Cancer Articles (Dr. S.N White)

What size tumors are indicated by the "T" classifications? TO means there is no evidence of primary tumor. Tl refers to a tumor that is 2 centimeters or less in its greatest dimension. T2 refers to a tumor which is more than 2 centimeters but not more than 5 centimeters. T3 means that the tumor is more than 5 centimeters. A T4 designation indicates a tumor of any size with direct extension to the chest wall or skin. Is there more than one kind of breast cancer?  Cancer of the breast is not a single disease. There are at least fifteen distinct varieties. The doctor and the patient need to know which variety they are dealing with before making the decision as to how to proceed. Among the types of breast cancer are intraductal, inflammatory, medulluary, papillary, tubular, lobular and Paget's disease. What is inflammatory breast cancer?  This is a rare type of breast cancer which often spreads rapidly to other parts of the body. In inflammatory breast cancer, the b...

Will my scar be red and swollen? Probably you will see a slight redness and swelling along the incision or find a small amount of pink draining from the scar area. These symptoms are normal. If there is a lot of redness and swelling or pus around the area or if you have heavy bleeding, call the doctor right away. Your scar will be red for a while but will soon fade in color. What if when I ask for a separate procedure for the biopsy, the doctor says that I will be doubling my risk of undergoing general anesthesia twice?  Your doctor, if he uses this argument, has overlooked the fact that a general anesthetic is not usually needed for a biopsy. In most cases, a biopsy can be performed under local anesthesia, with the patient fully conscious or, if she prefers, semiconscious. Most biopsies are now performed on an outpatient basis. What happens next if the pathological report shows that the tumor is cancerous?  Eight out of ten times, the lump will prove to be benign, b...

Won't all this time delay mean that the cancer has more chance to spread? No. Studies have shown that a short delay between biopsy and treatment will not affect the spread of disease or reduce the chances for successful treatment. An interval of 2 days to a week between the two procedures is not a problem. Many medical professionals now agree that this time delay is perfectly acceptable and in most cases is a wise way to proceed. The advantages of getting all of the necessary information about the extent of the cancer far outweigh the advantages of performing a quick, disfiguring operation. I feel I need some time to think, but everybody keeps pushing me to have the biopsy and the operation done right away. What should I do?  It is important to have the time to think and to look at the alternatives. You may want to talk it over with your husband and children, your sisters, your mother, or your friends. You may want to get a second opinion. It is all right to take a few extra d...

Chemo Side Effects What is meant by regional perfusion? That is when the drugs circulate in a closed circuit through the bloodstream of the cancer affected region. A tourniquet prevents the drug from reaching and damaging sensitive organs beyond the cancerous area. The drug is injected through an artery to the cancerous area, is withdrawn from a vein by special tubes, and then recirculated through artery and vein by means of a pump oxygenator. Regional perfusion allows large doses of drugs to be directed to one spot in the body. It is especially suited to treating certain tumors in the arms and legs. For how long and how often will I be getting chemotherapy treatments?  The length of time and how often you will be having treatments depend upon the kind of cancer you have, the drugs being used, how long it takes your body to respond to the drugs, and how well you tolerate them. Treatment schedules vary widely. Chemotherapy may be given daily, weekly, or monthly. Some drug...

Will I lose my hair? Many people find hair loss the most upsetting side effect of chemotherapy. The rapidly growing cells that make up the hair roots (follicles) are sensitive to chemotherapeutic drugs. Not all drugs cause hair loss, however. There are several important things to remember. The hair loss is temporary. Body hair generally returns once the chemotherapy drug is stopped. Occasionally, the hair will begin to regrow while you are still being treated with the chemotherapy drug. Complete baldness occurs generally within two to three cycles of the drug. When your hair begins to regrow it will be thick and soft and sometimes even better than before. If I am bald to begin with, will I grow hair when chemotherapy stops?  No. If you are already bald before starting your chemotherapy treatments, there will be no new hair growth. Will I lose my hair in places other than on my head?  The hair follicles of the beard, eyebrows, mustache, eyelashes, armpits, legs, and ...

What can be done to help control my nausea and vomiting from chemotherapy? Drugs called antiemetic agents are used to help lessen nausea and vomiting. They are usually given before the chemotherapy treatment begins. Nausea and vomiting vary from person to person and also depend upon the chemotherapy agent being given. Among the drugs that may be prescribed to help combat nausea and vomiting are Compazine, Thorazine, Phenergan, Torecan, Trilafon, Inapsine, Haldol, Decadron, and Metoclopramide. Most are given orally, intramuscularly, or rectally. Can I take drugs at different times of the day to help control nausea and vomiting?  It depends upon the drug. Some must be taken or given at specific times or else they will not be effective. However, most nausea and vomiting seem to occur 2 to 4 hours after the treatment and last less than 24 hours. For some drugs, and some people, getting the drug early in the morning (along with antinausea medicine), then taking the antinaus...

Chemotherapy can be given  • Orally, by mouth, in pill, capsule, or liquid form (PO) • Intravenously, either injected into a vein as a shot (IV push) or as a fluid drip (IV or IV drip) • Intramuscularly, by injecting it into a muscle in the arm, buttocks, or thigh (IM) • Subcutaneously, with an injection beneath the skin (SQ) • Intra arterially, by injecting it into an artery (IA) • Intrathecally, by injecting it directly into the spinal fluid (IT) • Intracavitarily, by injecting it into the pleural space (lung) or into abdomen (for fluid accumulation) How is the method of administration decided?   Some drugs can be given only in one or two ways. Adriamycin, for example, can be given only intravenously or intra arterially. If the drug can be given in different ways, the decision will hinge on the necessary dose, preferences of the doctor and the patient, what kind of cancer it is, and so on. Can drugs be given directly into the bloodstream without putting...

What are the different types of chemotherapy? Chemotherapy drugs are classified by their structure and function. They fall mainly into the following five classifications: • Alkylating agents are known for their chemical action, which interferes with cell division. They are called noncell cycle specific agents because they attack all cells in a tumor whether the cells are resting or dividing. They work by stopping or slowing down cell growth. • Antimetabolites are drugs which interfere with the cells' ability to replicate. These drugs are designed to starve cancer cells by interfering with vital life processes. They fool the cell by introducing the wrong building elements or blocking synthesis of the right ones. • Natural products include plant alkaloids and antibiotics. Plant alkaloids stop cell division at one of its phases. Antibiotics are made from molds like penicillin but are stronger and do not act in the same way as regular antibiotics. Rather, they interfere with c...

Chemotherapy Chemotherapy which simply means the use of drugs or medications to treat disease came into general use in the 1970s after clinical trials proved them to be effective in treating cancer. To many people, chemotherapy is frightening because of the fears of side effects that are sometimes caused by the use of the potent drugs needed to disrupt the cancer cells' ability to grow and multiply. The use of chemotherapy drugs has been greatly refined over the years, so that many of the earlier side effects have been modified. Chemotherapy may be given in several ways. Sometimes drugs are given in pill or capsule form and taken by mouth. Other times they may be injected into a muscle or given through a vein. How fast the cancer cells are destroyed may vary with the medication and the type of cancer. Because each drug acts on the cell in its own way, and at different times in the cell cycle, using them in combination can be more effective than using any one of them individually...

When will the doctor usually order a bone marrow study?   Usually bone marrow studies are ordered if some abnormality shows up in the complete blood count or peripheral smear. It is a routine test for suspicion of leukemia or to check if cancer has spread to the bone marrow. The presence of abnormal blood cells is frequently an early sign of tumor cell invasion of the bone marrow. Link What is a metastatic workup?  A metastatic workup is done to see if cancer has spread to other parts of the body. It usually consists of bone and liver scans; sometimes brain and lung scans are added. Why would the doctor order a bone scan if my cancer is in the breast?  This is a relatively routine check, so don't let it frighten you. It is done because the bone is a common place for breast cancer to spread. What does the doctor determine from the liver scan test?  Although they are not truly diagnostic, these tests are valuable in alerting the doctor to the presence of...

What is a biopsy?  A biopsy is the procedure in which a piece of tissue is obtained and examined under the microscope to determine whether cancer or other disease is present. This microscopic examination of the biopsy specimen is accepted by doctors in determining the nature of a tumor with complete accuracy. Therefore, whenever possible a doctor insists on obtaining a sample of every tumor that could be cancer before treatment is attempted. The biopsy provides the most reliable basis for a diagnosis of cancer. Who determines if the biopsy cells are cancerous?  The biopsy is "read" by a pathologist a physician who specializes in the study of normal and diseased body tissues. What kind of training does a pathologist have?  In order to be certified by the American Board of Pathology, the person must be a licensed doctor of medicine or osteopathy and have four years of training in both clinical and anatomic pathology or three years of training in either specialty ...