordinate the functions of our internal organs.
The brain is protected by the skull. Also, the spinal cord is protected by the bones (vertebrae) of the spine.
The brain and spinal cord are surrounded and cushioned by a special liquid, called cerebrospinal fluid (CSF). CSF is made by the choroid plexus, found in the spaces within the brain called ventricles. The ventricles and the spaces around the brain and spinal cord are filled with cerebrospinal fluid.
Parts of the brain and spinal cord
The main areas of the brain include the cerebrum, cerebellum and brain stem. Each of these parts has a special function.
Brain: The brain is the largest, outside of the brain. It has 2 hemisferios (halves) and controls reasoning, thought, emotion and language. It is also responsible for planned muscle movements (voluntary) (throw a ball, walking, chewing, etc.) and to take and interpret sensory information such as vision, hearing, smell, touch and pain.
The symptoms caused by a tumor in a cerebral hemisphere depend on the location of the tumor. Common symptoms include:
Seizures
Slurred speech
A change of mood such as depression
A change in personality
Weakness or paralysis on one side of the body
Changes in vision, hearing or other senses
Basal ganglia: The basal ganglia are structures deep within the brain that help control our muscle movements. Tumors or other problems in this part of the brain that normally cause weakness, but in rare cases can cause tremor or other involuntary movements.
Cerebellum: The cerebellum is located below the brain at the back of the brain. It helps to coordinate movement. Cerebellar tumors can cause problems with coordination in walking, difficulty with the precise movements of the hands, arms, feet and legs, trouble swallowing or timing of eye movements, and changes in rhythm of speech.
Brainstem: The brainstem is the lower part of the brain that is connected to the spinal cord. It contains bundles of very long nerve fibers that carry signals controlling muscles and sensation or feeling between the brain and the rest of the body. Special centers in the brain stem also help control breathing and heartbeat. In addition, most cranial nerves (which carry signals directly between the brain and face, eyes, tongue, mouth and other areas) start in the brain stem.
Tumors in this critical area of the brain may cause weakness, muscle stiffness, or problems with sensation, facial movement or eye, ear, or swallowing. Double vision is a common early symptom of brain stem tumors, as are problems with coordination in walking. Because the brain stem is a small area that is so essential for life, it may not be possible to surgically remove tumors in this area.
Spinal cord: The spinal cord has bundles of very long nerve fibers that carry signals controlling muscles, sensation or feeling, and bladder and bowel control.
Tumors of the spinal cord can cause weakness, paralysis or numbness. The spinal cord is a narrow structure, so within tumors usually cause symptoms on both sides of the body (for example, weakness or numbness in the legs). This is different from most brain tumors, which often affect one side of the body.
The nerves supplying arms start in the spinal cord in the neck (cervical spine). The nerves that branch out from the spinal cord of the legs, bowel and bladder are presented in the back (thoracic and lumbar spine). Most spinal cord tumors begin in the neck (cervical spine) and can cause symptoms in the arms and legs, as well as affect the function of the bowel and bladder. Tumors of the spinal cord below the neck only affect the legs and bowel and bladder function
Cranial nerves Cranial nerves extend directly from the base of the brain (as opposed to leaving the spinal cord). Tumors starting in cranial nerves may cause vision problems, difficulty swallowing, loss of hearing in one or both ears, or facial paralysis, numbness or pain.
Types of cells and tissues in the brain and spinal cord
The brain and spinal cord are many types of tissues and cells that can develop into different types of tumors.
The neurons (nerve cells): These are the most important cells in the brain. Transmit chemical and electrical signals that determine thought, memory, emotion, speech, muscle movement, sensation, and almost everything else that the brain and spinal cord do. Neurons send these signals through their nerve fibers (axons). The axons in the brain tend to be short, while the spinal cord can be as long as several feet.
Unlike many other types of cells that can grow and divide to repair damage caused by injury or disease, neurons in the brain and spinal cord largely stop dividing about a year after birth (with some exceptions). Neurons do not usually form tumors, but they are often damaged by tumors that start nearby.
Glial cells: Glial cells are supporting cells of the brain. Most brain tumors and spinal cord develop from glial cells. These tumors are sometimes referred to as gliomas.
There are 3 types of glial cells - astrocytes, oligodendrocytes, and ependymal cells. A fourth cell type called microglia is part of the immune system and is not really a glial cell.
Astrocytes help support and nourish neurons. When the brain is injured, astrocytes form scar tissue that helps repair the damage. Main tumors from these cells are called astrocytomas or glioblastomas.
Oligodendrocytes make myelin, a fatty substance that surrounds and insulates the axons of nerve cells in the brain and spinal cord. This helps neurons send electrical signals through axons. Tumors starting in these cells are called oligodendrogliomas.
Ependymal cells lining the ventricles (fluid-filled areas) in the central part of the brain and the shape of the channel through which flows the LCR. Tumors that begin in these cells are called ependymomas.
Microglia are the immune cells (fight infection) CNS.
Neuroectodermal cells: They are very early forms of nervous system cells, which are probably involved in the development of brain cells. They are found throughout the brain, but often are not seen in the adult central nervous system. The most common tumors arising from these cells develop in the cerebellum and are called medulloblastomas.
Meninges: These are layers of tissue that cover and protect the brain and spinal cord. CSF travels through the spaces formed by the meninges. The most common tumors that start in these tissues are called meningiomas.
Choroid plexus: The choroid plexus is the area of the brain within the ventricles that makes CSF, which nourishes and protects the brain.
The pituitary gland and the hypothalamus: The pituitary gland is a small gland at the base of the brain. It is connected to a part of the brain called the hypothalamus. Both produce hormones that help regulate the activity of several other glands in the body. For example, control the amount of thyroid hormone produced by the thyroid gland, the production and release of milk from the breasts, and the number of male or female hormones made by the testicles or ovaries. They also make growth hormone, which stimulates body growth, and vasopressin, which regulates water balance by the kidneys.
The growth of tumors in or near the pituitary or hypothalamus and surgery and / or radiotherapy in this area, may affect these functions. For example, tumors that begin in the pituitary gland sometimes make too much of a certain hormone, which can cause problems. On the other hand, a person may have low levels of one or more hormones after treatment and may need to take hormones to compensate for this.
Pineal gland: The pineal gland is not really part of the brain. It is, in fact, a small endocrine gland located between the cerebral hemispheres. It makes melatonin, a hormone that regulates sleep, in response to changes in light. The most common tumors of the pineal gland are called pineoblastomas.
Blood-brain barrier: The lining of the small blood vessels (capillaries) in the brain and spinal cord create a very selective barrier between the blood and tissues of the central nervous system. This barrier normally helps maintain the metabolic balance of the brain and keeps harmful toxins from entering the brain. Unfortunately, it also keeps out most chemotherapy drugs used to kill cancer cells, which in some cases limits their usefulness.
Tumors of the brain and spinal cord are masses of abnormal cells in the brain or spinal cord that have grown out of control.
In most other parts of the body, it is very important to distinguish between benign (non-cancerous) and malignant (cancerous). Benign tumors do not grow into nearby tissues or spread to distant areas, so in other parts of the body are almost never life threatening. One of the main reasons of malignant tumors are so dangerous is because they can spread throughout the body.
Although brain tumors rarely spread to other parts of the body, most of them can spread through the brain tissue. Even so-called benign tumors can, as they grow, press and destroy normal brain tissue, causing damage that often disabling and sometimes fatal. For this reason, doctors usually speak of "brain tumors" rather than "brain cancers." The main concerns with brain tumors and spinal cord are easily propagated through the rest of the brain or spinal cord and can be removed if not return.
Tumors of the brain and spinal cord tend to be different in adults and children. They often form in different areas, develop from different cell types, and may have a perspective and a different treatment.
This document refers only to brain tumors and spinal cord. Tumors in children are discussed in our document brain and spinal cord tumors in children.
The central nervous system
To understand the brain and spinal cord tumors, it helps to know about the normal structure and function of the central nervous system (CNS), which is the medical name for the brain and spinal cord.
The brain is the center of thought, feeling, memory, speech, vision, hearing, movement, and more. The spinal cord and special nerves in the head called cranial nerves help carry messages between the brain and the rest of the body. These messages tell our muscles how to move, transmit information gathered by our senses, and help coordinate the functions of our internal organs.
The brain is protected by the skull. Also, the spinal cord is protected by the bones (vertebrae) of the spine.
The brain and spinal cord are surrounded and cushioned by a special liquid, called cerebrospinal fluid (CSF). CSF is made by the choroid plexus, found in the spaces within the brain called ventricles. The ventricles and the spaces around the brain and spinal cord are filled with cerebrospinal fluid.
Parts of the brain and spinal cord
The main areas of the brain include the cerebrum, cerebellum and brain stem. Each of these parts has a special function.
Brain: The brain is the largest, outside of the brain. It has 2 hemisferios (halves) and controls reasoning, thought, emotion and language. It is also responsible for planned muscle movements (voluntary) (throw a ball, walking, chewing, etc.) and to take and interpret sensory information such as vision, hearing, smell, touch and pain.
The symptoms caused by a tumor in a cerebral hemisphere depend on the location of the tumor. Common symptoms include:
Seizures
Slurred speech
A change of mood such as depression
A change in personality
Weakness or paralysis on one side of the body
Changes in vision, hearing or other senses
Basal ganglia: The basal ganglia are structures deep within the brain that help control our muscle movements. Tumors or other problems in this part of the brain that normally cause weakness, but in rare cases can cause tremor or other involuntary movements.
Cerebellum: The cerebellum is located below the brain at the back of the brain. It helps to coordinate movement. Cerebellar tumors can cause problems with coordination in walking, difficulty with the precise movements of the hands, arms, feet and legs, trouble swallowing or timing of eye movements, and changes in rhythm of speech.
Brainstem: The brainstem is the lower part of the brain that is connected to the spinal cord. It contains bundles of very long nerve fibers that carry signals controlling muscles and sensation or feeling between the brain and the rest of the body. Special centers in the brain stem also help control breathing and heartbeat. In addition, most cranial nerves (which carry signals directly between the brain and face, eyes, tongue, mouth and other areas) start in the brain stem.
Tumors in this critical area of the brain may cause weakness, muscle stiffness, or problems with sensation, facial movement or eye, ear, or swallowing. Double vision is a common early symptom of brain stem tumors, as are problems with coordination in walking. Because the brain stem is a small area that is so essential for life, it may not be possible to surgically remove tumors in this area.
Spinal cord: The spinal cord has bundles of very long nerve fibers that carry signals controlling muscles, sensation or feeling, and bladder and bowel control.
Tumors of the spinal cord can cause weakness, paralysis or numbness. The spinal cord is a narrow structure, so within tumors usually cause symptoms on both sides of the body (for example, weakness or numbness in the legs). This is different from most brain tumors, which often affect one side of the body.
The nerves supplying arms start in the spinal cord in the neck (cervical spine). The nerves that branch out from the spinal cord of the legs, bowel and bladder are presented in the back (thoracic and lumbar spine). Most spinal cord tumors begin in the neck (cervical spine) and can cause symptoms in the arms and legs, as well as affect the function of the bowel and bladder. Tumors of the spinal cord below the neck only affect the legs and bowel and bladder function
Cranial nerves Cranial nerves extend directly from the base of the brain (as opposed to leaving the spinal cord). Tumors starting in cranial nerves may cause vision problems, difficulty swallowing, loss of hearing in one or both ears, or facial paralysis, numbness or pain.
Types of cells and tissues in the brain and spinal cord
The brain and spinal cord are many types of tissues and cells that can develop into different types of tumors.
The neurons (nerve cells): These are the most important cells in the brain. Transmit chemical and electrical signals that determine thought, memory, emotion, speech, muscle movement, sensation, and almost everything else that the brain and spinal cord do. Neurons send these signals through their nerve fibers (axons). The axons in the brain tend to be short, while the spinal cord can be as long as several feet.
Unlike many other types of cells that can grow and divide to repair damage caused by injury or disease, neurons in the brain and spinal cord largely stop dividing about a year after birth (with some exceptions). Neurons do not usually form tumors, but they are often damaged by tumors that start nearby.
Glial cells: Glial cells are supporting cells of the brain. Most brain tumors and spinal cord develop from glial cells. These tumors are sometimes referred to as gliomas.
There are 3 types of glial cells - astrocytes, oligodendrocytes, and ependymal cells. A fourth cell type called microglia is part of the immune system and is not really a glial cell.
Astrocytes help support and nourish neurons. When the brain is injured, astrocytes form scar tissue that helps repair the damage. Main tumors from these cells are called astrocytomas or glioblastomas.
Oligodendrocytes make myelin, a fatty substance that surrounds and insulates the axons of nerve cells in the brain and spinal cord. This helps neurons send electrical signals through axons. Tumors starting in these cells are called oligodendrogliomas.
Ependymal cells lining the ventricles (fluid-filled areas) in the central part of the brain and the shape of the channel through which flows the LCR. Tumors that begin in these cells are called ependymomas.
Microglia are the immune cells (fight infection) CNS.
Neuroectodermal cells: They are very early forms of nervous system cells, which are probably involved in the development of brain cells. They are found throughout the brain, but often are not seen in the adult central nervous system. The most common tumors arising from these cells develop in the cerebellum and are called medulloblastomas.
Meninges: These are layers of tissue that cover and protect the brain and spinal cord. CSF travels through the spaces formed by the meninges. The most common tumors that start in these tissues are called meningiomas.
Choroid plexus: The choroid plexus is the area of the brain within the ventricles that makes CSF, which nourishes and protects the brain.
The pituitary gland and the hypothalamus: The pituitary gland is a small gland at the base of the brain. It is connected to a part of the brain called the hypothalamus. Both produce hormones that help regulate the activity of several other glands in the body. For example, control the amount of thyroid hormone produced by the thyroid gland, the production and release of milk from the breasts, and the number of male or female hormones made by the testicles or ovaries. They also make growth hormone, which stimulates body growth, and vasopressin, which regulates water balance by the kidneys.
The growth of tumors in or near the pituitary or hypothalamus and surgery and / or radiotherapy in this area, may affect these functions. For example, tumors that begin in the pituitary gland sometimes make too much of a certain hormone, which can cause problems. On the other hand, a person may have low levels of one or more hormones after treatment and may need to take hormones to compensate for this.
Pineal gland: The pineal gland is not really part of the brain. It is, in fact, a small endocrine gland located between the cerebral hemispheres. It makes melatonin, a hormone that regulates sleep, in response to changes in light. The most common tumors of the pineal gland are called pineoblastomas.
Blood-brain barrier: The lining of the small blood vessels (capillaries) in the brain and spinal cord create a very selective barrier between the blood and tissues of the central nervous system. This barrier normally helps maintain the metabolic balance of the brain and keeps harmful toxins from entering the brain. Unfortunately, it also keeps out most chemotherapy drugs used to kill cancer cells, which in some cases limits their usefulness.
adrenal cancer
What is adrenal cancer?
About the adrenal glands
The adrenal glands are small glands that sit atop each kidney. Kidneys are located inside of the upper abdomen.
The adrenal gland has two parts. The outer part, called the cortex, where the majority of tumors develop. The cortex function is to make certain hormones for the body. These hormones all have a similar chemical structure and are called steroids. They include:
Cortisol causes changes in metabolism that help the body deal with stress.
Aldosterone helps the kidneys regulate the amount of salt in the blood and helps regulate blood pressure.
Adrenal androgens are hormones that can become the most common forms of the sex hormones estrogen and testosterone in other body parts. The amount of these hormones resulting from conversion of adrenal androgens is small compared to what is done in other body parts. The testes produce most of androgens (male hormones) in men. The ovaries produce most of the estrogens (female hormones) in women.
The inner part of the adrenal gland, called the core, is really an extension of the nervous system. Hormones nervous system such as norepinephrine and epinephrine (also called adrenaline) are made in the bone. Tumors and cancers arising in the adrenal medulla include pheochromocytomas (which are often benigna) and neuroblastomas.
This paper discusses tumors and cancers of the adrenal cortex. Not discussed the tumors of the adrenal medulla. Neuroblastomas are covered in a separate document.
Tumors of the adrenal cortex
There are 2 main types of tumors of the adrenal cortex: benign (non-cancerous) and malignant (cancers). Most of these tumors are benign and are called adenomas. Cancers of the adrenal cortex are rare. These 2 types of tumors can sometimes be difficult to distinguish when the cells were observed under a microscope. Although experienced pathologists (doctors who are trained to diagnose diseases by examining tissue under a microscope) can tell the difference in most cases, sometimes the only way to know with certainty that the tumor is a cancer is when it spreads. If it spreads to the lymph nodes or other organs and tissues, it is a cancer. Adenomas do not extend outside the adrenal gland.
Adrenocortical adenomas
Most tumors of the adrenal cortex are not cancer. They are benign tumors called adenomas. These tumors are small, usually less than 2 inches (5 centimeters) in diameter. They usually occur in one adrenal gland, but sometimes affect both.
Most people with adrenal adenomas have no symptoms and are not aware they have an adrenal tumor. Some of these adenomas are discovered by accident (of course) when CT or MRI of the abdomen are made due to a related health problem. About 5% of people who have an abdominal CT was found to have an adrenal tumor was not suspected. Many of these are functional, which means that produce adrenal hormones. Sometimes these tumors are known by the nickname incidentalomas because they are not causing problems and only found by accident.
Some adenomas produce too much adrenal steroid hormones. Sometimes, too much of the hormone can cause symptoms. Many symptoms related hormones adenomas are the same as those of adrenal carcinomas (cancers). These symptoms are discussed in the section, "The signs and symptoms of adrenal cancer." Adenomas are more likely than carcinomas produce high levels of aldosterone can cause high blood pressure.
Treatment: adenomas can be cured by removing the adrenal gland containing the adenoma. Some adrenal adenomas causing hormone-related symptoms can be effectively treated with medicines that block the production or action of these hormones. This may be the best treatment option for patients with other serious medical problems that may not be able to withstand a major operation.
Incidentalomas treatment depends on the possibility that there may be a cancer and whether or not it raise levels of hormones. Accidentally when an adrenal tumor is found, tests are often done to see if hormones are doing. If so, surgery often is recommended. Otherwise, surgery may be recommended only if it is likely to be a cancer. Small tumors are less likely to be cancer, and are often monitored but not treated. CT (or MRI) may be repeated in 6-24 months to see if the tumor has grown. If so, you may need to be removed. If you have not grown, hormone levels were observed in the coming years. If the tumor is still small and does not make any hormones, you may not need to be treated at all.
The remainder of this document refers only to adrenal cancers and adenomas not.
Cancer of the adrenal cortex
The type of cancer that develops in the cortex of the adrenal gland is called adrenocortical carcinoma. Also it is known as adrenocortical cancer (or carcinoma) or simply adrenal cancer. In this document, the term adrenal cancer is used to mean cancer that begins in the adrenal cortex.
Adrenal cancer most often is discovered when:
It is by accident on an imaging test done for something more.
It produces hormones that cause changes such as weight gain and fluid retention, precocious puberty in children, or excess facial or body hair growth in women.
Begins causing symptoms because it has gotten too big. Large tumors can put pressure on other organs in the abdomen, causing pain or a feeling of fullness. In general, adrenal cancers are much larger than adrenal adenomas. Adrenal tumor greater than 5 or 6 centimeters (about 2 to 2 1/2 inches) is assumed to be a cancer. In one study, the average size of an adrenal cancer was about 13 cm (or 5 inches).
Most cancers found in the adrenal gland and not start there are no adrenal cancers. Instead, they start in other organs or tissues, then (metastasis) spread through the bloodstream to the adrenal glands. For example, lung cancers, melanomas and breast cancers often spread to the adrenal glands. Even when other cancers spread to the adrenal glands; However, still they named after the place started and are treated as other cancers that begin in the same place. They are not considered adrenal cancer. Treatment described in our documents about these cancers.
About the adrenal glands
The adrenal glands are small glands that sit atop each kidney. Kidneys are located inside of the upper abdomen.
The adrenal gland has two parts. The outer part, called the cortex, where the majority of tumors develop. The cortex function is to make certain hormones for the body. These hormones all have a similar chemical structure and are called steroids. They include:
Cortisol causes changes in metabolism that help the body deal with stress.
Aldosterone helps the kidneys regulate the amount of salt in the blood and helps regulate blood pressure.
Adrenal androgens are hormones that can become the most common forms of the sex hormones estrogen and testosterone in other body parts. The amount of these hormones resulting from conversion of adrenal androgens is small compared to what is done in other body parts. The testes produce most of androgens (male hormones) in men. The ovaries produce most of the estrogens (female hormones) in women.
The inner part of the adrenal gland, called the core, is really an extension of the nervous system. Hormones nervous system such as norepinephrine and epinephrine (also called adrenaline) are made in the bone. Tumors and cancers arising in the adrenal medulla include pheochromocytomas (which are often benigna) and neuroblastomas.
This paper discusses tumors and cancers of the adrenal cortex. Not discussed the tumors of the adrenal medulla. Neuroblastomas are covered in a separate document.
Tumors of the adrenal cortex
There are 2 main types of tumors of the adrenal cortex: benign (non-cancerous) and malignant (cancers). Most of these tumors are benign and are called adenomas. Cancers of the adrenal cortex are rare. These 2 types of tumors can sometimes be difficult to distinguish when the cells were observed under a microscope. Although experienced pathologists (doctors who are trained to diagnose diseases by examining tissue under a microscope) can tell the difference in most cases, sometimes the only way to know with certainty that the tumor is a cancer is when it spreads. If it spreads to the lymph nodes or other organs and tissues, it is a cancer. Adenomas do not extend outside the adrenal gland.
Adrenocortical adenomas
Most tumors of the adrenal cortex are not cancer. They are benign tumors called adenomas. These tumors are small, usually less than 2 inches (5 centimeters) in diameter. They usually occur in one adrenal gland, but sometimes affect both.
Most people with adrenal adenomas have no symptoms and are not aware they have an adrenal tumor. Some of these adenomas are discovered by accident (of course) when CT or MRI of the abdomen are made due to a related health problem. About 5% of people who have an abdominal CT was found to have an adrenal tumor was not suspected. Many of these are functional, which means that produce adrenal hormones. Sometimes these tumors are known by the nickname incidentalomas because they are not causing problems and only found by accident.
Some adenomas produce too much adrenal steroid hormones. Sometimes, too much of the hormone can cause symptoms. Many symptoms related hormones adenomas are the same as those of adrenal carcinomas (cancers). These symptoms are discussed in the section, "The signs and symptoms of adrenal cancer." Adenomas are more likely than carcinomas produce high levels of aldosterone can cause high blood pressure.
Treatment: adenomas can be cured by removing the adrenal gland containing the adenoma. Some adrenal adenomas causing hormone-related symptoms can be effectively treated with medicines that block the production or action of these hormones. This may be the best treatment option for patients with other serious medical problems that may not be able to withstand a major operation.
Incidentalomas treatment depends on the possibility that there may be a cancer and whether or not it raise levels of hormones. Accidentally when an adrenal tumor is found, tests are often done to see if hormones are doing. If so, surgery often is recommended. Otherwise, surgery may be recommended only if it is likely to be a cancer. Small tumors are less likely to be cancer, and are often monitored but not treated. CT (or MRI) may be repeated in 6-24 months to see if the tumor has grown. If so, you may need to be removed. If you have not grown, hormone levels were observed in the coming years. If the tumor is still small and does not make any hormones, you may not need to be treated at all.
The remainder of this document refers only to adrenal cancers and adenomas not.
Cancer of the adrenal cortex
The type of cancer that develops in the cortex of the adrenal gland is called adrenocortical carcinoma. Also it is known as adrenocortical cancer (or carcinoma) or simply adrenal cancer. In this document, the term adrenal cancer is used to mean cancer that begins in the adrenal cortex.
Adrenal cancer most often is discovered when:
It is by accident on an imaging test done for something more.
It produces hormones that cause changes such as weight gain and fluid retention, precocious puberty in children, or excess facial or body hair growth in women.
Begins causing symptoms because it has gotten too big. Large tumors can put pressure on other organs in the abdomen, causing pain or a feeling of fullness. In general, adrenal cancers are much larger than adrenal adenomas. Adrenal tumor greater than 5 or 6 centimeters (about 2 to 2 1/2 inches) is assumed to be a cancer. In one study, the average size of an adrenal cancer was about 13 cm (or 5 inches).
Most cancers found in the adrenal gland and not start there are no adrenal cancers. Instead, they start in other organs or tissues, then (metastasis) spread through the bloodstream to the adrenal glands. For example, lung cancers, melanomas and breast cancers often spread to the adrenal glands. Even when other cancers spread to the adrenal glands; However, still they named after the place started and are treated as other cancers that begin in the same place. They are not considered adrenal cancer. Treatment described in our documents about these cancers.
What is bladder cancer?
To understand bladder cancer, it helps to know about the normal structure and function of the bladder.
The bladder is a hollow organ in the pelvis with flexible, muscular walls. Its main function is to store urine before it leaves the body. The average adult bladder holds about 2 cups of urine. Urine is made by the kidneys and is then carried to the bladder through tubes called ureters.
When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra. In women, the urethra is very short and opens just in front of the vagina. In men, the urethra is longer. It passes through the prostate gland and the penis, and opens at the tip of the penis.
The wall of the bladder has 4 main layers.
The innermost lining is made up of cells called urothelial or transitional cells, so this layer is called the urothelium or transitional epithelium.
Beneath the urothelium is a thin layer of connective tissue, blood vessels, and nerves, which is called the lamina propria.
Next is a thick layer of muscle called the muscularis propria.
Outside of this muscle, a layer of fatty connective tissue separates the bladder from other nearby organs.
Knowing about these layers is important in understanding how bladder cancer grows. Most bladder cancers start in the urothelium. As the cancer grows into or through the other layers in the bladder, it becomes more advanced and harder to treat.
Types of bladder cancer
Bladder cancers are divided into several types based how their cells look under a microscope. Different types can respond differently to treatments.
Transitional cell (urothelial) carcinoma
This is by far the most common type of bladder cancer. More than 9 out of 10 bladder cancers are this type. The cells from transitional cell carcinomas (TCCs) look like the urothelial cells that line the inside of the bladder.
Urothelial cells also line other parts of the urinary tract, such as the lining of the kidneys (called the renal pelvis), the ureters, and the urethra, so TCCs can also occur in these places. In fact, patients with bladder cancer sometimes have other tumors in the lining of the kidneys, ureters, or urethra. If someone has a cancer in one part of their urinary system, the entire urinary tract needs to be checked for tumors.
Bladder cancers are often described based on how far they have invaded into the wall of the bladder:
Non-invasive bladder cancers are still in the inner layer of cells (the transitional epithelium) but have not grown into the deeper layers.
Invasive cancers grow into the lamina propria or even deeper into the muscle layer. Invasive cancers are more likely to spread and are harder to treat.
A bladder cancer can also be described as superficial or non-muscle invasive. These terms include both non-invasive tumors as well as any invasive tumors that have not grown into the main muscle layer of the bladder.
Transitional cell carcinomas are also divided into 2 subtypes, papillary and flat, based on how they grow
Papillary carcinomas grow in slender, finger-like projections from the inner surface of the bladder toward the hollow center. Papillary tumors often grow toward the center of the bladder without growing into the deeper bladder layers. These tumors are called non-invasive papillary cancers. Very low-grade, non-invasive papillary cancer is sometimes called papillary neoplasm of low-malignant potential and tends to have a very good outcome.
Flat carcinomas do not grow toward the hollow part of the bladder at all. If a flat tumor is only in the inner layer of bladder cells, it is known as a non-invasive flat carcinoma or a flat carcinoma in situ (CIS).
If either a papillary or flat tumor grows into deeper layers of the bladder, it is called an invasive transitional cell (or urothelial) carcinoma.
Other cancers that start in the bladder
Several other types of cancer can start in the bladder, but these are all much less common than transitional cell (urothelial) cancer.
Squamous cell carcinoma: In the United States, only about 1% to 2% of bladder cancers are squamous cell carcinomas. Under a microscope, the cells look much like the flat cells that are found on the surface of the skin. Nearly all squamous cell carcinomas are invasive.
Adenocarcinoma: Only about 1% of bladder cancers are adenocarcinomas. The cancer cells have a lot in common with gland-forming cells of colon cancers. Nearly all adenocarcinomas of the bladder are invasive.
Small cell carcinoma: Less than 1% of bladder cancers are small-cell carcinomas, which start in nerve-like cells called neuroendocrine cells. These cancers often grow quickly and typically need to be treated with chemotherapy like that used for small cell carcinoma of the lung.
Sarcoma: Sarcomas start in the muscle cells of the bladder, but they are rare. More information about sarcomas can be found in our documents Sarcoma - Adult Soft Tissue Cancer and Rhabdomyosarcoma.
These less common types of bladder cancer (other than sarcoma) are treated similar to transitional cell cancers, especially for early stage tumors, but different drugs may be needed if chemotherapy is required.
Bone Cancer.....
What is bone cancer?
Normal bone tissue
Bone is the framework supporting your body. Most bones are hollow. The outer part of the bone is a network of fibrous tissue called matrix upon which calcium salts are established.
The hard outer bone layer is made of compact bone (cortical) covering the spongy (trabecular) bone lighter within. Outside the bone is covered with a layer of fibrous tissue called periosteum. Some bones are hollow and have a space called the medullary cavity containing the soft tissue called bone marrow (discussed below). The tissue lining the marrow cavity is called endosteum. At each end of the bone is an area of a milder form of bone-like tissue called cartilage.
Cartilage is softer than bone, but firmer than most tissues. It is made of a matrix mixed with a fibrous tissue similar to a gel that does not contain a lot of calcium substance.
Most of the bones start out as cartilage. The body then put down on calcium cartilage to form bone. After bone forms, some cartilage may remain in the ends to act as a buffer between the bones. This cartilage, along with ligaments and other tissues connect bone to form a joint. In adults, the cartilage is mainly at the end of some bones, as part of a joint. It also looks at the place in the chest where the ribs meet the sternum (breastbone) and parts of the face. The trachea (windpipe), larynx (voice box), and the outer ear are other structures that contain cartilage.
Own bone is very hard and strong. Some bone is capable of supporting up to 12,000 pounds per square inch. It takes as much as 1,200 to 1,800 pounds of pressure to break the femur (thigh bone). Bone itself contains two types of cells. The osteoblast cell is established new bone, and osteoclasts dissolves cell is the old bone. Bone often seems as if it does not change much, but the truth is that is very active. Throughout our bodies, new bone is always forming while old bone is dissolving.
In some bone marrow is only fatty tissue. In other bone marrow is a mixture of fat cells and blood-forming cells. Forming cells produce red blood cells, white cells and platelets in the blood. Other cells include bone marrow plasma cells, fibroblasts and reticuloendothelial cells.
The cells of any of these tissues can become a cancer.
Types of bone tumors
Most of the time when people with cancer are told they have cancer in your bones, the doctor is talking about a cancer that has spread to the bone from elsewhere. This is known as metastatic cancer. It can be seen in many different advanced cancers, such as breast cancer, prostate cancer, and lung cancer. When these types of cancer in the bone are viewed under a microscope, they look like they came tissue. For example, if someone has lung cancer that has spread to bone cancer, cancer cells in the bone still look and act like cell lung cancer. They do not look or act like cells of bone cancer, although they are in the bones. Because these cancer cells still act as cell lung cancer, which still need to be treated with drugs used for lung cancer.
Other cancers that are sometimes called "bone cancers" start in the cells that form bone marrow blood - not in the bone itself. The most common cancer that originates from the bone marrow, causing bone tumors is called multiple myeloma. Another cancer that starts in the bone marrow is leukemia, but is generally considered a cancer of the blood instead of bone cancer. Sometimes lymphomas, most often originate in lymph nodes, they can begin in the bone marrow. Multiple myeloma, lymphoma, and leukemia are not discussed in this document. For more information on these cancers, refer to each individual document.
A primary bone tumor begins in the bone itself. True (or primary) bone cancers are called sarcomas. Sarcomas are cancers that start in the bones, muscles, fibrous tissue, blood vessels, fatty tissue and some other tissues. They can develop anywhere in the body.
There are several different types of bone tumors. Their names are based on the area of bone or surrounding tissue that is affected and the type of cells that form the tumor. Some primary bone tumors are benign (noncancerous), and others are malignant (cancerous). Most bone cancers are sarcomas.
Benign bone tumors
Benign tumors do not spread to other tissues and organs, and usually are not life threatening. They are generally cured by surgery. Types of benign bone tumors include:
Osteoid osteoma (OS-tee-Oya OS-tee-oh-ma)
Osteoblastoma (OS-tee-oh-blas-TOE-muh)
Osteochondroma (OS-tee-oh-kon-droh-muh)
Enchondroma (en-kon-droh-muh)
Chondromyxoid (kon-dro-MIX-Oya) fibroma.
These benign tumors are discussed later in this document, which is limited to bone cancers.
Malignant bone tumors
Osteosarcoma: Osteosarcoma (also called osteogenic sarcoma) is the most common primary bone cancer. This type of cancer starts in bone cells. It most often occurs in young people between the ages of 10 and 30, but about 10% of osteosarcoma cases develop in people aged 60 to 70 years. It is uncommon in middle age and is more common in men than in women. These tumors develop most often in the bones of the arms, legs or pelvis. This type of cancer is not discussed in detail here, but is covered in our osteosarcoma document.
Chondrosarcoma: Chondrosarcoma (KON-droh-sar-KOH-muh) is a cancer of the cartilage cells. It is the second most common primary bone cancer. This cancer is rare in people under age 20. After age 20, the risk of getting a chondrosarcoma goes up until about 75 years women receive this type of cancer as often as men.
Chondrosarcomas can develop anywhere there cartilage. Most develop in bones such as the pelvis, leg bone or arm bone. Occasionally, chondrosarcoma will develop in the trachea, larynx and chest wall. Other sites are the scapula (shoulder blade), ribs or skull.
(Not cancerous), benign tumors of cartilage are more common than malignant. These are called enchondromas. Another type of benign tumor that has cartilage is a bony projection covered by cartilage called an osteochondroma. These benign tumors rarely develop into cancer. There is a slightly greater chance of developing cancer in people who have many of these tumors, but this is not yet common.
Chondrosarcomas are classified by grade, which measures how quickly they grow. The rating for the pathologist (a specially trained to examine and diagnose tissue samples under a microscope doctor) is assigned. The lower the level, the slower the cancer grows. When a cancer is slow growing, the possibility of spreading is minor and so the prognosis is better. Most chondrosarcomas are either low grade (grade I) or intermediate grade (grade II). High grade (grade III) chondrosarcomas, which are most likely to spread, are less common.
Some chondrosarcomas have distinctive features under a microscope. These variants of chondrosarcoma may have a different prognosis (outlook) than usual chondrosarcomas.
(Dee dih-feh-REN-shee-AY-ted) you dedifferentiated chondrosarcoma chondrosarcoma typical start but then some parts of the change in tumor cells as a high-grade sarcoma (eg high-grade forms fibrous histiocytoma malignant [SU-tee-oh-sy-TOH-muh], osteosarcoma, or fibrosarcoma). This variant of chondrosarcoma tends to occur in older patients and is more aggressive than usual chondrosarcomas.
Clear cell chondrosarcoma are rare and grow slowly. Rarely spread to other parts of the body unless they have already returned several times in the original location.
Mesenchymal chondrosarcoma (meh-ZEN-kih-mul) can grow rapidly, but like Ewing tumor, are sensitive to treatment with radiation and chemotherapy.
Ewing tumor: Ewing tumor is the third most common primary bone cancer and the second most common in children, adolescents and young adults. This cancer (also called Ewing's sarcoma) is named after the doctor who first described it in 1921, Dr. James Ewing. Most Ewing tumors develop into bone, but may begin at other tissues and organs. The most common sites for this cancer are the pelvis, chest wall (such as ribs or shoulder blades), and long bones of the legs or arms. This cancer is more common in children and adolescents is rare in adults over 30. Ewing tumors occur most often in white people and are very rare among African Americans and Asian Americans. More detailed information on this type of cancer can be found in our document Ewing family of tumors.
Malignant fibrous histiocytoma: Malignant fibrous histiocytoma (MFH) more often begins in soft tissue (connective tissue such as ligaments, tendons, fat and muscle) than in bone. This type of cancer is also called undifferentiated pleomorphic sarcoma, especially when starting on soft tissues. When MFH occurs in bones, usually affecting the legs (often around the knees) or arms. This cancer occurs most often in older and middle-aged adults and is rare in children. MFH mostly tends to grow locally, but may spread to distant sites such as the lungs.
Fibrosarcoma: This is another type of cancer that develops most often in soft tissue that makes the bones. Fibrosarcoma usually occurs in the elderly and middle-aged adults. The bones of the legs, arms and jaw are the most affected.
Giant cell tumor of bone: This type of primary bone tumor has benign and malignant forms. The (non-cancerous) benign form is the most common. Giant cell bone tumors typically affect the leg (usually near the knees) or arm bones of young adults and middle-aged. They often do not spread to distant sites, but they tend to go back where they started after surgery (this is called local recurrence). This can happen several times. With each repetition, it becomes more likely to spread to other parts of the body as the tumor. Rarely, a malignant bone giant cell tumor spreads to other parts of the body without recourse first locally.
Chordoma: This primary tumor of bone usually occurs at the base of the skull and bones of the spine. It develops most often in adults over 30 years and is twice as common in men as in women. Chordomas tend to grow slowly and often do not spread to other parts of the body, but they often come back in the same area if not eliminated altogether. Lymph nodes, lungs and liver are the most common areas of secondary spread of tumor.
Other cancers that develop in the bones
Non-Hodgkin lymphomas
Non-Hodgkin lymphoma usually develops in the lymph nodes, but sometimes starts in the bone. Primary non-Hodgkin lymphoma of bone is often a widespread disease due to multiple sites in the body are often involved. The picture is similar to other non-Hodgkin lymphomas of the same subtype and stage. It is not treated as a primary bone sarcoma - primary lymphoma of bone in the same way that lymphomas that originate in the lymph nodes occurs.
Multiple myelomas
Multiple myeloma usually develops in the bone, but doctors do not consider it a primary bone cancer, as it develops from the plasma cells in the bone marrow (the soft inner part of some bones). Although cause bone destruction, is no longer a bone cancer it is leukemia. It is a widespread disease. Sometimes, myeloma can be found first as a single tumor (called a plasmacytoma) in a bone, but most of the time it will spread to the marrow of other bones.
Normal bone tissue
Bone is the framework supporting your body. Most bones are hollow. The outer part of the bone is a network of fibrous tissue called matrix upon which calcium salts are established.
The hard outer bone layer is made of compact bone (cortical) covering the spongy (trabecular) bone lighter within. Outside the bone is covered with a layer of fibrous tissue called periosteum. Some bones are hollow and have a space called the medullary cavity containing the soft tissue called bone marrow (discussed below). The tissue lining the marrow cavity is called endosteum. At each end of the bone is an area of a milder form of bone-like tissue called cartilage.
Cartilage is softer than bone, but firmer than most tissues. It is made of a matrix mixed with a fibrous tissue similar to a gel that does not contain a lot of calcium substance.
Most of the bones start out as cartilage. The body then put down on calcium cartilage to form bone. After bone forms, some cartilage may remain in the ends to act as a buffer between the bones. This cartilage, along with ligaments and other tissues connect bone to form a joint. In adults, the cartilage is mainly at the end of some bones, as part of a joint. It also looks at the place in the chest where the ribs meet the sternum (breastbone) and parts of the face. The trachea (windpipe), larynx (voice box), and the outer ear are other structures that contain cartilage.
Own bone is very hard and strong. Some bone is capable of supporting up to 12,000 pounds per square inch. It takes as much as 1,200 to 1,800 pounds of pressure to break the femur (thigh bone). Bone itself contains two types of cells. The osteoblast cell is established new bone, and osteoclasts dissolves cell is the old bone. Bone often seems as if it does not change much, but the truth is that is very active. Throughout our bodies, new bone is always forming while old bone is dissolving.
In some bone marrow is only fatty tissue. In other bone marrow is a mixture of fat cells and blood-forming cells. Forming cells produce red blood cells, white cells and platelets in the blood. Other cells include bone marrow plasma cells, fibroblasts and reticuloendothelial cells.
The cells of any of these tissues can become a cancer.
Types of bone tumors
Most of the time when people with cancer are told they have cancer in your bones, the doctor is talking about a cancer that has spread to the bone from elsewhere. This is known as metastatic cancer. It can be seen in many different advanced cancers, such as breast cancer, prostate cancer, and lung cancer. When these types of cancer in the bone are viewed under a microscope, they look like they came tissue. For example, if someone has lung cancer that has spread to bone cancer, cancer cells in the bone still look and act like cell lung cancer. They do not look or act like cells of bone cancer, although they are in the bones. Because these cancer cells still act as cell lung cancer, which still need to be treated with drugs used for lung cancer.
Other cancers that are sometimes called "bone cancers" start in the cells that form bone marrow blood - not in the bone itself. The most common cancer that originates from the bone marrow, causing bone tumors is called multiple myeloma. Another cancer that starts in the bone marrow is leukemia, but is generally considered a cancer of the blood instead of bone cancer. Sometimes lymphomas, most often originate in lymph nodes, they can begin in the bone marrow. Multiple myeloma, lymphoma, and leukemia are not discussed in this document. For more information on these cancers, refer to each individual document.
A primary bone tumor begins in the bone itself. True (or primary) bone cancers are called sarcomas. Sarcomas are cancers that start in the bones, muscles, fibrous tissue, blood vessels, fatty tissue and some other tissues. They can develop anywhere in the body.
There are several different types of bone tumors. Their names are based on the area of bone or surrounding tissue that is affected and the type of cells that form the tumor. Some primary bone tumors are benign (noncancerous), and others are malignant (cancerous). Most bone cancers are sarcomas.
Benign bone tumors
Benign tumors do not spread to other tissues and organs, and usually are not life threatening. They are generally cured by surgery. Types of benign bone tumors include:
Osteoid osteoma (OS-tee-Oya OS-tee-oh-ma)
Osteoblastoma (OS-tee-oh-blas-TOE-muh)
Osteochondroma (OS-tee-oh-kon-droh-muh)
Enchondroma (en-kon-droh-muh)
Chondromyxoid (kon-dro-MIX-Oya) fibroma.
These benign tumors are discussed later in this document, which is limited to bone cancers.
Malignant bone tumors
Osteosarcoma: Osteosarcoma (also called osteogenic sarcoma) is the most common primary bone cancer. This type of cancer starts in bone cells. It most often occurs in young people between the ages of 10 and 30, but about 10% of osteosarcoma cases develop in people aged 60 to 70 years. It is uncommon in middle age and is more common in men than in women. These tumors develop most often in the bones of the arms, legs or pelvis. This type of cancer is not discussed in detail here, but is covered in our osteosarcoma document.
Chondrosarcoma: Chondrosarcoma (KON-droh-sar-KOH-muh) is a cancer of the cartilage cells. It is the second most common primary bone cancer. This cancer is rare in people under age 20. After age 20, the risk of getting a chondrosarcoma goes up until about 75 years women receive this type of cancer as often as men.
Chondrosarcomas can develop anywhere there cartilage. Most develop in bones such as the pelvis, leg bone or arm bone. Occasionally, chondrosarcoma will develop in the trachea, larynx and chest wall. Other sites are the scapula (shoulder blade), ribs or skull.
(Not cancerous), benign tumors of cartilage are more common than malignant. These are called enchondromas. Another type of benign tumor that has cartilage is a bony projection covered by cartilage called an osteochondroma. These benign tumors rarely develop into cancer. There is a slightly greater chance of developing cancer in people who have many of these tumors, but this is not yet common.
Chondrosarcomas are classified by grade, which measures how quickly they grow. The rating for the pathologist (a specially trained to examine and diagnose tissue samples under a microscope doctor) is assigned. The lower the level, the slower the cancer grows. When a cancer is slow growing, the possibility of spreading is minor and so the prognosis is better. Most chondrosarcomas are either low grade (grade I) or intermediate grade (grade II). High grade (grade III) chondrosarcomas, which are most likely to spread, are less common.
Some chondrosarcomas have distinctive features under a microscope. These variants of chondrosarcoma may have a different prognosis (outlook) than usual chondrosarcomas.
(Dee dih-feh-REN-shee-AY-ted) you dedifferentiated chondrosarcoma chondrosarcoma typical start but then some parts of the change in tumor cells as a high-grade sarcoma (eg high-grade forms fibrous histiocytoma malignant [SU-tee-oh-sy-TOH-muh], osteosarcoma, or fibrosarcoma). This variant of chondrosarcoma tends to occur in older patients and is more aggressive than usual chondrosarcomas.
Clear cell chondrosarcoma are rare and grow slowly. Rarely spread to other parts of the body unless they have already returned several times in the original location.
Mesenchymal chondrosarcoma (meh-ZEN-kih-mul) can grow rapidly, but like Ewing tumor, are sensitive to treatment with radiation and chemotherapy.
Ewing tumor: Ewing tumor is the third most common primary bone cancer and the second most common in children, adolescents and young adults. This cancer (also called Ewing's sarcoma) is named after the doctor who first described it in 1921, Dr. James Ewing. Most Ewing tumors develop into bone, but may begin at other tissues and organs. The most common sites for this cancer are the pelvis, chest wall (such as ribs or shoulder blades), and long bones of the legs or arms. This cancer is more common in children and adolescents is rare in adults over 30. Ewing tumors occur most often in white people and are very rare among African Americans and Asian Americans. More detailed information on this type of cancer can be found in our document Ewing family of tumors.
Malignant fibrous histiocytoma: Malignant fibrous histiocytoma (MFH) more often begins in soft tissue (connective tissue such as ligaments, tendons, fat and muscle) than in bone. This type of cancer is also called undifferentiated pleomorphic sarcoma, especially when starting on soft tissues. When MFH occurs in bones, usually affecting the legs (often around the knees) or arms. This cancer occurs most often in older and middle-aged adults and is rare in children. MFH mostly tends to grow locally, but may spread to distant sites such as the lungs.
Fibrosarcoma: This is another type of cancer that develops most often in soft tissue that makes the bones. Fibrosarcoma usually occurs in the elderly and middle-aged adults. The bones of the legs, arms and jaw are the most affected.
Giant cell tumor of bone: This type of primary bone tumor has benign and malignant forms. The (non-cancerous) benign form is the most common. Giant cell bone tumors typically affect the leg (usually near the knees) or arm bones of young adults and middle-aged. They often do not spread to distant sites, but they tend to go back where they started after surgery (this is called local recurrence). This can happen several times. With each repetition, it becomes more likely to spread to other parts of the body as the tumor. Rarely, a malignant bone giant cell tumor spreads to other parts of the body without recourse first locally.
Chordoma: This primary tumor of bone usually occurs at the base of the skull and bones of the spine. It develops most often in adults over 30 years and is twice as common in men as in women. Chordomas tend to grow slowly and often do not spread to other parts of the body, but they often come back in the same area if not eliminated altogether. Lymph nodes, lungs and liver are the most common areas of secondary spread of tumor.
Other cancers that develop in the bones
Non-Hodgkin lymphomas
Non-Hodgkin lymphoma usually develops in the lymph nodes, but sometimes starts in the bone. Primary non-Hodgkin lymphoma of bone is often a widespread disease due to multiple sites in the body are often involved. The picture is similar to other non-Hodgkin lymphomas of the same subtype and stage. It is not treated as a primary bone sarcoma - primary lymphoma of bone in the same way that lymphomas that originate in the lymph nodes occurs.
Multiple myelomas
Multiple myeloma usually develops in the bone, but doctors do not consider it a primary bone cancer, as it develops from the plasma cells in the bone marrow (the soft inner part of some bones). Although cause bone destruction, is no longer a bone cancer it is leukemia. It is a widespread disease. Sometimes, myeloma can be found first as a single tumor (called a plasmacytoma) in a bone, but most of the time it will spread to the marrow of other bones.
Bladder Cancer
What is bladder cancer?
To understand bladder cancer, it helps to know about the normal structure and function of the bladder.
The bladder is a hollow organ in the pelvis with flexible, muscular walls. Its main function is to store urine before it leaves the body. The average adult bladder holds about 2 cups of urine. Urine is made by the kidneys and is then carried to the bladder through tubes called ureters.
When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra. In women, the urethra is very short and opens just in front of the vagina. In men, the urethra is longer. It passes through the prostate gland and the penis, and opens at the tip of the penis.
The wall of the bladder has 4 main layers.
The innermost lining is made up of cells called urothelial or transitional cells, so this layer is called the urothelium or transitional epithelium.
Beneath the urothelium is a thin layer of connective tissue, blood vessels, and nerves, which is called the lamina propria.
Next is a thick layer of muscle called the muscularis propria.
Outside of this muscle, a layer of fatty connective tissue separates the bladder from other nearby organs.
Knowing about these layers is important in understanding how bladder cancer grows. Most bladder cancers start in the urothelium. As the cancer grows into or through the other layers in the bladder, it becomes more advanced and harder to treat.
To understand bladder cancer, it helps to know about the normal structure and function of the bladder.
The bladder is a hollow organ in the pelvis with flexible, muscular walls. Its main function is to store urine before it leaves the body. The average adult bladder holds about 2 cups of urine. Urine is made by the kidneys and is then carried to the bladder through tubes called ureters.
When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra. In women, the urethra is very short and opens just in front of the vagina. In men, the urethra is longer. It passes through the prostate gland and the penis, and opens at the tip of the penis.
The wall of the bladder has 4 main layers.
The innermost lining is made up of cells called urothelial or transitional cells, so this layer is called the urothelium or transitional epithelium.
Beneath the urothelium is a thin layer of connective tissue, blood vessels, and nerves, which is called the lamina propria.
Next is a thick layer of muscle called the muscularis propria.
Outside of this muscle, a layer of fatty connective tissue separates the bladder from other nearby organs.
Knowing about these layers is important in understanding how bladder cancer grows. Most bladder cancers start in the urothelium. As the cancer grows into or through the other layers in the bladder, it becomes more advanced and harder to treat.
Types of bladder cancer
Bladder cancers are divided into several types based how their cells look under a microscope. Different types can respond differently to treatments.
Transitional cell (urothelial) carcinoma
This is by far the most common type of bladder cancer. More than 9 out of 10 bladder cancers are this type. The cells from transitional cell carcinomas (TCCs) look like the urothelial cells that line the inside of the bladder.
Urothelial cells also line other parts of the urinary tract, such as the lining of the kidneys (called the renal pelvis), the ureters, and the urethra, so TCCs can also occur in these places. In fact, patients with bladder cancer sometimes have other tumors in the lining of the kidneys, ureters, or urethra. If someone has a cancer in one part of their urinary system, the entire urinary tract needs to be checked for tumors.
Bladder cancers are often described based on how far they have invaded into the wall of the bladder:
Non-invasive bladder cancers are still in the inner layer of cells (the transitional epithelium) but have not grown into the deeper layers.
Invasive cancers grow into the lamina propria or even deeper into the muscle layer. Invasive cancers are more likely to spread and are harder to treat.
A bladder cancer can also be described as superficial or non-muscle invasive. These terms include both non-invasive tumors as well as any invasive tumors that have not grown into the main muscle layer of the bladder.
Transitional cell carcinomas are also divided into 2 subtypes, papillary and flat, based on how they grow
Papillary carcinomas grow in slender, finger-like projections from the inner surface of the bladder toward the hollow center. Papillary tumors often grow toward the center of the bladder without growing into the deeper bladder layers. These tumors are called non-invasive papillary cancers. Very low-grade, non-invasive papillary cancer is sometimes called papillary neoplasm of low-malignant potential and tends to have a very good outcome.
Flat carcinomas do not grow toward the hollow part of the bladder at all. If a flat tumor is only in the inner layer of bladder cells, it is known as a non-invasive flat carcinoma or a flat carcinoma in situ (CIS).
If either a papillary or flat tumor grows into deeper layers of the bladder, it is called an invasive transitional cell (or urothelial) carcinoma.
Other cancers that start in the bladder
Several other types of cancer can start in the bladder, but these are all much less common than transitional cell (urothelial) cancer.
Squamous cell carcinoma: In the United States, only about 1% to 2% of bladder cancers are squamous cell carcinomas. Under a microscope, the cells look much like the flat cells that are found on the surface of the skin. Nearly all squamous cell carcinomas are invasive.
Adenocarcinoma: Only about 1% of bladder cancers are adenocarcinomas. The cancer cells have a lot in common with gland-forming cells of colon cancers. Nearly all adenocarcinomas of the bladder are invasive.
Small cell carcinoma: Less than 1% of bladder cancers are small-cell carcinomas, which start in nerve-like cells called neuroendocrine cells. These cancers often grow quickly and typically need to be treated with chemotherapy like that used for small cell carcinoma of the lung.
Sarcoma: Sarcomas start in the muscle cells of the bladder, but they are rare. More information about sarcomas can be found in our documents Sarcoma - Adult Soft Tissue Cancer and Rhabdomyosarcoma.
These less common types of bladder cancer (other than sarcoma) are treated similar to transitional cell cancers, especially for early stage tumors, but different drugs may be needed if chemotherapy is required.
Bladder cancers are divided into several types based how their cells look under a microscope. Different types can respond differently to treatments.
Transitional cell (urothelial) carcinoma
This is by far the most common type of bladder cancer. More than 9 out of 10 bladder cancers are this type. The cells from transitional cell carcinomas (TCCs) look like the urothelial cells that line the inside of the bladder.
Urothelial cells also line other parts of the urinary tract, such as the lining of the kidneys (called the renal pelvis), the ureters, and the urethra, so TCCs can also occur in these places. In fact, patients with bladder cancer sometimes have other tumors in the lining of the kidneys, ureters, or urethra. If someone has a cancer in one part of their urinary system, the entire urinary tract needs to be checked for tumors.
Bladder cancers are often described based on how far they have invaded into the wall of the bladder:
Non-invasive bladder cancers are still in the inner layer of cells (the transitional epithelium) but have not grown into the deeper layers.
Invasive cancers grow into the lamina propria or even deeper into the muscle layer. Invasive cancers are more likely to spread and are harder to treat.
A bladder cancer can also be described as superficial or non-muscle invasive. These terms include both non-invasive tumors as well as any invasive tumors that have not grown into the main muscle layer of the bladder.
Transitional cell carcinomas are also divided into 2 subtypes, papillary and flat, based on how they grow
Papillary carcinomas grow in slender, finger-like projections from the inner surface of the bladder toward the hollow center. Papillary tumors often grow toward the center of the bladder without growing into the deeper bladder layers. These tumors are called non-invasive papillary cancers. Very low-grade, non-invasive papillary cancer is sometimes called papillary neoplasm of low-malignant potential and tends to have a very good outcome.
Flat carcinomas do not grow toward the hollow part of the bladder at all. If a flat tumor is only in the inner layer of bladder cells, it is known as a non-invasive flat carcinoma or a flat carcinoma in situ (CIS).
If either a papillary or flat tumor grows into deeper layers of the bladder, it is called an invasive transitional cell (or urothelial) carcinoma.
Other cancers that start in the bladder
Several other types of cancer can start in the bladder, but these are all much less common than transitional cell (urothelial) cancer.
Squamous cell carcinoma: In the United States, only about 1% to 2% of bladder cancers are squamous cell carcinomas. Under a microscope, the cells look much like the flat cells that are found on the surface of the skin. Nearly all squamous cell carcinomas are invasive.
Adenocarcinoma: Only about 1% of bladder cancers are adenocarcinomas. The cancer cells have a lot in common with gland-forming cells of colon cancers. Nearly all adenocarcinomas of the bladder are invasive.
Small cell carcinoma: Less than 1% of bladder cancers are small-cell carcinomas, which start in nerve-like cells called neuroendocrine cells. These cancers often grow quickly and typically need to be treated with chemotherapy like that used for small cell carcinoma of the lung.
Sarcoma: Sarcomas start in the muscle cells of the bladder, but they are rare. More information about sarcomas can be found in our documents Sarcoma - Adult Soft Tissue Cancer and Rhabdomyosarcoma.
These less common types of bladder cancer (other than sarcoma) are treated similar to transitional cell cancers, especially for early stage tumors, but different drugs may be needed if chemotherapy is required.
Anal cancer
Anal cancer
Anal cancer is cancer (malignant tumor) that arises from the anus, the distal opening of the gastrointestinal tract. It is a distinct entity in the most common colorectal cancer.
Anal cancer is typically a squamous cell carcinoma arising annals near the squamocolumnar junction, often linked to infection with human papillomavirus (HPV). You can keratinizing (basaloid) or nonkeratinizing (cloacogenic). Other types of anal cancer are adenocarcinoma, lymphoma, sarcoma or melanoma. 2004-2010 collected data, the survival rate relative five US is 65.5%, although individual rates can vary depending on the stage of cancer in the diagnosis and treatment response.
Signs and symptoms
Symptoms of anal cancer may include pain or pressure in the anus or rectum, a change in bowel habits, a lump near the anus, rectal bleeding, itching or discharge. The bleeding can be severe.
Risk factors
Human Papillomavirus: The examination of the tumor tissues of squamous cell carcinoma patients in Denmark and Sweden showed a high proportion of anal cancers to be positive for HPV types are also associated with a high risk of cervical cancer. In another study ,. high-risk types of HPV, particularly HPV-16 were detected in 84 percent of samples examined anal cancer. Based on the study in Denmark and Sweden, Parkin estimated 90% of anal cancers are attributable to HPV.
Sexual activity: Having multiple sex partners due to increased risk of exposure to HPV.
Receptive anal sex, whether male or female, increases the chances of anal cancer sevenfold due to HPV. Those who engage in anal intercourse with multiple partners are 17 times more likely to develop anal cancer than those who do not.
Smoking: Current smokers are several times more likely to develop anal cancer compared with nonsmokers. Epidemiologist Janet Daling, Ph.D., a member of the Division of Public Health Sciences, Fred Hutchinson and his team found that smoking appears to play a significant. role in the development of anal cancer that is independent of other behavioral risk factors, such as sexual activity. More than half of patients with anal cancer-studied were current smokers at the time of diagnosis, compared to a smoking rate of about 23 percent among controls. "Current smoking is a very important promoter of the disease," Daling said. "There's a fourfold increase in risk if you're a current smoker, regardless of whether you are male or female." They explained that the mechanism behind smoking and anal-cancer development is unknown, but researchers speculate that smoking interferes with a process called apoptosis, or programmed cell death, which helps rid the body of abnormal cells that could become cancerous. Another possibility is that smoking suppresses the immune system, which may decrease the body's ability to eliminate persistent infection or abnormal cells.
Immunosuppression, which often is associated with HIV infection.
Benign anal lesions.
A history of cervical, vaginal and vulvar cancers
Pathology
Most anal cancers are squamous cell (epidermoid carcinomas), which arises near the squamocolumnar junction. You can keratinizing (basaloid) or nonkeratinizing (cloacogenic).
Other types of anal cancer are adenocarcinoma, lymphoma, sarcoma or melanoma.
Prevention
Since many, if not most, anal cancers derive from HPV infections, and since the HPV vaccine before exposure to HPV prevents infection by some strains of the virus and has been shown to reduce the incidence of potentially precancerous lesions, scientists assume that HPV vaccination can reduce the incidence of anal cancer.
The December 22, 2010, the Food and Drug Administration of the United States approved the Gardasil vaccine to prevent anal cancer and pre-cancerous lesions in men and women of 9-26 years. The vaccine has been used before to help prevent cervical, vulvar and vaginal cancer, and associated lesions caused by types 6, 11, 16 and 18 in women.
Screening
Anal Pap smears similar to those used in the detection of cervical cancer have been studied for early detection of anal cancer in high risk individuals. In 2011, the HIV clinic at Jackson Memorial Hospital implemented a program to improve access to anal cancer screening for HIV-positive men. Nurses performed anal Pap screening, and men with abnormal results receive further evaluation with high-resolution anoscopy. The program has helped identify many precancerous growths, which allows them to be disposed of safely.
Treatment
Localized disease
Localized (carcinoma-in-situ) and the precursor condition, anal intraepithelial neoplasia (anal dysplasia or AIN) disease may be minimally invasive ablation methods such as infrared photocoagulation.
Previously, anal cancer was treated with surgery, and in early stage disease (ie, localized cancer of the anus without metastasis to the inguinal lymph nodes), surgery is often curative. The difficulty with surgery has been the need to eliminate the internal and external anal sphincter, with concomitant fecal incontinence. For this reason, many patients with anal cancer have required permanent colostomies.
The current gold standard therapy is chemotherapy and radiotherapy to reduce the necessity of debilitating surgery. This approach "combined modality" has led to the increased preservation of an intact anal sphincter, and therefore improved quality of life after definitive treatment. The survival and cure rates are excellent, and many patients are left with a functional sphincter. Some patients have fecal incontinence after combined chemotherapy and radiation. Biopsies to document disease regression after chemotherapy and radiation were commonly advised, but are not as frequent any longer. Current Chemotherapy continuous infusion of 5-FU for four days with bolus mitomycin given concurrently with radiation. 5-FU and cisplatin is recommended for metastatic anal cancer.
Metastatic or recurrent disease
10 to 20% of patients treated for anal cancer will develop distant metastases after treatment. Metastatic or recurrent anal cancer is difficult to treat, and usually requires chemotherapy. Radiation is also used to alleviate specific locations of disease that may be causing the symptoms. Chemotherapy commonly used is similar to other epithelial squamous cell neoplasms, such as platinum analogs, anthracyclines such as doxorubicin, and antimetabolites such as 5-FU and capecitabine. Hainsworth JD developed a protocol that includes Taxol and Carboplatin along with 5-FU. The average survival rates for patients with distant metastases ranges 8-34 months.
Anal cancer is cancer (malignant tumor) that arises from the anus, the distal opening of the gastrointestinal tract. It is a distinct entity in the most common colorectal cancer.
Anal cancer is typically a squamous cell carcinoma arising annals near the squamocolumnar junction, often linked to infection with human papillomavirus (HPV). You can keratinizing (basaloid) or nonkeratinizing (cloacogenic). Other types of anal cancer are adenocarcinoma, lymphoma, sarcoma or melanoma. 2004-2010 collected data, the survival rate relative five US is 65.5%, although individual rates can vary depending on the stage of cancer in the diagnosis and treatment response.
Signs and symptoms
Symptoms of anal cancer may include pain or pressure in the anus or rectum, a change in bowel habits, a lump near the anus, rectal bleeding, itching or discharge. The bleeding can be severe.
Risk factors
Human Papillomavirus: The examination of the tumor tissues of squamous cell carcinoma patients in Denmark and Sweden showed a high proportion of anal cancers to be positive for HPV types are also associated with a high risk of cervical cancer. In another study ,. high-risk types of HPV, particularly HPV-16 were detected in 84 percent of samples examined anal cancer. Based on the study in Denmark and Sweden, Parkin estimated 90% of anal cancers are attributable to HPV.
Sexual activity: Having multiple sex partners due to increased risk of exposure to HPV.
Receptive anal sex, whether male or female, increases the chances of anal cancer sevenfold due to HPV. Those who engage in anal intercourse with multiple partners are 17 times more likely to develop anal cancer than those who do not.
Smoking: Current smokers are several times more likely to develop anal cancer compared with nonsmokers. Epidemiologist Janet Daling, Ph.D., a member of the Division of Public Health Sciences, Fred Hutchinson and his team found that smoking appears to play a significant. role in the development of anal cancer that is independent of other behavioral risk factors, such as sexual activity. More than half of patients with anal cancer-studied were current smokers at the time of diagnosis, compared to a smoking rate of about 23 percent among controls. "Current smoking is a very important promoter of the disease," Daling said. "There's a fourfold increase in risk if you're a current smoker, regardless of whether you are male or female." They explained that the mechanism behind smoking and anal-cancer development is unknown, but researchers speculate that smoking interferes with a process called apoptosis, or programmed cell death, which helps rid the body of abnormal cells that could become cancerous. Another possibility is that smoking suppresses the immune system, which may decrease the body's ability to eliminate persistent infection or abnormal cells.
Immunosuppression, which often is associated with HIV infection.
Benign anal lesions.
A history of cervical, vaginal and vulvar cancers
Pathology
Most anal cancers are squamous cell (epidermoid carcinomas), which arises near the squamocolumnar junction. You can keratinizing (basaloid) or nonkeratinizing (cloacogenic).
Other types of anal cancer are adenocarcinoma, lymphoma, sarcoma or melanoma.
Prevention
Since many, if not most, anal cancers derive from HPV infections, and since the HPV vaccine before exposure to HPV prevents infection by some strains of the virus and has been shown to reduce the incidence of potentially precancerous lesions, scientists assume that HPV vaccination can reduce the incidence of anal cancer.
The December 22, 2010, the Food and Drug Administration of the United States approved the Gardasil vaccine to prevent anal cancer and pre-cancerous lesions in men and women of 9-26 years. The vaccine has been used before to help prevent cervical, vulvar and vaginal cancer, and associated lesions caused by types 6, 11, 16 and 18 in women.
Screening
Anal Pap smears similar to those used in the detection of cervical cancer have been studied for early detection of anal cancer in high risk individuals. In 2011, the HIV clinic at Jackson Memorial Hospital implemented a program to improve access to anal cancer screening for HIV-positive men. Nurses performed anal Pap screening, and men with abnormal results receive further evaluation with high-resolution anoscopy. The program has helped identify many precancerous growths, which allows them to be disposed of safely.
Treatment
Localized disease
Localized (carcinoma-in-situ) and the precursor condition, anal intraepithelial neoplasia (anal dysplasia or AIN) disease may be minimally invasive ablation methods such as infrared photocoagulation.
Previously, anal cancer was treated with surgery, and in early stage disease (ie, localized cancer of the anus without metastasis to the inguinal lymph nodes), surgery is often curative. The difficulty with surgery has been the need to eliminate the internal and external anal sphincter, with concomitant fecal incontinence. For this reason, many patients with anal cancer have required permanent colostomies.
The current gold standard therapy is chemotherapy and radiotherapy to reduce the necessity of debilitating surgery. This approach "combined modality" has led to the increased preservation of an intact anal sphincter, and therefore improved quality of life after definitive treatment. The survival and cure rates are excellent, and many patients are left with a functional sphincter. Some patients have fecal incontinence after combined chemotherapy and radiation. Biopsies to document disease regression after chemotherapy and radiation were commonly advised, but are not as frequent any longer. Current Chemotherapy continuous infusion of 5-FU for four days with bolus mitomycin given concurrently with radiation. 5-FU and cisplatin is recommended for metastatic anal cancer.
Metastatic or recurrent disease
10 to 20% of patients treated for anal cancer will develop distant metastases after treatment. Metastatic or recurrent anal cancer is difficult to treat, and usually requires chemotherapy. Radiation is also used to alleviate specific locations of disease that may be causing the symptoms. Chemotherapy commonly used is similar to other epithelial squamous cell neoplasms, such as platinum analogs, anthracyclines such as doxorubicin, and antimetabolites such as 5-FU and capecitabine. Hainsworth JD developed a protocol that includes Taxol and Carboplatin along with 5-FU. The average survival rates for patients with distant metastases ranges 8-34 months.
HIV/AIDS
HIV/AIDS
Infection by HIV and acquired immunodeficiency syndrome (HIV / AIDS) is a spectrum of diseases caused by infection with human immunodeficiency virus (HIV) After the initial infection, a person may experience a brief period of influenza-like illness. This is typically followed by a long asymptomatic period. As the infection progresses, increasingly interfere with the immune system, making the person more susceptible to common infections such as tuberculosis and opportunistic infections and tumors that usually do not affect people who work the system immune. Later symptoms of the infection are known as AIDS. This stage is often complicated by a lung infection called pneumocystis pneumonia, severe weight loss, a type of cancer known as Kaposi's sarcoma and other AIDS-defining conditions.
HIV is transmitted primarily through sexual intercourse without protection (including anal and oral sex), transfusions of contaminated blood, needles, and from mother to child during pregnancy, childbirth or breastfeeding. Some body fluids, such as saliva and tears do not transmit HIV. Common methods of preventing HIV / AIDS include encouraging safer sex, needle exchange programs, and treatment of those infected. There is no cure or vaccine; However, antiretroviral therapy can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications of the disease, these drugs are expensive and have side effects. Without treatment, it is estimated that the average survival time after infection with HIV to be in 9-11 years, depending on the subtype of HIV.
Since its discovery, AIDS has caused an estimated 36 million deaths worldwide (as of 2012). In 2013 it led to a 1.34 million deaths. From 2012, approximately 35.3 million people live with HIV worldwide. HIV / AIDS is considered a pandemic outbreak of a disease that is present in a large area and is spreading actively. Genetic research indicates that HIV originated in west-central Africa during the late nineteenth and early twentieth century. AIDS was first recognized by the Centers for Disease Control and Prevention (CDC) in 1981 and their cause HIV-infection was identified in the early part of the decade.
HIV / AIDS has had a major impact on society, both as a disease and as a source of discrimination. The disease also have significant economic impacts. There are many misconceptions about HIV / AIDS, such as the belief that it can be transmitted by nonsexual contact casual ideas. The disease has become the subject of much controversy involving religion. It's called medical care and international politics as well as large-scale financing since it was identified in the 1980s.
Infection by HIV and acquired immunodeficiency syndrome (HIV / AIDS) is a spectrum of diseases caused by infection with human immunodeficiency virus (HIV) After the initial infection, a person may experience a brief period of influenza-like illness. This is typically followed by a long asymptomatic period. As the infection progresses, increasingly interfere with the immune system, making the person more susceptible to common infections such as tuberculosis and opportunistic infections and tumors that usually do not affect people who work the system immune. Later symptoms of the infection are known as AIDS. This stage is often complicated by a lung infection called pneumocystis pneumonia, severe weight loss, a type of cancer known as Kaposi's sarcoma and other AIDS-defining conditions.
HIV is transmitted primarily through sexual intercourse without protection (including anal and oral sex), transfusions of contaminated blood, needles, and from mother to child during pregnancy, childbirth or breastfeeding. Some body fluids, such as saliva and tears do not transmit HIV. Common methods of preventing HIV / AIDS include encouraging safer sex, needle exchange programs, and treatment of those infected. There is no cure or vaccine; However, antiretroviral therapy can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications of the disease, these drugs are expensive and have side effects. Without treatment, it is estimated that the average survival time after infection with HIV to be in 9-11 years, depending on the subtype of HIV.
Since its discovery, AIDS has caused an estimated 36 million deaths worldwide (as of 2012). In 2013 it led to a 1.34 million deaths. From 2012, approximately 35.3 million people live with HIV worldwide. HIV / AIDS is considered a pandemic outbreak of a disease that is present in a large area and is spreading actively. Genetic research indicates that HIV originated in west-central Africa during the late nineteenth and early twentieth century. AIDS was first recognized by the Centers for Disease Control and Prevention (CDC) in 1981 and their cause HIV-infection was identified in the early part of the decade.
HIV / AIDS has had a major impact on society, both as a disease and as a source of discrimination. The disease also have significant economic impacts. There are many misconceptions about HIV / AIDS, such as the belief that it can be transmitted by nonsexual contact casual ideas. The disease has become the subject of much controversy involving religion. It's called medical care and international politics as well as large-scale financing since it was identified in the 1980s.
Tuesday 19 May 2015
Liver Cancer.....
What is liver cancer?
Only cancers that start in the liver are called liver cancer. To understand liver cancer, it helps to know about the normal structure and function of the liver.
On the liver
The liver is the largest internal organ. It is located below the ribs on the right side just below his right lung. It is shaped like a pyramid and divided into right and left lobes. The lobes are segmented.
Unlike most other organs, the liver receives blood from two sources: the hepatic artery supplies the liver with oxygen-rich blood from the heart, and the portal vein carries nutrient-rich blood from the gut.
You can not live without your liver. It has several important functions:
It breaks down and stores many of the nutrients absorbed from the intestine that your body needs to function. Some nutrients must be changed (metabolized) by the liver before they can be used by the rest of the body for energy or to build and repair body tissues.
It makes most of the clotting factors that prevent excessive bleeding when cut or injured.
Bile is secreted into the intestine to help absorb nutrients (especially fats).
Filter and decomposes toxic wastes in the blood, which are then removed from the body.
The liver consists mainly of cells called hepatocytes. It also consists of other types of cells, including the cells that line blood vessels and the cells lining the small tubes called bile ducts of the liver. The bile ducts outside the liver spread and carry bile from the liver to the gallbladder or directly to the intestines.
These different types of cells in the liver can form various types of (non-cancerous) benign malignant (cancerous). These tumors have different causes, are treated differently and have a different prognosis (outlook).
Only cancers that start in the liver are called liver cancer. To understand liver cancer, it helps to know about the normal structure and function of the liver.
On the liver
The liver is the largest internal organ. It is located below the ribs on the right side just below his right lung. It is shaped like a pyramid and divided into right and left lobes. The lobes are segmented.
Unlike most other organs, the liver receives blood from two sources: the hepatic artery supplies the liver with oxygen-rich blood from the heart, and the portal vein carries nutrient-rich blood from the gut.
You can not live without your liver. It has several important functions:
It breaks down and stores many of the nutrients absorbed from the intestine that your body needs to function. Some nutrients must be changed (metabolized) by the liver before they can be used by the rest of the body for energy or to build and repair body tissues.
It makes most of the clotting factors that prevent excessive bleeding when cut or injured.
Bile is secreted into the intestine to help absorb nutrients (especially fats).
Filter and decomposes toxic wastes in the blood, which are then removed from the body.
The liver consists mainly of cells called hepatocytes. It also consists of other types of cells, including the cells that line blood vessels and the cells lining the small tubes called bile ducts of the liver. The bile ducts outside the liver spread and carry bile from the liver to the gallbladder or directly to the intestines.
These different types of cells in the liver can form various types of (non-cancerous) benign malignant (cancerous). These tumors have different causes, are treated differently and have a different prognosis (outlook).
Benign liver tumors
Benign tumors sometimes grow large enough to cause problems, but they do not grow in the near or spread to distant parts of the body tissues. If need be treated, the patient can be cured with surgery.
Benign tumors sometimes grow large enough to cause problems, but they do not grow in the near or spread to distant parts of the body tissues. If need be treated, the patient can be cured with surgery.
Hemangioma
The most common type of benign liver tumor, hemangiomas start in blood vessels. Most hemangiomas of the liver cause no symptoms and need no treatment. But some may bleed and need to be surgically removed.
The most common type of benign liver tumor, hemangiomas start in blood vessels. Most hemangiomas of the liver cause no symptoms and need no treatment. But some may bleed and need to be surgically removed.
Hepatic adenoma
Hepatic adenoma is a benign tumor of the hepatocytes (the main type of liver cells). Most cause no symptoms and need no treatment. But some eventually cause symptoms, such as pain or lump in the abdomen (stomach area) or blood loss. Because there is the risk that the tumor may break (leading to severe loss of blood) and a small risk that over time could become liver cancer, most experts usually advise surgery to remove the tumor, if possible.
The use of certain medications can increase the risk of these tumors. Women have a greater chance of having one of these tumors if they take birth control pills, although this is rare. Men who use anabolic steroids may also develop these tumors. Adenomas may shrink when the drugs are stopped.
Hepatic adenoma is a benign tumor of the hepatocytes (the main type of liver cells). Most cause no symptoms and need no treatment. But some eventually cause symptoms, such as pain or lump in the abdomen (stomach area) or blood loss. Because there is the risk that the tumor may break (leading to severe loss of blood) and a small risk that over time could become liver cancer, most experts usually advise surgery to remove the tumor, if possible.
The use of certain medications can increase the risk of these tumors. Women have a greater chance of having one of these tumors if they take birth control pills, although this is rare. Men who use anabolic steroids may also develop these tumors. Adenomas may shrink when the drugs are stopped.
Focal nodular hyperplasia
Focal nodular hyperplasia (FNH) is like a tumor composed of several cell types (hepatocytes, bile duct cells, and connective tissue cells) growth. Although FNH tumors are benign, it can be difficult to distinguish from true liver cancers, and doctors sometimes remove them when the diagnosis is unclear. If you have symptoms of an FNH tumor can be removed surgically.
Both hepatic adenomas and FNH tumors are more common in women than in men.
Focal nodular hyperplasia (FNH) is like a tumor composed of several cell types (hepatocytes, bile duct cells, and connective tissue cells) growth. Although FNH tumors are benign, it can be difficult to distinguish from true liver cancers, and doctors sometimes remove them when the diagnosis is unclear. If you have symptoms of an FNH tumor can be removed surgically.
Both hepatic adenomas and FNH tumors are more common in women than in men.
Types of primary liver cancer
A cancer that originates in the liver is called primary liver cancer. There are more than one type of primary liver cancer.
A cancer that originates in the liver is called primary liver cancer. There are more than one type of primary liver cancer.
Hepatocellular carcinoma (HCC)
This is the most common form of liver cancer in adults. It is also sometimes called hepatoma. On May 4 cancers that start in the liver are this type.
Hepatocellular cancer (HCC) can have different growth patterns:
Some begin as a single tumor that grows larger. Only late in the disease did not spread to other parts of the liver.
A second type seems to start as many small cancer nodules throughout the liver, not just a single tumor. This is seen most often in people with cirrhosis (chronic liver damage) and is the most common pattern seen in the United States.
Under the microscope, doctors can distinguish several subtypes of HCC. Very often these subtypes do not affect treatment or prognosis (outlook). But one of these subtypes, fibrolamellar is important to recognize. This type is rare, making up less than 1% of HCC. This type is more common in women under 35 years of age, and often the rest of the liver is not diseased. This subtype generally has a better prognosis than other forms of HCC.
Intrahepatic cholangiocarcinoma (cancer of the bile ducts)
About 10% to 20% of cancers that start in the liver are intrahepatic cholangiocarcinoma. These cancers start in the cells lining the small bile ducts (tubes that carry bile from the gallbladder) within the liver. (Most cholangiocarcinomas actually start in the bile ducts outside the liver.)
Hemangiosarcoma and Angiosarcoma
These are rare cancers that begin in cells that line the blood vessels of the liver. People who have been exposed to vinyl chloride or to thorium (Thorotrast) emissions are more likely to develop these cancers. See "What are the risk factors for liver cancer?" Some other cases are believed to be caused by exposure to arsenic or radio, or an inherited condition called hereditary hemochromatosis. In about half of all cases, there is no probable cause can be identified.
These tumors grow rapidly and are usually too widespread to be surgically removed at the time found. Chemotherapy and radiation therapy may help slow the disease, but these cancers are often very difficult to treat. These cancers are treated as other sarcomas.
This is the most common form of liver cancer in adults. It is also sometimes called hepatoma. On May 4 cancers that start in the liver are this type.
Hepatocellular cancer (HCC) can have different growth patterns:
Some begin as a single tumor that grows larger. Only late in the disease did not spread to other parts of the liver.
A second type seems to start as many small cancer nodules throughout the liver, not just a single tumor. This is seen most often in people with cirrhosis (chronic liver damage) and is the most common pattern seen in the United States.
Under the microscope, doctors can distinguish several subtypes of HCC. Very often these subtypes do not affect treatment or prognosis (outlook). But one of these subtypes, fibrolamellar is important to recognize. This type is rare, making up less than 1% of HCC. This type is more common in women under 35 years of age, and often the rest of the liver is not diseased. This subtype generally has a better prognosis than other forms of HCC.
Intrahepatic cholangiocarcinoma (cancer of the bile ducts)
About 10% to 20% of cancers that start in the liver are intrahepatic cholangiocarcinoma. These cancers start in the cells lining the small bile ducts (tubes that carry bile from the gallbladder) within the liver. (Most cholangiocarcinomas actually start in the bile ducts outside the liver.)
Hemangiosarcoma and Angiosarcoma
These are rare cancers that begin in cells that line the blood vessels of the liver. People who have been exposed to vinyl chloride or to thorium (Thorotrast) emissions are more likely to develop these cancers. See "What are the risk factors for liver cancer?" Some other cases are believed to be caused by exposure to arsenic or radio, or an inherited condition called hereditary hemochromatosis. In about half of all cases, there is no probable cause can be identified.
These tumors grow rapidly and are usually too widespread to be surgically removed at the time found. Chemotherapy and radiation therapy may help slow the disease, but these cancers are often very difficult to treat. These cancers are treated as other sarcomas.
Hepatoblastoma
This is a very rare kind of cancer that develops in children, usually in children under 4 years old. Hepatoblastoma cells are similar to fetal liver cells. About 2 in 3 children with these tumors are successfully treated with surgery and chemotherapy, but the tumors are more difficult to treat if they have spread outside the liver.
This is a very rare kind of cancer that develops in children, usually in children under 4 years old. Hepatoblastoma cells are similar to fetal liver cells. About 2 in 3 children with these tumors are successfully treated with surgery and chemotherapy, but the tumors are more difficult to treat if they have spread outside the liver.
Secondary liver cancer
Most of the time when cancer is found in the liver that did not start there but has spread (metastasized) from another part of the body such as the pancreas, colon, stomach, breast or lung. Because this cancer has spread from its original site (primary), it is a secondary liver cancer. These tumors are named and treated according to their primary site (where they started). For example, cancer that started in the lung and spread to the liver is called lung cancer spread to the liver, not liver cancer, and treated as lung cancer.
In the United States and Europe, the tumors (metastasis) of secondary liver are more common than primary liver cancer. The opposite is true for many areas of Asia and Africa.
Most of the time when cancer is found in the liver that did not start there but has spread (metastasized) from another part of the body such as the pancreas, colon, stomach, breast or lung. Because this cancer has spread from its original site (primary), it is a secondary liver cancer. These tumors are named and treated according to their primary site (where they started). For example, cancer that started in the lung and spread to the liver is called lung cancer spread to the liver, not liver cancer, and treated as lung cancer.
In the United States and Europe, the tumors (metastasis) of secondary liver are more common than primary liver cancer. The opposite is true for many areas of Asia and Africa.
Breasr Cancer
What is breast cancer?
Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) tissues or spread (metastasize) to distant areas of the body around. The disease occurs almost exclusively in women, but men can do it, too.
The normal breast
To understand breast cancer, it helps to have some basic knowledge about the normal structure of the breasts, as shown in the following diagram.
The female breast is composed mainly of lobules (milk-producing glands), ducts (small tubes that carry milk from the lobules to the nipple), and stroma (fatty tissue and connective tissue surrounding the ducts and lobules, vessels blood and lymph vessels).
Most breast cancers begin in cells that line the ducts (ductal cancer). Some start in the cells that line the lobules (lobular cancer), while a small number start in other tissues.
The (lymph) lymphatic system of the breast
The lymphatic system is important to understand because it is a form of breast cancer can spread. This system has several parts.
Lymph nodes are small groups of immune system cells (cells that are important in fighting infections) that are connected by lymphatic vessels, bean-shaped. Lymphatic vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast. Lymph contains tissue fluid and waste products, as well as immune cells. The breast cancer cells can enter lymphatic vessels and begin to grow in lymph nodes.
Most lymphatic vessels in the breast connect to lymph nodes under the arm (axillary nodes). Some lymphatic vessels connect to lymph nodes inside the chest (internal mammary nodes) and either above or below the collarbone (supraclavicular or infraclavicular nodes).
If cancer cells have spread to lymph nodes, there is a greater likelihood that the cells could have also entered the bloodstream and spread (metastasize) to other parts of the body. The more lymph nodes in breast cancer cells, it is likely that cancer can be found in other organs as well. Because of this, the search for cancer in one or more lymph nodes often affects the treatment plan. However, not all women with cancer cells in their lymph nodes develop metastases, and some women may have cancer cells in the lymph nodes and later develop metastases.
Benign breast lumps
Most breast lumps are not cancerous (benign). Still, some may need a biopsy (sample and viewed under a microscope) to prove they are not cancer.
Fibrosis and cysts
Most lumps turn out to be caused by fibrosis and / or cysts, benign changes in breast tissue that occur in many women at some point in their lives. (This is sometimes called fibrocystic changes and used to be called fibrocystic disease.) Fibrosis is the formation of scar (fibrous) tissue, and cysts are fluid-filled sacs. These conditions are most often diagnosed by a doctor based on the symptoms, such as breast lumps, swelling and tenderness or pain. These symptoms are often worse just before the menstrual period of women is about to begin. Your breasts may feel lumpy and, sometimes, you may notice a discharge from clear or slightly cloudy nipple.
Intraductal papillomas and fibroadenomas
Benign breast tumors such as fibroadenomas or intraductal papillomas are abnormal growths, but they are not cancerous and do not spread outside the breast to other organs. They are not life threatening.
But some benign breast conditions are important because women with these conditions have an increased risk of developing breast cancer.
Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) tissues or spread (metastasize) to distant areas of the body around. The disease occurs almost exclusively in women, but men can do it, too.
The normal breast
To understand breast cancer, it helps to have some basic knowledge about the normal structure of the breasts, as shown in the following diagram.
The female breast is composed mainly of lobules (milk-producing glands), ducts (small tubes that carry milk from the lobules to the nipple), and stroma (fatty tissue and connective tissue surrounding the ducts and lobules, vessels blood and lymph vessels).
Most breast cancers begin in cells that line the ducts (ductal cancer). Some start in the cells that line the lobules (lobular cancer), while a small number start in other tissues.
The (lymph) lymphatic system of the breast
The lymphatic system is important to understand because it is a form of breast cancer can spread. This system has several parts.
Lymph nodes are small groups of immune system cells (cells that are important in fighting infections) that are connected by lymphatic vessels, bean-shaped. Lymphatic vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast. Lymph contains tissue fluid and waste products, as well as immune cells. The breast cancer cells can enter lymphatic vessels and begin to grow in lymph nodes.
Most lymphatic vessels in the breast connect to lymph nodes under the arm (axillary nodes). Some lymphatic vessels connect to lymph nodes inside the chest (internal mammary nodes) and either above or below the collarbone (supraclavicular or infraclavicular nodes).
If cancer cells have spread to lymph nodes, there is a greater likelihood that the cells could have also entered the bloodstream and spread (metastasize) to other parts of the body. The more lymph nodes in breast cancer cells, it is likely that cancer can be found in other organs as well. Because of this, the search for cancer in one or more lymph nodes often affects the treatment plan. However, not all women with cancer cells in their lymph nodes develop metastases, and some women may have cancer cells in the lymph nodes and later develop metastases.
Benign breast lumps
Most breast lumps are not cancerous (benign). Still, some may need a biopsy (sample and viewed under a microscope) to prove they are not cancer.
Fibrosis and cysts
Most lumps turn out to be caused by fibrosis and / or cysts, benign changes in breast tissue that occur in many women at some point in their lives. (This is sometimes called fibrocystic changes and used to be called fibrocystic disease.) Fibrosis is the formation of scar (fibrous) tissue, and cysts are fluid-filled sacs. These conditions are most often diagnosed by a doctor based on the symptoms, such as breast lumps, swelling and tenderness or pain. These symptoms are often worse just before the menstrual period of women is about to begin. Your breasts may feel lumpy and, sometimes, you may notice a discharge from clear or slightly cloudy nipple.
Intraductal papillomas and fibroadenomas
Benign breast tumors such as fibroadenomas or intraductal papillomas are abnormal growths, but they are not cancerous and do not spread outside the breast to other organs. They are not life threatening.
But some benign breast conditions are important because women with these conditions have an increased risk of developing breast cancer.
Bile Duct Cancer
What is Bile Duct Cancer?
Bile Duct Cancer begins in a bile duct. To understand this cancer, it helps on the normal biliary tract and what they know to do.
About the bile ducts
The bile ducts are a series of thin tubes, the distance from the liver to the small intestine. The main function of the bile duct is a liquid, the bile from the liver and gall bladder into the small intestine, where it helps to digest the fats in the food to move.
Different parts of the biliary tree have different names. In the liver, it begins so many small tubes (called ductules) which collects bile from the liver cells. The Ductuli come together to form small channels, which then merge into larger ducts and finally the left and right hepatic ducts. All of these channels in the liver are called intrahepatic bile ducts.
The left and right hepatic ducts exit from the liver or to the common hepatic duct to form in a region called the hilum. Further down, the gallbladder (a small organ that stores bile) of the common hepatic duct joins the cystic duct called by a small canal. The combined channel called the common bile duct. The bile duct passes through a part of the pancreas before the junction with the pancreatic duct and opens into the first portion of the small intestine (duodenum) to the ampulla father.
Types of bile duct cancer by location
Cancer can develop in any part of the bile duct system and on the basis of their position (see picture below), are divided into 3 types:
Intrahepatic bile duct cancer
Perihilar (also hilar) bile duct cancer
Distal bile duct cancer
Cancers in these different areas may cause different symptoms.
Intrahepatic bile duct cancer
To develop in the smaller bile duct branches in the liver These cancers. You can sometimes find cancers that are confused to start frequently treated in the liver cells, which are called hepatocellular carcinomas and in the same way. Only about 1 in 10 bile duct cancer are intrahepatic.
Perihilar (also hilar) bile duct cancer
These cancers develop on the hilum, where the left and right hepatic ducts have joined forces and are straight out of the liver. These are also referred to Klatskin tumors. They are the most common type of bile duct cancer, more than half of all cancers bile duct. These cancers are grouped with distal bile duct cancer such as extrahepatic bile duct cancer.
Distal bile duct cancer
These cancers are found later in the bile duct, closer to the small intestine. How perihilar cancers, these extrahepatic bile duct cancer, as they start outside the liver. Distal bile duct cancer form 2 to 3 every 10 bile duct cancer.
Types of bile duct cancer by cell type
Bile duct cancer can also in species depending on how to divide the cancer cells under a microscope.
Almost all bile duct cancer are called cholangiocarcinomas. Most of these are adenocarcinomas, the cancers that begin in glandular cells. Bile duct adenocarcinomas develop from the mucous glands cells. The interior of the pipeline
Other types of bile duct cancer are much rarer. This includes sarcomas, lymphomas and small cell lung cancer. This document is not to discuss these types of bile duct cancer.
The remainder of this document refers only to cholangiocarcinomas.
Benign bile duct tumors
Not all bile duct tumors are malignant. Bile duct hamartomas and bile duct adenomas are examples of benign (non-cancerous) tumors that are not explained further in this document.
Other cancers in the liver
The most common form of cancer that starts in the liver - much more common than intrahepatic bile duct cancer - is hepatocellular carcinoma, which developed from liver cells. Hepatocellular carcinoma is discussed more liver cancer in our document.
Cancers that begin in some other organs can spread to the liver. These are called secondary liver cancer or liver metastases. Your attitude and treatment are not the same as cancer in the liver (eg hepatocellular carcinoma) or bile ducts (as cholangiocarcinoma) begins, but on where the cancer depend started. For this reason it is important to know if an adenocarcinoma in the liver in the bile ducts of the author (and is a cholangiocarcinoma), or whether it started in another organ (such as the colon) and then spread to the liver.
Bile Duct Cancer begins in a bile duct. To understand this cancer, it helps on the normal biliary tract and what they know to do.
About the bile ducts
The bile ducts are a series of thin tubes, the distance from the liver to the small intestine. The main function of the bile duct is a liquid, the bile from the liver and gall bladder into the small intestine, where it helps to digest the fats in the food to move.
Different parts of the biliary tree have different names. In the liver, it begins so many small tubes (called ductules) which collects bile from the liver cells. The Ductuli come together to form small channels, which then merge into larger ducts and finally the left and right hepatic ducts. All of these channels in the liver are called intrahepatic bile ducts.
The left and right hepatic ducts exit from the liver or to the common hepatic duct to form in a region called the hilum. Further down, the gallbladder (a small organ that stores bile) of the common hepatic duct joins the cystic duct called by a small canal. The combined channel called the common bile duct. The bile duct passes through a part of the pancreas before the junction with the pancreatic duct and opens into the first portion of the small intestine (duodenum) to the ampulla father.
Types of bile duct cancer by location
Cancer can develop in any part of the bile duct system and on the basis of their position (see picture below), are divided into 3 types:
Intrahepatic bile duct cancer
Perihilar (also hilar) bile duct cancer
Distal bile duct cancer
Cancers in these different areas may cause different symptoms.
Intrahepatic bile duct cancer
To develop in the smaller bile duct branches in the liver These cancers. You can sometimes find cancers that are confused to start frequently treated in the liver cells, which are called hepatocellular carcinomas and in the same way. Only about 1 in 10 bile duct cancer are intrahepatic.
Perihilar (also hilar) bile duct cancer
These cancers develop on the hilum, where the left and right hepatic ducts have joined forces and are straight out of the liver. These are also referred to Klatskin tumors. They are the most common type of bile duct cancer, more than half of all cancers bile duct. These cancers are grouped with distal bile duct cancer such as extrahepatic bile duct cancer.
Distal bile duct cancer
These cancers are found later in the bile duct, closer to the small intestine. How perihilar cancers, these extrahepatic bile duct cancer, as they start outside the liver. Distal bile duct cancer form 2 to 3 every 10 bile duct cancer.
Types of bile duct cancer by cell type
Bile duct cancer can also in species depending on how to divide the cancer cells under a microscope.
Almost all bile duct cancer are called cholangiocarcinomas. Most of these are adenocarcinomas, the cancers that begin in glandular cells. Bile duct adenocarcinomas develop from the mucous glands cells. The interior of the pipeline
Other types of bile duct cancer are much rarer. This includes sarcomas, lymphomas and small cell lung cancer. This document is not to discuss these types of bile duct cancer.
The remainder of this document refers only to cholangiocarcinomas.
Benign bile duct tumors
Not all bile duct tumors are malignant. Bile duct hamartomas and bile duct adenomas are examples of benign (non-cancerous) tumors that are not explained further in this document.
Other cancers in the liver
The most common form of cancer that starts in the liver - much more common than intrahepatic bile duct cancer - is hepatocellular carcinoma, which developed from liver cells. Hepatocellular carcinoma is discussed more liver cancer in our document.
Cancers that begin in some other organs can spread to the liver. These are called secondary liver cancer or liver metastases. Your attitude and treatment are not the same as cancer in the liver (eg hepatocellular carcinoma) or bile ducts (as cholangiocarcinoma) begins, but on where the cancer depend started. For this reason it is important to know if an adenocarcinoma in the liver in the bile ducts of the author (and is a cholangiocarcinoma), or whether it started in another organ (such as the colon) and then spread to the liver.
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