Saturday, March 10, 2012

New Alert! Great News For Cancer Patients

It is truly amazing the how far the advancing research and technology is rapidly advancing for cancer diagnosis and treatment,  Another amazing article of this type of technology!

The Greenville (S.C.) Hospital System's University Medical Center will be among the first to test Life Technologies' Ion Torrent system, a next-generation gene sequencer, according to a GHS announcement.
The technology promises to identify the genetic makeup of a patient's cancer and determine the treatment--reducing the time between diagnosis and therapy to about a week.
For patients with advanced forms of cancer time is critically important, not only medically but also psychologically, Larry Gluck, medical director of cancer services at Greenville (S.C.) Hospital System, told The Greenville News.
The technology eventually will allow a full analysis in about a day for less than $1,000, compared to the $5,000 to $10,000 it costs now, Michael Bolick, president of healthcare diagnostics company Lab 21 told the paper.
Technology continues to make cancer treatment more personal and targeted and genetic testing is becoming cheaper and more accessible. Personalized medicine also has been bolstered by efforts such as NIH's genetic testing registry and organizations such as St. Jude Children's Hospital in Memphis, Tenn., and Washington University School of Medicine in St. Louis, which recently launched a website to share DNA sequencing data of 600 forms of pediatric cancer with other researchers

                                               Next Generation Gene Sequencer

Read more: Hospital tests genomic tech to speed cancer treatment - FierceHealthIT

Friday, March 9, 2012

Cancer, A Lab Tech 's Perspective: Tumor Markers

Cancer, A Lab Tech 's Perspective: Tumor Markers: When cancer is present certain tumor markers are present.  Tumor markers are proteins that can be found in blood  and  can be increased with...

Acute Monocytic Leukemia

There are several types of white blood cells in our blood.  Above is a chart of the different kinds which include lymphocytes, monocytes, basophils, neutrophils and eosinophils. Any time any of these cell are produced rapidly from the bone marrow and seen in immature stages in the peripheral blood system then this is usually caused by cancer and is determined to be a leukemia.

In this article we will be addressing acute monocytic leukemia.  Acute stage of any leukemia is when the bone marrow produces an abnormal amount of premature white cells that can be seen in our blood system through a microscope.

Notice how large these monocytes are seen in the peripheral blood under a microscope after a smear has been made on a glass slide and then stained with Wrights. These are called white cells in the blast stage which is very immature.  Notice the center nucleus is very large. A normal monocyte nucleus is small and condensed.  The outer cytoplasm has vacuoles (holes).

Acute myeloid leukemia (AML) is one of the most common types of leukemia among adults. This type of cancer is rare under age 40. It generally occurs around age 60. (This article focuses on AML in adults.)
AML is more common in men than women.
Persons with this type of cancer have abnormal cells inside their bone marrow. The cells grow very fast, and replace healthy blood cells. The bone marrow, which helps the body fight infections, eventually stops working correctly. Persons with AML become more prone to infections and have an increased risk for bleeding as the numbers of healthy blood cells decrease.
Most of the time, a doctor cannot tell you what caused AML. However, the following things are thought to lead to some types of leukemia, including AML:
  • Certain chemicals (for example, benzene)
  • Certain chemotherapy drugs, including etoposide and drugs known as alkylating agents
  • Radiation
Problems with your genes may also play a role in the development of AML.
You have an increased risk for AML if you have or had any of the following:

Exams and Tests

The doctor will perform a physical exam. There may be signs of a swollen spleen, liver, or lymph nodes.
A complete blood count (CBC) shows anemia and a low number of platelets. A white blood cell count (WBC) can be high, low, or normal.
Bone marrow aspiration will show if there are any leukemia cells.
If your doctor learns you do have this type of leukemia, further tests will be done to determine the specific type of AML. There are eight subtypes of AML. They range from M0 to M7, based on which blood cells are abnormal.


Treatment involves using medicines to kill the cancer cells. This is called chemotherapy. But chemotherapy kills normal cells, too. This may cause side effects such as excessive bleeding and an increased risk for infection. Your doctor may want to keep you away from other people to prevent infection.
Other treatments for AML may include:
  • Antibiotics to treat infection
  • Bone marrow transplant or stem cell transplant after radiation and chemotherapy
  • Red blood cell transfusions to fight anemia
  • Transfusions of platelets to control bleeding
Most types of AML are treated the same way. However, a form of AML called acute promyelocytic leukemia (APL) is treated with a medicine called all-trans retinoic acid (ATRA). This medicine helps leukemia cells grow into normal white blood cells.
The drug arsenic trioxide is for use in patients with APL who do not get better with ATRA or chemotherapy.

Support Groups


Outlook (Prognosis)

When the signs and symptoms of AML go away, you are said to be in remission. Complete remission occurs in most patients.
With treatment, younger patients with AML tend to do better than those who develop the disease at an older age. The 5-year survival rate is much lower in older adults than younger persons. Experts say this is partly due to the fact that the body of a younger person can better tolerate strong chemotherapy medicines.
If the cancer does not come back (relapse) within 5 years of the diagnosis, you are considered permanently cured.

Possible Complications

Complications of AML and cancer treatment include severe infections and life-threatening bleeding. Sometimes, the cancer comes back (relapses) after treatment.

                      This video will explain about leukemias in acute and chronic stages.

For more information:

Thursday, March 8, 2012

Upratentorial Primitive Neuroectodermal Tumors, Childhood

Supratentorial primitive neuroectodermal tumors are fast-growing tumors that form in brain cells in the cerebrum. The cerebrum is at the top of the head and is the largest part of the brain. The cerebrum controls thinking, learning, problem-solving, emotions, speech, reading, writing, and voluntary movement.
Childhood supratentorial primitive neuroectodermal tumors are also called cerebral neuroblastomas or cerebral medulloblastomas.

                                            Supratentorial primitive neuroectodermal tumors

Although cancer is rare in children, brain tumors are the most common type of childhood cancer other than leukemia and lymphoma.
This summary refers to the treatment of primary brain tumors (tumors that begin in the brain). Treatment of metastatic brain tumors, which are tumors formed by cancer cells that begin in other parts of the body and spread to the brain, is not discussed in this summary.
Brain tumors can occur in both children and adults; however, treatment for children may be different than treatment for adults. (Refer to the PDQ treatment summary on Adult Brain Tumors for more information.)
The cause of most childhood brain tumors is unknown.
The symptoms of childhood supratentorial primitive neuroectodermal tumors and pineoblastoma vary and often depend on the child’s age, where the tumor is located, and the size of the tumor.
These symptoms may be caused by a supratentorial primitive neuroectodermal tumor, a pineoblastoma, or by other conditions. A doctor should be consulted if any of the following problems occur:

  • Weakness or change in sensation on one side of the body.
  • Morning headache or headache that goes away after vomiting.
  • Nausea and vomiting.
  • Seizures.
  • Unusual sleepiness or change in energy level.
  • Change in personality or behavior.
  • Unexplained weight loss or weight gain.
Besides the normal scans that will be performed such as X-ray, CT scans and MRI's there will also be laboratory testing.

If doctors think your child may have a CNS embryonal tumor, a biopsy may be done to remove a sample of tissue. For brain tumors, the biopsy is done by removing part of the skull and using a needle to remove a sample of tissue. Sometimes, a computer-guided needle is used to remove a sample of tissue. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor may remove as much tumor as safely possible during the same surgery.
The following tests may be done on the sample of tissue that is removed:
  • Immunohistochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer tissue to test for certain antigens. This type of study is used to tell the difference between different types of cancer.
  • Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
  • Cytogenetic analysis: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the chromosomes. 
  • Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.  
The standard treatment is surgery, radiation, chemotherapy and stem cell transplant.

Below is a video of mother dealing with the trauma of her daughter who has this brain tumor.  Cancer is traumatic for anyone and their family.  Support of such individuals is very important.

For more information:


Wednesday, March 7, 2012

Cancer Screening Statistics Not Completely Understood

This is a great article why there is misunderstanding by physicians in presenting statistics of Cancer Screening.

By Todd Neale, Senior Staff Writer, MedPage Today
Published: March 06, 2012
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston

Many primary care physicians in the U.S. accept misleading statistics as proof that cancer screening saves lives, a survey showed.
About three-quarters (76%) of respondents incorrectly said that increased five-year survival and early detection of cancer proves that a screening test saves lives, according to Odette Wegwarth, PhD, of the Max Planck Institute for Human Development in Berlin, and colleagues.
That rate was similar to the proportion who correctly stated that a reduction in mortality in a randomized trial proves the efficacy of a screening test (81%), the researchers reported in the March 6 issue of the Annals of Internal Medicine.

Misunderstanding of statistics ... matters, because it may influence how physicians discuss screening with their patients or how they teach trainees," the authors wrote. "To better understand the true contribution of specific tests, physicians need to be made aware that in the context of screening, survival and early detection rates are biased metrics and that only decreased mortality in a randomized trial is proof that screening has a benefit."
Although improved survival rates and earlier detection of cancer are often used to demonstrate the efficacy of screening for cancer, those measures are subject to lead-time and overdiagnosis biases, according to Wegwarth and colleagues.

For example, they wrote, in a cohort of individuals who will die at age 70, the five-year survival rate for those diagnosed with cancer because of symptoms at age 67 will be 0%, whereas the five-year survival rate for those diagnosed through screening at age 60 will be 100%.
"Yet, despite this dramatic improvement in survival ... nothing has changed about how many people die or when," the authors explained.
Similarly, screening that detects cancer that will not ultimately progress also can inflate survival rates without having any effect on mortality.

Mortality rates in a randomized trial, however, are not affected by these types of biases, and a committee of the National Cancer Institute concluded that that measure is the only one that can reliably prove that a screening test saves lives.
To find out whether primary care physicians -- who often recommend screening tests to their patients -- understand which statistics are most meaningful, Wegwarth and colleagues conducted an online survey of a national sample of 412 U.S. physicians.
The physicians were asked general knowledge questions about cancer screening statistics and were presented with two hypothetical scenarios based on real-world prostate cancer data.

The first scenario described a screening test that improved five-year survival from 68% to 99% and increased the early detection of cancer (considered irrelevant evidence). The second described a screening test that reduced cancer mortality rate from 2 to 1.6 per 1,000 people (considered relevant evidence).
The respondents were more supportive of the screening test backed by the irrelevant evidence, as illustrated by the percentage who said the evidence proves that the test saves lives (80% for the test backed by irrelevant evidence versus 60% for test backed by relevant evidence, P<0.001).
When presented with the irrelevant evidence of improved five-year survival, 69% of physicians said they would definitely recommend the screening test. Only 23% said they would definitely recommend the test that was based on the relevant evidence.

"We believe that many of the physicians mistakenly interpreted survival in screening as if it were survival in the context of a treatment trial," the authors wrote, noting that in the context of screening, the starting point for survival calculations is different for screened and unscreened populations.
In an accompanying editorial, Virginia Moyer, MD, MPH, of Baylor College of Medicine in Houston, said that the study suggests that physicians do not understand statistical concepts well.
She highlighted two possible solutions for the problem: "Medical journal editors should carefully monitor publications about screening to ensure that results are presented in such a way as to avoid misinterpretation, and medical educators should improve the quality of teaching about screening tests."

Even together, however, those solutions likely will not be enough, she wrote, noting that journalists and the general public for which they write also should be targets of education about screening statistics.
Wegwarth and colleagues acknowledged some limitations of their study, including the fact that recommendations were based on hypothetical scenarios and not actual practice, the lack of information on the effect of subjective factors like the fear of malpractice on the interpretation of the evidence, and the lack of information on testing harms in the scenarios.

To read the online article:

Monday, March 5, 2012

Chordoma Tumor Found In Children And Young Teens

Chorodoma tumors can affect any age but in children and adolescents tumors behave very aggressively and have high levels of mitotic activity, hypercellularity, and pleomorphism;13 some authors have suggested that the prognosis for patients younger than 40 years of age is significantly better than that for the older population  survival rates for the younger is 10 years.
Chordomas in children and adolescents comprise <5% of all chordomas and most frequently develop in the base of the skull or at end of the spine (in the sacrum or the coccyx [the tail bone]) with about equal frequency. The cells that give rise to chordoma come from the notochord. The notochord is an important structure in the early embryo that disappears before birth. However, even after birth, some cells from the notochord remain in bones at the base of the skull, in vertebrae, and in the tail bone. Rarely, one of these cells, which are called notochord remnants, undergoes changes that give rise to a chordoma.


In the United States, there are around 300 new cases of chordoma diagnosed each year. Based on this statistic, the annual incidence of chordoma is approximately one new case per million people per year. The incidence in Europe appears to be similar, but is unknown in other continents. Chordomas account for about 3% of all bone tumors and about 20% of primary spinal tumors. Chordomas are the most common tumor of the sacrum and cervical spine.

What are the signs and Symptoms?

The most common signs of chordoma are pain and neurological changes. Skull base chordomas most often cause headache, neck pain, diplopia (double vision), or facial nerve palsy (paralysis of facial muscles). Chordomas of the spine and sacrum can cause changes in bowel and/or bladder function, pain, aching, tingling, numbness, or weakness of the arms and legs. Often sacral chordomas do not cause symptoms until the tumor is quite large and sometimes a lump is the first sign of a sacral chordoma.

What is the treatment for Chordomas?

Currently, surgery is the first-line treatment for chordomas. Complete resection (removing the entire tumor) during the first surgery provides the best chances for local control and long-term survival.To achieve a complete resection, aggressive surgery is often required and can lead to significant complications or side-effects.
The goal of surgery should be to remove as much of the tumor as possible without causing unacceptable harm. Because outcome and prognosis are largely dependent on the success of the initial surgery, before having any operation it is very important to get multiple opinions from surgical teams who have experience treating chordomas on a regular basis. Some medical centers have multidisciplinary teams of experts who review cases and can help create a coordinated treatment plan for patients with chordomas.

Treatment of patients with chordoma of the skull base is a challenge for neurosurgeons. Because of the origin of the tumor from the bone at the base of the skull, exceptionally complete resection can be achieved. Microscopic total removal of chordoma frequently is followed by the finding of residual tumor in the postoperative computerized tomography and MR images. The recurrence rate, even after radical resection, remains high. The deep localization of chordomas at the middle of the skull base makes surgical access to these tumors difficult; nevertheless, many approaches lead to the clival from the superior, anterior or lateral view. The patterns of spread of the skull base chordoma preclude the use of a single surgical approach. Approaches to chordomas of the skull base should be based on the characteristics of growth in each case, and sometimes two or more skull base procedures may be necessary to achieve a radical removal. Extensive excision has an important role in the treatment of skull base chordoma; however, sometimes unacceptable procedure-related morbidity may occur. Currently, many authors consider that most cases of chordoma should be treated with resection. The average survival for patients with untreated chordoma is estimated to be 28 months after the onset of symptoms.32 Survival after surgery or radiation therapy, or both, ranges from 3.6 to 6.6 years, and all tumors are seen to recur with time.[ On average, recurrence is observed from 2 to 3 years after primary treatment, but sometimes the tumor recurs more than 10 years after initial treatment.

In many cases, radiation therapy following surgery is recommended and can improve chances of local control and survival. Because chordomas do not grow rapidly, high doses of radiation are required to kill the tumor cells. Chordomas that are close to critical structures (arteries, brain, brainstem, cranial nerves, dura, spinal nerves), often limit the dose of radiation that can be safely delivered to the tumor. In most cases, proton beam radiation can maximize the dose of radiation to the tumor, while sparing adjacent critical structures. Intensity modulated radiation therapy (IMRT), stereotactic radiosurgery (CyberKnife® or Gamma Knife®) and carbon-ion radiotherapy are also sometimes used to treat chordoma.

You may be wondering about chemotherapy to kill the tumor cells,but it has been found that this treatment has not been very effective in most patients with chordoma tumors.  There is hope because clinical trials are going on to find a successful chemotherapy drug.

                                        Dr. Chandranath Sen lecturing about Sugical treatment of 
                                              Chordoma tumors
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