Biomarkers are used in helping oncologists to diagnose several types of cancer. They are also used to monitor chemotherapy and radiation treatment in order for the doctor to know if they are killing the cancer cells. New biomarkers have been developed to provide more options in helping the different areas of oncology to treat patients.
Lee Biosolutions Inc. has expanded its line of biomarkers to include products used to track epithelial ovarian cancer, breast cancer and liver cancer.
Based in Brentwood, Lee Biosolutions collects biological materials — human saliva, semen, urine and vaginal secretions, among others — and produces finished proteins, enzymes, biologicals, immuno-reagents and antibodies for life science research and clinical diagnostic testing. The company’s core business is diagnostic and Lee Biosolutions sells proteins and enzymes to research labs like the Cleveland Clinic and pharmaceutical companies such as Abbott Laboratories.
Lee Biosolutions has developed a proprietary process to purify and test for novel cancer biomarkers. In addition to the new biomarkers, the company is expanding its production of the other biomarkers in its lineup.
"We continue to increase supply of CA 19-9 which often is used with patients with pancreatic cancer, CEA tumor marker that helps predict the outlook in patients with colorectal cancer and CA 72-4 which is now used in ovarian, pancreatic cancer and cancers starting in the digestive tract," said Burton Lee, president of the company. "Current research has identified CYFRA 21-1 used as a marker for non-small cell lung cancer and Lee Biosolutions has increased supply of Beta 2 Microglobuilnwhich is used as a marker for multiple myelomas and chronic lymphocytic leukemia."
The products are raw finished proteins that are used in formulations in invitro diagnostic products and research.
Lee Biosolutions had revenue of $6 million last year.
It is always heartbreaking when children have cancer. Usually cancer in children affects the blood cells or brain. A very rare cancer in children is rhabdomyosarcoma. Where is this cancer located in a child's body?
Fewer than 60 children are diagnosed with rhabdomyosarcoma
in the UK each year. About the same number in the United States. Most of them are younger than 10 years old. It's
more common in boys than girls.
Rhabdomyosarcoma is the most common of the soft tissue
sarcomas in children. These tumors develop from muscle or fibrous
tissue and can grow in any part of the body.
The most common areas of the body to be affected are
around the head and neck, the bladder or the testes. Sometimes tumours
are also found in a muscle or a limb, in the chest or in the abdominal
wall. If the tumour is in the head or neck region, it can
occasionally spread into the brain or the fluid around the spinal cord.
What causes this disease is unknown. Children who have rare genetic disorders are more prone to have rhabdommyosarcoma.
Image of rhabdomyosarcoma that has been removed from a child's body.
The images of the children with this cancer are very disturbing so they will not be displayed.
The signs and symptoms will depend on the part of the body
that's affected by the rhabdomyosarcoma. The most common sign is a
swelling or lump.
If the tumor is in the head area, it can sometimes
cause a blockage (obstruction) and a discharge from the nose or throat.
Occasionally, an eye may appear swollen and protruding.
If the tumor is in the abdomen (tummy), your child may
have discomfort in the abdomen and difficulty going to the toilet.
If the tumor is in the bladder, your child may have blood in the urine and difficulty passing urine.
A variety of tests and investigations
may be needed to diagnose a rhabdomyosarcoma. A small operation may be
needed to remove a sample from the tumour to be looked at under a
microscope. This called a biopsy. It's usually done under a general
anaesthetic.
Various tests may be done to check the exact size of the tumour and whether it has spread to any other part of the body. These may include:
a chest x-ray to check the lungs
an ultrasound
CT or MRI scans
blood and bone marrow tests.
Any tests and investigations that your child needs will be explained to you. The booklet A parent's guide to children's cancer gives details of what the tests and scans involve.
Rhabdomyosarcomas are rare tumours and should be treated at specialist centres.
Treatment depends upon the size of the tumour, its
position within the body, and whether it has spread. Treatment of
rhabdomyosarcoma usually includes surgery, radiotherapy or chemotherapy, or a combination of these treatments.
Surgery
If at all possible, surgery will be used to remove the tumour. Chemotherapy, using a combination of drugs,
is often given before surgery to shrink the tumour. Radiotherapy may
also be given to the area of the tumour, particularly if it cannot be
completely removed by surgery.
Chemotherapy
If the tumour cannot be removed with surgery, treatment
will usually involve a combination of chemotherapy and radiotherapy.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy
cancer cells and is usually given every three weeks. It may be given to
shrink the tumour before surgery or with radiotherapy when the tumour
can't be removed by surgery. The drugs used and the length of treatment
depends on the type and stage of the rhabdomyosarcoma.
Radiotherapy
Radiotherapy treats cancer by using high-energy rays,
which destroy the cancer cells while doing as little harm as possible to
normal cells. It's given to the area where the rhabdomyosarcoma occurs.
Side effects of treatment
Treatment for rhabdomyosarcoma often causes side effects,
and your child’s doctor will discuss this with you before treatment
starts. Any possible side effects will depend on the particular
treatment being given and the part of the body that's being treated.
Chemotherapy can make your child feel better by relieving
the symptoms of the cancer, but it can sometimes have side effects such
as feeling sick (nausea) and being sick (vomiting), hair loss, an increased risk of infection, bruising and bleeding, tiredness and diarrhoea.
Late side effects
A small number of children may develop side effects many years after their treatment for a rhabdomyosarcoma. Long-term side effects depend on the type of treatment used, and may include a possible reduction in bone growth, infertility,
a change in the way the heart and the kidneys work, and a slight
increase in the risk of developing another cancer in later life.
Your child’s doctor or nurse will talk to you about any
possible late side effects. There is more detailed information about
these late side effects in the booklet A parent’s guide to children’s cancer.
Merkel cell carcinoma is a rare and aggressive cancer. It is usually found in older patients and a compromised immune system. There are about 1500 reported cases per year but the number is increasing. One -third of patients could die quickly from being diagnosed with MCC and need to be treated immediately.
MCC is also referred as neuroendocrine carcinoma and grows in large amounts in the skin. Over weeks a small bump grows rapidly.
It is very difficult to look at the horrible picture,but this MCC growth can be seen on any part of the body.
This is a picture of Merkel Cell Carcinoma under a microscan which magnifies very high.
Merkel cells are found in the epidermis
(outer layer of the skin). Although the exact function of Merkel cells
is unknown, they are thought to be touch receptors. They have both
sensory and hormonal functions and are sometimes referred to as neuroendocrine cells.
Dr. Randall K. Roenigk of the prestigious Mayo Clinic explains Merkel Cell carcinoma.
What is the typical patient like that can get MCC? They are usually 65 or over,fair skinned,experienced lots of exposure to the sun and immuno depressed. Also persons who are HIV positive may be susceptible because this disease compromises their immune system.
The following testing is performed to diagnose MMC:
Sentinel node biopsy. When cancer cells spread,
they often travel first to your lymph nodes — small, rounded structures
that filter foreign particles from lymph, a tissue-cleansing fluid in
your body. A sentinel lymph node biopsy is a procedure to determine
whether cancer has spread to your lymph nodes. This procedure involves
injecting a dye near the skin tumor. The dye then flows through the
lymphatic system to your lymph nodes. The first lymph node that receives
the dye is called the sentinel node. Your doctor removes this lymph
node and looks for cancerous cells under a microscope.
Imaging tests. Your doctor may recommend a chest
X-ray and a CT scan of your chest and abdomen to help determine whether
the cancer has spread to other organs. Your doctor may also consider
other imaging tests such as a positron emission tomography (PET) scan or
an octreotide scan — a test that uses an injection of a radioactive
tracer to check for the spread of cancer cells.
Treatment for MCC is first of surgery to attempt to remove the carcinoma. Radiation is the next step to reduce the growth of remaining cancer cells. Finally, chemotherapy is used to also decrease continued growth and kill the growing tumor.
According to the Mayo Clinic, "Symptoms of ovarian cancer are
nonspecific and mimic those of many other more common conditions,
including digestive and bladder disorders." Colon cancer may also spread
to the lymph nodes, bones, lungs and liver. There are particular signs
and symptoms that the cancer has spread to the ovaries.
Abdominal Discomfort
Patients with colon cancer that has spread to the ovaries
may have already been experiencing pain, fullness or bloating in the
abdomen from the colon cancer and may not realize the cancer has spread.
Patients may also experience persistent indigestion, gas or nausea as
well as changes in bowel habits, such as constipation. One may lose
their appetite or quickly feel full after a meal.
Pelvic Discomfort
Women may experience pain during intercourse, lower back
pain and general pelvic discomfort. According to the Mayo Clinic,
patients may also experience changes in bladder habits, including a
frequent need to urinate as well as changes in menstruation (more
bleeding, much less bleeding or erratic bleeding).
The following is an abstract from a Colorectal Medical Journal
Abstract
Objective
To improve management of ovarian metastasis through assessment of
clinicopathological features and treatment outcomes associated with
ovarian metastasis from colorectal cancer.
Method
We recruited 103 subjects who were diagnosed with ovarian metastasis
and subjected to surgery between June 1989 and December 2005. Clinical
and pathological variables were evaluated. Survival and its associated
factors were analysed with a median follow-up of 31 months after ovarian
surgery (range 1–129 months).
Results
The mean age at diagnosis was 46 years (range 14–72 years), synchronous
ovarian metastasis occurred in 74 patients and metachronous in 29
patients. The primary tumour was more commonly associated with the colon
rather than the rectum (84/1608, 5.2%vs 19/1534, 1.2%, P <0.001).
Combined metastases occurred in 69 patients (67%). Complete resection
was achieved in 34 (33%) patients without other metastases. The
estimated 5-year disease free survival and overall survival rate were
40.1% and 26.6%, respectively. From univariate analysis, lymphovascular
invasion (35.6%vs 12.8%, P =0.034), combined metastasis (50.9%vs 15.6%, P =0.0035) and bilaterale ovarian metastasis (36.4%vs 10.6%, P =0.015)
were identified as significant poor prognosis factors, and from
multivariate analysis combined metastasis and bilaterale ovarian
metastasis were significant (P =0.034 and P =0.015, respectively).
Conclusion
This study suggests a role for regular follow-up computed tomography
scans within 6 months postoperatively and tumour marker assays for the
early detection of ovarian metastasis in premenopausal women after
primary surgery, especially in colonic patients with poor prognostic
factors.
Diagnosis
A pelvic examination and imaging including CT scan[39] and trans-vaginal ultrasound are essential. Physical examination may reveal increased abdominal girth and/or ascites
(fluid within the abdominal cavity). Pelvic examination may reveal an
ovarian or abdominal mass. The pelvic examination can include a Rectovaginal component for better palpation of the ovaries. For very young patients, magnetic resonance imaging may be preferred to rectal and vaginal examination.
To definitively diagnose ovarian cancer, a surgical procedure to take
a look into the abdomen is required. This can be an open procedure (laparotomy, incision through the abdominal wall) or keyhole surgery (laparoscopy). During this procedure, suspicious areas will be removed and sent for microscopic analysis. Fluid from the abdominal cavity can also be analysed for cancerous cells. If there is cancer, this procedure can also determine its spread (which is a form of tumor staging).
Staging
Ovarian cancer staging is by the FIGO staging system and uses information obtained after surgery, which can include a total abdominal hysterectomy, removal of (usually) both ovaries and fallopian tubes, (usually) the omentum, and pelvic (peritoneal) washings
for cytopathology. The AJCC stage is the same as the FIGO stage. The
AJCC staging system describes the extent of the primary Tumor (T), the
absence or presence of metastasis to nearby lymph Nodes (N), and the absence or presence of distant Metastasis (M).[43]
Stage I — limited to one or both ovaries
IA — involves one ovary; capsule intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings
IB — involves both ovaries; capsule intact; no tumor on ovarian surface; negative washings
IC — tumor limited to ovaries with any of the following: capsule ruptured, tumor on ovarian surface, positive washings
Stage II — pelvic extension or implants
IIA — extension or implants onto uterus or fallopian tube; negative washings
IIB — extension or implants onto other pelvic structures; negative washings
IIC — pelvic extension or implants with positive peritoneal washings
Advanced Ovarian Cancer
Ovarian adenocarcinoma deposit in the mesentry of the small bowel
Stage III — peritoneal implants outside of the pelvis; or limited to the pelvis with extension to the small bowel or omentum
Many people have thyroid problems. Due to the instability of trying to control the function of the thyroid nodules can develop. An endocrinologist will need to do a biopsy if calcification is seen from an ultrasound
report. The doctor will take an aspiration needle and extract tissue from the nodules to be put on slide and prepared by the histology lab for the pathologist to view to determine carcinoma.
Genzyme and Veracyte have a great announcement concerning diagnosing cancer from thyroid nodules . These companies are the leaders in molecular cytology as tool for diagnosis.
The following are excerpts from a recent news article on the web about a testing product and how it really can be better than a microscopic view under a microscope.
Genzyme,
a Sanofi company , and Veracyte,
Inc., a molecular diagnostics company pioneering the emerging field
of molecular cytology, today announced that the Afirma(R)
Thyroid FNA Analysis, an innovative approach for improved thyroid nodule
diagnosis, is now available to patients across the United States.
The Afirma(R) Thyroid FNA Analysis combines expert
cytopathology assessment of thyroid nodule fine needle aspiration (FNA)
samples, with the Afirma(R) Gene Expression Classifier, a novel
genomic test, used to resolve inconclusive results and thus help
patients whose nodules are actually benign avoid unnecessary surgery.
Two independent clinical studies to date have shown that the Afirma(R)
Gene Expression Classifier can reclassify patients with indeterminate
thyroid FNA results as "benign" with the same degree of accuracy as a
benign cytopathology diagnosis.
Thyroid cancer is the fastest-growing cancer in the U.S., with an
estimated 56,460 new cases expected in 2012, according to the American
Cancer Society. An estimated 450,000 thyroid nodule FNAs -- a minimally
invasive procedure to extract cells for examination under a microscope --
are performed in the U.S. each year to rule out cancer. Thyroid nodule
FNAs are challenging to interpret, however, producing ambiguous results
in up to 30 percent of cases. Current guidelines recommend that most
patients with ambiguous results undergo thyroid resection for a
definitive diagnosis. Post-surgical results, however, show that only
20-30 percent of these patients have cancer.
"Until now, most patients with 'indeterminate' thyroid nodules based on
cytology went to surgery to help ensure that a cancer was not missed,"
said Dr. Bryan Haugen, professor of medicine and pathology at the
University of Colorado School of Medicine. "Now, the Afirma(R) Gene
Expression Classifier can potentially help tens of thousands of patients
with inconclusive thyroid nodules each year avoid unnecessary surgery
and improve patient outcomes."
Genzyme is an established leader in endocrinology globally, developing
and marketing Thyrogen(R) (thyrotropin alfa for injection) for
patients with well-differentiated thyroid cancer. Thyrogen(R)
is used as an adjunctive diagnostic tool for serum thyroglobulin (Tg)
testing with or without radioiodine imaging. Thyrogen(R) is
also approved in the U.S. and Europe as an adjunctive treatment for
radioiodine ablation of thyroid tissue remnants in patients who have
undergone a near total or total thyroidectomy for well-differentiated
thyroid cancer and who do not have evidence of metastatic thyroid cancer.
When melanoma is discussed we immediately think of cancer of the skin , but it also can be present in our eyes. This type of cancer is called Intraocular Melanoma.
Melanoma in the iris of the eye.
Melanoma in the retina of the eye
Intraocular melanoma begins in the middle of 3 layers of the wall of the
eye. The outer layer includes the white sclera (the "white of the eye")
and the clear cornea at the front of the eye. The inner layer has a
lining of nerve tissue, called the retina, which senses light and sends
images along the optic nerve to the brain.
This type of cancer most often occurs in people who are middle aged. In
most cases of intraocular melanoma, doctors detect the cancer during a
routine eye examination. The chance of recovery (prognosis) will depend
on factors such as the size and cell type of the cancer. This type of melanoma is rare.
Most people with intraocular melanoma experience no symptoms of the
cancer in its early stages. Melanoma that starts in the iris may appear
as a dark spot on the iris. Intraocular melanoma that is in the ciliary
body or choroid may cause blurry vision.
Age and sun exposure may increase the risk of developing intraocular melanoma.
Anything that increases your risk of getting a disease is called a
risk factor. Having a risk factor does not mean that you will get
cancer; not having risk factors doesn’t mean that you will not get
cancer. People who think they may be at risk should discuss this with
their doctor. Risk factors for intraocular melanoma include the
following:
Older age
Being white
Having a fair complexion (light skin) or green or blue eyes.
Being able to tan
Possible signs of intraocular melanoma include a dark spot on the iris or blurred vision.
Intraocular melanoma may not cause any early symptoms. It is
sometimes found during a routine eye exam when the doctor dilates the
pupil and looks into the eye. The following symptoms may be caused by
intraocular melanoma or by other conditions. A doctor should be
consulted if any of these problems occur:
A dark spot on the iris
Blurred vision
A change in the shape of the pupil
A change in vision
Glaucoma may develop if the tumor causes the retina to separate from
the eye. If this happens, there may be no symptoms, or symptoms may
include the following:
Eye pain
Blurred vision
Eye redness
Nausea
Doctors stage intraocular melanoma based on the area of the eye
where the tumor is found and the size of the tumor. The stages of
intraocular melanoma include:
Iris melanoma
Ciliary body melanoma
Small choroidal melanoma
Medium and large choroidal melanoma
Extraocular extension and metastatic intraocular melanoma
Recurrent intraocular melanoma.
Iris Melanoma
Intraocular melanoma of the iris occurs in the front colored part
of the eye. Iris melanomas usually grow slowly and do not spread to
other parts of the body.
Ciliary Body Melanoma
Intraocular melanoma of the ciliary body occurs in the back part of the eye.
Small Choroidal Melanoma
Intraocular melanoma of the choroid occurs in the back part of the
eye. This type of tumor is classified by the size of the tumor. A small
choroidal melanoma is 3 millimeters or less in thickness.
Medium and Large Choroidal Melanoma
Intraocular melanomas of the choroid occur in the back part of the
eye. This type of tumor is classified by the size of the tumor. Medium
and large choroidal melanomas are more than 3 millimeters in thickness.
Extraocular Extension and Metastatic Intraocular Melanoma
In extraocular extension and metastatic intraocular melanoma, the
melanoma has spread outside the eye, to the nerve behind the eye (the
optic nerve), to the eye socket, or to other parts of the body.
Recurrent
Recurrent intraocular melanoma refers to cases of the cancer that have come back (recurred) after they were treated.
Treatment for Intraocular Melanoma
Treatment options for intraocular melanoma may include:
Surgery (taking out the cancer)
Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
Laser therapy (using an intensely powerful beam of light to destroy the tumor or blood vessels that feed the tumor).
In some cases (such as when the cancer is small and causing no
symptoms), the treatment plan may involve monitoring the patient's
cancer carefully and waiting to treat it until it changes or causes
symptoms. This is sometimes known as watchful waiting.
Video of a cancerous tumor of eye surgically removed.
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.
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.
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
Bladder cancer begins in the cells that line the inside of the bladder. The bladder is the place in your lower abdomen that stores the urine. Bladder cancer usually affects older patients , but anyone of any age can have this type of cancer.
Bladder tumor
The great majority of bladder cancers are diagnosed at an early stage —
when bladder cancer is highly treatable. However, even early-stage
bladder cancer is likely to recur. For this reason, bladder cancer
survivors often undergo follow-up tests to look for bladder cancer
recurrence for years after treatment.
Diagnosing bladder cancer
Tests and procedures used to diagnose bladder cancer may include:
Cystoscopy. During cystoscopy, your doctor inserts a
narrow tube (cystoscope) through your urethra. The cystoscope has a
lens and fiber-optic lighting system, allowing your doctor to see the
inside of your urethra and bladder. You usually receive a local
anesthetic during cystoscopy to make you more comfortable.
Biopsy. During cystoscopy, your doctor may pass a
special tool through your urethra and into your bladder in order to
collect a small cell sample (biopsy) for testing. This procedure is
sometimes called transurethral resection of bladder tumor (TURBT). TURBT
can also be used to treat bladder cancer. TURBT is usually performed
under general anesthesia.
Urine cytology. A sample of your urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology.
Imaging tests. Imaging tests allow your doctor to
examine the structures of your urinary tract. You may receive a dye,
which can be injected into a vein. An intravenous pyelogram is a type of
X-ray imaging test that uses a dye to highlight your kidneys, ureters
and bladder. A computerized tomography (CT) scanis a type of X-ray test that allows your doctor to better see your urinary tract and the surrounding tissues.
Staging bladder cancer
Once it's confirmed that you have bladder cancer, your doctor may order
additional tests to determine the extent, or stage, of the cancer.Staging tests may include:
CT scan
Magnetic resonance imaging (MRI)
Bone scan
Chest X-ray
Bladder cancer stages
The stages of bladder cancer are:
Stage I. Cancer at this stage occurs in the bladder's inner lining, but hasn't invaded the muscular bladder wall.
Stage II. At this stage, cancer has invaded the bladder wall, but is still confined to the bladder.
Stage III. The cancer cells have spread through the
bladder wall to surrounding tissue. They may also have spread to the
prostate in men or the uterus or vagina in women.
Stage IV. By this stage, cancer cells may have spread to the lymph nodes and other organs, such as your lungs, bones or liver.
Mayo Clinic Discussion of Bladder Cancer
For more information: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001517/ or
Did you know that bone cancer rarely is the only location that cancer is seen in the human body? Usually it is spread or metastasized by remote cancers in other organs of the body.
Bone tumor by X-Ray
Bone Cancer under the microscope from biopsy
Notice the abnormal growth of cells in the picture above which indicates cancer.
The Most Common Types of Bone Cancers :
Osteosarcoma, which arises from osteoid tissue in the bone. This tumor occurs most often in the knee and upper arm (1).
Chondrosarcoma, which begins in cartilaginous tissue. Cartilage pads the ends of bones and lines the joints. Chondrosarcoma occurs most often in the pelvis (located between the hip bones), upper leg, and shoulder. Sometimes a chondrosarcoma contains cancerous bone cells. In that case, doctors classify the tumor as an osteosarcoma.
The Ewing Sarcoma Family of Tumors (ESFTs), which usually occur in bone but may also arise in soft tissue (muscle, fat, fibrous tissue, blood vessels, or other supporting tissue). Scientists think that ESFTs arise from elements of primitive nerve tissue in the bone or soft tissue (2). ESFTs occur most commonly along the backbone and pelvis and in the legs and arms (3).
Other types of cancer that arise in soft tissue are called soft tissue sarcomas. They are not bone cancer and are not described in this resource.
What are bone cancer symptoms and signs?
The most common symptom of bone tumors is pain. In most cases, the
symptoms become gradually more severe with time, including bone pain.
Initially, the pain may only be present either at night or with
activity. Depending on the growth of the tumor, those affected may have
symptoms for weeks, months, or years before seeking medical advice. In
some cases, a mass or lump may be felt either on the bone or in the
tissues surrounding the bone. This is most common with MFH or
fibrosarcoma but can occur with other bone tumors. The bones can become
weakened by the tumor and lead to a fracture
after little or no trauma or just from standing on the affected bone.
This can occur with both benign and malignant tumors. Even benign tumors
can spread locally and weaken the surrounding bone. If the tumor
compresses the surrounding nerve it can cause pain, numbness, or
tingling in the extremities. If the surrounding blood vessels are
compressed, it can affect the blood flow to the extremities. Fever, chills, night sweats, and weight loss can occur but are less common. These symptoms are more common after spread of the tumor to other tissues in the body.
What are the possible causes of bone cancer?
Although
bone cancer does not have a clearly defined cause, researchers have
identified several factors that increase the likelihood of developing
these tumors. Osteosarcoma occurs more frequently in people who have had
high-dose external radiation therapy or treatment with certain anticancer drugs;
children seem to be particularly susceptible. A small number of bone
cancers are due to heredity. For example, children who have had hereditaryretinoblastoma (an uncommon cancer of the eye) are at a higher risk of developing osteosarcoma, particularly if they are treated with radiation. Additionally, people who have hereditary defects of bones and people with metal implants, which doctors sometimes use to repair fractures, are more likely to develop osteosarcoma (4). Ewing sarcoma is not strongly associated with any heredity cancer syndromes, congenital childhood diseases, or previous radiation exposure (2).
What are the treatment options for bone cancer?
Treatment options depend on the type, size, location, and stage of the cancer, as well as the person’s age and general health. Treatment options for bone cancer include surgery, chemotherapy, radiation therapy, and cryosurgery.
Surgery
is the usual treatment for bone cancer. The surgeon removes the entire
tumor with negative margins (no cancer cells are found at the edge or
border of the tissue removed during surgery). The surgeon may also use
special surgical techniques to minimize the amount of healthy tissue
removed with the tumor.
Dramatic improvements in surgical
techniques and preoperative tumor treatment have made it possible for
most patients with bone cancer in an arm or leg to avoid radical
surgical procedures (removal of the entire limb). However, most patients
who undergo limb-sparing surgery need reconstructive surgery to maximize limb function (1).
Chemotherapy
is the use of anticancer drugs to kill cancer cells. Patients who have
bone cancer usually receive a combination of anticancer drugs. However,
chemotherapy is not currently used to treat chondrosarcoma (1).
Radiation therapy, also called radiotherapy,
involves the use of high-energy x-rays to kill cancer cells. This
treatment may be used in combination with surgery. It is often used to
treat chondrosarcoma, which cannot be treated with chemotherapy, as well
as ESFTs (1). It may also be used for patients who refuse surgery.
Cryosurgery
is the use of liquid nitrogen to freeze and kill cancer cells. This
technique can sometimes be used instead of conventional surgery to
destroy the tumor (1).
This video educates us on how bone cancer is diagnosed. To learn more about bone cancer then go to the following websites :
What is an Astrocytoma brain tumor? Astrocytoma tumors are a form of glioma with star-shaped cells. Glioma is is a type of tumor that starts in the brain or spine. It is called a glioma because it arises from glial cells. The most common site of gliomas is the brain.
Astrocytoma tumors often grow very slowly or not at all for long periods of time.
Therefore, close observation rather than treatment is possible in some
cases (especially ones associated with neurofibromatosis ). They may occur in many parts of the
brain, but most commonly in the cerebrum. They occur less commonly in
the spinal cord. People of all ages can develop astrocytomas, but they
are more prevalent in adults, particularly middle-aged men. Astrocytomas
in the base of the brain are more prevalent in children or younger
people and account for the majority of children’s brain tumors. In
children, most of these tumors are considered low-grade, while in adults
most are high-grade.
General symptoms of an astrocytoma tumor are
a result of growing pressure inside the skull. These symptoms include
headache, vomiting and mental status changes. Other symptoms, such as
drowsiness, lethargy, obtuseness, personality changes, disordered
conduct and impaired mental faculties show up early in about one out of
every four patients with malignant brain tumors.
In
young children, the growing pressure of an astrocytoma tumor inside the
skull may enlarge the head. Changes (such as swelling) may be observed
in the back of the eye, where the blind spot is. Usually there are no
changes in temperature, blood pressure, pulse or respiratory rates
except just before death. Seizures are more common with meningiomas, slow-growing astrocytomas and oligodendrogliomas than with malignant gliomas.
Symptoms
of an astrocytoma tumor vary depending on what part of the brain (or
which glands or nerves) are affected by the tumor. Sometimes the nature
of the seizures can help determine the location of the brain tumor.
Astrocytomas are generally classified (graded) into one of three
types: Low grade astrocytomas, anaplastic astrocytomas and
glioblastomas. Low grade astrocytomas account for 10 percent of
astrocytomas. These tumors are typically slow growing and may not
require specific treatment at the time of diagnosis. Many patients with
low grade astrocytomas live for prolonged periods of time after their
diagnosis. However, these tumors often advance into the higher grades
and more rapidly growing forms of brain gliomas. Anaplastic astrocytomas
and glioblastomas are the most aggressive and, unfortunately, the most
common astrocytomas. Glioblastomas are fast growing astrocytomas that
contain areas of dead tumor cells. In adults, glioblastoma occurs most
often in the cerebrum, especially in the frontal and temporal lobes of
the brain.
Diagnosis
A
neurologic evaluation should be conducted if a patient has slowly
increasing signs of mental dysfunction, new seizures, persistent
headaches or evidence of pressure inside the skull, such as vomiting or
swelling or protrusion of the blind spot at the back of the eye.
A
neurologist (a doctor who has received special additional training in
the diagnosis and treatment of disorders of the brain, spinal cord and
nerves)performs a complete examination, which may include a magnetic resonance imaging (MRI) scan, a computed.
Treatment Options
Treatment
options include surgery, radiation, radiosurgery, and chemotherapy. The
main goal of surgery is to remove as much of the tumor as possible
without injuring brain tissue needed for neurological function (such as
the ability to speak, walk, motor skills, etc.). However, high-grade
tumors often have tentacle-like structures that invade surrounding
tissues, making it more difficult to remove the entire tumor. If the
tumor cannot be completely removed, surgery can still reduce or control
tumor size. In most cases, surgeons open the skull through a craniotomy
to best access the tumor site. The goal of radiation therapy is to
selectively kill tumor cells while leaving normal brain tissue unharmed.
In standard external beam radiation therapy, multiple treatments of
standard-dose "fractions" of radiation are applied to the brain. Each
treatment induces damage to both healthy and normal tissue. By the time
the next treatment is given, most of the normal cells have repaired the
damage, but the tumor tissue has not. This process is repeated for a
total of 10 to 30 treatments, depending on the type of tumor. This
additional treatment provides some patients with improved outcomes and
longer survival rates.
Radiosurgery is a treatment method that
uses computerized calculations to focus radiation at the site of the
tumor while minimizing the radiation dose to the surrounding brain.
Radiosurgery may be an adjunct to other treatments, or it may represent
the primary treatment technique for some tumors
Patients
undergoing chemotherapy are administered special drugs designed to kill
tumor cells. Although chemotherapy may improve overall survival in
patients with the most malignant primary brain tumors, it does so in
only about 20 percent of patients. Chemotherapy is often used in young
children instead of radiation, as radiation may have negative effects on
the developing brain. The decision to prescribe this treatment is based
on a patient’s overall health, type of tumor, and extent of the cancer.
Before considering chemotherapy, you should discuss it with your
doctor, as there are many side effects.
Because traditional
treatment modalities are unlikely to result in a prolonged remission of
malignant astrocytomas, researchers are presently investigating a number
of promising new treatments including gene therapy, highly focused
radiation therapy, immunotherapy and novel chemotherapies. A number of
new treatments are being made available on an investigational basis at
centers specializing in brain tumor therapies.
Astrocytoma Explained by Dr. Mark Atlas
For more information: http://www.cedars-sinai.edu/Patients/Health-Conditions/Astrocytoma-Brain-Tumors.aspx
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.
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
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
