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Bladder Cancer
The bladder is a hollow organ in your lower abdomen that stores urine. Bladder cancer occurs in the lining of the bladder. It is the sixth most common type of cancer in the United States.
Symptoms include:
- Blood in your urine
- A frequent urge to urinate
- Pain when you urinate
- Low back pain
Risk factors for developing bladder cancer include smoking and exposure to certain chemicals in the workplace. People with a family history of bladder cancer or who are older, white, or male have a higher risk.
Treatments for bladder cancer include surgery, radiation therapy, chemotherapy, and biologic therapy. Biologic therapy boosts your body's own ability to fight cancer.
NIH: National Cancer Institute
Breast Cancer
What is breast cancer?
Breast cancer is a cancer that starts in breast tissue. It happens when cells in the breast change and grow out of control. The cells usually form a tumor.
Sometimes the cancer does not spread any further. This is called "in situ." If the cancer spreads outside the breast, the cancer is called "invasive." It may just spread to nearby tissues and lymph nodes. Or the cancer may metastasize (spread to other parts of the body) through the lymph system or the blood.
Breast cancer is the second most common type of cancer in women in the United States. Rarely, it can also affect men.
What are the types of breast cancer?
There are different types of breast cancer. The types are based on which breast cells turn into cancer. The types include:
- Ductal carcinoma, which begins in the cells of the ducts. This is the most common type.
- Lobular carcinoma, which begins in the lobules. It is more often found in both breasts than other types of breast cancer.
- Inflammatory breast cancer, in which cancer cells block lymph vessels in the skin of the breast. The breast becomes warm, red, and swollen. This is a rare type.
- Paget's disease of the breast, which is a cancer involving the skin of the nipple. It usually also affects the darker skin around the nipple. It is also rare.
What causes breast cancer?
Breast cancer happens when there are changes in the genetic material (DNA). Often, the exact cause of these genetic changes is unknown.
But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.
There are also certain genetic changes that can raise your risk of breast cancer, including changes in the BRCA1 and BRCA2 genes. These two changes also raise your risk of ovarian and other cancers.
Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.
Who is at risk for breast cancer?
The factors that raise your risk of breast cancer include:
- Older age
- History of breast cancer or benign (noncancer) breast disease
- Inherited risk of breast cancer, including having BRCA1 and BRCA2 gene changes
- Dense breast tissue
- A reproductive history that leads to more exposure to the estrogen hormone, including
- Menstruating at an early age
- Being at an older age when you first gave birth or never having given birth
- Starting menopause at a later age
- Taking hormone therapy for symptoms of menopause
- Radiation therapy to the breast or chest
- Obesity
- Drinking alcohol
What are the signs and symptoms of breast cancer?
The signs and symptoms of breast cancer include:
- A new lump or thickening in or near the breast or in the armpit.
- A change in the size or shape of the breast.
- A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
- A nipple turned inward into the breast.
- Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
- Scaly, red, or swollen skin in the nipple area or the breast
- Pain in any area of the breast.
How is breast cancer diagnosed?
Your health care provider may use many tools to diagnose breast cancer and figure out which type you have:
- A physical exam, including a clinical breast exam (CBE). This involves checking for any lumps or anything else that seems unusual with the breasts and armpits.
- A medical history.
- Imaging tests, such as a mammogram, an ultrasound, or an MRI.
- Breast biopsy.
- Blood chemistry tests, which measure different substances in the blood, including electrolytes, fats, proteins, glucose (sugar), and enzymes. Some of the specific blood chemistry tests include a basic metabolic panel (BMP), a comprehensive metabolic panel (CMP), and an electrolyte panel.
If these tests show that you have breast cancer, you will have tests that study the cancer cells. These tests help your provider decide which treatment would be best for you. The tests may include:
- Genetic tests for genetic changes such as in the BRCA and TP53 genes.
- HER2 test. HER2 is a protein involved with cell growth. It is on the outside of all breast cells. If your breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body.
- An estrogen and progesterone receptor test. This test measures the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly.
Another step is staging the cancer. Staging involves doing tests to find out whether the cancer has spread within the breast or to other parts of the body. The tests may include other diagnostic imaging tests and a sentinel lymph node biopsy. This biopsy is done to see whether the cancer has spread to the lymph nodes.
What are the treatments for breast cancer?
Treatments for breast cancer include:
- Surgery such as
- A mastectomy, which removes the whole breast
- A lumpectomy to remove the cancer and some normal tissue around it, but not the breast itself
- Radiation therapy
- Chemotherapy
- Hormone therapy, which blocks cancer cells from getting the hormones they need to grow
- Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
- Immunotherapy
Can breast cancer be prevented?
You may be able to help prevent breast cancer by making healthy lifestyle changes such as:
- Staying at a healthy weight
- Limiting alcohol use
- Getting enough exercisee
- Limiting your exposure to estrogen by
- Breastfeeding your babies if you can
- Limiting hormone therapy
If you are at high risk, your health care provider may suggest that you take certain medicines to lower the risk. Some women at very high risk may decide to get a mastectomy (of their healthy breasts) to prevent breast cancer.
It's also important to get regular mammograms. They may be able to identify breast cancer in the early stages, when it is easier to treat.
NIH: National Cancer Institute
Colonoscopy
What are colonoscopy and flexible sigmoidoscopy?
Colonoscopy and flexible sigmoidoscopy are procedures that let your doctor look inside your rectum and colon (large intestine). They use instruments called scopes. Scopes have a light and a tiny camera attached to a long, thin tube. These procedures let your doctor see problems such as inflamed tissue, ulcers, polyps, and cancer.
Colonoscopy checks your entire colon and rectum. Flexible sigmoidoscopy checks the rectum and the lower colon (sigmoid colon) only.
What is a virtual colonoscopy?
A virtual colonoscopy also looks inside your rectum and part of your colon. But it does not use a scope. Instead, it is an x-ray test. Another name for this test is CT colonography.
Who needs a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy?
You may need a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy to find the cause of unexplained symptoms such as:
- Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
- Changes in your bowel activity, such as diarrhea
- Pain in your abdomen (belly)
- Unexplained weight loss
Doctors also use these procedures to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you are at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
How do you prepare for a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy?
To prepare for a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy, you will need to:
- Talk with your doctor about any health problems you have and all of the medicines and supplements that you take. You may need to stop taking some of your medicines and/or supplements before the procedure.
- Follow the bowel prep instructions from your doctor. The bowel prep clears the stool out of your colon, so your doctor will be able to see the colon during the procedure:
- You may need to follow a clear liquid diet, usually for about one day before the procedure. Avoid red or purple drinks or gelatin; the dye can look like blood in the colon. You probably need to stop eating and drinking the night before the exam.
- You will need to take some laxatives. They may be pills, a powder that you dissolve in liquid, an enema, or a combination of these. The laxative will cause diarrhea, so you need to stay close to the bathroom.
For a virtual colonoscopy, you will also need to drink a contrast medium the night before. The contrast medium is a dye or other substance that is visible on x-rays. It can help your doctor tell the difference between stool and polyps.
How are colonoscopy, virtual colonoscopy, and flexible sigmoidoscopy done?
For a colonoscopy:
- You will have the procedure at a hospital or outpatient center. It usually takes 30 to 60 minutes.
- You will get IV (intravenous) sedatives or anesthesia, usually along with pain medicine, so you won't be awake or feel pain during the procedure.
- You'll lie on a table while the doctor inserts a colonoscope through your anus and into your rectum and colon. The scope inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your colon.
- Once the scope reaches the opening to your small intestine, the doctor will slowly remove the scope. While doing so, your doctor will examine your colon again.
- If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
- If you have abnormal tissue, your doctor may do a biopsy.
- The sedative or anesthesia takes time to wear off completely. You'll stay at the hospital or outpatient center for 1 to 2 hours after the procedure. Then you will need someone to drive you home.
For a virtual colonoscopy:
- You will have the procedure at a hospital or outpatient center. It usually takes about 10 to 15 minutes.
- You do not need anesthesia.
- You'll lie on a table while a specially trained x-ray technician inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view.
- The table slides into a tunnel-shaped device where the technician takes the x-ray images. You will turn over on your side or stomach to get more images taken.
For a flexible sigmoidoscopy:
- You will have the procedure at a hospital, medical office, or outpatient center. It usually takes about 20 minutes.
- You do not need anesthesia.
- You'll lie on a table while the doctor inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your lower colon.
- Once the scope has reached the top of the lower colon, the doctor will slowly remove the scope. While doing so, your doctor will examine your lower colon again.
- If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
- If you have abnormal tissue, your doctor may do a biopsy.
What should I expect after a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy?
You may feel cramping in your abdomen or bloating during the first hour after the any of these procedures. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.
For a virtual colonoscopy or a flexible sigmoidoscopy, you go back to your regular activities and diet right after the test. For a colonoscopy, you can expect a full recovery and return to your normal diet by the next day.
Your doctor will give you the results of your procedure. If you had a biopsy, it can take a few days to get those results.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Colorectal Cancer
What is colorectal cancer?
Colorectal cancer is cancer that develops in the tissues of the colon or rectum. Your colon and rectum are part of your digestive system:
- Your colon is the first and longest part of your large intestine. It absorbs water and some nutrients from foods. It also changes the leftover waste products into stool (poop).
- Your rectum is the lower part of your large intestine. It's where your body stores stool.
Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Cancer that affects either of these parts may also be called colorectal cancer.
What causes colorectal cancer?
Colorectal cancer happens when there are changes in your genetic material (DNA). These changes are also called mutations or variants. Often, the genetic changes that lead to colorectal cancer happen during your lifetime and the exact cause is unknown. But certain genetic changes that raise your risk for colorectal cancer are inherited, meaning that you are born with them.
Besides genetics, other factors, including your lifestyle and the environment, can affect your risk of colorectal cancer.
Who is more likely to develop colorectal cancer?
Anyone can get colorectal cancer, but certain factors make you more likely to develop it:
- Being older; your risk of getting colorectal cancer increases as you age.
- Having a personal or family history of colorectal cancer.
- Having a history of adenomas. Adenomas are colorectal polyps (growths) that look abnormal under a microscope or are 1 centimeter or larger. Adenomas are not cancer, but they can sometimes turn into cancer over time.
- Having a genetic syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colorectal cancer).
- Having chronic ulcerative colitis or Crohn disease for 8 years or more.
- Having three or more alcoholic drinks per day.
- Smoking cigarettes.
- Being Black; Black people have an increased risk of colorectal cancer and death from colorectal cancer compared to other races.
- Having obesity.
What are the symptoms of colorectal cancer?
Colorectal cancer may not always cause symptoms, especially at first. If you do have symptoms, they could include:
- A change in bowel habits that lasts more than a few days, such as:
- Diarrhea
- Constipation
- Feeling that the bowel does not empty completely
- Your stool is narrower or has a different shape than usual
- Blood (either bright red or very dark) in the stool
- Frequent gas pains, bloating, fullness, or cramps
- Weight loss for no known reason
- Fatigue
What is screening for colorectal cancer and who needs it?
Because colorectal cancer may not cause symptoms at first, it's important to have screening tests for colorectal cancer. Screening tests look for signs of a disease before you have any symptoms. They can help find cancer early, when it may be easier to treat.
Most experts recommend that start screenings at 45 and continue until at least age 75. People over 75 and those who are at high risk should talk to their providers about how often you need screening and what type of test they should get.
The types of tests include different stool tests and procedures such as colonoscopies and flexible sigmoidoscopy. Talk with your provider about how often you need screening and what type of test you should get.
How is colorectal cancer diagnosed?
If you have symptoms that could be caused by colorectal cancer or if your screening test results are abnormal, you may need to have more tests to find out if you have cancer. Possible tests include:
- A physical exam.
- A digital rectal exam. For this exam, your provider inserts a lubricated, gloved finger into your rectum to feel for lumps or anything unusual.
- The tests that are also used for screening (colonoscopy, stool tests, etc.) and biopsy, if you have not already had them.
- Other blood and tissue tests.
What are the treatments for colorectal cancer?
Your treatment options usually depend on your age, your general health, how serious the cancer is, and which type of cancer you have.
For colon cancer, your treatment may include one or more of these options:
- Surgery.
- Radiofrequency ablation, a procedure that uses radio waves to heat and destroy abnormal cells. The radio waves travel through electrodes (small devices that carry electricity).
- Cryosurgery, a procedure in which an extremely cold liquid or an instrument called a cryoprobe is used to freeze and destroy abnormal tissue.
- Chemotherapy.
- Radiation therapy.
- Targeted therapy, which uses drugs or other substances that mainly attack specific cancer cells and cause less harm to normal cells.
- Immunotherapy.
For rectal cancer, your treatment may include one or more of these options:
- Surgery.
- Radiation therapy.
- Chemotherapy.
- Active surveillance, which means having regular tests to see if your rectal cancer has changed. If the tests show the cancer is starting to grow, then you will have treatment to try to cure the cancer.
- Targeted therapy, which uses drugs or other substances that mainly attack specific cancer cells and cause less harm to normal cells.
- Immunotherapy.
Can colorectal cancer be prevented?
Avoiding the risk factors that you have control over may help prevent some cancers. That includes:
- Not smoking
- Limiting alcohol to under three drinks per day
- Managing your weight
There are also other steps you can take to try to prevent colorectal cancer. They include:
- Getting regular colorectal cancer screenings
- Having polyps removed before they can become cancerous
- Getting regular exercise
CPR
When someone's blood flow or breathing stops, seconds count. Permanent brain damage or death can happen quickly. If you know how to perform cardiopulmonary resuscitation (CPR), you could save a life. CPR is an emergency procedure for a person whose heart has stopped (called sudden cardiac arrest) or who is no longer breathing. CPR can maintain the blood flow breathing until emergency medical help arrives.
Take these steps if someone is in sudden cardiac arrest:
- Call 911.
- If someone else is around, have them look for an automated external defibrillator (AED). An AED is a device that sends an electric shock to the heart to try to restore its normal rhythm. AEDs are available in many public places such as schools, businesses, and airports .
- Make sure that the person with sudden cardiac arrest is lying on their back on a firm surface.
- If you haven't had any CPR training, you can do "hands-only" CPR for a teen or adult whose heart has stopped beating ("hands-only" CPR isn't recommended for children). "Hands-only" CPR uses chest compressions to keep blood circulating. Chest compressions involve pushing hard and fast in the center of the chest.
- If you've had training, you can use chest compressions, clear the airway, and do rescue breathing. Rescue breathing helps get oxygen to the lungs for a person who has stopped breathing. To keep your skills up, repeat the CPR training every two years.
- Use the AED as soon as possible, if there is one available.
Lymphoma
Lymphoma is a cancer of a part of the immune system called the lymph system. There are many types of lymphoma. One type is Hodgkin disease. The rest are called non-Hodgkin lymphomas.
Non-Hodgkin lymphomas begin when a type of white blood cell, called a T cell or B cell, becomes abnormal. The cell divides again and again, making more and more abnormal cells. These abnormal cells can spread to almost any other part of the body. Most of the time, doctors don't know why a person gets non-Hodgkin lymphoma. You are at increased risk if you have a weakened immune system or have certain types of infections.
Non-Hodgkin lymphoma can cause many symptoms, such as :
- Swollen, painless lymph nodes in the neck, armpits or groin
- Unexplained weight loss
- Fever
- Soaking night sweats
- Coughing, trouble breathing or chest pain
- Weakness and tiredness that don't go away
- Pain, swelling or a feeling of fullness in the abdomen
Your doctor will diagnose lymphoma with a physical exam, blood tests, a chest x-ray, and a biopsy. Treatments include chemotherapy, radiation therapy, targeted therapy, biological therapy, or therapy to remove proteins from the blood. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells. Biologic therapy boosts your body's own ability to fight cancer. If you don't have symptoms, you may not need treatment right away. This is called watchful waiting.
NIH: National Cancer Institute
Melanoma
Melanoma is the most serious type of skin cancer. Often the first sign of melanoma is a change in the size, shape, color, or feel of a mole. Most melanomas have a black or black-blue area. Melanoma may also appear as a new mole. It may be black, abnormal, or "ugly looking."
Thinking of "ABCDE" can help you remember what to watch for:
- Asymmetry - the shape of one half does not match the other
- Border - the edges are ragged, blurred or irregular
- Color - the color is uneven and may include shades of black, brown and tan
- Diameter - there is a change in size, usually an increase
- Evolving - the mole has changed over the past few weeks or months
Surgery is the first treatment of all stages of melanoma. Other treatments include chemotherapy and radiation, biologic, and targeted therapies. Biologic therapy boosts your body's own ability to fight cancer. Targeted therapy uses substances that attack cancer cells without harming normal cells.
NIH: National Cancer Institute
Paralysis
Paralysis is the loss of muscle function in part of your body. It happens when something goes wrong with the way messages pass between your brain and muscles. Paralysis can be complete or partial. It can occur on one or both sides of your body. It can also occur in just one area, or it can be widespread. Paralysis of the lower half of your body, including both legs, is called paraplegia. Paralysis of the arms and legs is quadriplegia.
Most paralysis is due to strokes or injuries such as spinal cord injury or a broken neck. Other causes of paralysis include:
- Nerve diseases such as amyotrophic lateral sclerosis
- Autoimmune diseases such as Guillain-Barre syndrome
- Bell's palsy, which affects muscles in the face
Polio used to be a cause of paralysis, but polio no longer occurs in the U.S.
Prostate Cancer
What is prostate cancer?
Cancer is a disease in which cells in the body grow out of control. Prostate cancer begins in the cells of the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.
Prostate cancer is one of the most common types of cancer. It often grows very slowly. If it does not spread to other parts of the body, it may not cause serious problems. But sometimes prostate cancer can grow quickly and spread to other parts of the body. This kind of prostate cancer is serious.
What causes prostate cancer?
Researchers don't know for sure what causes prostate cancer. They do know that it happens when there are changes in the genetic material (DNA).
Sometimes these genetic changes are inherited, meaning that you are born with them. There are also certain genetic changes that happen during your lifetime that can raise your risk of prostate cancer. But often the exact cause of these genetic changes is unknown.
Who is more likely to develop prostate cancer?
Anyone who has a prostate can develop prostate cancer. But certain factors can make you more likely to develop it:
- Age. Your chance of developing prostate cancer increases as you get older. Prostate cancer is rare in people under age 50.
- Family health history. Your risk of prostate cancer is higher if you have a parent, sibling, or child who has or has had prostate cancer.
- Race. African Americans are more likely to get prostate cancer. They're also more likely to:
- Get prostate cancer at a younger age.
- Have more serious prostate cancer.
- Die from prostate cancer.
What are the symptoms of prostate cancer?
Prostate cancer doesn't always cause symptoms, especially at first. If it does cause symptoms, they may include:
- Problems urinating (peeing), such as:
- A urine stream that's weak, hard to start, or starts and stops
- Suddenly needing to urinate right away
- Urinating often, especially at night
- Pain or burning when urinating
- Blood in your urine or semen
- Pain in your lower back, hips, or pelvis that does not go away
- Painful ejaculation (the release of semen through the penis during orgasm)
But many of these symptoms may be from other common prostate problems that aren't cancer, such as an enlarged prostate.
You should discuss your prostate health with your health care provider if you:
- Have symptoms that could be prostate cancer
- Have a high risk for developing prostate cancer
- Had a screening test that suggests you could have prostate cancer
What are prostate tests and how is prostate cancer diagnosed?
Tests which check for prostate cancer include:
- A digital rectal exam (DRE). In this exam, your provider feels your prostate for lumps or anything unusual by inserting a lubricated, gloved finger into your rectum.
- A prostate-specific antigen (PSA) blood test. A high PSA blood level may be a sign of prostate cancer. But many other things can cause high PSA levels, too.
- Imaging tests. These tests may use ultrasound or MRI to make pictures of your prostate.
If these tests show that you might have prostate cancer, the next step is usually a prostate biopsy. A biopsy is the only way to diagnose prostate cancer.
During a biopsy, a doctor uses a hollow needle to remove some prostate tissue. The tissue is studied under a microscope to look for cancer cells.
What are the treatments for prostate cancer?
Your treatment options usually depend on your age, your general health, and how serious the cancer is. Your treatment may include one or more of options:
- Observation,which is mostly used if you are older, your prostate cancer isn't likely to grow quickly, and you don't have symptoms or you have other medical conditions. Your doctor will keep checking on your cancer over time so to see whether you will need to start treatment for the cancer. There are two types of observation:
- Watchful waiting means having little or no testing. If symptoms begin or change, you will get treatment to relieve them, but not to treat the cancer.
- Active surveillance means having regular tests to see if your prostate cancer has changed. If the tests show the cancer is starting to grow or if you develop symptoms, then you will have treatment to try to cure the cancer.
- Surgery to remove your prostate gland may be an option if your cancer hasn't spread outside of your prostate.
- Radiation therapy uses high energy to kill cancer cells or prevent them from growing.
- Hormone therapy blocks cancer cells from getting the hormones they need to grow. It may include taking medicines or having surgery to remove the testicles.
- Chemotherapy uses medicines to kill cancer cells, slow their growth, or stop them from spreading. You might take the drugs by mouth, as an injection (shot), as a cream, or intravenously (by IV).
- Targeted therapy uses drugs or other substances that attack specific cancer cells. This treatment causes less harm to healthy cells than radiation therapy or chemotherapy.
- Immunotherapy helps your own immune system to fight cancer.
Can prostate cancer be prevented?
Making healthy lifestyle changes may help to prevent some prostate cancers. These changes include:
- Being at a healthy weight
- Quitting smoking
- Getting enough exercise
- Eating healthy foods
NIH: National Cancer Institute