AO-MEDICINE

• Breasts that are their usual size, shape, and color.
• Breasts that are evenly shaped without visible distortion or swelling.

What is cancer of the colon and rectum?

The colon is the part of the digestive system where the waste material is stored. The rectum is the end of the colon adjacent to the anus. Together, they form a long, muscular tube called the large intestine (also known as the large bowel). Tumors of the colon and rectum are growths arising from the inner wall of the large intestine. Benign tumors of the large intestine are called polyps. Malignant tumors of the large intestine are called cancers. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can be easily removed during colonoscopy and are not life-threatening. If benign polyps are not removed from the large intestine, they can become malignant (cancerous) over time. Most of the cancers of the large intestine are believed to have

What is cancer?

Cancer is a group of more than 100 different diseases. They affect the body's basic unit, the cell. Cancer occurs when cells become abnormal and divide without control or order. Like all other organs of the body, the colon and rectum are made up of many types of cells. Normally, cells divide to produce more cells only when the body needs them. This orderly process helps keep us healthy.

Treatment

Staging

If the biopsy shows that you have breast cancer, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. The stage is based on the size of the cancer, whether the cancer has invaded nearby tissues, and whether the cancer has spread to other parts of the body.
Staging may involve blood tests and other tests:

• Bone scan: The doctor injects a small amount of a radioactive substance into a blood vessel. It travels through the bloodstream and collects in the bones. A machine called a scanner detects and measures the radiation. The scanner makes pictures of the bones. The pictures may show cancer that has spread to the bones.
  

Detection and diagnosis

Your doctor can check for breast cancer before you have any symptoms. During an office visit, your doctor will ask about your personal and family medical history. You'll have a physical exam. Your doctor may order one or more imaging tests, such as a mammogram.
Doctors recommend that women have regular clinical breast exams and mammograms to find breast cancer early. Treatment is more likely to work well when breast cancer is detected early.
During a clinical breast exam, your health care provider checks your breasts. You may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips.

Symptoms

Early breast cancer usually doesn't cause symptoms. But as the tumor grows, it can change how the breast looks or feels. The common changes include:

• A lump or thickening in or near the breast or in the underarm area
• A change in the size or shape of the breast
• Dimpling or puckering in the skin of the breast
• A nipple turned inward into the breast
• Discharge (fluid) from the nipple,

Risk factors

When you're told that you have breast cancer, it's natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesn't.
Doctors do know that bumping, bruising, or touching the breast does not cause cancer. And breast cancer is not contagious. You can't catch it from another person.
Doctors also know that women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of getting a disease.
Some risk factors (such as drinking alcohol) can be avoided. But most risk factors (such as having a family history of breast cancer) can't be avoided.

The breasts

Inside a woman's breast are 15 to 20 sections called lobes. Each lobe is made of many smaller sections called lobules. Lobules have groups of tiny glands that can make milk. After a baby is born, a woman's breast milk flows from the lobules through thin tubes called ducts to the nipple. Fat and fibrous tissue fill the spaces between the lobules and ducts.

The breasts also contain lymph vessels. These vessels are connected to small, round masses of tissue called lymph nodes. Groups of lymph nodes are near the breast in the underarm (axilla), above the collarbone, and in the chest behind the breastbone.

Picture of the anatomy of the breast

Cancer cells

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the breasts and other parts of the body.

Normal cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.

Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a lump, growth, or tumor.

Tumors in the breast can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors:

Benign tumors:

• are rarely a threat to life



• can be removed and usually don't grow back



• don't invade the tissues around them



• don't spread to other parts of the body

Malignant tumors:

• may be a threat to life



• often can be removed but sometimes grow back



• can invade and damage nearby organs and tissues (such as the chest wall)



• can spread to other parts of the body

Breast cancer cells can spread by breaking away from the original tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells may be found in lymph nodes near the breast. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.

The spread of cancer is called metastasis.

What are the causes of breast cancer?

Breast cancer is the most common cause of cancer in women and the second most common cause of cancer death in women in the U.S. While the majority of new breast cancers are diagnosed as a result of an abnormality seen on a mammogram, a lump, or change in consistency of the breast tissue can also be a warning sign of the disease. Heightened awareness of breast cancer risk in the past decades has led to an increase in the number of women undergoing mammography for screening, leading to detection of cancers in earlier stages and a resultant improvement in survival rates. Still, breast cancer is the most common cause of death in women between 45-55 years of age. Although breast cancer in women is a common form of cancer, male breast cancer does occur and accounts for about 1% of all cancer deaths in men.

Research has yielded much information about the causes of breast cancers, and it is now believed that genetic and/or hormonal factors are the primary risk factors for breast cancer. Staging systems have been developed to allow doctors to characterize the extent to which a particular cancer has spread and to make decisions concerning treatment options. Breast cancer treatment depends upon many factors, including the type of cancer and the extent to which it has spread. Treatment options for breast cancer may involve surgery (removal of the cancer alone or, in some cases, mastectomy), radiation therapy, hormonal therapy, and/or chemotherapy.

With advances in screening, diagnosis, and treatment, the death rate for breast cancer has declined. In fact, about 90% of women newly diagnosed with breast cancer will survive for at least five years. Research is ongoing to develop even more effective screening and treatment programs.

Prognosis is separated into three groups.

• Stage I osteosarcoma is rare and includes parosteal osteosarcoma or low-grade central osteosarcoma. It has an excellent prognosis (>90%) with wide resection.
• Stage IIb prognosis depends on the site of the tumor (proximal tibia, femur, pelvis, etc.) size of the tumor mass (in cm.), and the degree of necrosis from neoadjuvant chemotherapy (chemotherapy prior to surgery). Other pathological factors such as the degree of p-glycoprotein, whether the tumor is cxcr4-positive ^[8], or Her2-positive are also important, as these are associated with distant metastases to the lung. The prognosis for patients with metastatic osteosarcoma improves with longer times to metastases, (more than 12 months-24 months), a smaller number of metastases (and their resectability). It is better to have fewer metastases than longer time to metastases. Those with a longer length of time(>24months) and few nodules (2 or fewer) have the best prognosis with a 2-year survival after the metastases of 50% 5-year of 40% and 10 year 20%. If metastases are both local and regional, the prognosis is worse.
• Initial presentation of stage III osteosarcoma with lung metastates depends on the resectability of the primary tumor and lung nodules, degree of necrosis of the primary tumor, and maybe the number of metastases. Overall prognosis is about 30% ^[9].

Chemotherapy is the medication given to patients to treat cancer. Successful treatment of osteosarcoma requires the use of chemotherapy before and after surgery. Since osteosarcoma is caused by the uncontrolled dividing of bone cells, chemotherapy helps by interfering with the way that the cells can divide. Chemotherapy actually kills the tumor cells. Therefore once the cells are dead, the cancer can not spread any further.
Chemotherapy prior to surgery has been found to help with surgical removal by shrinking the tumor. With surgery alone, in more than 80% of patients the tumor came back, most often appearing in their lungs. The high recurrence rate indicates that most patients have micrometastatic disease at diagnosis, meaning they have metastases that are too small to be seen in their lungs with the imaging studies. Therefore, the use of chemotherapy before surgery is a critical part of the treatment of patients with osteosarcoma.

• High-dose methotrexate
• Doxorubicin (Adriamycin)
• Cisplatin
• Ifosfamide
• Etoposide

More specific information about these drugs can be found using Medline Plus. You must look up the name of the drug.

Treatment for lung cancer depends upon a variety of factors. The most important factors are the histopathologic (diseased tissue) type of lung cancer and the stage of the cancer.