Breast cancer and lymph system

Lymphatic system is important to understand because it is one of the ways in which breast cancer spreads.
The system has few parts.
Lymph nodes are small bean-shaped collections of the immune system cells
(important fight infections cells), associated with lymphatic vessels.
Lymph vessels are actually like small blood vessels, except that they carry fluid called lymph fluid
(instead of blood) from the breast.
Lymph contains tissue fluid and waste products and cells of the immune system.
Breast cancer cells can infiltrate the lymph nodes and start growing in the various lymph nodes.

Benign breast lumps

Most breast lumps are not malignant, they are benign.
However, samples should be taken from lumps and study them under a microscope in order to ensure that these lumps are not malignancies.

Other benign breast lumps

There are benign tumors such as Fibroadenoma or papilloma, which are not normal tumors,
but they are not malignant and do not spread outside the breast to other organs.
However, there are some benign breast conditions that are very important for women
who are in these situations are women who has higher risk for breast cancer.

Risk factors

• Higher populations at risk of developing breast cancer by country of residence -
  for example, in – the United States and northern Europe No. of women breast cancer patients much higher
  compared to Eastern Europe, Asia and South America.
• Age -  breast cancer incidence is very low at around age 20-30 with a constant increase up to age 75.
• Time exposure of breast tissue to estrogens – as it’s longer, the chance of developing breast cancer is higher.
  In other words, early age of first menstruation, menopause over the age of 50, few pregnancies, or pregnancies in old age.
• Family factors – Gene mutations (BRACA 1+2 ) is actually a very small part of breast cancer tumors 5-10%.
• Hormone replacement therapy – to breast cancer (after menopause), Prolonged use of hormone replacements,
  especially in older preparations is more risk factor of breast cancer and should therefore
  seriously consider if any to give and also, avoid prolonged use.
• Lifestyle – The Western world is more fat world and therefore more ill.
  Breast cancer undoubtedly will be more common with obese women but not quite clear which food is blame.
• Alcohol use – is a direct risk of breast cancer ill, no doubt as a larger quantity, so the risk increases,
  so womens should avoid as muchas possible, of alcohol regularly.
• Physical activity – an important factor in young women and older with a 10-70%
  decrease in risk of breast cancer in women is very active and – 30-40% of women with activity of about – 4 hours a week.

Radiation at a young age -

• Women who exposed to radiation for malignant diseases.
• Mammography – approximately – 1% of breast cancer in the United States
  attributed by Mammography with older devices.
• Medical staff dealing with radiation.

Treatment

Women with breast cancer undergo various types of treatments,
including surgery, radiation, chemotherapy, hormone treatment and biological treatment.
Most women undergo more than one type of treatment.
Choosing the right treatment depends mainly on the stage of disease.

The treatment can be local or systemic

Local treatment – surgery and radiotherapy are local treatments.
It remove or destroy breast cancer cells. When the affected cells spread to other organs in the body,
local therapy can be used to control the disease affected areas.

Systemic therapy – chemotherapy, hormone treatment and biological treatment are systemic treatments.
It enter the bloodstream and kill cancer cells throughout the body.
It is  possible to undergo such treatment before surgery to shrink the tumor or after surgery to prevent return of the tumor.

Because cancer treatments also damage healthy tissues and cells, there are side effects to treatments.
These side effects depend mainly on the type of treatment and it’s strength.
They can be different from person to person and from treatment to treatment.

Surgery

Is commonly used breast cancer treatment.
There are several types of surgery:

• Partial breast surgery (breast-sparing surgery) – surgery to remove the cancer but not the breast.
  Other names: breast-conserving surgery, lumpectomy, segmental and partial mastectomy.
• Full surgery (Mastectomy) – surgery to remove the breast.
  In most cases remove the lymph nodes in the armpit.

Radiation therapy

Radiation therapy (or radiotherapy) using a powerful beam to eliminate cancer cells.
Most women undergo this treatment after partial surgery. Treatment depends on tumor size and other factors.
Some women undergo radiation therapy before surgery to shrink the size of the tumor and kill cancer cells.
Doctors use this method when tumore is large or difficult to remove.
Some women undergo chemotherapy or hormone therapy before surgery.

There are two types of radiation therapy for breast cancer. Some women will receive both types:

• External radiation – radiation therapy machine directing beam to affected area.
  This treatment does not require hospitalization and usually takes five days a week to several weeks.
  This schedule protects healthy cells because it allows lower dosage of radiation.
• Internal radiation – with this therapy, doctor insert tubes contain radioactive material into the breast
  and leave them there for a few days.
  This treatment requires hospitalization. The patient comes in isolation during treatment
  to protect other from radiation.
  After removing the implant, there was no radioactive material left in the women body.
  Sometimes repeat the treatment several times for several weeks.

Side effects mainly depend on the dosage and radiotherapy type and the organ of the body
where treatment is performed.
Usually patient’s skin becomes red, dry, sensitive and scratches. Brest will be heavy and tight.
These side efects pass with the time.
Toward the end of treatment, the skin will be moist. Exposure to air as much as possible helps the skin heal.
At this period it is recommended to wear comfortable loose cotton clothing.
It is recommented to consult a doctor about using deodorant, creams and lotions in the treated area.

Chemotherapy

On chemotherapy using drugs to eliminate cancer cells.
Breast cancer chemotherapy usually consists of a combination of drugs.
Sometimes drugs are given orally (pills) and sometimes inveins infusion.
Most chemotherapy dose not require hospitalization and is a day clinic treatment.
Side effects depend on the drug given and the dosage.

Chemotherapy also affects healthy cells that divide rapidly, such as:

• Blood cells – cells that fight infection, cells associated with blood clotting and
  oxygen-carrying cells of the body organs.
  Therefore, women receive chemotherapy may suffer infections,
  bleed easily and feel fatigue and weakness.
  Therefore, frequent blood tests are done. If the results of tests are low,
  medication that can improve the situation are recommended.
• Root hair cells – Some drugs cause baldness. After the treatment the hair grows back,
  but can be changed its color and texture.
• Cells in the digestive system – Some drugs lead to loss of appetite, nausea and vomiting, diarrhea and pain in the mouth and lips.

When there is a chance that the cancer will come back, complementary chemotherapy is used breast cancer.
Some drugs may affect the ovaries and make hormones cease production.
patient may sense the signs of menopause include hot flushes dryness in the vagina.
Menstruation may stop or be irregular. Women over age 35 may become infertilit.

Hormones therapy

Some breast tumors need hormones to grow. Hormone therapy prevents cancer cells to receive or use hormones.
Hormones are estrogen and progesterone. Laboratory tests can show whether cancer cells have a receptor of these hormones.

If answer is positive, hormonal therapy should begin. This therapy uses drugs or surgery:
Drugs – the role of drugs is to block the passage of hormones or avoid certain hormone.
For example, Tamoxifen blocks the estrogen hormone.
Other drugs cause the body to prevent the production of estradiol, which is from estrogen formed.

Surgery – If you are not menopause, your doctor may recommend surgery to remove the ovaries.
The ovaries are the main source of the hormone estrogen in the body.
Postmenopausal women should not undergo surgery because their ovaries produce little estrogen.

Side effects of hormone therapy depends mainly on the type of drug treatment.
Generally, side effects of Tamoxifen similar to those of menopause.
Other side effects include irregular menstruation, headaches, weakness, nausea,
vomiting and vaginal dryness and itching.
You can get pregnant during treatment with Tamoxifen, but the drug may harm the fetus
and should discuss this with your doctor.

Biological treatment
Biological therapy helps the body and immune system to fight breast cancer.
The Immune system is the natural and effective protection to fight against diseases.
women with metastatic cancer receive a biological therapy called Herceptin, this is Monoclonal antibody.
The development was made in laboratory and it is tied to cancer cells.

The drug is vein given with or without chemotherapy in addition. The first time a woman receives Herceptin, she will feel heat and vibration.
Some women also feel pain, weakness, nausea, vomiting, diarrhea, headaches, difficulty breathing or skin rashes.
Typically, side effects,  become more moderate after the first treatment.

Herceptin may harm the heart and lead to heart attacks. It can also affect the lungs.
In case off breath difficultys, contact a doctor immediately.

Risk Factors

No one knows the exact cause of brain cancer. However, it is clear that cancer is not contagious.
Studies indicate that risk factors will raise the chances that a person will develop  brain cancer:

• Sex – Brain cancer is more common in men than women.
  However, Meningioma is more common in women.
• Race – brain cancer appears more among white men.
• Age – Most brain cancer are diagnosed in people over age 70.
• However, brain tumors are second most in distribution
  with children, (after leukemia) under the age of 8.
• Family history – people who has relatives with Glioma more likely to develop this disease.Exposure to radiation or certain chemicals at work:

• Radiation – nuclear reactor workers, are more likely to develop brain cancer.
• Formaldehyde – people working with this chemical (as pathologists)
  are more likely to develop brain cancer.
• Vinyl chloride – people who work in plastic industry may be exposed
  to this chemical and may develop brain cancer.
• Acrylonitrile – This textile and plastic industry common chemical, is a risk factor for brain tumor.
• Scientists investigating whether mobile phone usage increases the risk of brain cancer.

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Symptoms

Brain cancer symptoms depend on the size, type and location of the tumor.
Symptoms may appear when the tumor puts pressure on a nerve or destroys tissue in a brain.
They can also occur as a result of swollen head or accumulation of fluid in the brain.

These are common brain cancer symptoms:

• Headaches (usually they are stronger at morning).
• Nausea or vomiting.
• Changes in speech, eyesight or hearing.
• Problems with walking or balance.
• Changes in mood, personality or concentration.
• Memory problems.
• Muscle contraction and vibration.
• Feeling or tingling limbs.

These symptoms are not a sure sign for a brain cancer,
other conditions also can cause these symptoms appear.
Only a doctor can diagnose cancer and you must contact him if these symptoms appear.

Types of brain cancer

Brain tumors can be benign or malignant:

Benign tumors:

• This can usually be removed and do not return.
• You can easily see the edges of the bengin tumor. Tumor cells do not spread or penetrate other tissues.
  However, the tumor may press on sensitive areas of the brain and constitute a serious health problem.
• Unlike benign tumors in other organs of the body, bengin brain tumor could endanger the patient’s life.
• Rarely, benign tumor becomes malignant tumor.

Malignant tumors:

• Are usually more severe and life-threatening.
• Malignat tumors will grow quickly and invade other tissues in the brain.
• Rarely, malignant tumor becomes metastasis cancer,
  and send secondery growth to the spinal cord, brain or other organs in the body.
• Sometimes the tumor will remain only in the bones of the skull and not spread to other tissues.
  This type of tumor called an atom tumor.

Diagnosise

Following tests shall be made to a person with the symptoms described in up to diagnose brain cancer:

• Physical examination – The doctor checks general signs of health.
• Neurological examination – the doctor checks sharp movement, muscle strength, coordination, reflexes and response to pain.
• The doctor also search for eye swelling, caused by an increase of pressure on the optic nerve.
• CT – The patient receives an injection of contrast material and then photographing the head. Tumors can be seen in resulting picture.
• MRI – A powerful magnet connected to the computer generates a detailed picture of the head.
• Sometimes you need a special color Injection to increase the sharpness of the image.
  Tumors and other health problems, can be seen in picture.
• CT of the blood vessels. This test can also detect tumors.
• X-ray of the skull – some tumors alter the balance of calcium in the skull. The doctor examines it with X-ray.
• Acupuncture of the spine – with acupuncture doctor collects a sample of liquid from the spine.
• This procedure is performed under local anesthesia.
  The doctor uses a long thin needle for acupuncture.  This procedure takes about 30 minutes.
• CT of the spine, when injecting to the spine, contrast material to the spine liquid.
• Biopsy – removal of tissue by surgery for pathological examination for cancer cells.
  This is the only right safe way to diagnose cancer.

There are 3 ways to collect tissue by surgerys:

• Needle biopsy – The surgeon performs a small incision at the top of the skull and drill a hole in the skull.
• Stereotactic biopsy – using imaging device (such as CT or MRI) for directing the needle after making a hole in the skull.
• Biopsy during treatment – the surgeon takes a tissue sample from the patient while surgeon remove the tumor.

Treatment

There are several methods for brain cancer treatment depend on the type of cancer in his stage.
Patient can undergo surgery, radiation or chemotherapy.
Some patients receive a combination of several types of treatment.
In addition, patients will receive treatment for symptoms and side effects of treatment.
This is complementary therapy which not directed against cancer.

Surgery

This is the usual treatment of most brain cancers.
Surgery is performed under general anesthesia which during surgeon opens the skull.
Before the operation it is necessary to shave the hair head.
The surgeon performs a cut in the head, drill inside, and then cut out a piece of bone to open the skull.
Then, the surgeon removes the tumor or most of it and then put the bone back
(or close the skull using a metal), sewing the incision.
Sometimes you can not perform the surgery.
If the tumor is located in places that can not be reached without harming healthy tissue,
then the patient will receive other treatments.

Radiation

This method using a powerful beam to kill cancer cells.
This treatment usually comes after surgery to kill cancer cells that may still be in the head.
Sometimes this treatment replaces surgery. The treatment is performed in a hospital or clinic.
Radiation frequency depends on the type of cancer, patient’s age and size.
Each treatment takes few minutes.

Chemotherapy

Using drugs to kill infected cells. Drugs are given orally or intravenously.
In any case, they enter the blood stream, moving throughout the body.
Chemotherapy usually does not require hospitalization and can be a clinic or day treatment.
Children receive this treatment more than adults.
When brain cancer returned after treatment, the surgeon removes the tumor and plants small implants
that regularly chemotherapy liberators, until they dissolve after several weeks.

Complementary therapy

At any stage of the disease, patients can receive a complementary treatment to improve significantly the quality of life.
Patients can receive treatment for pain or against the symptoms of cancer, Treatment for side effects from treatment
and mental help to overcome illness.

These complementary treatments common for brain cancer:

• Steroids – can reduce brain swelling.
• Drugs against seizures (Anticonvulsant) – drugs to prevent seizures and stroke.
• Fluid drainage – with surgery, drain fluid’s accumulated in the brain.

The rapid formation of young cells and no mortality of the elderly, this situation creates an accumulation of cells,
in other words Earning needlepoint. This earning needlepoint is the tumor.
Cancer cells multiply at a rate independent, which is not related to the rate of origin tissue, and is usually faster.
The spread of malignant tumor call metastases.
For example, doubling the rate of cells in – blood cancer is with in number of days.


Tumor can be benign or malignant :

• Benign – tumor that can be usually removed with a surgical procedure.
  Constituent cells do not spread metastases to other parts of the body.
  Most benign tumor does not return after removed, it is important to remember that it is not a threat on patient’s life.
• Malignant tumor – complicated and more dangerous.
  Constituent cells can move from origin tissue, into other tissues in the body and harm them.
  These cells also can spread metastases and penetrate into the bloodstream and / or into the lymph system,
  creating tumor on distant organs from hurt organ.

Most patients with lung cancer are diagnosed at an
advanced  stage of their illness and only
about – 15% of all lung cancer patients cured.
Most patients diagnosed with advanced
disease or simplified, when the tumor can
not be more surgical pillow.
Standard treatment at this point of the disease,
improves quality of life and make them longer.

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There are two types of histology’s lung cancer:

• Lung cancer, which is not small cell type
  (NSCLC non-small cell lung cancer)
  which is 85% – 90% of all cases.
• Small cell lung cancer (SCLC) approximately
  7% -15% of cases.

Epidemiology primary cause of lung cancer is smoking.
70-75 cases out of 100 instances of lung cancer caused by smoking.
Passive smoking increases the risk of lung cancer.
The risk of developing lung cancer associated with smoking and for the total amount of cigarettes consumed.
For example, 40 years of smoking Double the risk of lung cancer compared with 30 years of smoking.
The risk doubled if smoking began before the age of 15.

Symptoms – cough, shortness of breath, phlegm blood, chest pain recurring lung infections.

Complete resection of lung cancer is the most likely cure.
25% -30% of patients are diagnosed at a point that allows surgical resection.
Locally advanced disease standard treatment is a combination of chemical treatment with radiation therapy
and simplified disease chemical treatment combines 2 medicines, One from the new-generation and one which is old-fashioned.
Old-fashioned remedies are: Carboplatin, Cisplatin.
New generation remedies are: Gemcitabine, Taxol, Taxotere and Navelbine.

It should be noted that the treatment of lung cancer is advanced in recent years thanks to new drugs
such as antibodies and target biological treatments,
some of which have been approved for the treatment, some are being tested on clinical trials.

Causes For Lung Cancer

Cigarette smoking is known to cause the vast majority of lung cancer.
Risk of developing the disease rises with increasing number of
cigarette smoked, and as smoking was started at a young age.
With filter cigarettes containing low tar quantity, can slightly reduce
the risk, but of course much higher risk than someone who
does not smoke, even in this case.
Someone who stopped smoking, significantly reduces his risk of lung cancer.
The risk is decreasing as time passes from time to quit smoking.
People who work with asbestos also or people with asbestos poisoning,
have higher risk of getting lung cancer.

Symptoms for early detection of Lung Cancer

Most people usually tend to see a doctor after a while they feel pain.
Those who have lung cancer characterized by the following symptoms:
Cough, short breath, beep while breathing, chest pain (especially when you cough),
outgoing mucus with blood, loss of appetite, weight loss, pneumonia not responding medication.

Diagnostic Process for Lung cancer

Diagnosis by X-ray is the first stage if the patient reports symptoms indicative of the disease.
Examination can reveal visible signs.
If there are no visible signs on the X-ray results but suspicion still exists
tests of lung biopsy is often necessary to locate the tumor and its kind.

Treatment Types for Lung Cancer

Type of treatment for lung cancer depends on the type of the tumor,
spread levels and general health condition of the patient.
Currently acceptable treatments are surgery, chemotherapy and radiation.

• Surgery
  Surgery is possible treatment if the lung cancer type is NSCLC, and limited only if the tumor is found only in the lung  and not spread to other parts of the body.
  In addition, it’s important that the patient will have enough independent breath tools to be possible to perform the surgery.
  Types of surgery’s are between remove one lobe, two lobes or removal of all lung.
• Chemotherapy
  With SCLC  type of lung cancer, chemotherapy is the tumor primary treatment.
  The main goal of such a treatment is to destroy the cancer cells of the patient.
  The main problem of such a treatment is that it finds it difficult to distinguish between normal cells and cancer cells,
  thats why often also destroys healthy cells completely, which can cause many side effects.
• Radiation
  Radiation therapy is also called radiotherapy.
  During radiation therapy the patient receives high-intensity radiation to the tumor to destroy infected cells.
  The treatment itself is local and only affects a local area you radiate.
  Sometimes the patient receiving radiation therapy before surgery to minimize the size of the tumor.
  Sometimes the patient receiv radiation therapy after surgery to destroy malignant cells remain after operation.

Hair Loss – Causes

Cause of male baldness is a combination of inherited genetic
tendency to hormonal effects of male hormones (androgens).
For people with a genetic predisposition baldness, the hormone “Dihydrotestoterone,”  becomes more active than
usual Ltstotron by an enzyme called “five-alpha reductase”.
Excess activity of the active follicle Htstoron makes people,
with a tendency balsness, the transition of hair follicles from
areas typical  of normal healthy hair into hair
that can not be seeing.

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Hair Loss – Treatment

• Minoksidil
  Use of drugs is by spreading it directly on the scalp, one ml dose of twice a day,
  while massaging the material would be absorbed in the skin.
  The drug is sold without a prescription.
• Propecia
  comes in the form of tablets and should be taken once a day.
  About 90% of users stop going bald and about 60% of users are growing new hair.
• Dutasteride
  “Dutasteride” drug tablet form is now 0.5% mg and given only to people suffering from enlarged prostate.
  Notwithstanding, many people taking the drug of individual choice problems of hair loss.
  The studies conducted so far show better results from  “Finstrid” treatment.
• Vitamins
  Often lack of vitamins caused by uncontrolled diets or extreme diets,
  which can reach to – nutrition, which can cause serious hair loss.
  Important vitamins that affect the hair are especially B12, B6 and 1B.
  Addition of vitamin B6 may result in strengthening hair and stop dropping out among women only,
  since this vitamin does not affect men in this context.
  Anyway, take vitamins and minerals recommended by a doctor’s recommendation only,
  mainly to avoid the acquisition of vitamin compounds distributed in the market
  actually contain a very small amount of vitamins, without any control.
• Laser
  Many people visit cosmetic centers ensureing the cease-dropout and renewal growing hair,
  scalp massage followed by laser treatment operations.
  The downside seems that patients need to reach these centers and spend long time on trips so.
  Against this background, several companies began about 5 years ago to produce a comb-shaped laser device,
  so you can perform the treatment at home independently.
• Mesotraphy
  “Mesotraphy” is a method for injecting a low concentration of “Minoksidil”,
  “Biotin” and “Patanol” into a sub skin region in the scalp.
  Injections are carried out by a special device,
  which does not allow the doctor to insert the needle beyond the tiny one millimeter into the skin,
  so it’s almost painless.

GERD is a collection of unpleasant clinic symptoms and histology’s changes,
resulting from chronic excessive repetition of the stomach contents down the esophagus (refluxate).
GERD can cause frequent to daily heartburn and damage to the esophagus.
The main symptoms are : Heartburn and Regurgitation.
These common elements affect our health and quality of life.
There are those who believe that GERD affects quality of life more than untreated high blood pressure,
duodenum ulcer, and mild heart failure.
GERD leads to serious physical and psychosocial consequences,
as a result of certain foods can worsen and urged discomfort.
Some patients avoid social situations involving meals or high levels of stress.
As a result of GERD causes increase in discomfort when lying supine,
there are disorders of rest and sleep patterns.
GERD which not treated can lead to serious consequences such as
Barrett’s esophagus which occurs when there is chronic exposure to acid,
causes Squamous epithelium type become Metaphysics epithelium type,
preliminary status of esophageal adenocarcinoma.
When developing this disorder, it is possible that typical treatment for GERD
will not prevent disease progression toward cancer.

Epidemiology

American College of Gastroenterology reports that more than – 60 million Americans
experience acid indigestion at least once a month.
Some researchers claim that 20% of patients reported Acid Reflux,
experience weekly symptoms, while many others experience daily symptoms.
International Association of gastrointestinal functional disorders reports
that GERD affects  5% -7% of the population.
Advanced age adults have a higher risk of complications of GERD
due to a long exposure of the esophagus to acid for many years.
In addition there is a higher incidence for Hiatal Hernia, decreased salivary volume and medications
which decreased pressure from esophagus lower sphincter.

Acid Reflux – Causes

Increaseing Acid provision, ghange the protection mechanism of acid esophageal,
esophagus motility disorder, hiatal hernia, overweight, spinal column damage,
partial paralysis of the stomach (gastroparesis).
All this can expose the patient to Acid Reflux.
Patients suffering from diseases such as Zollinger-ellison syndrome,
Thyroid disease, Diabetes or mixed disorders such Connective
can develop dysfunction of the esophagus associated with motion

Acid Reflux – Diagnosis

Early accurate diagnosis helps prevent complications and damage to quality of life.
Eeffective diagnostic tools are clinical presentation and medical history,
including characteristics, the way the disease developed,
frequency of symptoms duration and their progress.

Acid Reflux – Symptoms

Returns heartburn and/or regurgitation which become worse after a big meal, lying down or bending.
non origin cardiac chest pain and frequent hiccups.
Ulcers such aphthous, Middle ear infection, Erosion of the palate, Pharyngitis, and Sinusitis.
Reflux can occur in circumstances of pregnancy, and Overweight.
Patients who smoke or are taking certain medications may experience worsening of Reflux.

Treatment

Due to the chronic nature of the disease, management requires an ongoing process throughout life
even after control of symptoms achieved.
The patient will need monitoring, support and education to aid in the adjustment of daily life
and dedication to medical care.
Initial treatment for mild GERD begins with lifestyle adjustment that persist throughout the therapy.
In general nutritional recommendations include avoiding certain foods cause a rise of Acid Reflux like:

• chocolate,
• alcohol
• cola
• mint
• spicy foods or oils
• citrus fruit
• coffee
• onions and garlic.

There is a recommendation on interventions to prevent pressure on the lower esophagus cage:

• Raising the head of the bed on 6-10  inches.
• Weight loss according to the recommendations.
• Avoiding large meals.
• Avoiding lying about three hours after a meal.
• Avoiding smoking.

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