Thursday, December 29, 2011

New Diagnostic Technology Helps Oncologists Diagnosis In Colon Cancer

Rapid molecular testing in the laboratories has greatly helped oncologists to diagnose cancers of the breast, lymphoma and leukemia.
One type of cancer that is a high-profile target for improved diagnostic testing is colon cancer. It is one of the most common malignancies in men and women. The National Cancer Institute estimates that 141,210 new cases of colon and rectal cancers will be reported and an estimated 49,380 Americans will die of these diseases this year.  Anytime time a lab presents new testing it requires financial,clinical and operational resources. Since there is a high rate of colon cancer it is important to have more accurate testing.  Past testing such occult blood and sigmoidoscopy are variable and can have false positives.  The new testing is using monoclonal and polyclonal antibodies to detect only human blood in stool, this technology has improved specificity, sensitivity, accuracy, the White Paper reported.

In conclusion, the ability of new technologies to contribute to improved performance of assays used in screening individuals for colorectal cancer demonstrate how swiftly the standard of care in laboratory medicine can be changed for the better. New generation FOB lab tests are one example of the types of changes now occurring across the entire range of testing services offered by clinical laboratories and pathology groups.


Tuesday, December 27, 2011

Skin Cancer-Squamous Cell Carcinoma

Squamous Cell Carcinoma is the second most common skin cancer.  This cancers results from the uncontrolled rapid growth of abnormal cells.
The main symptom is a growing bump that may have a rough, scaly surface and flat reddish patches.



Squamous Cell Carcinoma under the nail
 
Below is a slide of a histology slide after biopsy of squamous cell carcinoma.


Squamous Cell Carcinoma is caused by UV rays over a period of a lifetime. Although SCC is usually found on the skin that has been exposed to the sun SCC can also be found in the mucus membranes and genitals.

Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a small needle. You will likely feel a small pinch and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy. Any biopsy is likely to leave a scar. Since different methods produce different types of scars, you should ask your dermatologist about biopsies and scarring before the procedure is done.



Diagnosis begins with a biopsy of the suspicious growth on skin. This procedure needs to be performed by a dermatologist.   Shave biopsy uses a thin surgical blade to shave off the top layers of skin. This is the most common method for diagnosing squamous cell skin cancer. Punch biopsy uses a round, cookie cutter-like tool. It is used to take a deeper skin sample.
Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a small needle. You will likely feel a small pinch and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy. Any biopsy is likely to leave a scar. Since different methods produce different types of scars, you should ask your dematologist about biopsies and scarring before the procedure is done.

 
Above is a video of the histology of a squamous cell carcinoma by Washington Deceit.  This explains how pathologists view cancerous tissue under the microscope to properly diagnosis the cancer for the doctor.


Below is a video of the treatment options of SCC by Dr. Shane Chapman

Sunday, December 25, 2011

Skin Cancer- Basal Cell

The chance of getting skin cancer needs to be taken seriously. Laying in tanning beds on a regular basis or not using protection when exposed to the sun such as hats,sunscreen ,etc will greatly increase the probability of skin cancer.  Skin cancer is abnormal growth of skin cells. There are three types of skin cancer which are basal cell, squamous cell and melanoma.  Basal cell cancer is the easiest to treat.
Basal Cell Carcinoma
Skin cancer is divided into two major groups: nonmelanoma and melanoma. Basal cell carcinoma is a type of nonmelanoma skin cancer, and is the most common form of cancer in the United States. According to the American Cancer Society, 75% of all skin cancers are basal cell carcinomas.
Basal cell carcinoma starts in the top layer of the skin called the epidermis. It grows slowly and is painless. A new skin growth that bleeds easily or does not heal well may suggest basal cell carcinoma. The majority of these cancers occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation. They may also appear on the scalp. Basal cell skin cancer used to be more common in people over age 40, but is now often diagnosed in younger people.
Your risk for basal cell skin cancer is higher if you have:
  • Light-colored skin
  • Blue or green eyes
  • Blond or red hair
  • Overexposure to x-rays or other forms of radiation
Basal cell skin cancer almost never spreads. But, if left untreated, it may grow into surrounding areas and nearby tissues and bone.
                                                 Basil Cell Cancer

 Basil Cell Cancer

Basal cell carcinoma may look only slightly different than normal skin. The cancer may appear as skin bump or growth that is:
  • Pearly or waxy
  • White or light pink
  • Flesh-colored or brown
In some cases the skin may be just slightly raised or even flat.
You may have:
  • A skin sore that bleeds easily
  • A sore that does not heal
  • Oozing or crusting spots in a sore
  • Appearance of a scar-like sore without having injured the area
  • Irregular blood vessels in or around the spot
  • A sore with a depressed (sunken) area in the middle

    If your doctor is suspicious of skin cancer then they will cut out the abnormal section of skin which is called a biopsy.

    Skin Cancer Nodular Basal Cell Carcinoma Cancer presented by Dr. Shane Chapman

    Treatment

  • Excision cuts the tumor out and uses stitches to place the skin back together.
  • Curettage and electrodesiccation scrapes away the cancer and uses electricity to kill any remaining cancer cells.
  • Surgery, including Mohs surgery, in which skin is cut out and immediately looked at under a microscope to check for cancer. The process is repeated until the skin sample is free of cancer.
  • Cryosurgery freezes and kills the cancer cells.
  • Radiation may be used if the cancer has spread to organs or lymph nodes or for tumors that can't be treated with surgery.
  • Skin creams with the medications imiquimod or 5-fluorouracil may be used to treat superficial basal cell carcinoma. 
  • For more information go to: www.mayoclinic.com ; www.nih.gov

Thursday, December 22, 2011

Skin Cancer; What You Need to Know To Save Your Life Video

This is an educational video that shows what skin looks like and other irregularities concerning the shape of the tumor.  You will have understanding as to what the pathologist views under the scope to determine a person's diagnosis of melanoma. 


Tuesday, December 20, 2011

Advancing Histology To Determine Cancer Diagnosis Video

Histology is extremely important in the diagnosis of all cancers.  Tissues from biopsies procedures from any part of the body are processed in the histology department. After the tissues are processed the pathologist will view the prepared tissue on slides to determine if cancer is present.

Peter Kilner demonstrates a whole new way of approaching tissue processing with the Thermo Scientific Securesette cassette making it easier and more efficient to carry out biopsies and other tests in the histology lab. http://www.thermoscientific.com/pathology




Monday, December 19, 2011

Pancreatic Cancer Chemotherapy

John Chabot, MD, chief, division of GI/Endocrine Surgery, executive director, Pancreas Center at New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, discusses the current chemotherapy options available to treat pancreatic cancer. The main drug available is gemcitabine
and is currently used in combination therapies.

There are currently trials underway that are demonstrating improved survival with aggressive chemotherapy. Nongemcitabine regiment was identified that proved to be a better treatment option for stage IV pancreatic cancer than gemcitabine. Chabot expects that drugs that are used in other types of cancer will show the most significant improvement in the future.

Saturday, December 17, 2011

New Anti-Cancer Vaccine Developed by University of Georgia

The Atlanta Journal-Constitution
Researchers from the University of Georgia have developed a vaccine that has shown promising results against cancer, the UGA News Service is reporting.
The vaccine dramatically reduced the size of tumors in laboratory mice and was particularly successful against breast and pancreatic tumors, two of the deadliest forms of cancer, the researchers reported.
"This vaccine elicits a very strong immune response," UGA researcher Geert-Jan Boons wrote. "It activates all three components of the immune system to reduce tumor size by an average of 80 percent."
The vaccine trains the immune system to distinguish and attack cancer cells based on their different chemical structures, said Sandra Gendler, a researcher at the Mayo Clinic in Arizona, which was also involved in the research.
"We are beginning to have therapies that can teach our immune system to fight what is uniquely found in cancer cells," Boons said. "When combined with early diagnosis, the hope is that one day cancer will become a manageable disease."
After further testing in the laboratory, clinical testing could begin in 2013, the researchers said.

Liver Cancer Video

This is a very informative video of liver cancer. You will learn about the functions of the liver,symptoms of liver cancer and treatment.


                                                             Video For Health

Friday, December 16, 2011

Histology of Bone Marrow Video

In the video you will learn what the pathologist is viewing in the bone marrow to determine the diagnosis of cancer or blood disorder.

Thursday, December 15, 2011

New Study Shows That HPV Test Is Better Than Pap Test for Cervical Cancer

HPV stands for Human Papillomavairus which is s the most common sexually transmitted virus in the United States. At least 50% of sexually active people will have genital HPV at some time in their lives.

A test that looks for the virus that causes most cases of cervical cancer may be the best way to screen women over age 30 for the disease, a new study shows.
The study followed 45,000 women ages 29 to 56 in the Netherlands who were split into two groups. The first group got a traditional Pap test to look for cervical cancer. The second group got a Pap test along with a newer test for human papillomavirus (HPV). Studies have shown that HPV causes more than 90% of all cervical cancers.
Five years after they were first screened, all women were rescreened using both Pap and HPV tests.
In the first round of testing, HPV tests detected significantly more precancerous changes to cervical cells than Pap testing alone.
Because doctors caught and treated those changes sooner, women who initially got HPV tests were less likely to have full-blown cervical cancer when they were tested again five years later compared to women who got Pap tests alone.
The study found that women who got an initial HPV test had about a 27% reduced risk of having advanced precancerous lesions five years later compared to women who had a Pap test alone.
HPV virus
They were also less likely to have cervical cancer. There were 14 cases of cancer found in the group that only got a Pap test at the start of the study compared to four cases in the women who also got an HPV test.

Mayo Clinic image of a woman with HPV
 For more info:
http://www.webmd.com/cancer/cervical-cancer/news/20111215/hpv-test-beats-pap-test-cervical-cancer-screening





Wednesday, December 14, 2011

Blood Disorder: Pernicious Anemia (Vitamin B12 Deficiency)

Pernicious Anemia is not a cancer but blood disorder.  This disorder is treated by a hematologist oncologist or a family physician.






Above an image of a patient's blood smear that has been stained showing classic pernicious anemia


Pernicious anemia is a disease that begins slowly and make take several years to realize what is happening in your body. This disease is classified as autoimmune.  The definition of autoimmune arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the immune system mistakes some part of the body as a pathogen and attacks its own cells. This may be restricted to certain organs (e.g. in autoimmune thyroiditis) or involve a particular tissue in different places (e.g. Goodpasture's disease which may affect the basement membrane in both the lung and the kidney). The treatment of autoimmune diseases is typically with immunosuppression—medication which decreases the immune response.
Pernicious anemia is a decrease in red blood cells that occurs when the body cannot properly absorb vitamin B12 from the gastrointestinal tract. Vitamin B12 is necessary for the proper development of red blood cells.
Pernicious anemia is a type of megaloblastic anemia. Megaloblastic anemia is a blood disorder in which there is anemia with larger-than-normal red blood cells.

The body needs vitamin B12 to make red blood cells. To provide vitamin B12 to your blood cells, you need to eat enough foods containing vitamin B12, such as meat, poultry, shellfish, eggs, and dairy products.To absorb vitamin B12, your body uses a special protein called intrinsic factor, which is released by cells in the stomach. The combination of vitamin B12 bound to intrinsic factor is absorbed in the last part of the small intestine.
When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12.
Very rarely, infants and children are born without the ability to produce enough intrinsic factor, or the ability to absorb the combination of intrinsic factor and vitamin B12 in the small intestine. Pernicious anemia that occurs at birth (congenital) is inherited. You need the defective gene from each parent to get it.
Common causes of pernicious anemia include:
  • Weakened stomach lining (atrophic gastritis)
  • The body's immune system attacking the cells that make intrinsic factor (autoimmunity against gastric parietal cells) or intrinsic factor itself
 RISK FACTORS
 
  • Family history of the disease
  • History of autoimmune endocrine disorders, including:
  • Scandinavian or Northern European descent

    SYMPTOMS

    People with mild anemia may have no symptoms or very mild symptoms. More typical symptoms of vitamin B12 deficiency anemia include:
  • Diarrhea or constipation
  • Fatigue, lack of energy, or light-headedness when standing up or with exertion
  • Loss of appetite
  • Pale skin
  • Problems concentrating
  • Shortness of breath, mostly during exercise
  • Swollen, red tongue or bleeding gums
  • Nerve damage caused by vitamin B12 deficiency that has been present for a longer time may cause:
    • Confusion or change in mental status (dementia) in severe or advanced cases
    • Depression
    • Loss of balance
    • Numbness and tingling of hands and feet

      LAB TESTING
       1. Complete blood count which is where blood is drawn and the lab tech will process the specimen through an analyzer that will measure the blood counts which include white counts,red counts,hemoglobin,hematocrit,platelets and indices .
      2. Serum holotranscobalamin II 
              Circulating homocysteine is a risk factor of cardiovascular and cerebrovascular events.    Hyperhomocysteinemia may be an early indicator for vitamin B12 disorders because cobalamin is a cofactor in the remethylation process of homocysteine. Serum holotranscobalamin (holoTC II) becomes decreased before the development of metabolic dysfunction. In this study, we assessed circulating holoTC II to estimate the diagnosis of vitamin B12 deficiency in the first ischemic cerebrovascular attack.       
                  3. Reticulocyte Count measures the amount of red cells that are being produced from the bone 
                       marrow. 


                 4.  Schilling test is a medical investigation used for patients with vitamin B12 deficiency. The                        patient is given radiolabeled B12 to drink. An intramuscular B12 injection an hour later.
                     24 hours later a urine sample is collected and is measured for B12 absorption.
                 
                5.  Methylmalonic Acid level is a blood test that is performed by gas chromotographic Mass
                     spectrometry. An elevated level may indicate a Vitamin B12 deficiency.


Treatment
 The treatment for pernicious anemia requires a monthly injection of vitamin B12 . This treatment brings great relief for the patient.  Fatigue and other symptoms are relieved.

For more information:  
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001595/

Tuesday, December 13, 2011

News on Prostrate Screening test

This following article was found at http://kansas.com in the Doc Talk section. 
There has been a lot of controversy regarding prostate cancer screening of late.
Most recently, the United States Preventive Services Task Force (USPSTF) made the recommendation that PSA (prostate specific antigen) screening should be stopped as there can be more harm than benefit from using this practice.
What is prostate cancer? The prostate is a gland in men that produces fluid to carry sperm during ejaculation. In some men, this gland develops cancer. This typically occurs in men older than 50. Risk factors for prostate cancer include increasing age and ethnicity (black men are more likely to develop prostate cancer than Hispanic or white men).
Commonly, prostate cancer screening involves two tests: The PSA and a rectal examination. This is typically done annually in men age 50 and older. Prostate cancer screening is not recommended for men who are 75 and older as the risks of screening outweigh the benefits.
First, we should talk about what PSA is. PSA is a protein made by the prostate gland. It can be measured in a blood sample. PSA may be elevated in prostate cancer, and this is why it has been used to screen for the condition. PSA can be elevated in other conditions as well, so a high PSA level does not necessarily mean that a man has prostate cancer.
Rectal examination involves checking the prostate via the rectum where it can be assessed for nodules or enlargement that may suggest cancer.
The controversy has risen from the review of some medical studies that have shown no benefit of screening. Many medical organizations have made recommendations and statements about this topic, including the American Urological Association, USPSTF and the American Cancer Society. It should be noted that, at this time, there is no consensus by experts on whether PSA testing should be done.
Finding prostate cancer early has the benefit for some men of increasing their life span, but this is not the case for everyone. Early diagnosis can also limit the morbidity of advanced disease (or the spread of cancer). However, PSA testing also can lead to false positive tests, which can then lead

Read more: http://www.kansas.com/2011/12/13/2138279/doc-talk-prostate-cancer-screenings.html#ixzz1gQUUEYD4

Monday, December 12, 2011

Blood Disorder: Paroxysmal Nocturnal Hemoglobinuria

PNH is not a cancer but blood disease and is treated at cancer facility. PNH is a rare disease and can become life threatening. Another name for PNH is Marchiafava-Micheli syndrome characterized by complement-induced intravascular hemolytic anemia , red urine and thrombosis. 
Since this is a blood disease it will be usually treated by a Hematology Oncologist.  The disease,PNH, is different from other hemolytic anemias because the cause is from an intrinsic defect.  Intrinsic defect means that in the cell membrane (deficiency of glycophosphatidylinositol) leading to absence of protective proteins on the membrane.
Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in a hematopoietic stem cell; the mutated cell then expands in the bone marrow. This mutation is usually acquired in adulthood, and the disorder is not inherited or passed down to children.
The disease causes the breakdown of circulating red cells (hemolysis), which can produce symptoms including red or darkened urine and a low red blood cell count (anemia). PNH patients can also develop aplastic anemia, which is accompanied by a decreased platelet and/or white blood count in addition to anemia. Conversely, patients with aplastic anemia sometimes develop PNH. Patients are also at increased risk of developing blood clots, which cause symptoms such as severe leg, abdominal, or chest pain, shortness of breath, jaundice, or headache.
Physicians diagnose PNH using one of two blood tests — either a Ham test or flow cytometry. Treatments for PNH patients with hemolytic anemia include transfusion, folic acid, and if appropriate, iron supplements. Low red blood cell, platelet, and white cell counts can be treated with steroids or with the same immunosuppressive drugs used to treat aplastic anemia. Blood clots are usually treated with anticoagulants, and sometimes, if severe, with tissue plasminogen activator (TPA). PNH can be cured by bone marrow transplantation; this procedure should be considered on an individual basis, based on the patient’s age and symptoms.

TESTING FOR DIAGNOSIS OF PNH

Bone marrow samples can be obtained by aspiration and trephine biopsy. Sometimes, a bone marrow examination will include both an aspirate and a biopsy. The aspirate yields semi-liquid bone marrow, which can be examined by a pathologist under a light microscope as well as analyzed by flow cytometry, chromosome analysis, or polymerase chain reaction (PCR). Frequently, a trephine biopsy is also obtained, which yields a narrow, cylindrically shaped solid piece of bone marrow, 2mm wide and 2 cm long (80 μL), which is examined microscopically (sometimes with the aid of immunohistochemistry) for cellularity and infiltrative processes. An aspiration, using a 20 mL syringe, yields approximately 300 μL of bone marrow.[1] A volume greater than 300 μL is not recommended, since it may dilute the sample with peripheral blood.[1]



In a bone marrow analysis detection of the red cells will produce a defective protective layer. The white cell and platelets will be lower than normal . This result will decrease immunity in the body and therefore decrease resistance against disease. 

The Ham Test is also used in the diagnosis of PNH. 
HAM test is used to evaluate patients with suspected PNH (Paroxysmal Noctural Hemoglobinuria) or suspected congential dyserythropoietic anemia, especially with hemosiderinuria, Pancytopenia, decreased RBC acetyl cholinesterase, decreased leukocyte alkaline phosphatase, negative direct Coomb’s test, and/or apparent marrow failure.
Patients red cells show a high sensitivity to complement mediated hemolysis .

 LDH ( lactate dehydrgenase) is a blood test that is used to monitor tissue damage. The most important measure of hemolysis — can help provide a more complete clinical picture of PNH when performed in conjunction with other laboratory tests and patient-reported assessments. Monitoring of hemolysis in patients with PNH can be done by measuring LDH levels. LDH levels in PNH can be frequently elevated, in some cases exceeding 20 times the upper limit of normal during severe exacerbations.3 It is important to establish a baseline LDH level and continue monitoring over time. Static or “snapshot” measurements of LDH may not reflect the chronic and progressive course of the disease.








TREATMENT

Some of the supportive therapies that are currently being used to help ease the symptoms of PNH include transfusions and anticoagulants (Blood thinners)
Transfusions are recommended during times of severe haemoglobin depletion when your body cannot generate enough new cells to make up for those lost to haemolysis. It may be used on a periodic basis when your haemoglobin level is steadily decreasing.
Your physician may prescribe anticoagulants to you, in order to either reduce the risk of getting blood clots or may need to dissolve a clot when it happens.

Complement Inhibition:

When unregulated, the complement can lead to various severe diseases causing damages in multiple organs. Complement inhibitors are compounds which bind to enzymes in the complement system. Their role is to suppress or reduce the activity of complement.

Bone Marrow Transplantation:

Bone marrow transplantation (BMT) is the only known treatment that may cure PNH. It involves replacing the body’s defective blood stem cells by new healthy ones from a donor. However, bone marrow transplantations carry significant risks which should be discussed with your doctor.
It is important to remember that symptoms of PNH may vary from patient to patient, and a plan to manage your PNH may work for you but may not work for someone else. This is why it is so important to discuss treatment options with your doctor.


 The following websites are helpful.

http://www.pnhsource.eu/Diagnosing%20PNH/Flow%20Cytometry/Default.aspxhttp://www.mskcc.org/cancer-care/adult/rare-hematologic-disorders/paroxysmal-nocturnal-hemoglobinuria
http://www.medindia.net/bloodtest/hematology/pnh_test.htmhttp://pnhsource.eu/Treatment%20Options/Default.aspx

Friday, December 9, 2011

Blood Disorder: Sickle Cell Anemia





Sickle Cell anemia is not a cancer but is treated by an oncologists at a local cancer center.  The local oncologist may refer the patient to a larger facility that has physicians that are specialists in hematology disorders.

Sickle Cell anemia is not a contagious disease but is a disease of the blood caused by inherited abnormal hemoglobin. Hemoglobin is the protein found in red blood cells that help transport oxygen throughout ones body. Sickle Cell disease is when a person inherits two abnormal genes, one from each parent. A person with a single Sickle cell is a carrier and will go on to lead a very normal life. 
This abnormality causes diseased cells to change shape from round to a crescent like shape, the cells become fragile and are prone to rupture. The odd shaped Sickle cells can also clog blood vessels which may cause organ and tissue damage.
bones, lungs,





Sickle Cell Trait

People who inherit a sickle hemoglobin gene from one parent and a normal gene from the other parent have a condition called sickle cell trait. Their bodies make sickle hemoglobin and normal hemoglobin.
People who have sickle cell trait usually have few, if any, symptoms and lead normal lives. However, some people may have medical complications.
People who have sickle cell trait can pass the sickle hemoglobin gene to their children. The following image shows an example of an inheritance pattern for sickle cell trait.

Sickle Cell Symptoms

The initial symptom may be pain throughout the whole body.  This is an indication of a sickle cell crisis. This crisis may affect various organs and structures of the human body such as bones,lungs joints and abdomen.
Other symptoms include headaches,dizziness,shortness of breath,jaundice(yellow coloring of skin and whites of the eyes).  Also, the skin will appear whiter than normal.

How is Sickle Cell Diagnosed?

The initial test is a complete blood count.  The CBC includes testing of the white count,red count,hemoglobin, hematocrit, and platelet.  In Sickle Cell the hemoglobin and red count will be abnormally low.  The lab tech will be alarmed that a peripheral smear need to be made from the patient's blood specimen and viewed under the microscope. The lab tech will alert the doctor of the result and he will order more specific testing.
The test that is used for a confirming diagnosis is the hemoglobin S.

Sickle cell tests are used to detect, diagnose, and confirm sickle cell anemia (also called sickle cell disease) and to identify those who may have sickle cell trait. Sickle cell anemia is an inherited disorder that leads to the production of an abnormal hemoglobin called hemoglobin S (Hb S or Hgb S). Hemoglobin is a protein found in red blood cells (RBCs) that binds to oxygen in the lungs and carries it to tissues throughout the body.
Typically, hemoglobin A (Hb A) makes up most of the hemoglobin found in normal RBCs in adults, with small amounts of hemoglobin A2 and hemoglobin F. Before babies are born, they normally produce large amounts of hemoglobin F (Hb F), which is then slowly replaced by Hb A after birth. Mutations in the genes that code for the production of hemoglobin can lead to abnormal types of hemoglobin. Common mutations include beta thalassemia and those associated with hemoglobin variants such as Hb S, hemoglobin C (Hb C). With a normal hemoglobin gene copy from one parent and a Hb S gene copy from the other parent (heterozygous), a person is said to have sickle cell trait and be a sickle cell carrier. When a person has two Hb S gene copies (one from each parent; homozygous), then he has sickle cell anemia (disease). If he has one Hb S gene and one other abnormal gene, such as Hb C gene, then he will experience some of the same symptoms associated with sickle cell disease.
Sickle_arrows.png
Hb S can form crystals that change the shape of the RBC from a round disc to a characteristic sickle shape. This altered shape limits the RBC's ability to flow smoothly throughout the blood vessels in the body, limits the hemoglobin's ability to transport oxygen to tissues, and decreases the RBCs' lifespan from 120 days to about 10-20 days. A person with sickle cell disease (homozygous for Hb S) can become severely anemic because the body cannot produce RBCs as fast as they are destroyed. The affected person can suffer painful episodes and a variety of complications when sickled cells become lodged in and obstruct small blood vessels.
Sickle cell tests are done to determine whether someone is producing hemoglobin S, thus carrying a sickle gene. They are ordered routinely as part of newborn screening programs and are mandated by every state in the US and the District of Columbia. If results of a newborn screen are abnormal, then one or more sickle cell tests may be ordered to confirm abnormal findings. Sickle cell tests may also be ordered along with or following an abnormal CBC and blood smear, with normal iron studies to help evaluate a patient who has an unexplained hemolytic anemia or demonstrate symptoms that suggest the presence of sickle cell anemia.

Sickle Cell Treatment

Sickle Cell patients have a low response of being cured through blood and bone marrow stem cell ,but  the  pain symptoms can be treated by medications, rest, heat pads, drinking lots of water and oxygen therapy.

stemcellresources.org

Severe sickle cell anemia can be treated with a medicine called hydroxyurea. This medicine prompts your body to make fetal hemoglobin. Fetal hemoglobin, or hemoglobin F, is the type of hemoglobin that newborns have.
In people who have sickle cell anemia, fetal hemoglobin helps prevent red blood cells from sickling and improves anemia.
Given daily, hydroxyurea reduces how often painful sickle cell crises and acute chest syndrome occur. Many people taking hydroxyurea also need fewer blood transfusions and have fewer hospital visits.
Doctors are studying the long-term effects of hydroxyurea on people who have sickle cell anemia. Early studies in children suggest that the medicine may help improve growth and preserve organ function, but this has not been proven.
Hydroxyurea can reduce the number of white blood cells in your blood. (These cells help fight infections.) This can lead to an increased risk of infections.
People who take hydroxyurea must have careful medical followup, including blood tests. The dose of this medicine may need to be adjusted to reduce the risk of side effects.
A doctor who has knowledge about hydroxyurea can tell you about the risks and benefits of taking this medicine.
Trials
Clinical trials currently are under way for Sickle Cell Anemia. For more information about these studies, visit www.clinicaltrials.gov


For more information go to the following web sites: 
http://www.nhlbi.nih.gov/health/health-topics/topics/sca/
http:// www.labstestsonline.org
http://www.healthfixdaily.com

Wednesday, December 7, 2011

Colon Cancer Stage 2 Testing News

About the Oncotype DX Colon Cancer Assay and Stage II Colon Cancer

The Oncotype DX colon cancer assay is a colon cancer test that provides an individual, numerical assessment of how likely colon cancer is to return in patients with stage II colon cancer following surgery to remove the tumor. The multigene expression assay examines the activity of specific genes within a patient´s tumor sample in order to provide individualized information to each person and their physician about the specific biological make-up of their colon cancer.
The Oncotype DX assay is appropriate for people who are newly diagnosed with stage II colon cancer and is performed on tumor tissue removed during the original surgery. Because of this, the Oncotype DX assay does not require any additional surgery or procedures in order for a patient to get the test.
For detailed information about the Oncotype DX, please call: (866) ONCOTYPE or visit www.oncotypedx.com

Breast Cancer and The New Test Oncotype dx Assay

Information That Can Help Define Treatment Options and Make Treatment Decisions for Breast and Colon Cancer Patients

About the Oncotype DX Breast Cancer Assay and Early Stage Breast Cancer

The Oncotype DX breast cancer assay, is a test that examines a breast cancer patient's tumor tissue at a molecular level, and gives information about a patient's individual disease. This information can help individualize breast cancer treatment planning and identify options. The Oncotype DX breast cancer test is the only multigene expression test commercially available that has clinical evidence validating its ability to predict the likelihood of chemotherapy benefit as well as recurrence in early-stage breast cancer. The Oncotype DX gene expression assay is intended to be used by women with early-stage (stage I or II), node-negative, estrogen receptor-positive (ER+) invasive breast cancer who will be treated with hormone therapy.

Oncotype DX Breast Cancer Assay Evaluation and Impacts on Breast Cancer Treatment Options

The Oncotype DX breast cancer multigene expression test has been extensively evaluated in 14 clinical studies involving more than 4,000 breast cancer patients worldwide, including a large validation study published in The New England Journal of Medicine and a chemotherapy benefit study published in the Journal of Clinical Oncology.
Oncotype DX is the only test incorporated in published ASCO® and NCCN® breast cancer treatment guidelines for patients with node-negative breast cancer that is estrogen-receptor positive and/or progesterone-receptor positive. For complete information on Oncotype DX for Patients & Caregivers, Healthcare Providers, and Managed Care Organizations, visit Oncotype DX.com.
For additional information for Patients & Caregivers and detail about breast cancer treatment options, visit MyBreastCancerTreatment.org.  You may also watch a great, informative video at the address below.

http://www.genomichealth.com/en-US/Company/LabVideo.aspx

Tuesday, December 6, 2011

Chemotherapy and Lab Testing

During a patient's chemotherapy treatments routine blood draws for lab testing are important. Chemotherapy drugs can affect your blood cell counts and organs of your body .  This can be monitored through the results of the lab test that are ordered.  A Complete Blood Count is very important as to monitor low white cell counts, platelet counts, red cell counts and low hemoglobin. When a CBC is ordered before a next chemo treatment they are looking for changes in all blood counts. The nurse will look at the ANC which stand for the Absolute Neutrophil Count.

Since chemotherapy attacks the fast growing cells, the normal tissues with high growth rate suffer the major brunt of attack of the chemotherapy drugs. These include the fast growing cells of the bone marrow, oral mucus membrane and lining of the stomach and intestine. This may subsequently lead to low blood counts, mouth soars, diarrhea, and abdominal upset. White blood cells are the guardian defense system of your body, and when the white cell count decrease due to the chemotherapy; you may be at great risk of an infection. Also when your body defense system is low due to low white cell count, once you get an infection it could be overwhelming.

Physicians usually calculate the absolute neutrophil count (ANC) from your regular blood count to determine the risk of infection. ANC is calculated by multiplying the total white cell count by the percentage of neutrophils and then dividing by 100. For example if your total white cell count is 4,000 and neutrophil percentage is 50 then your ANC is 2000 x 50 divided by 100 and equals 1000. If your white cell count is 8000 but neutrophil percentage is 25 then the ANC is again 1000. If your ANC is 500 to 1000 you have slightly increased risk of getting infections. If ANC is 300 to 500 you are at moderate risk of getting infections. If the ANC is less than 300 then you are at high risk of getting infections. Infection can come from out side or from your own body (example gut).

Some other blood tests that the physician may order during cycles of chemotherapy are a Complete Metabolic Panel and a Magnesium level.
A typical CMP-16 will specifically measure the levels of Glucose, Waste Products ( Blood Urea Nitrogen, Creatinine, Uric Acid, & the Glom Filtration Rate), Electrolytes (Sodium & Potassium Chloride), Minerals (Calcium & Phosphorus), Blood Fats (Cholesterol & Triglycerides), Proteins (Albumin, Globulin, & Total Protein), Enzymes (Total Bilirubin, Alkaline Phosphatase, GGTP, LDH, & SGOT (AST)).
cThe glucose checks your pancreas function.  Blood Urea Nitrogen and creatinine levels relate to kidney function.  Protein levels are important in liver and kidney damage.  Finally bilirubin and the enzyme testing is very important in determining liver damage. Magnesium is another electrolyte.  The magnesium can be low during chemo and may cause kidney damage. 





It is vitally important that you have your pre-chemotherapy  lab testing done the day before your chemo appointment.  When you do not have the labs performed then they have to order the tests stat and then wait and hour or two to begin your infusion.  As a result, this makes your nurse behind in her infusion schedule and other patients have to wait.

If you are experience weakness, shortness of breath, bleeding or muscle pain before your next blood draw for your chemotherapy then you need to contact the oncologist.

For more information :  http://www.labtestsonline.org ; http://www.medicineworld.org/cancer














Sunday, December 4, 2011

Bone Marrow Biopsy

I wanted to educate about why a Bone Marrow is needed in diagnosing the reason of abnormal complete blood count results.  The Bone Marrow is the spongy tissue that is inside some of your larger bones such  as iliai crest which is the on the side of hip area.  Cells are produced in the bone marrow and should have normal amounts. If you have leukemia then there will be abnormal amount of cells.
In order to diagnose your medical condition the oncologist must do a Bone Marrow aspirate. Inside your bone is a fluid portion and a solid portion and this needs to be aspirated with a larger needle.



                                           Educational video of a Bone Marrow Aspirate





If your diagnosis is a blood cancer then you may have other bone marrow biopsies to see if your treatment is succeeding .  Your bone marrow will be put into several tubes and the core(bone part) will be put in formalin.
 The will perform genetic testing, flow cytometry , histology and stains.

  Complications to bone marrows are rare.  I would not take any aspirin and always make the doctor aware if you are taking any blood thinners.

Blood Disorders : Aplastic Anemia

Aplastic anemia is a condition where the bone marrow does not produce sufficient enough of new cells to replenish the blood cells in the body.








There are many circumstances why the bone marrow can shut down production of new cells.


  • Radiation and chemotherapy treatments. While these cancer-fighting therapies kill cancer cells, they can also damage healthy cells, including stem cells in bone marrow. Aplastic anemia can be a temporary side effect of these treatments.
  • Exposure to toxic chemicals. Exposure to toxic chemicals, such as some used in pesticides and insecticides, may cause aplastic anemia. Exposure to benzene — an ingredient in gasoline — also has been linked to aplastic anemia. This type of anemia sometimes gets better on its own if you avoid repeated exposure to the chemicals that caused your initial illness.
  • Use of certain drugs. Some medications, such as those used to treat rheumatoid arthritis and some antibiotics, can cause aplastic anemia.
  • Autoimmune disorders. An autoimmune disorder, in which your immune system begins attacking healthy cells, may involve stem cells in your bone marrow.
  • A viral infection. Viral infections that affect bone marrow may play a role in the development of aplastic anemia in some people. Viruses that have been linked to the development of aplastic anemia include hepatitis, Epstein-Barr, cytomegalovirus, parvovirus B19 and HIV.
  • Pregnancy. Aplastic anemia that occurs in pregnancy may be related to an autoimmune problem — your immune system may attack your bone marrow during pregnancy.
  • Unknown factors. In many cases, doctors aren't able to identify the cause of aplastic anemia. This is called idiopathic aplastic anemia.
Above is an image of Aplastic anemia bone marrow biopsy under a microscope.

How is Aplastic Anemia Diagnosed?
A complete blood count is performed and the cell counts, hemoglobin will be low.  Also a bone marrow biopsy will be performed and sent to pathology for the cytology technologists to stain and prepare to be read by the pathologist.  The report is then sent to your family doctor , specialist or oncologist.  Hematology oncologist is the doctor who should treat aplastic anemia. If you like to view a bone marrow biopsy then go tot the following website.http://youtube.com/watch?v=dTKAU34
Reticulocyte count is another test that is ordered in the diagnosis of Aplastic anemia. It is a test that measures how fast the bone marrow is producing new red cells. The reticulocyte test will be higher in if the hemoglobin is low and the bone marrow is trying to produce more cells due to blood loss.
Erythropoietin is a blood test that measures the amount of erythropoietin, a hormone which tells the bone marrow to produce more red cells.  This hormone is made by the cells in the kidney. The kidney produces more of the EPO hormone when oxygen levels are lower.  When someone is anemic they have trouble breathing because they do not have enough red cells to carry the oxygen.

Treatment for Aplastic anemia includes blood transfusions, platelet transfusions, a stem cell transplant, immunosuppressants, bone marrow stimulants and antiviral medications.

Anytime you may feel abnormally fatigued and have shortness of breath you need to see care from a medical professional.  You need to make sure that a complete blood count is performed .

http://www.mayoclinic.com/health/aplastic-anemia/; http://www.medline.com ; http://labsonline.com













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Saturday, December 3, 2011

Blood From Mollusk Could Cure Cancer

There is great research being done on a giant keyhole limpets hemolymph.that carries a protein that is essential component of the new cancer vaccine. What it the function of the keyhole limpets hemocyanin? It is to carry oxygen in their blood.  The protein is unusually large in size, nearly the size of a virus. Keyhole limpet hemolymph contains epititopes. An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by the immune system, specifically by antibodies, B cells, or T cells. The part of an antibody that recognizes the epitope is called a paratope. Although epitopes are usually thought to be derived from non-self proteins, sequences derived from the host that can be recognized are also classified as epitopes.
The epitopes of protein antigens are divided into two categories, conformational epitopes and linear epitopes, based on their structure and interaction with the paratope.[1] A conformational epitope is composed of discontinuous sections of the antigen's amino acid sequence. These epitopes interact with the paratope based on the 3-D surface features and shape or tertiary structure of the antigen. Most epitopes are conformational.
By contrast, linear epitopes interact with the paratope based on their primary structure. A linear epitope is formed by a continuous sequence of amino acids from the antigen.

The result of doctors injecting  keyhole limpet hemolymph (KLH) is a poweful immune response. The immune system can be stimulated to attack a certain cancer by attaching markers to KLH. A real plus by using KLH is that it is nontoxic.

As you know before using a vaccine for cancer treatment clinical trials have to performed.  A treatment for bladder cancer is now approved in Europe and Asia.
You can read more in Popular Science article written by Sam Roudman on the December 2011 issue.

Friday, December 2, 2011

Blood Disorders: Polycythemia Vera

Polycythemia vera is not a cancer,but is a disease of the bone marrow.  Hematology oncologists handle the diagnosis and treatment of this disease. The bone marrow makes too many red cells.  Polycythemia is rare and develops slowly.  The problem of elevated red blood cells is usually found in a routine complete blood count which is ordered by doctor.   The image below shows what polycythemia vera looks like under the microscope.



If  polycythemia vera is not treated then it could become life threatening. The symptoms are the following:
In its early stages, polycythemia vera usually doesn't cause any signs or symptoms. However, as the disease progresses, you may experience:
  • Headache
  • Dizziness
  • Itchiness, especially following a warm bath or shower
  • Redness of your skin
  • Shortness of breath
  • Breathing difficulty when you lie down
  • Numbness, tingling, burning or weakness in your hands, feet, arms or legs
  • A feeling of fullness or bloating in your left upper abdomen due to an enlarged spleen
  • Fatigue  
Blood tests
Doctors most frequently use blood tests to diagnose polycythemia vera. If you have polycythemia vera, blood tests may reveal:
  • An increase in the number of red blood cells and, in some cases, an increase in platelets or white blood cells.
  • Elevated hematocrit measurement, the percentage of red blood cells that make up total blood volume.
  • Elevated levels of hemoglobin, the iron-rich protein in red blood cells that carries oxygen.
  • Very low levels of erythropoietin (EPO), a hormone that stimulates bone marrow to produce new red blood cells.
Bone marrow aspiration or biopsy
If your doctor suspects you have polycythemia vera, he or she may recommend a bone marrow aspiration or biopsy to collect a sample of your bone marrow. A bone marrow biopsy involves taking a sample of solid bone marrow material. A bone marrow aspiration is usually done at the same time as a biopsy. During an aspiration, your doctor withdraws a sample of the liquid portion of your marrow.
If an examination of your bone marrow shows that it's producing higher than normal numbers of blood cells, it may be a sign of polycythemia vera.
Tests for the gene mutation that causes polycythemia vera
If you have polycythemia vera, analysis of your bone marrow or blood also may show the mutation in the cells (JAK2 V617F mutation) that's associated with the disease.
n a bone marrow aspiration and biopsy, a doctor or nurse uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone called the posterior iliac crest. A bone marrow biopsy is often taken at the same time. This second procedure removes a small piece of bone tissue and the enclosed marrow.

Treatment of polycythemia include doing a phlebotomy to remove blood that is putting your circulatory system in overload.  It is similar to giving blood to the Red Cross.  Drugs are given if the phlebotomy is not enough to relieve the increased red cell production.  
 Hydroxyurea (Droxia, Hydrea) or anagrelide (Agrylin), to suppress your bone marrow's ability to produce blood cells may be used. Interferon-alpha may be used to stimulate your immune system to fight the overproduction of red blood cells.
Any abnormal symptoms should always be addressed by a doctor.  Be in tune with your body and document changes to help the doctor to have a clearer picture of your health problems.

You can get more information be searching https:www.mayoclinic.com

Thursday, December 1, 2011

Cancer Testing update

September 1, 2011
Testing Anti Cancer Virus A breakthrough in medical science is on the door steps as scientists try to develop an anti-cancer virus. It is likely to change the approach to cancer treatment in the coming days. Modifying vaccinia virus which is being used to develop a smallpox vaccine were first time have been used on cancer patients with positive results.
The virus has initially been injected for testing its safety in 23 patients. The virus named JX-594, is dependent upon a chemical pathway, common in some cancers, in order to replicate. Its replication stops the growth of cancerous cells though does not kill them. In the eight patients receiving the highest dose, seven had the virus replicating in their tumors, but not in healthy tissue.
The approach is new and advances are encouraging. The currently recommended method is intravenous injection so that it can reach to all affected organs but higher concentrations directly at the affected points is also being considered to enable killing of diseased cells.
Cancer Research UK’s Prof Nick Lemoine, also director of Barts Cancer Institute, said: “Viruses that multiply in just tumor cells – avoiding healthy cells – are showing real promise as a new biological approach to target hard-to-treat cancers.

http://www.mediconews.com

Wednesday, November 30, 2011

Multiple Myeloma

Multiple Myeloma is a cancer that begins in a person's bone marrow.  Bone marrow is the soft tissue inside the bone.  The bone produces many cells in the blood of circulating in out body.  Multiple myeloma is the cancer of the plasma cells.  Below is an image of plasma cells be viewed through a microscope.









       
Plasma cells are a type of white cell that produces antibodies.  Cancer causes cells to multiply at an abnormal rate.  This what happens in Multiple Myeloma.

Collections of abnormal cells accumulate in bones, where they cause bone lesions (abnormal areas of tissue), and in the bone marrow where they interfere with the production of normal blood cells. Most cases of myeloma also feature the production of a paraprotein, an abnormal antibody that can cause kidney problems and interferes with the production of normal antibodies leading to immunodeficiency. Hypercalcemia (high calcium levels) is often encountered.[1] Myeloma is diagnosed with blood tests (protein electrophoresis, peripheral blood smear), microscopic examination of the bone marrow (bone marrow biopsy), and radiographs of commonly involved bones. Myeloma is generally thought to be incurable, but remissions may be induced with steroids, chemotherapy, thalidomide and stem cell transplants. Newer drugs, such as lenalidomide and bortezomib, are often used in more advanced disease. Radiation therapy is sometimes used to treat bone lesions that are causing symptoms.[1]
The disease develops in 1–4 per 100,000 people per year. It is more common in men, and for yet unknown reasons is twice as common in African Americans as it is in white Americans. With conventional treatment, the prognosis is 3–4 years, which may be extended to 5–7 years or longer with advanced treatments. Multiple myeloma is the second most common hematological malignancy (13%) and constitutes 1% of all cancers.[1]


What are the common lab tests performed in diagnosing and managing multiple myeloma?

A blood test called serum protein electrophoresis separates your blood proteins and can detect the presence of monoclonal proteins (M proteins) — referred to as an "M spike" — in your blood. Parts of M proteins may also be detected in a test of your urine. When M proteins are found in urine, they're referred to as Bence Jones proteins. Monoclonal proteins may indicate multiple myeloma, but also can indicate other conditions.







Monoclonal refers to a set of antibodies. These antibodies are the similar or identical antibodies. The reason behind these being similar antibodies is that they are produced by a single type of immune cell and all of them are clones of a single parent cell. If you give any substance, it is probable to generate monoclonal antibodies that specially bind to that matter. These antibodies can then serve up to sense or purify that matter. These antibodies have become a very important tool in the fields such as medicine, molecular biology and biochemistry.

As a tumor marker: a blood B2Microglobulin test may be ordered to help determine the severity and spread (stage) of multiple myeloma and may sometimes be ordered to evaluate the effectiveness of treatment. B2M has been associated with tumor burden, the amount of cancer present, and may be ordered to help evaluate the prognosis of cancers such as leukemia and lymphoma.

Sometimes people with multiple myeloma don't have signs or symptoms. Other times, they may have fever, bruising, bleeding and tiredness. People with multiple myeloma may also have painful bone fractures and damage to organs, especially the kidneys.
Although there is no cure at this time, the latest treatments can help control the disease, relieve pain, limit complications and slow the progress of multiple myeloma in most people. This tremendous progress in treatment means that most people with multiple myeloma live longer than ever before.

Repeated lab tests help the oncologist to know the progression of the Multiple Myeloma and if the treatment is working to control the cancer.





To learn more go to www.mayoclinic.com , www.labtestsonline.org, www.wikipedia.org