DEFINITION

Lung cancer occurs when cells divide in the lungs uncontrollably .This causes tumors to grow .These can reduce a persons ability to breathe and spread to other parts of the body

TYPES

Main types are

• Non small cell lung cancer – there are three subtypes

1. adenocarcinoma
2. squamous cell cancer
3. large cell carcinoma

• Small cell lung cancer- these type tend to grow more quickly than non small cell lung cancer

SYMPTOMS

Early symptoms

• A cough that wont quit or changes
• Breathing changes or wheezing
• Body pain
• Raspy ,hoarse voice
• Drop in weight

Advanced symptoms

• Fatigue
• Pain
• Breathing
• Persistent coughing
• Loss of appetite
• Coughing blood

CAUSES

90 % are caused by smoking .From the moment you inhale smoke into your lungs it starts damaging your lung tissue .  Once cells get damaged they behave abnormally and eventually cancer may develop

RISK FACTORS

• Smoking
• Exposure to secondary smoke
• Previous radiation therapy
• Exposure to radon gas
• Exposure to asbestos and other carcinogens
• Family history

COMPLICATIONS

• Shortness  of breath
• Coughing up blood
• Pain
• Fluid in chest ( pleural effusion)
• Metastasis

TESTS

• Imaging tests-X ray, CT
• Sputum cytology
• Tissue sample ( biopsy)

TREATMENT 

• SURGERY-During surgery your surgeon works to remove the lung cancer and a margin of healthy tissue. Procedures to remove lung cancer include:

a)Wedge resection – to remove a small section of lung that contains the tumor alone with a margin of                                                                                                     healthy tissue

b)Segmental resection- to remove a larger portion of lung but not an entire lobe

c)Lobectomy- to remove the entire lobe of one lung

d)Pneumonectomy-to remove entire lung

• RADIATION THERAPY – For people with locally advanced lung cancer ,radiation may be used before surgery  before surgery or after surgery. Its often combined with chemotherapy treatment
• CHEMOTHERAPY- Chemotherapy is often used after surgery to kill any cancer cells that may remain .It can be used alone or in combined  with radiation therapy. Chemotherapy may also be used before surgery to shrink cancers and make them easier to  remove
• TARGETED DRUG THERAPY- These treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities , targeted drug treatments can cause cancer cells to die
• IMMUNO THERAY- Immuno therapy uses your immune system to fight cancer. Your body’s  disease fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells
• PALLIATIVE CARE-People with lung cancer often experiences signs and symptoms of the caner as well as side effects of the treatment .Supportive care also known as palliative care is a specialty area of medicine  that involves working with a doctor to minimize your signs and symptoms

 

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Prepared by-Dr Sajna Hamza

DEFINITION

A cancer in a mans prostate , a small walnut sized gland that produces seminal fluid . A mans prostate produces the seminal fluid that nourishes and transports sperm. It is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However while some types  of prostate cancer grow slowly and may need minimal or even no treatment other types are aggressive and can spread quickly.

SYMPTOMS

Symptoms and signs of prostate cancer may include

• Frequent urination
• Weak or interrupted urine flow or the need to strain to empty the bladder.
• The urge to urinate frequently at night
• Blood in the urine
• New onset of erectile dysfunction
• Pain or burning during urination which is much less common
• Discomfort or pain when sitting caused by an enlarged prostate

Other noncancerous conditions of the prostate such as BPH or an enlarged prostate can cause similar symptoms .Or the cause of a symptom may be a different medical condition that is also not related to cancer .Urinary symptoms also can be caused by an infection of the bladder or other conditions

If cancer spread outside of the prostate gland symptoms may include

• Pain in the back , hips ,thigh ,shoulders or other bones
• Swelling or fluid build up in the legs or feet
• Unexplained weight loss
• Fatigue
• Change in bowel habits

CAUSES

Its  not clear what causes prostate cancer. Prostate cancer begins when cells in the prostate develop changes in this DNA. A  cells DNA contains the instruction that tell the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living , when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue . In time some abnormal cells can break away and spread metastasize to other parts of the body

RISK FACTORS

• Age
• Race
• Family history
• Hereditary breast and ovarian cancer  (HBOC)
• Other genetic changes
• Eating habits

COMPLICATIONS

• Erectile dysfunction
• Incontinences
• Metastasis

STAGES OF PROSTATE CANCER

TNM Staging:

TNM system is a way of staging prostate cancer. TNM stands for Tumor, Node, Metastasis

T1-T1 means the cancer is too small to be seen on a scan , or felt during examination of the prostate. Its  divided into T1a, T1b, T1c.T1ameans that the cancer is in less than 5% of the removed tissue.T1b means that the cancer is in 5 % or more of the removed tissue . T1c cancers are found by biopsy for example after a raised PSA level

T2-T2 means the cancer is completely inside the prostate gland. Its divided into T2a, T2b and T2c.T2a means the cancer is  in only half of one side of the prostate gland.T2b  means the cancer is in more than half of one side of the prostate gland , but not both sides.T2c means the cancer is in both sides but is still inside the prostate gland

T3-T3 means the cancer has broken through the capsule of the prostate gland. Its divided into T3a and T3b.T3a means the cancer has broken through the capsule of the prostate gland.T3b means the cancer has spread into the tubes that carry semen.

T4z-T4 means the cancer has spread into other body organs nearby such as  the back passage ,bladder or the pelvic wall

NODES-N

NODES(N) describes whether the cancer has spread to lymph nodes. N is split into N0 and N1 . No means that the nearby lymph nodes does not contain cancer cells.N1 means there are cancer cells in lymph node near the prostate

METASTASIS-M

M describes whether the cancer has spread to different part of the body

There are two stages- M0 and M1.M0 -cancer has not spread to other parts of the body,M1 -cancer has spread to other parts of the body

TREATMENT

Considering the factors like

• The size of your tumor and how far it has spread .This is called the stage of your disease
• How quickly the tumor is likely to grow
• Your age and how healthy you are
• Your personal preferences

1. Surgery-Its an option if you are healthy and your cancer has not spread. There are several types. Your doctor may only remove your prostate gland or they might take it and the tissue around it
2. Radiation- this treatment uses high energy beams to kill the cancer cells. Its often a chance if your cancer is low grade  or  still only in your prostate
3. Proton beam radiation -This special type of radiation therapy uses very small particles to attack and kill cancer cells that have not spread
4. Hormone therapy- Prostate cancer cells need male hormone testosterone to keep growing . This treatment keeps the cancer cells from getting them
5. Chemo therapy- Drugs that you take by mouth or through  IV travel  through your body, attacking and killing cancer cells and shrinking tumors
6. Immuno therapy- This treatment works with your immune system to fight the disease
7. Cryotherapy- If you have early  prostate cancer your doctor may choose to kill cancer cells by freezing them
8. High intensity focused ultra sound- This device produce sound waves that deliver heat energy to kill cancer cells

 

 

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Prepared by : Dr Sajna Hamza

 

 

INTRODUCTION

Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors .Radiation therapy most often uses X-rays but protons or other types of energy also can be used

The term radiation therapy most often refers to external beam radiation therapy. During this type of radiation the high energy beams come from a machine outside of your body that aims the beams at a precise point on your body. Radiation therapy damages cells by destroying the genetic material that controls how cells grow and divide . While both healthy and cancerous cells are damaged by radiation therapy is to destroy as few normal healthy cells as possible .Normal cells can often repair much of the damage caused by radiation

TYPES OF RADIATION THERAPY

There are two broad types of radiation therapy-Internal and external

External beam radiation : It is the most common type of radiation treatment for cancer. External means that the energy beams come from a machine outside of the body. A health care professional precisely aims  the beams to reach the cancer site .Another name for external beam radiation is teletherapy

Internal beam radiation : The second main type of radiation treatment is internal radiation therapy also known as brachy therapy. During this treatment a doctor places an implant containing radiation in or near the cancer site

Systemic radiation therapy : Systemic radiation therapy is another kind of internal radiation therapy . It requires a person to swallow a radioactive substance,  which travels throughout the body to find and kill the cancerous cells. Alternatively a health care professional may inject the radio active substance into a persons vein.

GOALS

Radiation oncologists use radiation therapy to destroy cancer cells and slow tumor growth while limiting the harm to nearby healthy tissue. Sometimes doctors recommend radiation therapy as the first cancer treatment .Other times people receive radiation therapy after surgery or therapies using meditation like chemotherapy .This is called adjuvant therapy. It targets cancer cells remaining after the initial treatment . When it is not possible to destroy all the cancer , the doctors may use radiation therapy to shrink tumors and relieve symptoms. This is called palliative radiation therapy. Palliative radiation therapy may reduce pressure , pain and other symptoms. The goal is to improve a persons quality of life.

SIDE EFFECTS

• Hair loss
• Appetite changes
• Mouth and throat changes
• Trouble swallowing
• Swelling
• Coughing
• Diarrhea
• Nausea and vomiting
• Urinary and bladder changes
• Sexual changes
• Fatigue
• Skin reactions

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Prepared by: Dr Sajna Hamza

INTRODUCTION

Chemotherapy is a drug treatment that uses powerful chemicals to kill fast growing cells in your body.Chemotherapy is most often used to treat cancer  since cancer cells grow and multiply much more quickly than most cells in the body.

Chemotherapy is often used in combination with other therapies, such as surgery, radiation or hormone therapy.The use of combination therapy depends on

• The stage and type of cancer you have
• your overall health
• previous cancer treatments you have had
• the location of the cancer cells
• your personal treatment preferences

Chemotherapy has been proven to effectively attack cancer cells, but it can cause serious side effects that can severely impact your quality of life.

WHY CHEMOTHERAPY IS USED ?

Chemotherapy is primarily used to

• lower the total number of cancer cells in your body
• reduce the likelihood of cancer spread
• shrink tumor size
• reduce current symptoms

SIDE EFFECTS

• Fatigue
• Hair loss
• infection
• anemia
• nausea and vomiting
• appetite changes
• constipation
• diarrhea
• mouth,tongue and throat problems such as sores and with swallowing
• Peripheral neuropathy
• skin and nail changes
• weight changes mood changes
• fertility problems

PROCEDURE

Chemotherapy is typically given in pill form or directly into veins by injection or an IV.In addition to these two  forms, chemotherapy may also be administered in several other ways.

Chemotherapy delivery option include the following

• Chemotherapy can be delivered directly into the tumor ,depending on the tumors location
• Some skin cancers can be treated with chemotherapy creams
• Chemotherapy can be delivered to a specific part of the body through localized treatments such as directly into abdomen ,chest ,CNS or into bladder through urethra
• some types of chemotherapy can be taken by mouth through pills.
• liquid chemotherapy drugs can be delivered in single shots

GOALS

The goal of chemotherapy depends on the type of cancer , its location and persons unique circumstances.Based on the specific goal there are three main categories of chemotherapy treatment

• Curative: the therapy attempts to destroy all cancer cells so that a person is cancer free
• Adjuvant or neoadjuvant :The therapy  targets cancer cells remaining in the body after surgery or attempts to shrink cancerous growths prior to surgery
• Palliative:If the cancer cells cant be eliminated ,treatment can focus on relieving symptoms slowing cancer  growth

Chemotherapy is often just one part of a larger treatment plan.It may be given with other treatments like radiation surgery or other medication

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Prepared by: Dr Sajna Hamza

DEFINITION

A Bone marrow transplant is a medical treatment that replaces your bone marrow with healthy cells.The replacement cells can either come from your body or from a donor .

TYPES

• Allogeneic stem cell transplant
• Autologous stem cell transplant

ALLOGENEIC STEM CELL TRANSPLANT

An allogeneic stem cell transplant uses healthy blood stem cells from a donor to replace your diseased or damaged bone marrow.A donor may be a family member, an acquaintance or someone you dont know

AUTOLOGOUS STEM CELL TRANSPLANT

An autologous stem cell transplant uses healthy blood stem cells from your own body to replace your diseased or damaged bone arrow.An autologous stem cell transplant is also called an autologous bone marrow transplant

USES

• Safely allow treatment of your condition with high dose of chemotherapy or radiation by replacing or rescuing the bone marrow damaged by treatment
• Replace diseased or damaged marrow with new cells
• Provide new stem cells which can help kill cancer cells directly

Bone marrow transplants can benefit people with a variety of both cancerous and non cancerous diseases including

• Acute  leukemia
• Aplastic anaemia
• Bone marrow failure syndrome
• Chronic leukemias
• Hemoglobinoplathies
• Hodgkins lymphoma
• Immune deficiencies
• Multiple myeloma
• Neuro blastoma
• Non hodgkins lymphoma
• Plasma cell disorders

COMPLICATIONS

Short complications

• drop in blood pressure
• headache
• nausea
• pain
• shortness of breath
• chills
• fever

Long term complications

• Graft versus host disease (GVHD) which is a condition in which donor cells attack your body
• Graft failure which occurs when transplanted cells dont begin producing new cells as planned
• Bleeding in lungs ,brain and other parts of body
• Cataracts
• Damage of vital organs
• Early menopause
• Anemia
• Infections

PROCEDURE

When your doctor thinks you are ready  you will have the transplant .The procedure is similar to a blood transfusion.If you are having an allogeneic transplant bone marrow cells will be harvested from your donor a day or two before your procedure .If your own cells are being used, they will be retrieved from the stem cell bank

Cell are collected in two ways.During a bone marrow harvest cells are collected from both hipbones through   needle.Your are under anesthesia for this procedure meaning you will be asleep and free of any pain

OUTLOOK

The body’s response to a bone marrow transplant varies greatly from person to person .Factors such as age overall health and the reason for the transplant can all affect a persons long term outlook.If a person receives a bone marrow transplant to treat cancer ,their outlook depends in part on how far the cancer has spread .Cancer  that has spread far from its origin for example respond less to the treatment

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Prepared by : Dr Sajna Hamza

 

 

DEFINITION

Electro surgery is the use of a high frequency electrical energy in the radio transmission frequency band applied directly to tissue to induce histological effects.Current is in the range 1.5-7.5 million per second or megahertz

WORKING

High frequency electro surgery works by using electrical current and make it pass through the body tissue so as to create the desired clinical effect. Occurring biological in nature once the current is converted into heat ,the tissue will have thermal damage.It is important to note that there should be a sufficient amount of frequency to avoid causing muscle contraction .With inappropriate amount of frequency ,it can stop the heart from beating.Contrarily instead of merely causing heat through electrical current,  electro cautery involves the usage of a hand held element to apply the heat directly to the affected area.Other modalities that can be combined are electro surgery such as scalpel, scissors and curette. In combining there a specimen can be preserved for  histo pathological examination and this can also have better hold into the coverage of detruction

ADVANTAGES

• Electro surgery offers less operating time and limited bleeding,which is advantageous to parents
• Compared to laser surgery this procedure is also much cheaper
• A less post operative time for recovery can also be expected
• Recurrence rates are reported to be low

RISKS

• Because of utilization of electric currents ,electric shock can be a risk when there is no grounding pad and if the current is being randomly sent to any part of the body
• Burns can also be evident
• In order to prevent burns , the skin must be cleaned and then a conductive gel should be used to enhance the contact with return electrode
• All in all to avoid any unwanted side effects, proper handling of equipment and precise way of executing should always be achieved

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Prepared by :Dr Sajna Hamza

 

DEFINITION

Cryosurgery is a type of surgery that involves the use of extreme cold to destroy abnormal tissue such as tumors.The surgery most often involves the use of liquid nitrogen ,although carbon dioxide and argon may also be used

WHAT TYPES OF CANCER CAN BE TREATED WITH CRYOSURGERY

It is used to treat several types of cancer and some precancerous or noncancerous conditions.In addition to prostate and liver tumors cryosurgery can be an effective treatment for

• Retinoblastoma- childhood cancer that affect retina of eye
• Early stage skin cancers
• Precancerous skin growths known as actinic keratosis
• Precancerous conditions of the cervix known as cervical intra epithelial neoplasia
• Low grade cancerous and non cancerous tumors of the bone

ADVANTAGES

• It is less invasive than surgery  involving only a small incision or insertion of the cryoprobe through the skin
• Consequently pain,bleeding and other complications of surgery are minimized
• Cryosurgery is less expensive than other treatments and requires shorter recovery time and a shorter hospital stay
•  Some times it can be done using  only local anesthesia
• Because physicians can focus cryosurgical treatment on a limited area,they can avoid the destruction of nearby areas
• Treatment can be safely repeated and may be used along with standard treatments such as surgery,chemotherapy,hormone therapy and radiation
• It can be used for patients who are not good candidates for conventional surgery because of their age or other medical conditions

DISADVANTAGES

The major disadvantage of cryosurgery is the uncertainty surrounding its long term effectiveness.While cryosurgery may be effective in treating tumors the physician can see by using imaging tests,it can miss microscopic cancer spread

HOW A CRYOSURGERY IS PERFORMED

Your doctor will place liquid nitrogen on your skin using a cotton swab or spray.A numbing medicine may be used to prevent any pain or discomfort.

If an internal area is being treated your surgeon will use a scope which is a flexible tube that can fit into various openings in your body such as urethra,rectum or a surgical incision.The liquid nitrogen is fed to the area under treatment and applied to the targeted cells.The cells freeze ,die and then will be slowly absorbed in your body.Your doctor will use imaging equipment such as ultrasound as a guide for carrying out the procedure

RISKS ASSOCIATED

Risk include

• blisters
• damage of nearby healthy tissue
• Pain
• Scarring
• Sexual dysfunction
• Ulcers
• White skin at the site of surgery

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Prepared by : Dr Sajna Hamza

Proton therapy also called proton beam therapy is a type of radiation therapy.It uses protons rather than x rays to treat cancer

A proton is a positively charged particle.At high energy protons can destroy cancer cells.Like x-ray radiation , proton therapy is a type of external beam radiation therapy.It painlessly delivers radiation through skin from a machine outside the body

HOW PROTON THERAPY WORKS

A machine called synchroton or cyclotron speeds up protons.The high speed of the protons creates high energy.This energy makes the protons travel to the desired depth in the body.The protons then give the targeted radiation dose in the tumor

CANCERS TREATED WITH PROTON THERAPY

It is useful for treating tumors that have not spread and are near important parts of body

Proton therapy also may be used to treat these cancers

• Central nervous system cancers including chordoma,chordosarcoma and malignant meningeoma
• Eye cancer including uveal melanoma or choroidal melanoma
• Head and neck cancers including nasal cavity and paranasal sinus cancers and nasopharyngeal cancers
• Lung cancer
• Liver cancer
• Prostate cancer
• Spinal and pelvic sarcomas
• Non cancerous brain tumors

SIDE EFFECTS

The treatment itself is painless.Afterwards you  may experience fatigue.You may also have skin problems including redness,irritation,swelling ,dryness,or blistering and peeling.The side effects of the proton therapy depend on the part of the body being treated ,the size of the tuor and the types of healthy tissue near the tumor

RISKS AND BENEFITS

Compare with x-ray radiation therapy proton therapy has several benefits.

• Usually upto 60% less radiation can be delivered to the healthy tissues around the tumor.This lowers the risk of radiation damage to these tissues
• It may allow for a higher radiation dose to the tumor.This increases the chances that all of these tumor cells targeted by the proton therapy will be destroyed
• It may cause fewer and less severe side effects such as low blood counts, fatigue and nausea during and after treatment

But there are also some drawbacks to proton therapy

• Because proton therapy requires highly specialized and costly equipments.It is available at just a few medical centers.
• Cost is high compared to x ray radiation therapy
• Not all cancers can be treated with proton therapy

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Prepared by Dr Sajna Hamza

 

Surgery is used to treat many types of cancer .It works best for solid tumors that are contained in one area.

HOW IT IS USED

• Prevention : If you have a high risk of developing cancer in certain tissues or organs your Doctor my recommend removing those tissues or organs before cancer develops.
• Diagnosis: Your doctor may use a form of cancer surgery to remove all or part of a tumor allowing to be studied under microscope to determine whether it is cancerous or not
• Staging : It helps in determining the stage of cancer .By evaluating the size and extend of spread Doctor can able to determine the current stage
• Primary treatment :If cancer is localized and didnt spread much the doctor can to remove that part completely
• Debulking: Surgery helps in debulking the cancerous tumor if it is very large
• Helps in relieving symptoms or side effects

COSTS

Cost depend  on many factors, including

• The type of surgery you have
• How many specialists are involved in your surgery
• If you need local regional or general anesthesia
• Where you have surgery
• If you need to stay in hospital and for how long

RISKS

In general most cancer operations carry a risk of

• Pain -It is the common side effect of mast operations
• Infections-The site of your surgery can become infected.Your health care team will show you how to care for your wound after surgery.Follow this routine closely to avoid infection
• Loss of organ function-In order to remove your cancer,the surgeon may need to remove an entire organ
• Bleeding
• Blood clots-While you are recovering from surgery you are at an increased risk of developing blood clot.Though the risk is small this complication can be serious
• Altered bowel and bladder functions-Immediately after your surgery you may experience difficulty having a bowel movement or emptying your bladder.This typically resolves in a few days ,depending on your specific operation.

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Prepared by:Dr Sajna Hamza