Endometrial Cancer

Endometrial cancer affects many women.  This is why it is so important to follow the guidelines set forth by Cancer organizations for pap smears.

                               Endometrial Cancer shown under the microscope after histology preparation.

Cancer that forms in the tissue lining the uterus (the small, hollow, pear-shaped organ in a woman's pelvis in which a fetus develops). Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). 

Estimated new cases and deaths from endometrial (uterine corpus) cancer in the United States in 2012:

	New cases: 47,130
	Deaths: 8,010

Diagnosing endometrial cancer
Tests and procedures used to diagnose endometrial cancer include:

• Examining you for abnormalities. During a pelvic exam, your doctor carefully inspects the outer portion of your genitals (vulva), and then inserts two fingers of one hand into your vagina and simultaneously presses the other hand on your abdomen to feel your uterus and ovaries. He or she also inserts a device called a speculum into your vagina. The speculum opens your vagina so that your doctor can view your vagina and cervix for abnormalities.
• Using sound waves to create a picture of your uterus. Your doctor may recommend a transvaginal ultrasound to look at the thickness and texture of the endometrium and help rule out other conditions. In this procedure, a wand-like device (transducer) is inserted into your vagina. The transducer uses sound waves to create a video image of your uterus. This test helps your doctor look for abnormalities in your uterine lining.
• Using a scope to examine your endometrium. During a hysteroscopy, your doctor inserts a thin, flexible, lighted tube (hysteroscope) through your vagina and cervix into your uterus. A lens on the hysteroscope allows your doctor to examine the inside of your uterus and the endometrium.
• Removing a sample of tissue for testing. To get a sample of cells from inside your uterus, you'll likely undergo an endometrial biopsy. This involves removing tissue from your uterine lining for laboratory analysis. This may be done in your doctor's office and usually doesn't require anesthesia.
• Performing surgery to remove tissue for testing. If enough tissue can't be obtained during a biopsy or if the biopsy results are unclear, you'll likely need to undergo a procedure called dilation and curettage (D&C). During D&C, tissue is scraped from the lining of your uterus and examined under a microscope for cancer cells. D&C usually requires general anesthesia, so you won't be aware during the procedure.

• Tissue microarray immunohistochemical expression analysis is the newest test.  issue microarray technology allows molecular profiling of tumor samples at the DNA, RNA, and protein levels.

  .

If endometrial cancer is found, you'll likely be referred to a gynecologic oncologist — a doctor who specializes in treating cancers involving the female reproductive system.
Staging endometrial cancer
Once your cancer has been diagnosed, your doctor works to determine the extent, or stage, of your cancer. Tests used to determine your cancer's stage include a chest X-ray, a computerized tomography (CT) scan and blood tests. The final determination of your cancer's stage may not be made until after you undergo surgery to treat your cancer.
Stages of endometrial cancer include:

• Stage I cancer is found only in your uterus.
• Stage II cancer is present in both the uterus and cervix.
• Stage III cancer has spread beyond the uterus, but hasn't reached the rectum and bladder. The pelvic area lymph nodes may be involved.
• Stage IV cancer has spread past the pelvic region and can affect the bladder, rectum and more distant parts of your body. 

                                        Risks for Endometrial Cancer by Dr. David Holtz

http://www.mayoclinic.com/health/endometrial-cancer/DS00306/DSECTION=tests-and-diagnosis

http://www.ncbi.nlm.nih.gov/pubmed/14614055
    

New Guidelines For Cervical Cancer Screening

The American Cancer Society today released new screening recommendations for the prevention and early detection of cervical cancer. Screenings are tests for women who have no symptoms of cervical cancer. Among the changes: the American Cancer Society no longer recommends that women get a Pap test every year.
During the past few decades, screening has reduced deaths from cervical cancer, as doctors have been able to find cancer early and treat it, or prevent it from ever developing. Researchers continue to find out more about what causes cervical cancer, and the best ways to screen for it.
There are 2 types of tests used for cervical cancer screening.

• The Pap test can find early cell changes and treat them before they become cancer. The Pap test can also find cervical cancer early, when it's easier to treat.
• The HPV (human papilloma virus) test finds certain infections that can lead to cell changes and cancer. HPV infections are very common, and most go away by themselves and don't cause these problems. The HPV test may be used along with a Pap test, or to help doctors decide how to treat women who have an abnormal Pap test.

The American Cancer Society regularly reviews the science and updates screening recommendations when new evidence suggests that a change may be needed. The latest recommendations are:

• All women should begin cervical cancer screening at age 21.
• Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
• Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
• Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical pre-cancer should continue to be screened.
• Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.
• Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
• Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. They should talk with their doctor or nurse. 

http://www.sciencedaily.com/releases/2012/03/120314183348.htm

Circumcision and Prostate Cancer

According to a new article published Bradenton Herald recently , support the Jews are right in promoting circumcision on male infants.

 

 NEW YORK, March 13, 2012 — /PRNewswire/ -- It's never too early to fight prostate cancer, according to new research linking male circumcision at birth and a reduced risk of prostate cancer. A recent study published in the Cancer journal shows circumcised men could be 15 percent less likely to develop prostate cancer as an adult. As New York's leading robotic prostate cancer surgeon, Dr. David Samadi, welcomes this close-to-home news in the battle against prostate cancer.

These new findings in favor of an age-old tradition seem to support what our Jewish ancestors have espoused for years – circumcision is the secret to a blessed and healthy life. The covenant of circumcision takes place when a Jewish male infant is eight days old and is intended as a visible sign of a his covenant with God.
In the U.S. today, the procedure for removing a man's foreskin is widespread  for Jews and non-Jews, alike. Often pediatricians and urologists recommend circumcision for both cosmetic and health reasons. Many men prefer the physical characteristics of a circumcised penis and it has proven to offer significant hygiene benefits, particularly in reducing risk of sexually transmitted diseases (STDs).
The medical benefit of circumcision may now extend to the prostate. In the absence of the germ-trapping foreskin, the cleaner environment of a circumcised penis may reduce the risk of infection that can cause prostate inflammation that could ultimately lead to prostate cancer. So far, the findings are observational and do not show definitive cause and effect. The 15 percent reduced risk of prostate cancer was found in men who were circumcised prior to their first sexual intercourse.
Dr. Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center, explains these findings. "This is not to say that prostate cancer is a sexually transmitted disease; however, there is substantial evidence linking infection and certain cancers. The human papillomavirus (HPV) is a prime example of one such cancer. Other cancers of the throat, cervix, and stomach have similar origins."
Dr. Samadi reminds men of other lifelong wellness factors for decreasing risk of prostate cancer, while raising awareness about risk factors and the importance of early detection.
Exercise and weight – Obesity can increase a man's risk of prostate cancer death by 33 percent. Maintaining a healthy weight through moderate exercise helps prevent prostate cancer and better positions you to fight the disease should you ever be diagnosed.
Healthy diet – In addition to supporting a healthy weight, certain diet factors are believed to aid in prostate cancer prevention. Among them are foods rich in antioxidants like tomatoes, cruciferous vegetables such as broccoli, and green tea.
Annual PSA test – A recent European study found a 38 percent reduction in prostate cancer death through routine PSA blood screening. Dr. Samadi encourages all men to discuss risk factors with their doctor and determine the right age to begin annual PSA level monitoring, no later than age 50. A qualified physician should monitor a man's PSA velocity each year, watching for any spikes indicating the need for further testing.

Read more here: http://www.bradenton.com/2012/03/13/3936425/the-rabbi-was-right-prostate-cancer.html#storylink=cpy

 http://www.bradenton.com/2012/03/13/3936425/the-rabbi-was-right-prostate-cancer.html

Read more here: http://www.bradenton.com/2012/03/13/3936425/the-rabbi-was-right-prostate-cancer.html#storylink=cpy

Bile Duct Cancer

Bile duct cancer is also know as Cholangiocarcinoma. Your bile duct is like a slender tube that moves a fluid called bile from your liver to your small intestine. Bile duct cancer (sometimes called cholangiocarcinoma) is a cancerous (malignant) growth in the duct. Cancer of the bile duct is rare and is most prevalent in people ages 50 to 70.

Cholangiocarcinoma or bile duct cancer is a cancerous (malignant) growth in one of the ducts that carries bile from the liver to the small intestine.

isks for this condition include:

• Bile duct (choledochal) cysts
• Chronic biliary irritation
• History of infection with the parasitic worm, liver flukes
• Primary sclerosing cholangitis
• Ulcerative colitis

Cholangiocarcinoma is rare. It occurs in approximately 2 out of 100,000 people.

Symptoms

• Chills
• Clay-colored stools
• Fever
• Itching
• Loss of appetite
• Pain in the upper right abdomen that may radiate to the back
• Weight loss
• Yellowing of the skin (jaundice)

Signs and tests

Your health care provider will perform a physical exam. Tests will be done to check for a tumor or blockage in the bile duct. These may include:

• Abdominal CT scan
• Abdominal ultrasound
• CT scan-directed biopsy
• Cytology -biopsy by surgeon and tissue evaluated prepared by tech and evaluated by pathologist
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Magnetic resonance cholangiopancreatography (MRCP)
• Percutaneous transhepatic cholangiogram (PTCA)

Blood tests that may be done include:

• Liver function tests (especially alkaline phosphatase or bilirubin levels) the elevation values of these tests will alert physicians to liver disfunction.
  

Treatment

The goal is to treat the cancer and the blockage it causes. When possible, surgery to remove the tumor is the treatment of choice and may result in a cure. If the tumor is large, the entire liver may need to be removed and a liver transplant will be needed. However, often the cancer has already spread by the time it is diagnosed.
Chemotherapy or radiation may be given after surgery to decrease the risk of the cancer returning. However, the benefit of this treatment is not certain.
Endoscopic therapy with stent placement can temporarily relieve blockages in the biliary ducts and relieve jaundice in patients when the tumor cannot be removed. Laser therapy combined with light-activated chemotherapy medications is another treatment option for those with blockages of the bile duct.

                                         New Treatment for Bile Duct Cancer

                                         Overall Discussion of Bile Cancer

For more information:  http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001336/

or http://www.cancer.gov/cancertopics/types/bileduct