Cervical Cancer

Cervical Cancer is a cancer arising from the cervix or in the any layer of the wall of the cervix.  It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body.

Early on, typically no symptoms are seen.  Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse. While bleeding after sex may not be serious, it may also indicate the presence of cervical cancer.

Human papillomavirus infection (HPV) causes more than 90% of cases; most who have had HPV infections, however, do not develop cervical cancer.  HPV 16 and 18 strains are responsible for nearly 50% of high grade cervical pre-cancers.

Other risk factors include smoking, a weak immune system, birth control pills, starting sex at a young age, and having many sexual partners, but these are less important. Genetic factors also contribute to cervical cancer risk.

Cervical cancer typically develops from precancerous changes called cervical intraepithelial neoplasia over 10 to 20 years.

About 90% of cervical cancer cases are squamous cell carcinomas, 10% are adenocarcinoma, and a small number are other types.  Diagnosis is typically by cervical screening followed by a biopsy.  Medical imaging is then done to determine whether or not the cancer has spread.

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Together for Health

Cervical Cancer - International Resources

Australian Cervical Cancer Foundation

Cancer Research UK - Cervical cancer resources and support organizations

European Society for Medical Oncology (ESMO) - Cervical Cancer: A Guide for Patients

Jo's Cervical Cancer Trust (UK)

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Clinical Trials
Awareness
Month

A clinical trial is a comparison test with volunteers designed to learn more about a pharmaceutical or other medical therapy against a placebo (an inert look-alike) to learn more about how our bodies respond to potential new medicines or treatments.

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International Clinical Cancer Trials

Gallbladder & Bile Duct Cancer

Gallbladder cancer is a relatively uncommon cancer, with an incidence of fewer than 2 cases per 100,000 people per year in the United States. It is particularly common in central and South America, central and eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics.

If it is diagnosed early enough, it can be cured by removing the gallbladder, part of the liver and associated lymph nodes. Most often it is found after symptoms such as abdominal pain, jaundice and vomiting occur, and it has spread to other organs such as the liver.

It is a rare cancer that is thought to be related to gallstones building up, which also can lead to calcification of the gallbladder, a condition known as porcelain gallbladder.

Cholangiocarcinoma, also known as bile duct cancer, is a type of cancer that forms in the bile ducts. 

Symptoms of cholangiocarcinoma may include abdominal pain, yellowish skin, weight loss, generalized itching, and fever.  Light colored stool or dark urine may also occur.  Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater.

Cholangiocarcinoma is typically incurable at diagnosis which is why early detection is ideal. In these cases palliative treatments may include surgical resection, chemotherapy, radiation therapy, and stenting procedures.

In about a third of cases involving the common bile duct and less commonly with other locations the tumor can be completely removed by surgery offering a chance of a cure. Even when surgical removal is successful chemotherapy and radiation therapy are generally recommended.

In certain cases surgery may include a liver transplantation. Even when surgery is successful the 5-year survival is typically less than 50%.

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Colorectal Cancer

Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine).

Signs and symptoms may include blood in the stool, a change in bowel movements, weight loss, abdominal pain and fatigue. Most colorectal cancers are due to old age and lifestyle factors, with only a small number of cases due to underlying genetic disorders. Risk factors include diet, obesity, smoking, and lack of physical activity. Dietary factors that increase the risk include red meat, processed meat, and alcohol. Another risk factor is inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis.

Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer; however, these represent less than 5% of cases. It typically starts as a benign tumor, often in the form of a polyp, which over time becomes cancerous.

Colorectal cancer may be diagnosed by obtaining a sample of the colon during a sigmoidoscopy or colonoscopy. This is then followed by medical imaging to determine whether the disease has spread.

Treatments used for colorectal cancer may include some combination of surgery, radiation therapy, chemotherapy, and targeted therapy.

Cancers that are confined within the wall of the colon may be curable with surgery, while cancer that has spread widely is usually not curable, with management being directed towards improving quality of life and symptoms.

The five-year survival rate in the United States was around 65% in 2014. The individual likelihood of survival depends on how advanced the cancer is, whether or not all the cancer can be removed with surgery, and the person's overall health.

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Kidney Cancer

Kidney cancer, also known as Renal cancer, is a group of cancers that starts in the kidney. Symptoms may include blood in the urine, a lump in the abdomen, or back pain. Fever, weight loss, and tiredness may also occur. The main types of kidney cancer are renal cell cancer (RCC), transitional cell cancer (TCC), and Wilms' tumor.

RCC makes up approximately 80% of kidney cancers, and TCC accounts for most of the rest. Risk factors for RCC and TCC include smoking, certain pain medications, previous bladder cancer, being overweight, high blood pressure, certain chemicals, and a family history. Risk factors for Wilms' tumor include a family history and certain genetic disorders such as WAGR syndrome. Diagnosis may be suspected based on symptoms, urine testing, and medical imaging. It is confirmed by tissue biopsy.

Treatment may include surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy. Onset is usually after the age of 45. Males are affected more often than females. The overall five-year survival rate is 75% in the United States, 71% in Canada, 70% in China, and 60% in Europe.

For cancers that are confined to the kidney, the five-year survival rate is 93%, if it has spread to the surrounding lymph nodes it is 70%, and if it has spread widely, it is 12%.

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Multiple Myeloma Cancer

Multiple Myeloma Cancer is a cancer of plasma cells, a type of white blood cell normally responsible for producing antibodies.

In multiple myeloma, collections of abnormal plasma cells accumulate in the bone marrow, where they interfere with the production of normal blood cells.

Most cases of multiple myeloma also feature the production of a paraprotein—an abnormal antibody which can cause kidney problems. Bone lesions and hypercalcemia (high blood calcium levels) are also often encountered.

The cause of multiple myeloma is unknown. Risk factors include obesity, radiation exposure, family history, age and certain chemicals. There is an increased risk of multiple myeloma in certain occupations. This is due to the occupational exposure to aromatic hydrocarbon solvents having a role in causation of multiple myeloma.

Multiple myeloma may develop from monoclonal gammopathy of undetermined significance (MGUS) that progresses to smoldering myeloma. The abnormal plasma cells produce abnormal antibodies, which can cause kidney problems and overly thick blood. The plasma cells can also form a mass in the bone marrow or soft tissue.  When one tumor is present, it is called a plasmacytoma; more than one is called multiple myeloma.

Multiple myeloma is diagnosed based on blood or urine tests finding abnormal antibody proteins - (often using electrophoretic techniques revealing the presence of a monoclonal spike in the results - termed an m-spike), bone marrow biopsy finding cancerous plasma cells, and medical imaging finding bone lesions. Another common finding is high blood calcium levels.

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Testicular Cancer

is cancer that develops in the testicles, a part of the male reproductive system.

Not all lumps on the testicles are tumors, and not all tumors are malignant (cancerous).

There are many other conditions, such as testicular microlithiasis, epididymal cysts, and appendix testis (hydatid of Morgagni), which may be painful but are non-cancerous.

Testicular cancer has one of the highest cure rates of all cancers with an average five-year survival rate of 95%.

If the cancer has not spread outside the testicle, the 5-year survival is 99% while if it has grown into nearby structures or has spread to nearby lymph nodes, the rate is 96% and if it has spread to organs or lymph nodes away from the testicles, the 5-year survival is around 74%.

Even for the relatively few cases in which cancer has spread widely, chemotherapy offers a cure rate of at least 80%.

Globally testicular cancer affected about 686,000 people in 2015. That year it resulted in 9,400 deaths up from 7,000 deaths in 1990. Rates are lower in the developing than the developed world.

Onset most commonly occurs in males 20 to 34 years old, rarely before 15 years old. The five-year survival rate in the United States is about 95%. Outcomes are better when the disease remains localized.

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Esophageal Cancer

Esophageal cancer (or oesophageal cancer) is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach.

Symptoms often include difficulty in swallowing and weight loss. Other symptoms may include pain when swallowing, a hoarse voice, enlarged lymph nodes ("glands") around the collarbone, a dry cough, and possibly coughing up or vomiting blood.

The two main sub-types of the disease are esophageal squamous-cell carcinoma (often abbreviated to ESCC), which is more common in the developing world, and esophageal adenocarcinoma (EAC), which is more common in the developed world.  A number of less common types also occur. 

Squamous-cell carcinoma arises from the epithelial cells that line the esophagus. Adenocarcinoma arises from glandular cells present in the lower third of the esophagus, often where they have already transformed to intestinal cell type (a condition known as Barrett's esophagus).

Causes of the squamous-cell type include tobacco, alcohol, very hot drinks, poor diet, and chewing betel nut. The most common causes of the adenocarcinoma type are smoking tobacco, obesity, and acid reflux.

The disease is diagnosed by biopsy done by an endoscope (a fiberoptic camera). Prevention includes stopping smoking and eating a healthy diet. Treatment is based on the cancer's stage and location, together with the person's general condition and individual preferences.

Small localized squamous-cell cancers may be treated with surgery alone with the hope of a cure. In most other cases, chemotherapy with or without radiation therapy is used along with surgery. Larger tumors may have their growth slowed with chemotherapy and radiation therapy. In the presence of extensive disease or if the affected person is not fit enough to undergo surgery, palliative care is often recommended.

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Head & Neck Cancer

Head and neck cancer develops from tissues in the lip and oral cavity (mouth), larynx (throat), salivary glands, nose, sinuses, or skin of the face. The most common types of head and neck cancer occur in the lips, mouth, and larynx.

Symptoms predominantly include a sore that does not heal or a change in the voice. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity. Given the location of these cancers, it is possible for an afflicted individual to experience difficulty breathing.

The majority of head and neck cancer is caused by the use of alcohol or tobacco, including smokeless tobacco, with increasing cases linked to the human papillomavirus (HPV).

Other risk factors include the Epstein–Barr virus, betel quid, radiation exposure, and certain workplace exposures. About 90% are pathologically classified as squamous cell cancers. The diagnosis is confirmed by a tissue biopsy. The degree of surrounding tissue invasion and distant spread may be determined by medical imaging and blood tests.

Not using tobacco or alcohol can reduce the risk of head and neck cancer.  Head and neck cancer is often curable if it is diagnosed early; however, outcomes are typically poor if it is diagnosed late.

Treatment may include a combination of surgery, radiation therapy, chemotherapy, and targeted therapy. Previous diagnosis and treatment of a head and neck cancer confer a higher risk of developing a second head and neck cancer or recurrence.

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Melanoma & Skin Cancer

Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes.  It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye (uveal melanoma). 

In women, melanomas most commonly occur on the legs; while in men, on the back. Melanoma is frequently referred to as malignant melanoma. However, the medical community stresses that there is no such thing as a 'benign melanoma' and recommends that the term 'malignant melanoma' should be avoided as redundant.

About 25% of melanomas develop from moles.  Changes in a mole that can indicate melanoma include increase—especially rapid increase—in size, irregular edges, change in color, itchiness, or skin breakdown.

The primary cause of melanoma is ultraviolet light (UV) exposure in those with low levels of the skin pigment melanin. The UV light may be from the sun or other sources, such as tanning devices. Those with many moles, a history of affected family members, and poor immune function are at greater risk.  A number of rare genetic conditions, such as xeroderma pigmentosum, also increase the risk.   Diagnosis is by biopsy and analysis of any skin lesion that has signs of being potentially cancerous.

Avoiding UV light and using sunscreen in UV-bright sun conditions may prevent melanoma. Treatment typically is removal by surgery of the melanoma and the potentially affected adjacent tissue bordering the melanoma.  In those with slightly larger cancers, nearby lymph nodes may be tested for spread (metastasis). 

Most people are cured if metastasis has not occurred. For those in whom melanoma has spread, immunotherapy, biologic therapy, radiation therapy, or chemotherapy may improve survival.

With treatment, the five-year survival rates in the United States are 99% among those with localized disease, 65% when the disease has spread to lymph nodes, and 25% among those with distant spread. The likelihood that melanoma will reoccur or spread depends on its thickness, how fast the cells are dividing, and whether or not the overlying skin has broken down.

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Brain Cancer

A brain tumor occurs when abnormal cells form within the brain.There are two main types of tumors: malignant (cancerous) tumors and benign (non-cancerous) tumors. These can be further classified as primary tumors, which start within the brain, and secondary tumors, which most commonly have spread from tumors located outside the brain, known as brain metastasis tumors.

All types of brain tumors may produce symptoms that vary depending on the size of the tumor and the part of the brain that is involved. Where symptoms exist, they may include headaches, seizures, problems with vision, vomiting and mental changes. Other symptoms may include difficulty walking, speaking, with sensations, or unconsciousness.

The cause of most brain tumors is unknown, though up to 4% of brain cancers may be caused by CT scan radiation.  Uncommon risk factors include exposure to vinyl chloride, Epstein–Barr virus, ionizing radiation, and inherited syndromes such as neurofibromatosis, tuberous sclerosis, and von Hippel-Lindau Disease.  Studies on mobile phone exposure have not shown a clear risk. The most common types of primary tumors in adults are meningiomas (usually benign) and astrocytomas such as glioblastomas.

In children, the most common type is a malignant medulloblastoma. Diagnosis is usually by medical examination along with computed tomography (CT) or magnetic resonance imaging (MRI). The result is then often confirmed by a biopsy. Based on the findings, the tumors are divided into different grades of severity.

Treatment may include some combination of surgery, radiation therapy and chemotherapy.  If seizures occur, anticonvulsant medication may be needed.  Dexamethasone and furosemide are medications that may be used to decrease swelling around the tumor. Some tumors grow gradually, requiring only monitoring and possibly needing no further intervention. 

Outcomes for malignant tumors vary considerably depending on the type of tumor and how far it has spread at diagnosis. Although benign tumors only grow in one area, they may still be life-threatening depending on their size and location. Malignant glioblastomas usually have very poor outcomes, while benign meningiomas usually have good outcomes

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Bladder Cancer

Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder. Symptoms include blood in the urine, pain with urination, and low back pain. It is caused when epithelial cells that line the bladder become malignant.

Bladder cancer characteristically causes blood in the urine, which may be visible or detectable only by microscope. Blood in the urine is the most common symptom in bladder cancer, and is painless.

Visible blood in the urine may be of only short duration, and a urine test may be required to confirm non-visible blood. Between 80 and 90% of people with bladder cancer initially presented with visible blood. Blood in the urine may also be caused by other conditions, such as bladder or ureteric stones, infection, kidney disease, kidney cancers or vascular malformations, though these conditions (except kidney cancers) would typically be painful.

Other possible symptoms include pain during urination, frequent urination, or feeling the need to urinate without being able to do so. These signs and symptoms are not specific to bladder cancer, and may also be caused by non-cancerous conditions, including prostate infections, overactive bladder or cystitis. Some rare forms of bladder cancer like urachal adenocarcinoma produce mucin, which is then excreted in the urine causing it to be thick.

Risk factors for bladder cancer include smoking, family history, prior radiation therapy, frequent bladder infections, and exposure to certain chemicals. Diagnosis is typically by cystoscopy with tissue biopsies. Staging of the cancer is determined by transurethral resection and medical imaging.

Treatment depends on the stage of the cancer. It may include some combination of surgery, radiation therapy, chemotherapy, or immunotherapy. Surgical options may include transurethral resection, partial or complete removal of the bladder, or urinary diversion. The typical five-year survival rates in the United States is 77%, Canada is 75%, and Europe is 68%.]

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Cancer Survivor
Awareness
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Sarcoma Cancer

A sarcoma is a malignant tumor, a type of cancer that arises from cells of connective tissue (mesenchymal) origin. 

Connective tissue is a broad term that includes bone, cartilage, fat, vascular, or other structural tissues, and sarcomas can arise in any of these types of tissues.  As a result, there are many subtypes of sarcoma, which are classified based on the specific tissue and type of cell from which the tumor originates.

Sarcomas are primary connective tissue tumors, meaning that they arise in connective tissues.  This is in contrast to secondary (or "metastatic") connective tissue tumors, which occur when a cancer from elsewhere in the body (such as the lungs, breast tissue or prostate) spreads to the connective tissue. Sarcomas are one of five different types of cancer, classified by the cell type from which they originate.

Symptoms of soft-tissue sarcomas vary, but they often present as firm, often times painless lumps or nodules.

Gastrointestinal stromal tumors (GIST, a subtype of soft-tissue sarcoma) often are asymptomatic, but can be associated with vague complaints of abdominal pain, bleeding into the intestines, a feeling of fullness, or other signs of intestinal obstruction.

Symptoms of bone sarcomas typically include bone pain, especially at night, and swelling around the site of the tumor.

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Childhood Cancer

Childhood cancer (also known as pediatric cancer) is cancer in a child.

In the United States, an arbitrarily adopted standard of the ages used are 0–14 years inclusive, that is, up to 14 years 11.9 months of age.

However, the definition of childhood cancer sometimes includes young adults between 15–19 years old.

The most common cancers in children are (childhood) leukemia (34%), brain tumors (23%), and lymphomas (12%).

Pediatric oncology is the branch of medicine concerned with the diagnosis and treatment of cancer in children.

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Gynecological Cancer

Gynecologic cancer is a type of cancer that affects the female reproductive system, including ovarian cancer, uterine cancer, vaginal cancer, cervical cancer, and vulvar cancer.

Signs and symptoms usually vary depending on the type of cancer. The most common symptoms across all gynecological cancers are abnormal vaginal bleeding, vaginal discharge, pelvic pain and urination difficulties.

Gynecological cancers comprise 10-15% of women's cancers, mainly affecting women past reproductive age but posing threats to fertility for younger patients.

The most common route for treatment is combination therapy, consisting of a mix of both surgical and non-surgical interventions (radiotherapy, chemotherapy).

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Leukemia Cancer

Leukemia, also spelled leukaemia, is a group of cancers that usually begin in the bone marrow and result in high numbers of abnormal white blood cells.

These white blood cells are not fully developed and are called blasts or leukemia cells.

Symptoms may include bleeding and bruising problems, feeling tired, fever, and an increased risk of infections. These symptoms occur due to a lack of normal blood cells. 

Diagnosis is typically made by blood tests or bone marrow biopsy.

The exact cause of leukemia is unknown. Different kinds of leukemia are believed to have different causes.

Both inherited and environmental (non-inherited) factors are believed to be involved.

Risk factors include smoking, ionizing radiation, some chemicals (such as benzene), prior chemotherapy, and Down syndrome.

People with a family history of leukemia are also at higher risk.

There are four main types of leukemia:

• Acute Lymphoblastic Leukemia (ALL)
• Acute Myeloid Leukemia (AML),
• Chronic Lymphocytic Leukemia (CLL)
• Chronic Myeloid Leukemia (CML)

There are also a number of less common types of leukemia.

Leukemias and lymphomas both belong to a broader group of tumors that affect the blood, bone marrow, and lymphoid system, known as tumors of the hematopoietic and lymphoid tissues.

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Lymphoma Cancer

Lymphoma is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). The name typically refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlarged lymph nodes, fever, drenching sweats, unintended weight loss, itching, and constantly feeling tired. The enlarged lymph nodes are usually painless.  The sweats are most common at night.

Many subtypes of lymphomas are known. The two main categories of lymphomas are the non-Hodgkin lymphoma (NHL) (90% of cases) and Hodgkin lymphoma (HL) (10%).  Lymphomas, leukemias and myelomas are a part of the broader group of tumors of the hematopoietic and lymphoid tissues.

Risk factors for Hodgkin lymphoma include infection with Epstein–Barr virus and a history of the disease in the family.  Risk factors for common types of non-Hodgkin lymphomas include autoimmune diseases, HIV/AIDS, infection with human T-lymphotropic virus, immunosuppressant medications, and some pesticides. 

Diagnosis, if enlarged lymph nodes are present, is usually by lymph node biopsy.   Blood, urine, and bone marrow testing may also be useful in the diagnosis. Medical imaging may then be done to determine if and where the cancer has spread. Lymphoma most often spreads to the lungs, liver, and brain.

Treatment may involve one or more of the following: chemotherapy, radiation therapy, proton therapy, targeted therapy, and surgery.  In some non-Hodgkin lymphomas, an increased amount of protein produced by the lymphoma cells causes the blood to become so thick that plasmapheresis is performed to remove the protein.  The outcome depends on the sub-type with some being curable and treatment prolonging survival in most.

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Ovarian Cancer

Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen.

The ovary is made up of three different cell types including epithelial cells, germ cells, and stromal cells.  When these cells become abnormal, they have the ability to divide and form tumors.

These cells can also invade or spread to other parts of the body.  When this process begins, there may be no or only vague symptoms.  Symptoms become more noticeable as the cancer progresses.  These symptoms may include bloating, vaginal bleeding, pelvic pain, abdominal swelling, constipation, and loss of appetite, among others. 

Early signs and symptoms of ovarian cancer may be absent or subtle.  In most cases, symptoms exist for several months before being recognized and diagnosed. 

Symptoms can often be misdiagnosed as irritable bowel syndrome.  The early stages of ovarian cancer tend to be painless which makes it difficult to detect it early on. Symptoms can vary based on the sub-type.

Treatment usually includes some combination of surgery, radiation therapy, and chemotherapy. Outcomes depend on the extent of the disease, the sub-type of cancer present, and other medical conditions.

The risk of ovarian cancer increases with age. Most cases of ovarian cancer develop after menopause.  It is also more common in women who have ovulated more over their lifetime.  This includes those who have never had children, those who began ovulation at a younger age and those who reach menopause at an older age. 

Epithelial ovarian carcinoma is the most common type of ovarian cancer, comprising more than 95% of cases. There are five main subtypes of ovarian carcinoma, of which high-grade serous carcinoma (HGSC) is the most common.

Less common types of ovarian cancer include germ cell tumors and sex cord stromal tumors. A diagnosis of ovarian cancer is confirmed through a biopsy of tissue, usually removed during surgery.

Those at very high risk may have their ovaries removed as a preventive measure. If caught and treated in an early stage, ovarian cancer is often curable.

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Prostate Cancer

Prostate cancer is the uncontrolled growth of cells in the prostate, a gland in the male reproductive system below the bladder.

Early prostate cancer causes no symptoms. Abnormal growth of prostate tissue is usually detected through screening tests, typically blood tests that check for prostate-specific antigen (PSA) levels. Those with high levels of PSA in their blood are at increased risk for developing prostate cancer.

Diagnosis requires a biopsy of the prostate. If cancer is present, the pathologist assigns a Gleason score, and a higher score represents a more dangerous tumor. Medical imaging is performed to look for cancer that has spread outside the prostate. Based on the Gleason score, PSA levels, and imaging results, a cancer case is assigned a stage 1 to 4. A higher stage signifies a more advanced, more dangerous disease.

Most prostate tumors remain small and cause no health problems. These are managed with active surveillance, monitoring the tumor with regular tests to ensure it has not grown. Tumors more likely to be dangerous can be destroyed with radiation therapy or surgically removed by radical prostatectomy.

Prostate cancer prognosis depends on how far the cancer has spread at diagnosis. Most men diagnosed have tumors confined to the prostate; 99% of them survive more than 10 years from their diagnoses. Tumors that have metastasized to distant body sites are most dangerous, with five-year survival rates of 30–40%.

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Thyroid Cancer

Thyroid cancer is cancer that develops from the tissues of the thyroid gland.  It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body.

Symptoms can include swelling or a lump in the neck.  Cancer can also occur in the thyroid after spread from other locations, in which case it is not classified as thyroid cancer.

Risk factors include radiation exposure at a young age, having an enlarged thyroid, family history and obesity.  The four main types are papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and anaplastic thyroid cancer.

Diagnosis is often based on ultrasound and fine needle aspiration.  Screening people without symptoms and at normal risk for the disease is not recommended as of 2017.

Treatment options may include surgery, radiation therapy including radioactive iodine, chemotherapy, thyroid hormone, targeted therapy, and watchful waiting. Surgery may involve removing part or all of the thyroid.  Five-year survival rates are 98% in the United States.

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Breast Cancer

Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin.

Risk factors for developing breast cancer include obesity, a lack of physical exercise, alcohol consumption, hormone replacement therapy during menopause, ionizing radiation, an early age at first menstruation, having children late in life (or not at all), older age, having a prior history of breast cancer, and a family history of breast cancer. 

About five to ten percent of cases are the result of an inherited genetic predisposition, including BRCA mutations among others. Breast cancer most commonly develops in cells from the lining of milk ducts and the lobules that supply these ducts with milk.

Cancers developing from the ducts are known as ductal carcinomas, while those developing from lobules are known as lobular carcinomas.  There are more than 18 other sub-types of breast cancer.   Some, such as ductal carcinoma in situ, develop from pre-invasive lesions.   The diagnosis of breast cancer is confirmed by taking a biopsy of the concerning tissue.   Once the diagnosis is made, further tests are carried out to determine if the cancer has spread beyond the breast and which treatments are most likely to be effective.

Most people with breast cancer have no symptoms at the time of diagnosis; their tumor is detected by a breast cancer screening test.  For those who do have symptoms, a new lump in the breast is most common. Most breast lumps are not breast cancer, though lumps that are painless, hard, and with irregular edges are more likely to be cancerous.  Other symptoms include swelling or pain in the breast; dimpling, thickening, redness, or dryness of the breast skin; and pain, or inversion of the nipple.  Some may experience unusual discharge from the breasts, or swelling of the lymph nodes under the arms or along the collar bone.

Some less common forms of breast cancer cause distinctive symptoms. Up to 5% of people with breast cancer have inflammatory breast cancer, where cancer cells block the lymph vessels of one breast, causing the breast to substantially swell and redden over three to six months.  Up to 3% of people with breast cancer have Paget's disease of the breast, with eczema-like red, scaly irritation on the nipple and areola.

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Liver Cancer

Liver cancer, also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy, is cancer that starts in the liver.  Liver cancer can be primary in which the cancer starts in the liver, or it can be liver metastasis, or secondary, in which the cancer spreads from elsewhere in the body to the liver. Liver metastasis is the more common of the two liver cancers.

The leading cause of liver cancer is cirrhosis due to hepatitis B, hepatitis C, or alcohol.  Other causes include aflatoxin, non-alcoholic fatty liver disease and liver flukes.  The most common types are HCC, which makes up 80% of cases and intrahepatic cholangiocarcinoma.  The diagnosis may be supported by blood tests and medical imaging, with confirmation by tissue biopsy. 

Given that there are many different causes of liver cancer, there are many approaches to liver cancer prevention.  These efforts include immunization against hepatitis B, hepatitis B treatment, hepatitis C treatment, decreasing alcohol use, decreasing exposure to aflatoxin in agriculture, and management of obesity and diabetes.  Screening is recommended in those with chronic liver disease.  For example, it is recommended that people with chronic liver disease who are at risk for hepatocellular carcinoma be screened every 6 months using ultrasound imaging. 

Because liver cancer is an umbrella term for many types of cancer, the signs and symptoms depend on what type of cancer is present. Symptoms can be vague and broad. Cholangiocarcinoma is associated with sweating, jaundice, abdominal pain, weight loss, and liver enlargement. Hepatocellular carcinoma is associated with abdominal mass, abdominal pain, vomiting, anemia, back pain, jaundice, itching, weight loss and fever.

Treatment options may include surgery, targeted therapy and radiation therapy.   In certain cases, ablation therapy, embolization therapy or liver transplantation may be used.

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Pancreatic Cancer

Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass.

These cancerous cells have the ability to invade other parts of the body.

There are a number of types of pancreatic cancer. The most common, pancreatic adenocarcinoma, accounts for about 85% of cases, and the term "pancreatic cancer" is sometimes used to refer only to that type.

These adenocarcinomas start within the part of the pancreas which makes digestive enzymes. Several other types of cancer, which collectively represent the majority of the non-adenocarcinomas, can also arise from these cells.

One to two in every hundred cases of pancreatic cancer are neuroendocrine tumors, which arise from the hormone-producing cells of the pancreas. These are generally less aggressive than pancreatic adenocarcinoma.

Signs and symptoms of the most common form of pancreatic cancer may include yellow skin, abdominal or back pain, unexplained weight loss, light-colored stools, dark urine and loss of appetite.

There are usually no symptoms in the disease's early stages, and symptoms that are specific enough to suggest pancreatic cancer typically do not develop until the disease has reached an advanced stage. By the time of diagnosis, pancreatic cancer has often spread to other parts of the body.

Pancreatic cancer rarely occurs before the age of 40, and more than half of cases of pancreatic adenocarcinoma occur in those over 70.

Risk factors for pancreatic cancer include tobacco smoking, obesity, diabetes, and certain rare genetic conditions.

About 25% of cases are linked to smoking,and 5–10% are linked to inherited genes.

Pancreatic cancer is usually diagnosed by a combination of medical imaging techniques such as ultrasound or computed tomography, blood tests, and examination of tissue samples (biopsy).

The disease is divided into stages, from early (stage I) to late (stage IV). Screening the general population has not been found to be effective

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Lung Cancer

Lung cancer, also known as lung carcinoma, is a malignant tumor that begins in the lung.  Lung cancer is caused by genetic damage to the DNA of cells in the airways, often caused by cigarette smoking or inhaling damaging chemicals.

Damaged airway cells gain the ability to multiply unchecked, causing the growth of a tumor. Without treatment, tumors spread throughout the lung, damaging lung function.  Eventually lung tumors metastasize, spreading to other parts of the body.

Early lung cancer often has no symptoms and can only be detected by medical imaging. As the cancer progresses, most people experience nonspecific respiratory problems: coughing, shortness of breath, or chest pain.

Other symptoms depend on the location and size of the tumor. Those suspected of having lung cancer typically undergo a series of imaging tests to determine the location and extent of any tumors. Definitive diagnosis of lung cancer requires a biopsy of the suspected tumor be examined by a pathologist under a microscope.

In addition to recognizing cancerous cells, a pathologist can classify the tumor according to the type of cells it originates from. Around 15% of cases are small-cell lung cancer (SCLC), and the remaining 85% (the non-small-cell lung cancers or NSCLC) are adenocarcinomas, squamous-cell carcinomas, and large-cell carcinomas.  After diagnosis, further imaging and biopsies are done to determine the cancer's stage based on how far it has spread.

Treatment for early stage lung cancer includes surgery to remove the tumor, sometimes followed by radiation therapy and chemotherapy to kill any remaining cancer cells. Later stage cancer is treated with radiation therapy and chemotherapy alongside drug treatments that target specific cancer subtypes.

Most lung cancer cases are caused by tobacco smoking. The remainder are caused by exposure to hazardous substances like asbestos and radon gas, or by genetic mutations that arise by chance. Consequently, lung cancer prevention efforts encourage people to avoid hazardous chemicals and quit smoking. Quitting smoking both reduces one's chance of developing lung cancer and improves treatment outcomes in those already diagnosed with lung cancer.

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Stomach Cancer

Stomach cancer, also known as gastric cancer, is a cancer that develops from the lining of the stomach.  Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes, including gastric adenocarcinomas.  Lymphomas and mesenchymal tumors may also develop in the stomach. 

Early symptoms may include heartburn, upper abdominal pain, nausea, and loss of appetite.   Later signs and symptoms may include weight loss, yellowing of the skin and whites of the eyes, vomiting, difficulty swallowing, and blood in the stool, among others.  The cancer may spread from the stomach to other parts of the body, particularly the liver, lungs, bones, lining of the abdomen, and lymph nodes.

The most common cause is infection by the bacterium Helicobacter pylori, which accounts for more than 60% of cases.  Certain strains of H. pylori have greater risks than others.  About 10% of cases run in families, and between 1% and 3% of cases are due to genetic syndromes inherited such as hereditary diffuse gastric cancer. 

Most of the time, stomach cancer develops in stages over years.  Diagnosis is usually by biopsy done during endoscopy.  This is followed by medical imaging to determine if the disease has spread to other parts of the body.  Japan and South Korea, two countries that have high rates of the disease, screen for stomach cancer.

A Mediterranean diet lowers the risk of stomach cancer, as does not smoking.  Tentative evidence indicates that treating H. pylori decreases the future risk.  If stomach cancer is treated early, it can be cured.  Treatments may include some combination of surgery, chemotherapy, radiation therapy, and targeted therapy.  For certain subtypes of gastric cancer, cancer immunotherapy is an option as well.  If treated late, palliative care may be advised.

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Carcinoid Cancer

A carcinoid (also carcinoid tumor) is a slow-growing type of neuroendocrine tumor originating in the cells of the neuroendocrine system that can grow in several places throughout the body. 

A carcinoid tumor often begins in the stomach, small intestine, colon, rectum, or lungs; carcinoid tumors are the most common malignancy of the appendix. Carcinoid tumors of the mid-gut are associated with carcinoid syndrome.  In some cases, metastasis may occur. 

Symptoms often don't appear until late in the disease and are vague. Examples include diarrhea and skin flushing.  

While most carcinoids are asymptomatic and are discovered only upon surgery for unrelated reasons, all carcinoids are considered to have malignant potential.

About 10% of carcinoids secrete excessive levels of a range of hormones, most notably serotonin (5-HT), causing:   

• Flushing
• Diarrhea
• Wheezing
• Abdominal cramping
• Peripheral edema
  

The outflow of serotonin can cause a depletion of tryptophan leading to niacin deficiency. Niacin deficiency, also known as pellagra, is associated with dermatitis, dementia, and diarrhea.

This constellation of symptoms is called carcinoid syndrome or (if acute) carcinoid crisis. Occasionally, hemorrhage or the effects of tumor bulk are the presenting symptoms.

Treatment includes surgery and medications, such as drugs that block cancer cells from secreting hormones or boost the immune system.

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Cancer Caregivers Month

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Clinical Cancer Trials
Information & Resources

A clinical trial is a comparison test with volunteers designed to learn more about a pharmaceutical or other medical therapy against a placebo (an inert look-alike) to learn more about how our bodies respond to potential new medicines or treatments.

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International Clinical Cancer Trials

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Cancer Discussion
Forums

Sometimes you need to talk to someone who understands what you are experiencing, to know that you're not alone. It helps to communicate with others and gain their help and advice.

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Universal Resources
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