Cancer Types

Cancer Types

Because cancer can occur in the cells of virtually any bone, tissue or organ throughout the body, there are many types of the disease. By definition, cancer is an uncontrolled growth of abnormal cells. Cancer cells rapidly reproduce despite restriction of space, nutrients, or signals sent from the body to stop reproduction. Additionally, a cancer that begins in one area may spread into other parts of the body.

It is our goal to detect and treat cancer cells as early as possible. While Big Horn Basin Regional Cancer Center treats nearly every kind of cancer, some of the more common are listed below. Click on the links below to learn more about each cancer type:

Bladder Cancer

The wall of the bladder is lined with cells called transitional cells and squamous cells. More than 90% of bladder cancers begin in the transitional cells. This type of bladder cancer is called transitional cell carcinoma. About 8 % of bladder cancer patients have squamous cell carcinomas. Cancer that is only in cells in the lining of the bladder is called superficial bladder cancer. Cancer that begins as a superficial tumor may grow through the lining and into the muscular wall of the bladder. This is known as invasive cancer. Invasive cancer may extend through the bladder wall.

The cause of bladder cancer is unknown, although there are many risk factors that increase a person’s chance of developing the disease. Some of these risk factors are age, tobacco usage, occupation, infections, previous treatment with cytoxan or arsenic, race, being a man, family history, and personal history of bladder cancer. Some of the common symptoms of bladder cancer can include: blood in urine, pain during urination, frequent urination, or feeling the need to urinate without results. People with these symptoms may see their family doctor or a urologist, who specializes in diseases of the urinary system.

Upon a doctor visit with a urologist the patient may have one or more of the following tests: physical exam, urine tests, intravenous pyelogram, and cystoscopy. During a cystoscopy the doctor may remove sample tissue, called a biopsy to be sent to a pathologist for diagnosis. Staging is sometimes done at the time of diagnosis, or sometimes additional tests such as, CT scan, MRI, sonogram, intravenous pyelogram, bone scan, or chest x-ray may need to be done. Sometimes staging is not done till surgery. Once staging is complete the doctor may refer you to doctor who specializes in treating cancer. Treatment generally begins within a few weeks after diagnosis. Treatment may consist of surgery, chemotherapy, radiation therapy, or biological therapy. A treatment plan that is best for you will be decided upon by you and your healthcare team.

Bone Cancer

Bone cancer is a cancerous tumor of the bone that destroys normal bone tissue. Not all bone tumors are cancerous. Noncancerous bone tumors are more common than malignant ones. Both types of bone tumors may grow and compress healthy bone tissue, but noncancerous tumors do not spread, or destroy bone tissue, and are rarely a threat to life.

Cancerous tumors that begin in bone tissue are called primary bone cancer. Cancer that spreads to the bones from other parts of the body, such as the breast, lung, or prostate is called metastatic cancer, and is named for the organ or tissue in which it began. Primary bone cancer is far less common than cancer that spreads to the bones. Common types of primary bone cancer are osteosarcoma, chondrosarcoma, and The Ewing Sarcoma Family of Tumors.

Osteosarcoma is a cancer of the bone that usually affects the large bones of the arm or leg. It occurs most commonly in young people and affects more males than females. Sarcoma is cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. The cause of bone cancer is not exactly known but factors that contribute to developing tumors are high-dose external radiation therapy, treatment with certain anticancer drugs, and heredity.

The most common symptom of bone cancer is pain, but not all bone cancers cause pain. Swelling can also be seen with bone cancer. To help diagnose bone cancer the doctor will ask your personal and family medical history. He or she will also perform a physical exam and order lab and diagnostic testing that may include x-rays, bone scan, CT scan, MRI , PET scan, and biopsy. A biopsy is used to remove a tissue sample from the bone tumor to determine if cancer is present. This tissue is then sent to a pathologist to determine if it is cancer or not. Treatment options depend on the type, size, location, and stage of the tumor, as well as age and person’s health. Once diagnosis is confirmed the doctor will go over treatment options with you. Treatment options include surgery, chemotherapy, radiation therapy, and cryosurgery. A treatment plan that is best for you will then be decided upon by you and your physician.

Brain Cancer

Brain cancer is the growth of abnormal cells in the tissues of the brain. Brain tumors can be benign or malignant. Brain tumors are grouped by grade. The grade of the tumor refers to the way the cells look under a microscope. Cells from low grade tumors (grade 1 and 2) look more normal and generally grow more slowly than cells from high grade tumors (grades 3 and 4). Over time a low grade tumor may become a high grade tumor. There are many types of primary brain tumors. Tumors are named according to the type of cells or the part of the brain in which they begin.

Most primary tumors begin in glial cells. This type of tumor is called a glioma. Among adults the most common types of tumors are; 1. astrocytomas which arise from star-shaped glial cells called astrocytes. It can be any grade and most often occurs in the cerebrum. 2. Meningioma which is a tumor that arises in the meninges. It can be grade 1, 2,or 3. It is usually benign and grows slowly. 3. Oligodendroglioma which the tumor arises from cells that make the fatty substance that covers and protects nerves. It usually occurs in the cerebrum. It’s most common in middle aged adults. It can be grade 2 or 3.

No one knows the exact cause of brain tumors. Researchers are studying whether people with certain risk factors are more likely than others to develop a brain tumor. Studies have found the following as risk factors for brain tumors: ionizing radiation and family history. Symptoms of a brain tumor depend on tumor size, type, and location. Symptoms may be caused when a tumor presses on a nerve or harms a part of the brain. They also may be caused when a tumor blocks the fluid that flows through and around the brain, or when the brain swells because of the buildup of fluid. The most common symptoms of brain tumors are headaches, nausea and vomiting, changes in speech, vision, or hearing, problems balancing or walking, changes in mood, personality, or ability to concentrate, problems with memory, muscle jerking, or twitching, and numbness or tingling in the arms or legs.

If you have symptoms that exhibit a brain tumor your doctor will give you a physical exam and ask about your personal and family health history. Additional tests including neurologic exam, MRI, CT scan, angiogram, spinal tap, and biopsy may be done also. A biopsy is the removal of tissue to look for tumor cells. Biopsies are done by a surgeon and sent to a pathologist to evaluate the tissue under a microscope for diagnosis and grade. Once testing is complete, treatment options are discussed with the patient. Brain cancer treatment options include surgery, chemotherapy and radiation therapy. The choice of treatment depends on the type and grade of brain tumor, its location in the brain, its size, and your age and general health. A treatment plan that is best for you will then be decided upon by you and your physician.

Breast Cancer

Occurring in both men and women, breast cancer forms in tissues of the breast, usually the ducts and lobules. Each breast is divided into 15-20 sections called lobes. Lobes contain many smaller lobules. Lobules contain groups of tiny glands that can produce milk. The breasts also contain lymph vessels, which carry a clear fluid called lymph. The lymph vessels lead to small, round organs called lymph nodes. Groups of lymph nodes are found near the breast in the axilla, above the collarbone, in the chest behind the breastbone, and in many other parts of the body.

No one knows the exact cause of breast cancer, although there are many risk factors that may increase a person’s chance of developing the disease. Some of the risk factors are age, personal history of breast cancer, family history, certain breast changes, genetic alterations, reproductive and menstrual history, race, radiation therapy to chest, breast density, taking diethylstilbestrol, being obese after menopause, physical inactivity, and, use of alcoholic beverages. A woman should talk with her health care provider about personal risk of getting breast cancer and screenings available to detect breast cancer. Screenings available to detect breast cancer before any symptoms would arise are: mammogram, clinical breast exam, and breast self-exam. Symptoms that women should watch for are a change in how the breast or nipple feels, a change in how the breast or nipple looks, and nipple discharge.

If a woman has a breast change, her doctor must determine whether it is due to breast cancer or some other cause. Additional tests that are performed to determine this are clinical breast exam, diagnostic mammography, ultrasound, MRI, and/or biopsy. Often, tissue must be removed from the breast to help the physician determine if cancer is present. If the diagnosis is cancer, the physician needs to know the stage of the disease to determine treatment plan. Staging may involve x-rays and labs and often the extent of the cancer is not known until after surgery to remove the tumor in the breast and the lymph nodes under the arm. Once the testing is complete and staging is done, your physician will discuss all available treatment options consisting of surgery, radiation therapy, chemotherapy, hormonal therapy, and biological therapy.

A treatment plan that is best for you will then be decided upon by you and your healthcare team.

Cervical Cancer

The organ connecting the uterus and vagina is called the cervix, and cervical cancer forms in its tissues. It is usually a slow-growing cancer that may not have symptoms but can be found with regular pap tests. Cervical cancer is almost always caused by human papillomavirus infection. Early detection is very important in cervical cancer. If all women had pelvic exams and Pap tests regularly, most precancerous conditions would be detected and treated before cancer develops. With this, most invasive cancers could be prevented and any invasive cancer that does occur would likely be found at an early, curable stage.

Precancerous changes that may occur do not usually cause pain, so therefore are often not detected unless a woman has a pelvic exam and a pap test. Symptoms usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens the most common symptom is abnormal bleeding. Menstrual bleeding may last longer and be heavier than usual. Bleeding after menopause and increased vaginal discharge is another symptom of cervical cancer. The pap test and pelvic exam allow the doctor to detect abnormal changes of the cervix. If the exam suggests something other than infection, other tests will be done to find out what the problem is. One of the most common tests is colposcopy in which they use a colposcope to look closely at the cervix. During this procedure the doctor may remove a small amount of cervical tissue to be examined by a pathologist. Removing tissue may cause some bleeding or discharge, but healing usually occurs quickly. Some pain similar to menstrual cramping may also be experienced.

In some cases it is not clear whether an abnormal pap test is caused by problems in the cervix or in the endometrium. If this should arise, the doctor may do a D and C (dilatation and curettage) to scrape tissue from the lining of the uterus as well as the cervical canal to determine where the problem is. Treatment for precancerous lesions depends on whether the lesion is low or high grade, if the woman wants to have children in the future, age and general health, and the preference of the woman and her doctor. Some of these options are cryosurgery, cauterization, or laser surgery to destroy the abnormal area without harming nearby healthy tissue.

The choice of treatment for cervical cancer depends on the location and size of the tumor, the stage of the disease, woman’s age and general health. Staging is then done to determine if the cancer has spread and if so to what parts. Blood tests, urine tests, CT scan, intravenous pyelogram, ultrasound, and MRI are usually done as well as a thorough pelvic exam in the operating room with patient under anesthesia. Some of the procedures done are called cystoscopy and proctosigmoidoscopy. Once staging is complete your physician will go over all available treatment options for the diagnosis which include surgery, radiation therapy, chemotherapy, and biological therapy. A treatment plan will then be decided upon by you and your healthcare team.

Colorectal Cancer

Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids) and form in the tissues of the colon. The rectum is the last several inches of the largest intestine closest to the anus, and it is in these tissues that rectal cancer may form. Cancers that affect either of these organs may also be called colorectal cancer.

The exact causes of colorectal cancer are not known, however there are several risk factors that increase a persons chance of developing colorectal cancer. These are: age, diet, polyps, personal medical history, family medical history, and ulcerative colitis. Research shows that colorectal cancer develops gradually from benign polyps. Early detection and removal of polyps may help to prevent colorectal cancer. Research has also shown that changes in certain genes raise the risk of colorectal cancer. People who have increased risk factors should ask their doctors when to begin checking for colorectal cancer through testing. Some of these tests are fecal occult blood test, sigmoidoscopy, colonoscopy, double contrast barium enema, and digital rectal exam.

Signs and symptoms of colorectal cancer include, change in bowel habits, diarrhea, constipation, and feeling that bowel does not empty completely. Other symptoms include blood in the stool, stools that are narrower than usual, abdominal discomfort, weight loss, constant tiredness, and vomiting. To find the cause of the symptoms the physician will evaluate your medical history, perform a physical exam, and order diagnostic tests. Some of the tests include: x-rays, sigmoidoscopy, colonoscopy, polypectomy, and biopsy. A biopsy is removing a sample of tissue to be sent to lab for a pathologist to look at under a microscope to be used to determine diagnosis. Once diagnosis is determined the doctor will want to know the stage or extent of the disease. Additional tests may be ordered to determine this.

Treatment of colorectal cancer depends on the size, location, and extent of the tumor, as well as patient’s general health. Patients are often treated by a team of specialists, including a gastroenterologist, surgeon, medical oncologist, and radiation oncologist. Several different types of treatment options can be used and are sometimes combined. These include surgery, chemotherapy, radiation therapy, biological therapy, and clinical trials. After diagnosis, a treatment plan that is best for you will then be decided upon by you and your healthcare team.

Esophageal Cancer

Cancer that begins in the esophagus is divided into two major types, squamous cell carcinoma and adenocarcinoma. Squamous cell carcinomas are present in squamous cells that line the esophagus. They usually occur in the upper and middle part of the esophagus. Adenocarcinomas usually develop in the glandular tissue in the lower part of the esophagus. Treatment is similar for both types.

The exact causes of esophageal cancer is not known, but the following risk factors can increase the risk of developing cancer of the esophagus. These risk factors are: age, sex, tobacco use, alcohol use, Barrett’s esophagus, and medical history. Early esophageal cancer usually does not cause symptoms. However, as the cancer grows, symptoms may include: difficult or painful swallowing, severe weight loss, pain in the throat or back, behind the breastbone or between the shoulder blades, hoarseness or chronic cough, vomiting, and coughing up blood.

Testing is done to help find the cause of symptoms, and may include a barium swallow or an endoscopy. If an abnormal area is found during an endoscopy the doctor can collect cells and tissue in a procedure called a biopsy. The biopsy can show cancer, tissue changes that may lead to cancer, or other conditions. If the diagnosis is esophageal cancer the next step is to determine the stage of the disease to see if it has spread to any other parts of the body. Some tests used to determine this are, CT scan, bone scan, and bronchoscopy.

Treatment options depend on size, location, and extent of the tumor, and the general health of the patient. Patients are often treated by a team of specialists, which may include a gastroenterologist, surgeon, medical oncologist, and radiation oncologist. Treatment options available for esophageal cancer are surgery, radiation therapy, chemotherapy, laser therapy, and photodynamic therapy. After diagnosis, a treatment plan that is best for you will be decided upon by you and your physician.

Gastric Cancer

The exact cause of gastric cancer, which forms in tissues lining the stomach, is unknown, but there are certain risk factors that may contribute to why one person develops the disease and another does not. Risk factors for gastric cancer are: age, sex, race, diet, helicobacter pylori infection, smoking, certain health problems, and family history.

Early stomach cancer often does not cause clear symptoms, but as the cancer grows the most common symptoms are discomfort in the stomach area, feeling full or bloated after a small meal, nausea and vomiting, and weight loss. If you have some of the above symptoms that suggest stomach cancer your doctor may refer you to a gastroenterologist, who specializes in diagnosing and treating digestive problems. The physician will obtain your personal and family health history. Additional blood or other lab tests may be done along with a physical exam, upper GI series that consists of x-rays of your esophagus and stomach, endoscopy, and biopsy. Through a biopsy the tissue is sent to a pathologist to check the tissue for cancer cells.

Once diagnosis of gastric cancer is confirmed the doctor needs to know the extent or stage of the disease. Additional tests may be ordered to check this. Blood tests, chest x-rays, CT scan, endoscopic ultrasound, or laparoscopy may be used to determine stage. Treatment options depend mainly on the size and place of the tumor, the stage of disease, and your general health. Treatment may involve surgery, chemotherapy, or radiation therapy. After diagnosis, a treatment plan that is best for you will be decided up on by you and your physician.

Head & Neck Cancer

Cancer that arises in the head or neck region (in the nasal cavity, sinuses, lips, mouth, salivary glands, throat, or larynx). Head and neck cancers account for approximately 3 to 5% of all cancers in the United States. These cancers are more common in men and people over 50. 85% of head and neck cancers are linked to tobacco use. People who use both tobacco and alcohol are at greater risk for developing these cancers.

Certain risk factors for head and neck cancer include:

  • Oral cavity: Sun exposure; possibly human papillomavirus infection
  • Salivary glands: Radiation to the head and neck
  • Paranasal sinuses and nasal cavity: Certain industrial exposures, such as wood or nickel dust inhalation
  • Nasopharynx: Asian/Chinese ancestry, Epstein-Barr virus infection, occupational exposure to wood dust and consumption of certain preservatives or salted foods
  • Oropharynx: Poor oral hygiene, human papilomavirus infection, and use of mouthwash that has a high alcohol content are possible risk factors
  • Hypopharynx: Pummer-Vinson syndrome, a rare disorder that results from iron and other nutritional deficiencies.
  • Larynx: Exposure to airborne particles of asbestos


Symptoms that have been associated with this type of cancer include a lump or sore that does not heal, a sore throat that doesn’t go away, difficulty swallowing, and change or hoarseness in the voice. To find the cause of the symptoms a doctor evaluates your medical history, performs a physical exam, and orders diagnostic tests. Tests may include endoscopy, lab tests, x-rays, CT scan, MRI, PET scan, and a biopsy to remove tissue from suspicious area for a pathologist to examine to determine diagnosis. If the diagnosis is cancer the doctor will then need to know the stage or extent of the disease to see if it has spread. This may involve x-rays, lab tests, and examination under anesthesia in the operating room.

Once diagnosis and stage are confirmed your doctor will go over treatment options with you. The treatment plan depends on the location of the tumor, the stage of the cancer and the person’s age and general health. Treatment options consist of surgery, radiation therapy, and chemotherapy. A plan that is best for you will then be decided upon by you and your healthcare team.

Hodgkin's Lymphoma

Hodgkin’s Lymphoma is a cancer of the immune system that is marked by the presence of a type of cell called the Reed-Sternberg cell. The two major types of Hodgkin’s lymphoma are classical Hodgkin’s lymphoma and nodular lymphocyte-predominant Hodgkin’s lymphoma.

Hodgkin’s lymphoma begins in cells of the immune system. The lymphatic system is part of the immune system and includes the lymph vessels, lymph, and lymph nodes. Since lymphatic tissue is in many parts of the body, Hodgkin’s lymphoma can start almost anywhere. Usually, it’s first found in a lymph node above the diaphragm, but may also be found in a group of lymph nodes.

Hodgkin’s lymphoma begins when a lymphocyte becomes abnormal. The abnormal cell divides to make copies of itself. Hodgkin’s lymphoma cells are called Reed-Sternberg cells. These cells don’t protect the body from infections or other diseases, and also don’t die when they should. The lymph node that contains the Reed-Sternberg cells becomes enlarged, and the abnormal cells can spread throughout the body.

It is unknown why one person develops this and another does not, but there are certain risk factors that increase the chance that a person will develop the disease. These include certain viruses, weakened immune system, age and family history. Hodgkin’s lymphoma can cause many symptoms also. Symptoms consist of swollen lymph nodes in the neck, underarms, or groin, becoming more sensitive to the effects of alcohol, having painful lymph nodes after drinking alcohol, weight loss for no known reason, fever that does not go away, soaking night sweats, itchy skin, coughing, trouble breathing, chest pain, and weakness and tiredness that don’t go away.

Upon visiting with your physician about your symptoms you may also have a physical exam, blood tests, chest x-rays, and biopsy. A biopsy is the only sure way to diagnosis Hodgkin’s lymphoma and is done by removal of entire lymph node or part of lymph node. A pathologist checks the tissue under microscope for Hodgkin’s lymphoma cells. This helps determine the type of Hodgkin’s lymphoma either classical Hodgkin’s lymphoma which most people have that show Reed-Sternberg cells. The nodular lymphocyte-predominant Hodgkin’s lymphoma is rare and the abnormal cell is called a popcorn cell.

In order to come up with the best treatment plan the doctor needs to know the stage of the disease. To find out what parts of the body are affected by the disease additional testing may need to be done involving CT scan, MRI, PET scan, and bone marrow biopsy may be done. Upon final test results a treatment plan will be determined by you and your healthcare team and will be determined mainly on the type of your Hodgkin’s lymphoma, its stage, whether you have a mass or tumor that is more than 4 inches wide, age, and if you’ve had weight loss, drenching night sweats, or fever. People with Hodgkin’s lymphoma may be treated with chemotherapy, radiation therapy, or both which will be discussed to you by your healthcare provider.

Leukemia

Cancer that starts in blood-forming tissues such as the bone marrow and causes large numbers of blood cells to be produced and enter the blood stream is called leukemia. In leukemia, the bone marrow makes abnormal white blood cells. The abnormal cells are leukemia cells and like normal blood cells, leukemia cells don’t die when they should. They may crowd out normal white blood cells, red blood cells, and platelets, making it hard for normal blood cells to do their work.

Types of leukemia can be grouped based on how quickly the disease develops and gets worse. Leukemia is either chronic in which the disease usually gets worse slowly, and the leukemia cells can still do some of the work of normal white blood cells. Leukemia can also be acute in which the disease gets worse quickly and the leukemia cells can’t do any of the work of normal white blood cells. The types of leukemia can also be grouped based on the type of white blood cell that is affected. The four common types are chronic lymphocytic leukemia (CML), chronic myeloid leukemia (CLL), acute lymphocytic leukemia (ALL), and acute myeloid leukemia (AML).

No one knows the exact cause of leukemia but there are certain risk factors that increase the chance that a person will get this disease. Risk factors include being exposed to high levels of radiation, atomic bomb explosions, smoking, benzene, chemotherapy, down syndrome and certain other inherited diseases, myelodysplastic syndrome and certain other blood disorders, human T-cell leukemia virus type 1, and family history of leukemia.

The symptoms of leukemia depend on the number of leukemia cells and where these cells collect in the body. With chronic leukemia people may not have symptoms and the doctor may find the disease during a routine blood test. With acute leukemia people usually go to the doctor because they feel sick. Common symptoms of chronic or acute leukemia may include swollen lymph nodes that usually don’t hurt, fevers or night sweats, frequent infections, feeling weak or tired, bleeding and bruising easily, swelling or discomfort in the abdomen, weight loss for no known reason, and pain in the bone or joints.

During your appointment with a physician a personal and family medical history will be taken. Additional tests include blood tests, physical exam, cytogenetics, spinal tap, chest x-ray, and bone marrow biopsy. A bone marrow biopsy is the only sure way to know if there are leukemia cells in you bone marrow. During the biopsy a small amount of bone marrow is removed for a pathologist to examine under a microscope to check for leukemia cells. When final test results are received the doctor will discuss treatment options consisting of watchful waiting, chemotherapy, targeted therapy, biological therapy, radiation therapy, and stem cell transplant.

The choice of the treatment depends mainly on the type of leukemia, age, and if leukemia cells were found in your cerebrospinal fluid. Your doctor can describe your treatment choices, expected results, and possible side effects. Together you and your healthcare team will develop a treatment plan to meet your needs.

Lung Cancer

Lung cancer forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope. Each type of lung cancer grows and spreads in different ways and is treated differently. Non-small cell lung cancer is more common, and generally grows and spreads more slowly. Non-small cell cancer is divided into three main types and are named for the type of cells in which the cancer develops. These three types are squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Small cell lung cancer, sometimes referred to as oat cell cancer, is less common than non-small cell lung cancer. This cancer grows more quickly and is likely to spread to other organs of the body.

There are several causes of lung cancer, most related to the use of tobacco, including cigarettes, cigars and pipes, environmental tobacco smoke, radon, asbestos, pollution, lung diseases, and personal history. Some of the common symptoms of lung cancer include cough that doesn’t go away and gets worse over time, constant chest pain, coughing up blood, shortness of breath, wheezing, hoarseness, repeated problems with pneumonia or bronchitis, swelling of the neck and face, loss of appetite or weight loss, and fatigue.

During your doctor appointment a family history of cancer will be taken along with, your medical history, smoking history, and exposure to environmental and occupational substances. A physical exam is performed as well as a chest x-ray and sputum cytology to detect lung cancer. To confirm the diagnosis the doctor must examine tissue from the lung and this is done through a biopsy. Tissue can be obtained through bronchoscopy, needle aspiration, thoracentesis, or thoracotomy. The tissue is then examined under a microscope by a pathologist for diagnosis.

If the diagnosis is cancer the doctor will next need to know the stage of the disease to help plan treatment. Tests used for staging include CT scan, MRI, radionuclide scanning, bone scan, and mediastinoscopy. Planning for treatment depends on the type of lung cancer non-small cell versus small cell, the size, location and extent of tumor, as well as general health of the patient. Treatment options available are surgery, chemotherapy, radiation therapy, photodynamic therapy, and clinical trials. Together you and your healthcare team will answer your questions and develop a treatment plan to best meet your needs.

Melanoma

Melanoma is a form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole, but can also begin in other pigmented tissues, such as in the eye or in the intestines. Melanoma is the most serious type of cancer of the skin. Melanoma occurs when melanocytes (produce melanin, the pigment that gives skin it natural color) become malignant. Most pigment cells are in the skin therefore when melanoma starts in the skin, the disease is called cutaneous melanoma. Melanoma may also occur in the eye (ocular melanoma or intraocular melanoma).

Chances of developing melanoma increase with age and can occur on any skin surface. In men it is often found on the trunk or head and neck and in women it often develops in the lower legs. If developed in dark-skinned people it tends to occur under the fingernails or toenails, or on palms or soles. The exact cause of melanoma is not known although there are certain risk factors that may contribute to people developing melanoma. Some of them are dysplastic nevi, many ordinary moles, fair skin, personal history of melanoma or skin cancer, family history of melanoma, weakened immune system, severe blistering sunburns, and ultraviolet radiation.

Most time the first sign of melanoma is the change in the size, shape, color or feel of an existing mole. Most melanomas have a black or blue-black area and some early stage melanomas may be found when an existing mole changes slightly for example, when a new black area forms. Other symptoms like newly formed fine scales and itching in a mole also are common symptoms of early melanoma. In advanced melanoma, the texture of the mole may change leaving the mole hard or lumpy. Melanomas may feel different than regular moles. More advanced moles may itch, ooze, or bleed also, but melanomas usually don’t cause pain.

A skin examination is often part of a routine checkup by a health care provider. Upon skin exam if the doctor sees a suspicious spot on the skin that he thinks is melanoma, the patient will need a biopsy. During a biopsy the doctor tries to remove all the suspicious looking growth then the tissue is sent to a pathologist to examine under a microscope to look for cancer cells. If the diagnosis is melanoma, the doctor then needs to know the stage of the disease before planning treatment. To stage the doctor may need to remove nearby lymph nodes to check for cancer cells, and may also order chest x-ray, blood tests, and scans to help facilitate this process. If melanoma is diagnosed early and treated when the tumor is thin and has not deeply invaded the skin a cure is possible. However, if melanoma is not removed in its early stage, cancer cells may grow downward from the skin surface and invade healthy tissue. If this happens the disease often spreads to other parts of the body making the disease difficult to control.

Melanoma patients are often treated by a team consisting of a dermatologist, surgeon, medical oncologist, radiation oncologist, and plastic surgeon. Treatment choices such as surgery, chemotherapy, biological therapy, or radiation therapy are discussed with the patient after staging is complete. The doctor and patient work together to develop a plan to best fit the patient’s needs.

Multiple Myeloma

A type of cancer that begins in plasma cells, multiple myeloma may also be called Kahler disease, myelomatosis, and plasma cell myeloma. Plasma cells are white blood cells that make antibodies. Antibodies are part of the immune system that works with other parts of the immune system to help protect the body from germs and other harmful substances.

Like other cancers, myeloma begins when a plasma cell becomes abnormal. Over time myeloma cells collect in the bone marrow. They may damage the solid part of the bone. When myeloma cells collect in several of your bones, the disease is called multiple myeloma. Myeloma cells make antibodies called M proteins and others proteins that can collect in the blood, urine, and organs.

No one knows the exact cause of multiple myeloma, but research has shown that certain risk factors increase the chance of developing the disease. Some of these are age 65 and over, race, being a man, personal history of monoclonal gammopathy of undertermined significance, and family history of multiple myeloma. Symptoms associated with multiple myeloma include bone pain, usually in the back and ribs, broken bones, usually in the spine, feeling weak and very tired, feeling very thirsty, frequent infections and fevers, weight loss, nausea or constipation, and frequent urination.

Multiple myeloma can sometimes be found after a routine blood test, but it is suspected more often after an x-ray for a broken bone. To help evaluate for multiple myeloma your doctor may ask you about your personal and family medical history and do a physical exam. Additional tests may include blood tests, urine tests, x-rays, and a biopsy to evaluate to see if there are myeloma cells in your bone marrow. After the biopsy tissue from the biopsy is sent to a pathologist to review under a microscope to determine if the diagnosis is multiple myeloma. If diagnosis is confirmed that you may need additional blood tests, CT scan, and MRI to determine the extent or stage of the disease and best treatment plan.

With multiple myeloma there are many treatment options. These include watchful waiting, chemotherapy, and stem cell transplant. If bone disease is involved radiation therapy is also sometimes involved. The choice of treatment depends on how advanced the disease is and symptoms that accompany it. A treatment plan that is best for you will be decided upon by you and your healthcare team.

Myelodysplastic Syndromes (MDS)

Myelodysplastic syndromes, or MDS, is a group of diseases in which the bone marrow does not make enough healthy blood cells. Also called preleukemia and smoldering leukemia. When you have MDS, your bone marrow doesn’t totally stop working, it still makes blood cells. It makes fewer cells, and the cells it does make don’t always work right.

The cause of MDS is unknown in about 70-80 out of 100 people who have it. In the other 20-30 people who have MDS, it may be caused by treatment for another disease. MDS is more common in smokers and is more common in people who have spent time around or worked with chemicals like benzene. It is also more common in those 60 years or older and is rare in young people.

Some of the symptoms of MDS are fatigue, weakness, shortness of breath, bruising easily, bleeding for no reason, and frequent infections. Symptoms of MDS can be managed by blood transfusions, antibiotics to help or control infection and growth factors that help healthy or normal cells make more cells.

Tests that are done to determine if you have MDS are blood tests and bone marrow biopsy. Once diagnosis is confirmed the doctor will go over treatment options with you. Options for treatment may consist of demethylating agents to help bone marrow make blood cells normally, immunosuppressive drug therapy to help make blood cells more slowly, chemotherapy, bone marrow transplant, and/or stem cell transplant. A treatment plan that is best for you will be decided upon by you and your healthcare team.

Non-Hodgkin’s Lymphoma

Non-Hodgkin’s lymphoma can be any of a large group of cancers of the lymphocytes (white blood cells). It is a cancer that begins in cells of the immune system, which fights infections and other diseases and is composed of the lymphatic system which includes the following: lymph vessels, lymph, and lymph nodes. Since lymphatic tissue is in many parts of the body, lymphoma can start almost anywhere, but it’s first found in a lymph node. Non-Hodgkin’s Lymphoma begins when a lymphocyte (usually a B cell) becomes abnormal. There are several risk factors that can increase the chance that a person will develop this disease. Some of them are weakened immune system, certain infections, and age.

Symptoms associated with Non-Hodgkin’s Lymphoma are swollen, painless lymph nodes in the neck, armpits, or groin, unexplained weight loss, fever, soaking night sweats, coughing, trouble breathing, chest pain, weakness and tiredness that don’t go away, pain, swelling, or a feeling of fullness in the abdomen.

If you have swollen lymph nodes or other symptoms that suggest lymphoma your physician will perform a series of tests. He may start with a personal and family history and do a physical exam as well as some blood tests. A chest x-ray may be ordered to check for swollen lymph nodes or other signs of disease as well as a biopsy of a lymph node to confirm diagnosis.

After the biopsy is performed a pathologist reviews the tissue sample and identifies the type of lymphoma found. The most common types of Non-Hodgkin’s Lymphoma are diffuse large b-cell lymphoma and follicular lymphoma. Lymphomas may also be grouped by how quickly they are likely to grow also. Indolent or low-grade lymphomas grow slowly. They tend to cause few symptoms. Aggressive also called intermediate-grade and high-grade lymphomas grow and spread more quickly. They tend to cause severe symptoms. Over time may indolent lymphomas become aggressive lymphomas.

In order for your doctor to make a plan of care he needs to know the stage and extent of the disease. Staging may involve some of the following tests; bone marrow biopsy, CT scan, MRI, ultrasound, spinal tap, and PET scan. The stage is based on where lymphoma cells are found and how many areas of the body are affected. After all testing is complete your physician will go over treatment options with you. Treatment options for Non-Hodgkin’s Lymphoma consist of chemotherapy, biological therapy, radiation therapy, or watching the disease since no symptoms are noticed at this time. A treatment plan that is best for you will be decided upon by you and your healthcare team.

Ovarian Cancer

Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells). Ovarian cancer cells can break away from the ovary and spread to other tissues and organs in a process called shedding. When ovarian cancer sheds, it tends to form new tumors on the peritoneum or the large membrane that lines the abdomen and on the diaphragm. Ovarian cancer cells can also enter the blood stream or lymphatic system and travel and form new tumors in other parts of the body.

The exact causes of ovarian cancer is not known, however there are certain risk factors that increase the chance of developing the disease. These are family history, age, if you’ve had children, personal history, fertility drugs, talc use, and hormone replacement therapy. About 1 in every 57 women in the United States develop ovarian cancer. Most women are over 50, but it can also affect younger women. Studies have now shown that breastfeeding and taking birth control pills may decrease a woman’s chance of developing ovarian cancer. Also women who have had a tubal ligation or hysterectomy are at lower risk. Evidence also shows that reducing the amount of fat in the diet may lower the risk of developing ovarian cancer.

Ovarian cancer can be hard to detect early. The sooner it is found and treated, the better a woman’s chance for recovery. Many times women with ovarian cancer have no symptoms or just mild symptoms until the disease is in an advanced stage. Some of the symptoms of ovarian cancer may include general abdominal discomfort and/or pain, nausea, diarrhea, constipation, frequent urination, loss of appetite, feeling of fullness even after a light meal, weight gain or loss with no known reason, and abnormal bleeding from the vagina.

Scientists are studying ways to detect ovarian cancer before symptoms develop. They are exploring the usefulness of measuring the level of CA-125, a substance called a tumor marker which is often found in higher-than-normal amounts in the blood of women with ovarian cancer. They are also evaluating transvaginal ultrasounds to help detect the disease early.

To help find the cause of the symptoms a doctor will evaluate your medical history and also perform a physical exam. Tests used to help diagnose ovarian cancer include pelvic exam, ultrasound, CA-125, lower GI series, CT scan, and biopsy. A biopsy is removing some of the tissue to be examined under a microscope by a pathologist for diagnosis. If the diagnosis is ovarian cancer the doctor will want to learn the extent or stage of the disease to see if the cancer has spread to other parts of the body. This may involve surgery, x-rays, other imaging procedures, and lab tests.

Treatment depends on the stage of the disease and general health of the patient. Patients are often treated by a team of specialists including gynecologic oncologist, medical oncologist, and radiation oncologist. Some treatment options are surgery, chemotherapy, radiation therapy, and clinical trials. A treatment plan that is best for you will be decided by you and your healthcare team.

Pancreatic Cancer

Also called exocrine cancer, pancreatic cancer is a disease in which malignant cells are found in the tissues of the pancreas. Most pancreatic cancers begin in the ducts that carry pancreatic juices.

The exact cause of pancreatic cancer is not known, but research has shown that people with certain risk factors are more likely than others to develop pancreatic cancer. These risk factors are age, smoking, diabetes, being male, being African American, family history, and chronic pancreatitis. Other studies have shown that exposure to certain chemicals in the workplace or a diet high in fat may increase the chance of getting pancreatic cancer.

Early pancreatic cancer often does not cause symptoms and is often called silent disease. As the cancer grows the symptoms may include pain in the upper abdomen or upper back, yellow skin and eyes, dark urine, weakness, loss of appetite, nausea and vomiting, and weight loss. If a patient has symptoms that suggest pancreatic cancer the physician will ask about the patient’s medical history, perform a physical exam, and order lab tests. Other tests that may be done consist of CT scan, ultrasound, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, and biopsy. The biopsy is used to remove tissue from the tumor for a pathologist to look under a microscope for cancer cells to confirm diagnosis.

When pancreatic cancer is diagnosed the doctor needs to know the extent or stage of the disease to help plan treatment so additional tests may be ordered. Such tests may include blood tests, CT scan, ultrasound, laparoscopy, or angiography. Tests results help your physician decide which treatment is appropriate for you. Cancer of the pancreas is very hard to control with current treatments so for this reason many doctors encourage patients to consider taking part in a clinical trial. Other treatment options for pancreatic cancer are radiation therapy, chemotherapy, and surgery. A treatment plan that is best for you will be decided upon by you and your healthcare team.

Prostate Cancer

The prostate is a gland in the male reproductive system found below the bladder and in front of the rectum. No one knows the exact cause of prostate cancer; however, research has shown that men with certain risk factors are more likely than others to develop prostate cancer. Some of the risk factors are age 65 and over, family history, race, certain prostate changes, and certain genetic changes.

A man who develops prostate cancer may not have any symptoms, but for men who do, the common symptoms include urinary problems, including not being able to pass urine, hard time starting or stopping the urine flow, needing to urinate often, especially at night, weak flow of urine, urine flow that starts and stops, and pain or burning during urination. Other symptoms include difficulty having an erection, blood in the urine or semen, and frequent pain in the lower back, hips, or upper thighs. Your doctor can check for prostate cancer before you have any symptoms by asking about you personal and family medical history. You’ll have a physical exam, digital rectal exam, and blood test for prostate-specific antigen to help detect any presence of prostate cancer.

If the digital rectal exam and PSA test detect a problem in the prostate your doctor may suggest other tests to make the diagnosis. These may include other lab tests, transrectal ultrasound, and transrectal biopsy. A biopsy is removal of tissues to look for cancer cells. It is the only sure way to diagnosis prostate cancer. Tissue is removed from areas of the prostate and sent to the lab for a pathologist to check the sample for cancer cells.

If cancer is found the pathologist studies tissue samples to report the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue and suggests how fast the tumor is likely to grow. Tumors with higher grades tend to grow faster than those with lower grades. They are also more likely to spread. Doctors use tumor grading along with your age and other factors to suggest treatment options.

If the biopsy shows that you have cancer, your doctor needs to learn the extent or stage of the disease to help you choose the best treatment. Staging is done to find out whether the tumor has invaded nearby tissues and has spread. Some additional tests that may be done to help determine this are bone scan, CT scan, and MRI. Once testing is complete treatment options will be gone over with you. Treatment depends mainly on your age, the grade of the tumor, the number of biopsy tissue samples that contain cancer cells, the stage of the cancer, your symptoms, and your general health. Treatment options for prostate cancer are active surveillance, or watching, surgery, radiation therapy, hormone therapy, and chemotherapy.

Renal Cancer

Cancer that forms in the tissues of the kidneys is called renal cancer. Kidney cancer includes renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and removes waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects).

Kidney cancer develops most often in people over 40, but no one knows the exact causes of this disease. Research has shown that people with certain risk factors are more likely than others to develop kidney cancer. Some of the risk factors are smoking, obesity, high blood pressure, long-term dialysis, Von Hippel-Lindau syndrome, occupation, and gender.

Symptoms of kidney cancer can include blood in the urine, pain in the side that does not go away, a lump or mass in the side of the abdomen, weight loss, fever, and feeling very tired or having a general feeling of poor health.

If a patient has symptoms that suggest kidney cancer the doctor will perform some tests. These include physical exam, urine tests, blood tests, intravenous pyelogram, CT scan, ultrasound, biopsy, and surgery. A biopsy is done to get a sample of tissue from the kidney to be sent to the pathologist to look for cancer cells and determine diagnosis. The doctor also needs to know the extent of the disease or stage to help plan the best treatment. Staging may involve testing such as ultrasound, CT scan, and MRI. After testing is complete your doctor will go over treatment options with you. These include surgery, arterial embolization, radiation therapy, biological therapy, or chemotherapy.

Skin Cancer

There are several types of skin cancer. Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma. Skin cancer that forms in basal cells (small, round cells in the base of the outer layer of skin) is called basal cell carcinoma. Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma. Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin. Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems.

The two most common types of skin cancer are basal cell cancer and squamous cell cancer. These cancers usually form on the head, face, neck, hands, and arms. These areas are exposed to the sun, but skin cancer can occur anywhere. Basal cell skin cancer grows slowly. It usually occurs on areas of the skin that have been in the sun. It is most common on the face. Basal cell cancer rarely spreads to other parts of the body. Squamous cell skin cancer also occurs on parts of the skin that have been in the sun, but it also may be in places that are not in the sun. Squamous cell cancer sometimes spreads to lymph nodes and organs inside the body.

Research has shown that people with certain risk factors are more likely than others to develop skin cancer. Some of these risk factors are ultraviolet radiation, scars or burns on the skin, infection, exposure to arsenic, chronic skin inflammation or skin ulcers, diseases that make the skin sensitive to the sun, radiation therapy, medical conditions or drugs that suppress the immune system, personal history of one or more skin cancers, and family history of skin cancer. The best way to prevent skin cancer is to protect yourself from the sun and use sunscreen lotions.

If found and treated early most basal cell and squamous cell skin cancers can be cured. Changes on the skin are the most common signs of skin cancer. This may consist of a new growth, a sore that doesn’t heal, or a change in an old growth. Skin changes to watch for are small, smooth, shiny, pale, or waxy lump; firm, red lump; sore or lump that bleeds or develops a crust or a scab; flat red spot that is rough, dry, or scaly and may become itchy or tender; red or brown patch that is rough and scaly. Sometimes skin cancer is painful, but usually is not.

If you notice changes on the skin the doctor must find out whether it is due to skin cancer or something else. The doctor will remove all or part of the area that does not look normal by a procedure called a biopsy. This will then be sent to a lab for a pathologist to check for skin cancer. A biopsy is the only sure way to diagnose skin cancer. If the biopsy shows you have cancer, the doctor will then need to know the extent or stage of the disease. The stage is determined by the size of the growth, how deeply it has grown beneath the top layer of the skin, and whether it has spread to nearby lymph nodes or to other parts of the body. Once diagnosis and staging is done your doctor will go over treatment options with you.

Sometimes all of the cancer is removed during the biopsy and no additional treatment is needed. Treatment for the disease depends on the type and stage of the disease, the size and place of the growth, and your general health and medical history. Treatment options include surgery, topical chemotherapy, photodynamic therapy, or radiation therapy.

Testicular Cancer

Testicular cancer forms in tissues of the testis (one of two egg-shaped glands inside the scrotum that make sperm and male hormones). It usually occurs in young or middle-aged men. Two main types of testicular cancer are seminomas, or cancers that grow slowly and are sensitive to radiation therapy and make up about 30% of all testicular cancers. The other type of testicular cancer is nonseminomas or different cell types that grow more quickly than seminomas. Nonseminomas include choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumors.

The cause of testicular cancer is unknown however; there are several factors that increase a man’s chance of developing testicular cancer. These are undescended testicle, abnormal testicular development, Klinefelter syndrome, and history of testicular cancer. Most testicular cancers are often found by men themselves.

Doctors generally examine the testicles during routine physical exams also. Some of the symptoms of testicular are painless lump or swelling in either testicle, any enlargement of a testicle or change in the way it feels, a feeling of heaviness in the scrotum, a dull ache in the lower abdomen or the groin, a sudden collection of fluid in scrotum, and pain or discomfort in a testicle or in the scrotum.

If any of these symptoms appear you should see your doctor and he will evaluate your general health as well as perform a physical exam, ultrasound, and lab tests. If a tumor is suspected the doctor will order a biopsy which involves surgery to remove the testicle. If only one testicle remains, a small incision is made to get tissue from the testicle. Once sample tissue is obtained it is sent to the lab for a pathologist to review under a microscope to determine diagnosis. If the diagnosis is testicular cancer the stage or extent of the disease will have to be determined to plan appropriate treatment for the patient.

Most men with testicular cancer can be cured with surgery, radiation therapy, and/or chemotherapy. Seminomas and nonseminomas grow and spread differently, and each type may need different treatment. Treatment also depends on the stage of the cancer, patient’s age, and general health.

Thyroid Cancer

The thyroid is an organ at the base of the throat that makes hormones that help control heart rate, blood pressure, body temperature, and weight. Four main types of thyroid cancer are papillary, follicular, medullary, and anaplastic thyroid cancer. The four types are based on how the cancer cells look under a microscope.

Papillary and follicular thyroid cancers account for 80-90% of all thyroid cancers. Both types begin in the follicular cells of the thyroid. Most of this type tends to grow slowly and if detected early, most can be treated successfully.

Medullary thyroid cancer accounts for 5-10% of thyroid cancer cases and it arises in C cells not follicular cells. Medullary thyroid cancer is easier to control if it is found and treated before it spreads to other parts of the body. Anaplastic cancer is least common with only 1-2% of cases. It arises in follicular cells and the cells are highly abnormal and difficult to recognize. This type of cancer is usually very hard to control because the cancer cells tend to grow and spread very quickly.

The exact cause of thyroid cancer is unknown however; certain risk factors are more likely to contribute to thyroid cancer in one individual versus another. The risk factors associated with an increased chance of developing thyroid cancer are radiation, family history, being female, age, race, and not enough iodine in the diet. Early thyroid cancer does not cause symptoms. As cancer grows symptoms may include a lump or nodule in the front of the neck near the Adam’s apple, hoarseness or difficulty speaking in a normal voice, swollen lymph nodes, especially in the neck, difficulty swallowing or breathing or pain in the throat or neck. If a person has symptoms that suggest thyroid cancer the doctor may perform a physical exam and ask about the patient’s personal and family medical history. Lab tests and imaging including ultrasound, radionuclide scanning, and a biopsy may also be performed. A biopsy is the removal of tissue to look for cancer cells and is the only sure way to know whether a nodule is cancerous. The tissue is examined under a microscope by a pathologist for diagnosis.

If the diagnosis is thyroid cancer, the doctor then needs to know the extent or stage of the disease. Additional testing including ultrasound, MRI, CT scan, and radiounuclide scan may be done to see whether the cancer has spread to the lymph nodes or other areas within the neck. After testing and staging are complete treatment options are discussed. Treatment options are surgery, radioactive iodine therapy, hormone treatment, external radiation therapy, and chemotherapy.

Uterine Cancer

Two types of uterine cancer are endometrial cancer (cancer that begins in cells lining the uterus) and uterine sarcoma (a rare cancer that begins in muscle or other tissues in the uterus). No one knows the exact causes of uterine cancer however; there are certain risk factors that make it more likely for one woman to get the disease over another. Risk factors include age, endometrial hyperplasia, hormone replacement therapy, obesity, tamoxifen use, race, and colorectal cancer.

Uterine cancer usually occurs after menopause, but it may also occur around the time menopause begins. Some of the symptoms seen with uterine cancer are unusual vaginal bleeding or discharge, difficult or painful urination, pain during intercourse, and pain in the pelvic area. If a woman has symptoms that may suggest uterine cancer her doctor may check lab and urine tests and do a pelvic exam, pap test, transvaginal ultrasound, and a biopsy to remove tissue from the uterine lining to confirm diagnosis.

Once diagnosis is determined the doctor needs to know the extent or stage of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so to what parts of the body. Additional tests to determine stage may be blood and urine tests, x-rays, CT scan, ultrasound test, MRI, sigmoidoscopy, or colonoscopy. In most cases, the most reliable way to stage uterine cancer is to remove the uterus so the pathologist can examine it for any signs of cancer. Once staging is complete treatment options are gone over with you. Treatment options consist of surgery, radiation therapy, and hormonal therapy.