Posts Tagged ‘Staging’

Colon Cancer Staging Prognosis

Sometime in August 2004, his problem started with changed bowel habits and there was blood in his stools. Colon Cancer Staging PrognosisAn endoscopy revealed sigmoid colon cancer. Henry underwent a surgery to remove 10 inches of his infected bowel. It was a Stage 2 cancer. CT showed that his liver and spleen were normal in size and appearance. Both kidneys and adrenal glands were also normal in appearance. The urinary bladder was normal. There was no pelvic mass or lymph node enlargement. The lung bases did not show any nodule. Based on these findings, the doctor concluded that there was NO evidence of distance metastasis.

Following standard protocol, Henry underwent six cycles of chemotherapy. The treatment lasted six months and was completed in February 2005. A follow up CT scan on 18 March 2005 revealed “possible metastasis in the left lung base” but the liver, both kidneys and urinary bladder were all normal.

In October 2005, Henry suffered severe pains due to suspected urine infection. A CT scan on 8 October 2005, indicated “left hydronephosis”, which according to the doctor could be due to “a mid ureteric stone.” However, the CT of the chest revealed at least five well defined nodules in both lung fields. This result clearly showed that Henry suffered multiple lung metastasis.

Earlier, the doctor suspected kidney stone. But it was not to be. A more detailed examination showed tumor in his left kidney. A biopsy report dated 31 March 2006 indicated moderately differentiated adenocarcinoma of the left lower ureter. This was suggestive of metastasis from colonic primary. Henry was asked to undergo another surgery to remove the infected kidney but he declined.

On 4 April 2006 a colonic biopsy showed recurrence of the colon cancer. The doctor had to install a stent in his colon to prevent tumour from blocking the passageway. CT scan also showed presence of a 1.5 cm nodule in segment 8 of his liver. There was a tiny hypodense focus in segment 3 suspicious of a new lesion.

On 15 July 2006, a CT scan of the chest, abdomen and pelvis was done. It showed a 2 cm mass in the mid rectum extending up to the rectosigmoid junction. The report confirmed once again a recurrent carcinoma of the rectosigmloid region with local infiltration and metastasis to the lungs, liver and left ureter.

Lung Cancer Secrets Revealed Click here

Henry underwent three cycles of chemotherapy and each treatment cycle cost him about RM 15,000. Unfortunately the treatment was not effective. The oncologist suggested more chemotherapy using a different drug regiment. This new treatment costs RM 25,000 per cycle. Henry had two cycles of this treatment and became completely bald. He developed acne with pus all over his face and some parts of his body. He was given antibiotics by a dermatologist but his condition worsened.

On 7 March 2007, MRI of the lumber spine indicated multiple focal bony metatasis involving the sacrum and illium. There was also direct involvement of the urinary bladder. A biopsy of the bladder tumor done on 30 March 2007 indicated a moderately differentiated adenocarcinoma and was likely to be an extension from a colorectal tumor. In essence, Henry ended with more cancer spread — this time to his urinary bladder and bone.

Henry said his doctors installed three stents in his body — two colonic stents and one stent for his kidney to prevent further tumor blockage. Henry was asked to undergo more chemotherapy or radiotherapy. He declined and came to seek our help instead.

Comments: This is a sad story indeed. Let me point out that Henry started off with a Stage 2 colorectal cancer without any metastasis whatsoever. After surgery and chemotherapy his fortune turned for the worse. Compare this story with other cases that I have related earlier. These people had more serious cancer than Henry but they declined chemotherapy. And they did not have any recurrence or metastasis. The question is: “Why not recurrence or metastasis.”

This has always been my hunch all along after observing patients for more than a decade: “Could chemotherapy have caused all these metastasis and havoc?” I have no way to argue because I have no data to support by observation. However, let me alert you to the three quotations below:

A small, insignificant column in The Star on 7 April 2007 had this heading: “Study: Treatment may fuel cancer’s spread.” The study reported in the Journal of Clinical Investigation by Dr. Carlos Arteaga and colleagues at Vanderbilt University, USA, showed that treating cancer with surgery, chemotherapy or radiation may sometimes cause tumors to spread. In their work they used doxorubicin (a common chemo-drug used for breast cancer) or radiation and found that these treatments raised levels of TGF-beta, which in turn helped breast cancer tumors to spread to the lung. The researchers wrote: “The repopulation and progression of tumours after anti-cancer therapy (such as radiotherapy, chemotherapy and surgery) is a well-recognised phenomenon.” Is this research relevant to Henry’s case?

Andrew Weil wrote (in Health and Healing): “There is never ending struggle. Patients are sucked into same way of thinking, finding themselves more and more dependent on the system giving one treatment after another.” How true are these words as applied to Henry’s case?

Professor Jane Plant (in Your Life in Your Hands) wrote: “This sounds like a battle between the disease and the treatments — with the patient as the battle ground. Conventional cancer treatment can process patients to the extent that they no longer understand what is really being done to them.”

Let me end by these words: For colon cancer, the way to go could be just a change of one’s lifestyle and diet besides taking herbs. It could prove to be far more effective and humane than the so-called scientific medicine. Read the cases I have presented so far and make your own conclusion.

Note: After three weeks on herbs, Henry reported that his health had improved and he decided to continue taking the herbs.

lung cancer treatment breakthroughs Click here

Staging of breast cancer

According to the TMN system cancers are the size of the tumor (T) after the appearance of “daughter of tumors (metastases) in lymph nodes (N; Latin” nodus = knot and divided the occurrence of metastases in other organs (M) . It derived from each of consequences for individual therapy.

T = size of the tumor
For breast cancer the following classifications are distinguished:

T stage Tx: no assessment of possible tumor T0: No evidence of a tumor Tis: non-invasive (not in the surrounding tissue ingrown) tumor T1: tumor in greatest dimension no greater than 2 cm T2: Tumor size 2-5 cm in greatest diameter T3: Tumor larger than 5 cm in greatest dimension T4: tumor extends into neighboring tissues (eg, chest muscles, skin or fins)

N = involvement of lymph nodes:
N stage

Nx: lymph nodes can not be assessed N0: Lymph nodes are not affected N1: metastasis in the axillary lymph nodes on the same side as the affected breast, the lymph nodes can move during the examination by the doctor N2: metastasis in the axillary lymph nodes on the same side as the affected breast, the lymph nodes can be moved during the examination by the doctor, since they are fused together or with the surrounding tissue N3: metastasis along the internal thoracic artery on the same side as the affected breast

M = metastases:
M stage:

Mx: presence of organ metastases not assessable M0: no organ metastases detected M1: metastases in other organs, there

Grading:
Furthermore, the biological behavior of tumor tissue in the histological examination will be further explored ( “Grading”). This can for example inferences about the rate of growth of the tumor, or a tendency to metastasize. It distinguishes the grading stages G1, G2 and G3.

Dukes Colon Cancer Staging

Dukes Colon Cancer Staging

The rash or other changes in the nipple can indicate a cancer in the breast ducts, many times located under the nipple, which has then extended itself onto the surface of the nipple.

Dukes Colon Cancer Staging

Sometimes this sign of breast cancer indicates a small ductal carcinoma in situ (DCIS), which is a very early breast cancer that has not yet left the duct. Other times, Paget’s disease of the nipple may indicate an invasive cancer somewhere else in the breast. In some cases, a woman who shows signs of Paget’s disease of the nipple will additionally have an abnormal mammogram or have lump in her breast.

Before we move on I want to clarify that Paget’s disease of the nipple is not the same as Paget’s disease of the bone, which is a severe bone disease. Sir James Paget, a British surgeon and physiologist, discovered both conditions which were first documented by him, but they are completely unrelated diseases. Paget’s disease of the nipple can also affect men, although it is rare.

Paget’s disease of the nipple is often first noticed when physical signs of the disease appear. Signs of Paget’s disease usually only occur on one nipple and can include persistent crustiness, scaliness, or redness of the nipple, itching or burning of the nipple and surrounding areola and bleeding or oozing from the nipple and areola.

Paget’s disease can often be confused with other skin conditions, such as breast eczema. Breast Eczema is a highly treatable condition which can be characterized by red, itchy patches or weeping blisters around the nipple which reoccur, but clear up with proper treatment. Paget’s disease does not clear up with routine treatment for eczema or infection and usually only affects one nipple.

Lung Cancer Secrets Revealed Click here

A mammogram is the next step to check for cancer in the actual breast. Sometimes any underlying abnormal breast mass will not be present on a mammogram. A clean mammogram combined with an abnormal nipple finding requires further investigation.

A biopsy of the nipple tissue will need to be performed. Usually this consists of a “punch biopsy” that removes a small amount of tissue to check for cancer. If the mammogram indicates other areas of concern within the breast, biopsies of those areas should be performed.

If Paget’s disease is caught early while it is still confined to the nipple and underlying breast ducts, the patient typically has an excellent prognosis. However, if Paget’s disease of the nipple is associated with an invasive breast cancer or if the cancer has spread out of the breast to other areas of the body (metastatic disease), the survival rate can be lower.

Treatment of Paget’s disease of the nipple involves surgery, radiation treatment and Chemotherapy or drug therapy (such as tamoxifen). Like other types of breast cancer, the location of the cancer will determine which type of surgery is done – a lumpectomy or mastectomy. Radiation therapy usually follows a lumpectomy.

A recent development in surgical treatment involves removing only the nipple and areola (sometimes followed by radiation therapy) in patients whose Paget’s disease has no other underlying breast cancer, thus allowing the woman to keep her breast. Following treatment, an artificial nipple can be recreated using skin grafts and tattooing.

lung cancer treatment breakthroughs Click here