Cancer Understanding Cancer Reviewed By Charles Patrick Davis, MD, PhD on 7/22/2016 ( courtecy;- RECEIVED AND POSTED FROM face book shearing & webMD )

Cancer

Understanding Cancer

Reviewed By Charles Patrick Davis, MD, PhD on 7/22/2016

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What Is Cancer?

In the most basic terms, cancer refers to cells that grow out-of-control and invade other tissues. Cells may become cancerous due to the accumulation of defects, or mutations, in their DNA. Certain inherited genetic defects (for example, BRCA1 and BRCA2 mutations) and infections can increase the risk of cancer. Environmental factors (for example, air pollution) and poor lifestyle choices—such as smoking and heavy alcohol use—can also damage DNA and lead to cancer.

Most of the time, cells are able to detect and repair DNA damage. If a cell is severely damaged and cannot repair itself, it usually undergoes so-called programmed cell death or apoptosis. Cancer occurs when damaged cells grow, divide, and spread abnormally instead of self-destructing as they should.

Malignant Tumors Vs. Benign Tumors

A tumor is an abnormal mass of cells. Tumors can either be benign (non-cancerous) or malignant (cancerous).

Benign Tumors

Benign tumors grow locally and do not spread. As a result, benign tumors are not considered cancer. They can still be dangerous, especially if they press against vital organs like the brain.

Malignant Tumors

Malignant tumors have the ability to spread and invade other tissues. This process, known as metastasis, is a key feature of cancer. There are many different types of malignancy based on where a cancer tumor originates.

Cancer Metastasis

Metastasis is the process whereby cancer cells break free from a malignant tumor and travel to and invade other tissues in the body. Cancer cells metastasize to other sites via the lymphatic system and the bloodstream. Cancer cells from the original—or primary—tumor can travel to other sites such as the lungs, bones, liver, brain, and other areas. These metastatic tumors are "secondary cancers" because they arise from the primary tumor.

What Is Metastasized Cancer?

Metastatic cancer retains the name of the primary cancer. For example, bladder cancer that metastasizes to the liver is not liver cancer. It is called metastatic bladder cancer. Metastasis is significant because it helps determine the staging and treatment. Some types of metastatic cancer are curable, but many are not.

What Causes Cancer?

Certain genes control the life cycle—the growth, function, division, and death—of a cell. When these genes are damaged, the balance between normal cell growth and death is lost. Cancer cells are caused by DNA damage and out-of-control cell growth. The following is a partial list of factors known to damage DNA and increase the risk of cancer:

Mutations Cause

Genetic mutations may cause cancer. For example, mutations of genes BRCA1 and BRCA2 (linked to an increased risk of breast and ovarian cancers) can inhibit the body's ability to safe-guard and repair DNA. Copies of these mutated genes can be passed on genetically to future generations, leading to a genetically-inherited increased risk of cancer.

Environment Cause

Cancer may be caused by environmental exposure. Sunlight can cause cancer through ultraviolet radiation. So can air pollutants like soot, wood dust, asbestos, and arsenic, to name just a few.

Microbes Cause

Some microbes are known to increase cancer risks. These include bacteria like H. pylori, which causes stomach ulcers and has been linked to gastric cancer. Viral infections (including Epstein-Barr, HPV, and hepatitis B and C) have also been linked to cancer.

Lifestyle and Diet Causes

Lifestyle choices can lead to cancer as well. Eating a poor diet, inactivity, obesity, heavy alcohol use, tobacco use including smoking, and exposure to chemicals and toxins are all associated with greater cancer risk.

Causes of Cancer: Treatment

Medical treatment with chemotherapy, radiation, targeted treatments (drugs designed to target a specific type of cancer cell) or immunosuppressive drugs used to decrease the spread of cancer throughout the body can also cause damage to healthy cells. Some “second cancers”, completely separate from the initial cancer, have been known to occur following aggressive cancer treatments; however, researchers are producing drugs that cause less damage to healthy cells (for example, targeted therapy).

Cancer Symptoms and Signs

There are more than 100 different types of cancer. Every cancer and every individual is unique. Cancer symptoms and signs depend on the size and location of the cancer as well as the presence or absence of metastasis.

Common Cancer Symptoms and Signs

Symptoms and signs of cancer may include:

• Fever
• Pain
• Fatigue
• Skin changes (redness, sores that won't heal, jaundice, darkening)
• Unintended weight loss or weight gain

Other more obvious signs of cancer may include:

• Lumps or tumors (mass)
• Difficulty swallowing
• Changes or difficulties with bowel or bladder function
• Persistent cough or hoarseness
• Short of breath
• Chest pain
• Unexplained bleeding or discharge

6 Types of Cancer

Cancer can occur anywhere in the body. Broadly, cancers are classified as either solid (for example breast, lung, or prostate cancers) or liquid (blood cancers). Cancer is further classified according to the tissue in which it arises.

What Is Carcinoma?

Carcinomas are cancers that occur in epithelial tissues in the body. They comprise 80% to 90% of all cancers. Most breast, lung, colon, skin, and prostate cancers are carcinomas. This class includes the two most common skin cancers, basal cell carcinoma and squamous cell carcinoma. Also in this class is the glandular cancer adenocarcinoma.

What Is Sarcoma Cancer?

Sarcomas occur in connective tissue like the bones, cartilage, fat, blood vessels, and muscles. This class of cancers includes the bone cancers osteosarcoma and Ewing sarcoma, Kaposi sarcoma (which causes skin lesions), and the muscle cancers rhabdomyosarcoma and leiomyosarcoma.

What Is Myeloma Cancer?

Myelomas are cancers that occur in plasma cells in the bone marrow. This class of cancer includes multiple myeloma, also known as Kahler disease.

What Is Leukemia?

Leukemias are a group of different blood cancers of the bone marrow. They cause large numbers of abnormal blood cells to enter the bloodstream.

What Is Lymphoma Cancer?

Lymphomas are cancers of the immune system cells. These include the rare but serious Hodgkin lymphoma (Hodgkin's lymphoma, also Hodgkin's disease) and a large group of white blood cell cancers known collectively as non-Hodgkin lymphoma (non-Hodgkin's lymphoma).

What Is Mixed Cancer?

Mixed cancers arise from more than one type of tissue.

7 Common Cancers

Cancer is the second leading cause of death in the United States. The most common cancers diagnosed in the U.S. are those of the breast, prostate, lung, colon and rectum, and bladder. Cancers of the lung, colon and rectum, breast, and pancreas are responsible for the most deaths. The prognosis of different cancers is highly variable. Many cancers are curable with early detection and treatment. Cancers that are aggressive or diagnosed at a later stage may be more difficult to treat, and can even be life threatening.

What Is a Breast Cancer?

Breast cancer is the most common cancer in the United States, and one of the deadliest. About one in eight women will develop invasive breast cancer at some point in her life. Though death rates have decreased since 1989, more than 40,000 U.S. women are thought to have died from breast cancer in 2015 alone.

What Is Lung Cancer?

Lung cancer is the second-most-common cancer in the United States, and it is the deadliest for both men and women. In 2012, more than 210,000 Americans were diagnosed with lung cancer, and in the same year more than 150,000 Americans died from lung cancer. Worldwide, lung cancers are the most common cancers.

What Is a Prostate Cancer?

Prostate cancer is the most common cancer found in men. In 2013, more than 177,000 Americans were diagnosed with prostate cancer, and more than 27,000 American men died from prostate cancer.

What Is a Colorectal Cancer?

Of the cancers that can impact both men and women, colorectal cancer is the second-greatest killer in the United States.

What Is a Liver Cancer?

Liver cancer develops in about 20,000 men and 8,000 women each year. Hepatitis B and C and heavy drinking increase one's risk of developing liver cancer.

What Is a Ovarian Cancer?

About 20,000 American women are diagnosed with ovarian cancer each year. For American women, ovarian cancer is the eighth most common cancer and the fifth leading cause of cancer death.

What Is a Pancreatic Cancer?

Pancreatic cancer has the highest mortality rate of all major cancers. Of the roughly 53,000 Americans diagnosed with pancreatic cancer each year, only 8 percent will survive more than five years.

How Stages of Cancer Are Determined

Doctors use the stages of cancer to classify cancer according to its size, location, and extent of spread. Staging helps doctors determine the prognosis and treatment for cancer. The TNM staging system classifies cancers according to:

• Tumor (T): Primary tumor size and/or extent
• Nodes (N): Spread of cancer to lymph nodes in the regional area of the primary tumor
• Metastasis (M): Spread of cancer to distant sites away from the primary tumor

Some cancers, including those of the brain, spinal cord, bone marrow (lymphoma), blood (leukemia), and female reproductive system, do not receive a TNM classification. Instead, these cancers are classified according to a different staging systems.

What Are The Stages of Cancer?

The TNM classification of a cancer usually correlates to one of the following five stages.

• Stage 0: This refers to cancer that is "in situ," meaning that cancerous cells are confined to their site of origin. This type of cancer has not spread and is not invading other tissues.
• Stage I – Stage III: These higher stages of cancer correspond to larger tumors and/or greater extent of disease. Cancers in these stages may have spread beyond the site of origin to invade regional lymph nodes, tissues, or organs.
• Stage IV: This type of cancer has spread to distant lymph nodes, tissues, or organs in the body far away from the site of origin.

Diagnosing Cancer

Various tests may be performed in order to confirm a cancer diagnosis. Positron Emission Tomography and Computed Tomography (PET-CT) Scans and other similar tests can highlight “hot spots” of cancer cells with high metabolic rates.

The most common test and procedures used to diagnose cancer include:

• Mammogram
• Pap Test
• Tumor Marker Test
• Bone Scan
• MRI
• Tissue Biopsy
• PET-CT Scan

The Role of Lymph Nodes in Cancer Diagnosis

Cancer that originates in the lymph nodes or other area of the lymphatic system is called lymphoma. Cancer that originates elsewhere in the body can spread to lymph nodes. The presence of metastasized cancer in the lymph nodes is may mean the cancer is growing quickly and/or is more likely to spread to other sites. The presence of cancer in lymph nodes often affects prognosis and treatment decisions. Many diagnostic tests look at the lymph nodes as an indicator.

What Are Treatment Options?

The treatment is highly variable depending on the type and stage of a cancer as well as the overall health of the patient. The most common treatments are surgery, radiation, and chemotherapy. Other treatments include targeted/biological therapies, hematopoietic stem cell transplants, angiogenesis inhibitors, cryosurgery, and photodynamic therapy.

Every treatment has potential risks, benefits, and side effects. The patient and his or her care team, which may include an internist or other specialist, surgeon, oncologist, radiation oncologist, and others, will help determine the best and most appropriate course of treatment.

Is There a Cure for Cancer?

Despite enormous effort and funding, no one cure has been found yet to eliminate cancer. In 2016, the United States announced a $1 billion investment into creating such a cure, named the “National Cancer Moonshot” by President Barack Obama.

Until a cure can be found, prevention through a healthy lifestyle is the best way to stop cancer. Some ways to help protect yourself from cancer include eating plenty of fruits and vegetables, maintaining a healthy weight, abstaining from tobacco, drinking only in moderation, exercising, avoiding sun damage, getting immunizations, and getting regular health screenings.

Surgery

Surgery is often performed to remove malignant tumors. Surgery allows for the determination of the exact size of the tumor as well as the extent of spread and invasion into other nearby structures or lymph nodes – all-important factors in prognosis and treatment. Surgery is often combined with other cancer treatments, such as chemotherapy and/or radiation.

Sometimes, cancer cannot be entirely surgically removed because doing so would damage critical organs or tissues. In this case, debulking surgery is performed to remove as much of the tumor as is safely possible. Similarly, palliative surgery is performed in the cases of advanced cancer to reduce the effects (for example, pain or discomfort) of a cancerous tumor. Debulking and palliative surgeries are not curative, but they seek to minimize the effects of the cancer.

Reconstructive surgery can be performed to restore the look or function of part of the body after cancer surgery. Breast reconstruction after a mastectomy is an example of this kind of surgery.

Radiation Therapy

Radiation is a very common cancer treatment. About 50% of all cancer patients will receive radiation treatment, which may be delivered before, during, or after surgery and/or chemotherapy. Radiation can be delivered externally -- where X-rays, gamma rays, or other high-energy particles are delivered to the affected area from outside the body -- or it can be delivered internally. Internal radiation therapy involves the placement of radioactive material inside the body near cancer cells. This is called brachytherapy.

Systemic radiation involves the administration of radioactive medication by mouth or intravenously. The radioactive material travels directly to the cancerous tissue. Radioactive iodine (I-131 for thyroid cancer) and strontium-89 (for bone cancer) are two examples of systemic radiation treatments.

Typically, external radiation is delivered 5 days a week over the course of 5 to 8 weeks. Other treatment regimens are sometimes used.

Chemotherapy Procedure

Chemotherapy, or "chemo," refers to more than 100 different medications used to treat cancer and other conditions. If eliminating all cancer cells is not possible, the goals of treatment may be to slow the growth of the cancer, keep the cancer from spreading, and/or relieve cancer-associated symptoms (such as pain).

Depending on the type of chemotherapy prescribed, the medications may be given by mouth, injection, intravenously (IV), or topically. IV chemotherapy may be delivered via a catheter or port, which is usually implanted in a blood vessel of the chest for the duration of the therapy. Sometimes chemotherapy is delivered regionally, directly to the area that needs treatment. For example, intravesical therapy is used to infuse chemotherapy directly into the bladder for the treatment of bladder cancer.

The chemotherapy regimen a patient receives depends upon the type and stage of the cancer, any prior cancer treatment, and the overall health of the patient. Chemotherapy is usually administered in cycles over the course of days, weeks, or months, with rest periods in between.

Other Treatments

In addition to surgery, radiation, and chemotherapy, other therapies are used to treat cancer. These include:

Targeted or Biological Therapies

Targeted or biological therapies seek to treat cancer and boost the body's immune system while minimizing damage to normal, healthy cells. Monoclonal antibodies, immunomodulating drugs, vaccines, and cytokines are examples of targeted or biological therapies.

Hematopoietic Stem Cell Transplants

Hematopoietic stem cell transplants involve the infusion of stem cells into a cancer patient after the bone marrow has been destroyed by high-dose chemo and/or radiation.

Angiogenesis Inhibitors

Angiogenesis inhibitors are medications that inhibit the growth of new blood vessels that cancerous tumors need in order to grow.

Cryosurgery

Cryosurgery involves the application of extreme cold to kill precancerous and cancerous cells.

Photodynamic Therapy

Photodynamic therapy (PDT) involves the application of laser energy of a specific wavelength to tissue that has been treated with a photosensitizing agent, a medication that makes cancerous tissue susceptible to destruction with laser treatment. Photodynamic therapy selectively destroys cancer cells while minimizing the damage to normal, healthy tissues nearby.

Ongoing Research

Ongoing cancer research continues to identify newer, less toxic, and more effective cancer treatments. Visit the National Cancer Institute (NCI) to see a list of ongoing clinical trials.

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Cancer

Top Cancer-Fighting Foods

By Michael W. Smith, MD on 2/23/2016

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Fighting Cancer by the Plateful

No single food can prevent cancer, but the right combination of foods may help make a difference. At mealtimes, strike a balance of at least two-thirds plant-based foods and no more than one-third animal protein. This "New American Plate" is an important cancer fighting tool, according to the American Institute for Cancer Research. Check out better and worse choices for your plate.

Fighting Cancer With Color

Fruits and vegetables are rich in cancer-fighting nutrients -- and the more color, the more nutrients they contain. These foods can help lower your risk in a second way, too, when they help you reach and maintain a healthy body weight. Carrying extra pounds increases the risk for multiple cancers, including colon, esophagus, and kidney cancers. Eat a variety of vegetables, especially dark green, red, and orange vegetables.

The Cancer-Fighting Breakfast

Naturally occurring folate is an important B vitamin that may help protect against cancers of the colon, rectum, and breast. You can find it in abundance on the breakfast table. Fortified breakfast cereals and whole wheat products are good sources of folate. So are orange juice, melons, and strawberries.

More Folate-Rich Foods

Other good sources of folate are asparagus and eggs. You can also find it in beans, sunflower seeds, and leafy green vegetables like spinach or romaine lettuce. The best way to get folate is not from a pill, but by eating enough fruits, vegetables, and enriched grain products.

Pass Up the Deli Counter

An occasional Reuben sandwich or hot dog at the ballpark isn't going to hurt you. But cutting back on processed meats like bologna, ham, and hot dogs will help lower your risk of colorectal and stomach cancers. Also, eating meats that have been preserved by smoking or with salt raises your exposure to chemicals that can potentially cause cancer.

Cancer-Fighting Tomatoes

Whether it's the lycopene -- the pigment that gives tomatoes their red color -- or something else isn't clear. But some studies have linked eating tomatoes to reduced risk of several types of cancer, including prostate cancer. Studies also suggest that processed tomato products such as juice, sauce, or paste increase the cancer-fighting potential.

Tea's Anticancer Potential

Even though the evidence is still spotty, tea, especially green tea, may be a strong cancer fighter. In laboratory studies, green tea has slowed or prevented the development of cancer in colon, liver, breast, and prostate cells. It also had a similar effect in lung tissue and skin. And in some longer term studies, tea was associated with lower risks for bladder, stomach, and pancreatic cancers.

Grapes and Cancer

Grapes and grape juice, especially purple and red grapes, contain resveratrol. Resveratrol has strong antioxidant and anti-inflammatory properties. In laboratory studies, it has prevented the kind of damage that can trigger the cancer process in cells. There is not enough evidence to say that eating grapes or drinking grape juice or wine (or taking supplements) can prevent or treat cancer.

Limit Alcohol to Lower Cancer Risk

Cancers of the mouth, throat, larynx, esophagus, liver, and breast are all linked with drinking alcohol. Alcohol may also raise the risk for cancer of the colon and rectum. The American Cancer Society recommends limiting alcohol to no more than two drinks per day for men and one for women. Women at higher risk for breast cancer may want to talk with a doctor about what amount of alcohol, if any, is safe based on their personal risk factors.

Water and Other Fluids Can Protect

Water not only quenches your thirst, but it may protect you against bladder cancer. The lower risk comes from water diluting concentrations of potential cancer-causing agents in the bladder. Also, drinking more fluids causes you to urinate more frequently. That lessens the amount of time those agents stay in contact with the bladder lining.

The Mighty Bean

Beans are so good for you, it's no surprise they may help fight cancer, too. They contain several potent phytochemicals that may protect the body's cells against damage that can lead to cancer. In the lab these substances slowed tumor growth and prevented tumors from releasing substances that damage nearby cells.

The Cabbage Family vs. Cancer

Cruciferous vegetables include broccoli, cauliflower, cabbage, Brussels sprouts, bok choy, and kale. These members of the cabbage family make an excellent stir fry and can really liven up a salad. But most importantly, components in these vegetables may help your body defend against cancers such as colon, breast, lung, and cervix.

Dark Green Leafy Vegetables

Dark green leafy vegetables such as mustard greens, lettuce, kale, chicory, spinach, and chard have an abundance of fiber, folate, and carotenoids. These nutrients may help protect against cancer of the mouth, larynx, pancreas, lung, skin, and stomach.

Protection From an Exotic Spice

Curcumin is the main ingredient in the Indian spice turmeric and a potential cancer fighter. Lab studies show it can suppress the transformation, proliferation, and invasion of cancerous cells for a wide array of cancers.

Cooking Methods Matter

How you cook meat can make a difference in how big a cancer risk it poses. Frying, grilling, and broiling meats at very high temperatures causes chemicals to form that may increase cancer risk. Other cooking methods such as stewing, braising, or steaming appear to produce fewer of those chemicals. And when you do stew the meat, remember to add plenty of healthy, protective vegetables.

A Berry Medley With a Punch

Strawberries and raspberries have a phytochemical called ellagic acid. This powerful antioxidant may actually fight cancer in several ways at once, including deactivating certain cancer causing substances and slowing the growth of cancer cells.

Blueberries for Health

The potent antioxidants in blueberries may have wide value in supporting our health, starting with cancer. Antioxidants fight cancer by ridding the body of free radicals before they can do their damage to cells. Try topping oatmeal, cold cereal, yogurt, even salad with blueberries to boost your intake of these healthful berries.

Pass on the Sugar

Sugar may not cause cancer directly. But it may displace other nutrient-rich foods that help protect against cancer. And it increases calorie counts, which contributes to overweight and obesity. Excess weight is also a cancer risk. Fruit offers a sweet alternative in a vitamin-rich package.

Don't Rely on Supplements

Vitamins may help protect against cancer. But that's when you get them naturally from food. Both the American Cancer Society and the American Institute for Cancer Research emphasize that getting cancer-fighting nutrients from foods like nuts, fruits, and green leafy vegetables is vastly superior to getting them from supplements. Eating a healthy diet is best.

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Cancer

Lung Cancer Symptoms, Stages, and Treatment

By Charles Patrick Davis, MD, PhD on 7/22/2016

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Lung Cancer: The Leading Cause of Cancer Death

Lung cancer has emerged as the leading killer of men and women stricken with invasive cancer, affecting husbands and wives, friends and neighbors, and causing suffering for many families. In the United States, lung cancer overtook breast cancer as the leading cause of cancer deaths in women in 1987. Lung cancer deaths account for a quarter of all American cancer deaths, killing more people every year than prostate, breast, and colon cancer combined. Over 157,000 Americans are estimated to have died from lung cancer in 2015.

This disease is difficult to detect in its early stages, and treatments for lung cancer in its later stages provide a poor prognosis: Those with stage IV non-small cell lung cancer—the most common type—have an estimated 1 percent survival rate five years after diagnosis. The other type of lung cancer—small cell lung cancer—is even more aggressive. According to the American Cancer Society, the overall survival rate for lung cancer as of Jan. 1, 2014 stands at just 3%.

What Causes Lung Cancer?

The exact cause of lung cancer is still being investigated. Certain risk factors have been shown to play a part in causing cells to become cancerous. Risk factors for lung cancer include smoking, exposure to air pollution, and genetics.

Does Smoking Cause Lung Cancer?

The major cause of lung cancer in men and women is mainly due to cigarette smoking. In 1876, a machine was invented to make rolled-up cigarettes and thus provided cheap tobacco products to almost everyone. At that time, lung cancer was relatively rare. Smoking dramatically increased and so did lung cancers following this innovation. Currently about 90% of all lung cancers are related to smoking. Radon gas, pollution, toxins, and other factors contribute to the remaining 10%.

Cigarettes and cigarette smoke contains over 70 cancer-causing chemicals (carcinogens). Some of the carcinogens found in cigarette smoke include:

• Lead (a highly poisonous metal)
• Arsenic (an insecticide)
• Cadmium (a battery component)
• Isoprene (used to make synthetic rubber)
• Benzene (a gasoline additive)

Cigar smoke is particularly heavy on tobacco-specific nitrosamines (TSNAs), which are considered particularly cancerous.

Lung Cancer and Cilia

Cigarette smoke damages and can kill hair-like projections on airway cells termed cilia. The cilia normally sweep out toxins, carcinogens, viruses, and bacteria. When the cilia are damaged or destroyed by smoke, all of these items may accumulate in the lungs and may cause problems such as infections or lung cancer.

Lung Cancer Symptoms

Unfortunately, lung cancers often have either no early symptoms or nonspecific early symptoms that people often dismiss. About 25% of people with lung cancer and no symptoms are diagnosed after having a chest X-ray or CT during a routine test or as a procedure for other problems. Lung cancer symptoms that may be detected are included below.

List of Lung Cancer Symptoms

• Cough (chronic, recurrent)
• Fatigue
• Weight loss
• Shortness of breath or wheezing
• Coughing up phlegm that contains blood
• Chest pain

Three Common Lung Cancer Screening Methods

Screening for lung cancer is usually accomplished using three methods.

Physical Exam

A physical exam will look for signs of wheezing, shortness of breath, cough, pain and other possible signs of lung cancer. Depending on the advancement of the cancer, other early signs of lung cancer symptoms may include a lack of sweating, dilated neck veins, face swelling, excessively constricted pupils, and other signs. The physical exam will also include the patient's history of smoking and a chest X-ray.

Sputum Cytology Exam

A sputum cytology exam involves a microscopic examination of a patient's mucus (sputum).

Spiral CT Exam

This method of CT scanning builds a detailed image of the body's internal workings. Inside a spiral CT machine, detailed images are taken of the relevant parts of the patient's body. Those images are then linked to an X-ray machine to create 3D images of the patient's internal organs. These images may reveal potentially cancerous tumors.

A study by researchers suggested that people aged 55 to 74 years old who had smoked at least one pack of cigarettes a day for 30 or more years may benefit from a spiral CT study of the lungs. At best, the screening methods find about 30% of lung cancers leaving the bulk (about 70%) cancers of lung undetected. In addition, some test results are not clearly diagnostic which can lead to patient concerns and possibly unnecessary biopsies or surgeries.

Lung Cancer Diagnosis

If the screening tests suggest a person has lung cancer, definitive diagnostic tests may be done by a pathologist. The pathologist will examine the patient's lung cells in sputum, phlegm, or from a biopsy sample to type and stage the lung cancer.

Lung Cancer: Biopsy

As stated previously, a tissue sample taken from the patient's suspected cancer is usually the best method to establish a definitive lung cancer diagnosis. In general, lung biopsies are obtained by either needle biopsy, a lung bronchoscopy technique, or by surgical removal of tissue. Many other tests may be done to get more information about the cancer's spread.

See the following slides for types of lung cancer and lung cancer stages, including stage IV lung cancer.

Types of Lung Cancer

There are only two major types of lung cancers: small cell lung cancer and non-small cell lung cancers. Less than 5% of lung cancer tumors will take the form of a carcinoid tumor, while other cancerous tumors are even more rare, including adenoid cystic carcinomas, lymphomas, and sarcomas. Although cancer from another part of the body may spread to the lungs, these are not categorized as lung cancer.

Non-Small Cell Lung Cancer

Non-small cell lung cancers are the most common type of lung cancer. These cancers account for about 90% of all lung cancers and are less aggressive than small cell lung cancers, meaning they spread to other tissues and organs more slowly.

Small Cell Lung Cancer

Small cell lung cancer, also called oat cell lung cancer, accounts for about 10% of all lung cancers. This form of cancer tends to spread quickly.

Lung Cancer Stages: Stage 0 Through Stage 4

After the type of lung cancer is determined, the type is then assigned a lung cancer stage. The stage indicates how much the cancer has spread in the body (for example, to the lymph nodes or to distant organs like the brain). Stages for non-small cell lung cancers are different from small cell lung cancers. The stages listed below are taken from the National Cancer Institute's lung cancer staging information:

Small Cell Lung Cancer Stages

Limited stage: In this form, small cell lung cancer is limited to one side of the chest, typically in the lungs and lymph nodes. About one in three people with small cell lung cancer have limited stage cancer upon the first diagnosis.

Extensive stage: This refers to small cell lung cancer that has spread throughout one lung, spread into both lungs, to lymph nodes on the other side of the chest or to other body parts. About two in three people with small cell lung cancer have extensive stage cancer upon first diagnosis.

Non-Small Cell Lung Cancer Stages

Occult (hidden) stage: In this stage, cancer cells appear in a sputum cytology exam or other test, though no tumor location can be found.

Stage 0 (carcinoma in situ): In this lung cancer stage, cancer cells are only found in the top layer of cells lining air passages and has not crept deeper into the lungs or spread beyond the air passages.

Stage I: A small lung cancer tumor (less than 3 centimeters across) is discovered, but has not spread to surrounding lung membranes, lymph nodes, or the main bronchial branches of the lungs.

Stage II: There are several ways that stage II lung cancer may be diagnosed. One is that the lung cancer has spread to lymph nodes near the lungs.

• Stage IIA: If the tumor is between 3 centimeters and 5 centimeters, the lung cancer is defined as stage IIA. Other factors can lead to this classification as well.
• Stage IIB: If the lung cancer tumor is between 5 centimeters and 7 centimeters, it is categorized as Stage IIB. Other factors can lead to this classification as well.

Stage III: As in stage II lung cancer, stage III has several definitions. One is that the lung cancer is found in both the lung and lymph nodes in the middle of the chest. Stage III lung cancer is divided into two subsets.

• Stage IIIA: This defines a lung cancer that has spread on the same side of the chest from where it started.
• Stage IIIB: This defines a lung cancer in which the cancer has spread to either the opposite side of the chest or above the collar bone.

Stage IV: This is the most advanced stage of lung cancer. The cancer can be any size, but two of these three things have happened:

• The cancer has spread to the opposite lung from where it began.
• Cancer cells have been discovered in the fluid surrounding the lung.
• Cancer cells have been discovered in the fluid surrounding the heart.

Lung Cancer Survival Rates

The American Cancer Society statistics are currently based on people diagnosed between 1998 and 2000 so the data may not reflect the effects of newer treatments. The data indicates that survival rates of patients living 5 years after being diagnosed with non-small cell lung cancers was dependent on the stage of the disease.

Stage I was about 49% (with surgical removal, about 75%) while stage IV survival was about 1%. Small cell lung cancers are more aggressive and the data, like that for non-small cell lung cancers, is not reflective of current survival rates.

However, even some data collected as late as 2008 indicates slow progress in increasing 5-year survival rates. The overall rate of both limited-stage and extensive-stage small cell lung cancer is about 6%. The overall rate of all stages (I to IV combined) non-small cell lung cancer is about 15%.

Early-Stage Lung Cancer Treatment: Surgery

Early stage (stage 0 or even some stage I) cancer treatment of non-small cell lung cancer may benefit from surgery. Part or all of a lung segment that contains the cancer may be removed; in some individuals, this may result in a cure. However, many patients still undergo chemotherapy, radiation therapy or both to kill any cancer cells not removed by surgery. Because small cell lung cancers are almost never diagnosed early, surgery (and other treatments) may prolong life but rarely, if ever, result in a cure.

Advanced Lung Cancer Treatment

Most small cell and non-small-cell lung cancers are treated with chemotherapy; they may also be treated with radiation therapy and surgery. In many patients with advanced disease, these methods may be used together, depending on the patient's condition and recommendations by their cancer doctors.

Targeted Lung Cancer Therapies

New therapeutic treatments are being tried; for example, some therapies termed targeted therapies are designed to prevent or stop lung cancer cells from growing by targeting the new blood vessels that are needed to allow the cancer cells to survive and grow; other treatments target growth and multiplication of lung cancer cells by interfering with chemical signals required by growing or multiplying cancer cells (illustrated in this slide).

Clinical Trials for Lung Cancer

In addition to targeted therapies, there are a number of clinical trials that a person may qualify for. Some may be available in your hometown. These clinical trials have patients try the newest potentially helpful therapeutic methods and drugs to combat lung cancers. The National Cancer Institute's web site listed below offers a list of current clinical trials; you and your doctor may find a clinical trial that may help you with this disease.

Life After Lung Cancer Diagnosis

After a diagnosis of lung cancer, it is not unusual to feel depressed and upset. However, research is ongoing and it is possible to survive and extend your life with treatment. Even with the diagnosis, there is evidence that people who develop a healthy lifestyle and stop smoking do better than those who do not change.

Lung Cancer and Secondhand Smoke

Tobacco smokers put others at risk of developing lung cancer. A nonsmoker (wife, child, significant other) who lives with a smoker has a 20% to 30% increase in risk of developing lung cancer due to exposure to smoke concentrations in their local environment.

Lung Cancer and Work Exposures

Although smoking results in the highest risk of causing lung cancers, other environmental exposures to certain compounds and chemicals increase the risk of lung cancer. Such agents as asbestos, uranium, arsenic, benzene, and many others increase the risk for developing lung cancers. Exposure to asbestos may cause lung cancer (mesothelioma) many years after the initial exposure so people may be at risk for lung disease for decades (10 to 40 years).

Lung Cancer and Radon Gas

Another chemical, radon gas, is considered to be the second leading cause of lung cancer. It occurs naturally but can seep into homes and collect in basements and crawl spaces. It is colorless and odorless but can be detected with relatively simple and inexpensive test kits. Smokers exposed to this gas have a higher risk of developing lung cancer than nonsmokers.

Lung Cancer and Air Pollution

There are a number of investigators that suggest air pollution contributes to the development of lung cancers. Several studies present data that airborne pollutants like diesel exhaust may cause some people to develop lung cancers. Researchers estimate that about 5% of lung cancers are due to air pollutants.

Increased Risk Factors for Lung Cancer

Although much is understood about lung cancers, there are still many things and situations that are unclear. For example, it is unclear why some families have a history of individuals with lung cancer and no clear risk factors. The same is true for some patients who develop lung cancers with no clear risk factors. Another occurrence such as drinking water that has high arsenic concentrations may increase lung cancer risk but how the process happens is not clear. In addition, the reason why adenocarcinoma in the lungs is more common in nonsmokers than smokers is also not known.

Lung Cancer Prevention

For the majority of lung cancers, prevention is possible if a person never smokes and avoids second-hand smoke. For smokers who quit -- within 10 years -- the risk of getting lung cancer drops to about the same risk as if they had never smoked. Avoiding other risk factors (for example, certain chemicals or compounds like benzene or asbestos or air pollution) may also prevent some people from developing lung cancers.

Additional Information on Lung Cancer

For more information about Lung Cancer, please consider the following:

• American Cancer Society
• National Cancer Institute
• LungCancer.org
• American Lung Association
• Centers for Disease Control and Prevention

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Cancer

Prostate Cancer Warning Signs & Prevention

By Charles Patrick Davis, MD, PhD on 8/7/2016

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What Is Prostate Cancer?

Prostate cancer is the development of cancer cells in the prostate gland (a gland that produces fluid for semen). It is the most common cancer in men; some cancers grow very slowly while others are very aggressive and spread quickly to other organs.

How Does Prostate Cancer Develop?

Like all cancers, prostate cancer begins when a mass of cells has grown out of control and begins invading other tissues. Cells become cancerous due to the accumulation of defects, or mutations, in their DNA.

Most of the time, cells are able to detect and repair DNA damage. If a cell is severely damaged and cannot repair itself, it undergoes so-called programmed cell death or apoptosis. Cancer occurs when damaged cells grow, divide, and spread abnormally instead of self-destructing as they should.

Prostate Cancer Symptoms

Symptoms of prostate cancer are variable; some men have no symptoms until the cancer develops over years. However, symptoms that can develop include the following:

• Urinary frequency
• Difficulty starting or stopping urination
• Interrupted or weak or slow urinary stream
• Blood in urine or in semen
• Discomfort (pain or burning sensation with urination or ejaculation)
• Intense pain in the low back, hips, or thighs, often present with aggressive or prostatic cancer spread to other organs

Prostate Cancer or Enlarged Prostate?

Two conditions can cause some symptoms that mimic those seen in prostate cancer described previously.

Benign prostatic hyperplasia (BPH)

BPH results from the prostate growing larger. BPH causes symptoms by creating pressure on the bladder, urethra, or both. BPH commonly occurs in elderly men and is a relatively benign condition.

Prostatitis (inflammation or infection of the prostate gland)

In the case of prostatitis, prostate tissue becomes inflamed, causing the prostate gland to swell. Any bacteria that can cause a urinary tract infection (UTI) can also cause prostatitis, and it may be caused by sexually transmitted diseases (STDs) including chlamydia and gonorrhea.

Both conditions are treated medically but some individuals with BPH may require surgical treatment.

Prostate cancer is differentiated from the above conditions by identifying cancer cells in a biopsy of the prostate.

Who Is at Risk of Prostate Cancer?

Aging in men (beginning at age 50) is the greatest risk factor for both BPH and prostate cancer. In addition, having a father or brother with prostate cancer doubles the risk for prostate cancer; however, African American males have the highest risk for prostate cancer. Research suggests that the majority of men at age 70 have some form of prostatic cancer with most of them showing no symptoms.

Preventing Prostate Cancer

Researchers suggest a diet low in fruits and vegetables but high in meats and high-fat dairy products increases the risk for prostate cancer. The mechanism(s) for this is being investigated, but current speculation suggests meat and high-fat foods contain compounds that augment the growth of cancer cells.

Can Too Much Sex Cause Prostate Cancer?

There are many myths about why prostate cancer develops. However, there is no evidence that "too much sex," masturbation, benign prostatic hyperplasia (BPH), or a vasectomy increases the risk or causes prostate cancer. Current research is investigating if STDs, prostatitis, or alcohol use increase the risk of developing prostate cancer.

Prostate Cancer Screening Guidelines

Although screening tests are not routinely done for prostatic cancers, the American Cancer Society guidelines suggest some men should be screened.

Screening Guidelines Based on Age and Risk

• Men aged 40 with more than one close relative (father, brother, or son) diagnosed with prostate cancer at an early age
• Men aged 45 that are African American or have a father, brother, or son diagnosed with prostate cancer before age 65
• Men aged 50 or older who have average risk and expect to live at least 10 more years

However, not everyone agrees with these guidelines; clinicians should explain that treatments can have severe side effects, may have little or no effects on the cancer, and that some cancers are so slow-growing.

Digital Rectal Exam and PSA Test

Two tests are particularly helpful in screening for prostate cancer.

Digital rectal exam (DRE)

A DRE is done to determine if the prostate is enlarged and is either soft, has bumps or is very firm (hard prostate). During a digital rectal exam, a doctor checks for prostate abnormalities using a gloved, lubricated finger (digit).

PSA Test

Another test is done on a blood sample to determine the level of a protein (prostate-specific antigen or PSA) produced by prostate cells. The PSA test may indicate a person has a higher chance of having prostate cancer but controversies about the test exist (see following slide). The patient and his doctor need to carefully consider the meaning and the use of these test results.

PSA Test Results

In general, a PSA level less than 4 nanograms per mililiter (ng/mL) of blood is considered a normal level while a PSA greater than 10 ng/mL suggests a high risk of having cancer. Unfortunately, some men have intermediate levels (5 to 9 ng/mL), making their situations more difficult to judge. To make matters worse, some men have prostate cancer despite showing PSA levels of less than 4 ng.

PSA Test False Positives

BPH and prostatitis can increase PSA levels resulting in a false positive test.

PSA Test False Negatives

Some drugs may lower PSA levels and result in a false negative PSA test. Your doctor can help decide the meaning of both the PSA test and the digital rectal exam results and determine if additional tests need to be done.

Prostate Cancer Biopsy

If your doctor determines that the PSA and digital rectal exam suggest prostate cancer, the physician may suggest that a biopsy of the prostate is warranted, depending on your age, medical condition, and other factors. A biopsy is done by inserting a needle through the rectum or between the rectum and scrotal junction and then removing small samples of prostatic tissue that can be examined under a microscope for cancer tissue. The biopsy may detect and determine the aggressiveness of prostatic cancer cells.

Prostate Cancer Gleason Score

Biopsy samples from the prostate gland are examined by a pathologist. The pathologist makes determinations based on the samples as to the aggressiveness of the cancer. This determination is called the Gleason score.

How the Gleason Score Is Determined

The pathologist gives the prostate biopsy tissue a grade of 1 to 5, with 5 as the worst grade of tumor pattern. Then the pathologist looks at the individual cells in the tumor pattern and grades the cell types from 1 to 5 with 5 being the most aggressive cancer cell type. The Gleason score is based on the sum of these two numbers (tissue grade and cell type grade). A Gleason score of 5 + 5 = 10 indicates a highly aggressive prostate tumor while a low score (2 + 2 = 4) indicates a less aggressive cancer.

Prostate Cancer Imaging

The spread of prostate cancer may be detected by several different tests such as ultrasound, CT, MRI, and a radionuclide bone scan. Doctors will help determine which tests are best for each individual patient.

Prostate Cancer Staging

Prostate cancer staging is a method that indicates how far the cancer has spread in the body and is used to help determine the best treatment method for the patient. Cancer that has spread to other body sites or organs is termed metastatic cancer.

The Stages of Prostate Cancer

In terms of prostate cancer, the cancer stages are as follows:

• Stage I: The cancer is small and still contained within the prostate gland.
• Stage II: The cancer is more advanced, but is still confined within the prostate gland.
• Stage III: The cancer has spread to the outer part of the prostate and to the nearby seminal vesicles.
• Stage IV: The cancer has spread to lymph nodes, other nearby organs, or tissues such as the rectum or bladder, or to distant sites such as the lungs or bones.
• Aggressive prostate cancer often reaches stage IV but others that are less aggressive may never progress past stage I, II, or III.

Prostate Cancer Survival Rates

In most individuals, prostate cancer progresses slowly through stages; about all individuals diagnosed with stage I through III prostate cancer survive 5 years or longer and with current treatments, the outlook is even better for future survival.

Stage 4 Prostate Cancer

Even stage IV has a 5-year survival rate of about 31% and this figure may also increase with advancement in treatment methods.

Prostate Cancer Treatment: Watch and Wait

"Watch and wait," is a phrase that is being used more frequently to describe a program of active surveillance without other cancer treatment for some patients with prostate cancer. It means that if your cancer is not aggressive (based on the Gleason score and the cancer stage), treatments may be deferred and your condition periodically checked. This approach is used because the risks of urinary and sexual problems inherent in most prostate cancer treatments are serious and may be put off or avoided if the cancer is not aggressive. However, aggressive prostatic cancer is usually treated even if secondary complications of treatments are serious.

Prostate Cancer Treatment: Radiation Therapy

Radiation, focused as a beam, can be used to kill cancer cells, especially those cells that have migrated (metastasized) from the prostate gland. Beams of radiation can be used to reduce bone pain caused by invasive cancer cells.

Low Dose Rate Brachytherapy

In another type of radiation therapy termed low dose rate brachytherapy, radioactive pellets about the size of a grain of rice are inserted into the prostate.

High Dose Rate Brachytherapy

High dose rate brachytherapy applies more radioactive sources temporarily into the cancerous prostate gland.

Both methods have side effects that can include erectile dysfunction, urinary tract problems, diarrhea, and other side effects.

Prostate Cancer Treatment: Prostate Cancer Surgery

Radical prostatectomy is the surgical removal of the prostate gland. Usually, this treatment is performed when the cancer is located only in the prostate gland. New surgical techniques help avoid damage to nerves, but the surgery may still have the side effects of erectile dysfunction and impaired urinary control. However, these side effects may gradually improve in some patients. Surgeons today may use robotic technique to assist in the operation.

Tips: Coping With Incontinence

Urinary incontinence is a common complication for men following prostate cancer surgery, and this problem can persist even five years after the surgery takes place. In one survey of 111 men published in 2003, 69% reported incontinence after prostate surgery. Most of these men used pelvic muscle exercises (Kegel exercises) to help. Many used containment devices, including pads, special underwear, and sanitary napkins to manage incontinence.

Here are some post-surgical incontinence tips:

• Keep a diary of how much you drink, and when and how often you use the bathroom. Note when you leak, and consider whether something could have caused the leak, such as bending in a certain way or drinking too much coffee or soda. The diary can give your doctor powerful in formation to help further your treatment.
• Practice double-voiding, meaning that after you finish urinating, wait a minute and try again.
• Drink less caffeine and alcohol. Both of these drugs can irritate the bladder and increase your need to go. Reducing or eliminating them from your diet can help stave off the frequent need to urinate.
• Avoid food triggers that for some men include chocolates, artificial sweeteners, spicy, or acidic foods. Other men find that food plays a small role or no role at all in their incontinence problems.
• Quit smoking. Along with all of its other many health hazards, tobacco has been linked with aggravated urinary incontinence in men.

Prostate Cancer Treatment: Hormone Therapy

Hormone therapy is designed to use drugs to shrink or slow the growth of prostate cancer cells, but it does not kill the prostate cancer cells. It is used to reduce the symptoms of prostate cancer and to slow the spread of aggressive prostatic cancers by blocking or reducing the production of male hormones (androgens) like testosterone.

Hormone Therapy Side Effects

• Impotence
• Breast tissue growth
• Hot flashes
• Weight gain

Prostate Cancer Treatment: Chemotherapy

Chemotherapy is designed to kill fast-growing cancer cells anywhere in the body so it is often used when aggressive prostate cancer cells metastasizeto other body sites. Usually, chemotherapy is given through a special intravenous line in a series of treatments over several months. There have been new advances in both the hormonal and chemotherapy treatment of prostate cancer. Unfortunately, chemotherapy often kills other fast-growing body cells like hair cells, mucosal cells, and cells that line the gastrointestinal tract. This can result in several unwanted side effects.

Prostate Cancer Chemotherapy Side Effects

• Hair loss
• Mouth sores
• Nausea
• Vomiting
• Other body ailments

Prostate Cancer Treatment: Cryotherapy

Cryotherapy is a treatment that kills cancer cells by freezing the cells which break apart when they are rewarmed. The treatment is less invasive than surgery, but the long-term effectiveness is still under study.

Prostate Cancer Cryotherapy and Impotence

Unfortunately, freezing damages nerves, sometimes including those near the prostate that control erections. Many men (up to 80%) become impotent after cryotherapy. Erectile dysfunction is a more common side effect following cryotherapy than following a radical prostatectomy.

Prostate Cancer Treatment: Prostate Cancer Immune Therapy

Please note that the term prostate cancer immune therapy has been called a vaccine, but that is somewhat misleading because it does not prevent prostatic cancer from developing in men. The prostate cancer “vaccine” is a highly individualized treatment method, designed to provide immune cells derived from a single patient's own cells. These cells are laboratory enhanced immune cells that become capable of killing or damaging the patient's own prostate cancer cells.

Like hormone therapy, this "vaccine" does not kill off all cancer cells and is currently used to slow the progression of aggressive cancers, especially those unresponsive to other treatments. Research is ongoing and perhaps this or similar methods may be developed to be more effective in the future.

Hope for Advanced Prostate Cancer

Follow-up of diagnosed prostate cancer is important. Whether the decision is to use the "wait and see" approach or any of the above-mentioned treatment methods, the prostate cancer may advance so additional tests like the PSA test or treatments may be necessary. In addition, follow-up can monitor how changes in the patient's lifestyle (appropriate diet and exercise, for example) can lower the risk of death from prostate cancer.

Prostate Cancer: Coping With Erectile Dysfunction (ED)

Erectile dysfunction (ED or failure obtain or sustain an erection) is a very common side effect of most prostate cancer treatments. In some men, especially those under age 70, improved erectile function may occur within about 2 years after surgery. Additionally, the patient may benefit from various ED medications and therapies, including several types of devices specific for men with ED. Men with ED should discuss the various options with their doctor and partner to determine the best individual treatment method(s).

Cancer-Conscious Diet

As stated previously, a good diet and lifestyle may help lower the risk for prostate cancer; the same is true for those men diagnosed with prostate cancer in terms of cancer recurrence. Consequently, it is appropriate to review diet and lifestyle changes.

Diet Tips to Avoid Recurring Prostate Cancer

• Increase frequency and portion sizes of fruits and vegetables. A 2014 study of more than 40,000 Japanese men found that fiber (found in abundance in fruits and vegetables) may reduce the risk of prostate cancer.
• Eat whole grains and avoid processed grains and white flour. As with fruits and vegetables, whole grains provide more fiber than their processed counterparts. Adding more fiber may help reduce prostate cancer risk.
• Reduce or stop eating high-fat dairy products and meats, especially processed meats like bacon, sausage, and baloney. The World Health Organization found in 2015 that diets high in red meat were linked to an increased risk of prostate cancer. Consuming a lot of high-fat dairy products seems to slightly elevate prostate cancer risk as well.
• Some research suggests that spinach, orange juice, and other foods may decrease the risk of cancer; prostate cancer patients may get additional diet and lifestyle recommendations when they follow up with their doctors.

Prostate Cancer: Beware of Supplements

Prostate cancer patients and other cancer patients should be very cautious about taking supplements and other items marketed as cancer preventives or cures. Before taking any such compounds, the person should discuss the compound with their doctor. In addition, cancer patients are advised not to self-medicate or change medication dosages without first conferring with their doctor(s).

Additional Information on Prostate Cancer

For more information about Prostate Cancer, please consider the following:

• American Cancer Society
• National Cancer Institute
• Prostate Cancer Foundation
• Centers for Disease Control and Prevention

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Cancer

The Stages of Colon Cancer

By Jay B. Zatzkin, MD on 5/3/2016

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What Is Colorectal Cancer?

Colorectal cancer is the third most common non-skin cancer diagnosed in men and women in the U.S. It is also the second highest cause of cancer deaths. Still, colorectal cancer is highly curable when it is detected early enough. Colorectal cancer is a result of cancer cells that form in the lining of the colon (large intestine) or rectum.

How Colorectal Cancer Starts

Colorectal cancer often begins as a benign growth known as a polyp. Adenomas are a type of polyp and are benign tumors of the tissue lining the colon or rectum. Most polyps will stay benign, but some adenomas have the potential to turn into cancer over the long term. If they are removed early, this prevents them from turning in to cancer.

Risk Factors You Can't Control

Some risk factors for getting colorectal cancer are beyond your control. The following all increase the risk of getting colorectal cancer:

• Inflammatory bowel disease
• Colon polyps
• Age over 50
• Family history of colorectal cancer
• History of breast or ovarian cancer

Risk Factors You Can Control

However, there are other risk factors for colorectal cancer that you can control. The following risk factors can be modified:

• Eating a diet high in red or processed meat, or eating meat cooked at high temperatures
• Overweight or obesity
• Inadequate exercise
• Cigarette smoking
• Drinking alcohol

Warning Signs of Colorectal Cancer

Screening is important because colorectal cancer in its early stages usually doesn't produce any symptoms. Screening can detect the cancer before it produces symptoms, when it is most curable. After the disease begins to spread, it can produce blood in the stool, changes in bowel patterns (like diarrhea or constipation), abdominal pain, weight loss, or fatigue. Tumors that cause symptoms are typically larger and harder to treat.

Screening for Colorectal Cancer

It is recommended that most people have a screening colonoscopy every 10 years starting at age 50. A colonoscopy allows examination of the entire colon and rectum using a tiny camera. This test can find cancers in the early, most treatable stage and actually prevent cancers from developing by removing polyps, as shown here.

What Is a Virtual Colonoscopy?

An alternative to colonoscopy uses CT scan images to visualize the colon. This is known as a virtual colonoscopy. As with a conventional colonoscopy, the colon must be emptied as thoroughly as possible prior to the examination. In virtual colonoscopy, polyps or tumors are visualized without inserting the camera into the intestine. One disadvantage is that a virtual colonoscopy can only identify and not remove any polyps that are found. A real colonoscopy is needed to remove polyps that may be identified.

Colon X-Rays (Lower GI)

An X-ray of the colon, known as a lower GI series, can provide another way to image the colon and rectum. A chalky liquid known as barium is used as a contrast agent. This photo shows an example of an "apple core" tumor that narrows the colon. As with a virtual colonoscopy, a real colonoscopy or other surgical procedure would be needed to remove any tumors or polyps that may be found.

Colorectal Cancer Diagnosis

If there are abnormalities seen in your colon or rectum, a biopsy is done to determine whether cancer is present. This can be done during a colonoscopy. The tissue is examined microscopically to look for cancer cells. This picture shows a highly magnified view of colon cancer cells.

Colorectal Cancer Staging

Staging is the process of determining how far a tumor has spread beyond its original location. Staging may not be related to the size of the tumor. Treatment decisions also depend upon the stage of a tumor. Staging for colorectal cancer is as follows:

• Stage 0 – The cancer is found only in the innermost lining of the rectum or colon.
• Stage I – The cancer has not spread beyond the inner wall of the rectum or colon.
• Stage II – The cancer has spread into the muscle layer of the rectum or colon.
• Stage III – The cancer has spread to at least one lymph node in the area.
• Stage IV – The cancer has spread to distant sites in the body, such as the bones, liver, or lungs. This stage is NOT dependent on how far the tumor has penetrated or if the cancer has spread to lymph nodes near the tumor.

Survival Rates for Colorectal Cancer

Higher stages mean that a cancer is more serious and has a worse prognosis. Patients with stage I colorectal cancer have a 5-year survival rate of 74%, while that rate drops to 6% for Stage IV tumors.

Colorectal Cancer Surgery

Except for very advanced cases, colorectal cancer is usually treated by surgically removing the tumor and surrounding tissues. Surgery has a very high cure rate for early stage tumors. For advanced tumors that have spread outside the colon, surgery does not typically cure the condition, but removing larger tumors may reduce symptoms.

Advanced Colorectal Cancer Treatment

Colorectal cancer that has spread to the lymph nodes (stage III) can sometimes still be cured. In this case treatment usually consists of surgery and chemotherapy for colon cancer. In cases of rectal cancer, radiation therapy is added both prior to and following surgery in more advanced cases. Cancers that return after treatment or spread to other organs are harder to treat and more difficult to cure, but treatments may relieve symptoms and prolong life.

Coping With Chemotherapy

Modern chemotherapy drugs are less likely to cause nausea and other troubling side effects than older drugs, and medications are also available to help control these side effects. Clinical trials are always underway to develop better and more tolerable chemotherapy drugs.

Radiofrequency Ablation

Radiofrequency ablation (RFA) is a kind of cancer treatment that uses heat to destroy tumor tissue. CT scanning is used to guide insertion of a needle-like device into the tumor, through which intense heat is applied. RFA can be an option for destroying tumors that cannot be removed by surgery. In patients who have a few metastatic tumors in the liver that cannot be removed by surgery, chemotherapy is sometimes combined with RFA to destroy the tumors.

Colorectal Cancer Prevention: Diet

Eating a nutritious diet, getting enough exercise, and controlling body fat could prevent 45% of colorectal cancers, according to researchers. This means that adopting a healthy lifestyle can dramatically lower your risk of getting colorectal cancer. The National Cancer Institute recommends a diet low in fat with plenty of fiber and at least five servings of fruits and vegetables each day.

Preventing Cancer With Exercise

One study showed that people who got the most physical exercise were 24% less likely to get colorectal cancer than their least active counterparts. There was no difference if this activity was related to work or recreation. The American Cancer Society recommends at least 30 minutes of exercise a day for 5 or more days a week.

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Cancer

Spot the Early Warning Signs of Skin Cancer

By Charles Patrick Davis, MD, PhD on 8/8/2016

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Common Skin Cancer Symptoms and Causes

Sunlight contains ultraviolet light that is harmful to human skin cells. These energetic light waves can produce mutations in the DNA of skin cells, which in turn can lead to skin cancer. In areas close to the equator, the incidence of cutaneous cancers is dramatically higher due to the increase in sun exposure.

The most obvious skin cancer warning sign is the development of a persistent bump or spot in an area of sun-damaged skin. These spots are likely to bleed with minimal trauma and produce a superficial erosion.

Ultraviolet Light and Skin Cancer

Ultraviolet rays are classified by three types: UVA, UVB, and UVC. UVC is very dangerous, but it does not reach the earth's surface due to the ozone layer. Exposure to both UVA and UVB radiation poses potential skin cancer risks.

UVA Radiation

UVA light is the most abundant source of solar radiation. Scientists think it can penetrate the top layer of skin, potentially damaging connective tissue and causing skin cancer. An estimated 50% of UVA exposure occurs in the shade. Light skin is far more vulnerable to UVA radiation: while dark skin allows only 17.5% of UVA to penetrate, light skin allows 55% of UVA light to pass through.

UVB Radiation

Sunburns are mostly caused by UVB radiation. Because of the ozone layer, UVB light accounts for only about 5% of the light that reaches the earth's surface. UVB light can be filtered out by glass windows and does not penetrate as far into the skin as UVA, but it can still cause some forms of skin cancer. UVB is absorbed directly by DNA. Dark skin is twice as effective as light skin at protecting against UVB penetration.

How Skin Cancer Develops

UV light causes skin cancer by damaging the skin's cellular DNA. That damage is caused by free radicals, which are hyperactive molecules found in UV light. Free radicals cause damage to the DNA double helix, changing the way cells replicate and naturally die, which is how cancer develops. In addition to sun exposure, free radicals are also found in environmental pollutants, cigarette smoke, alcohol, and other toxins.

Skin Cancer: Actinic Keratosis (Solar Keratosis)

Actinic keratoses are scaling, horny, red, tender bumps present in sun-exposed areas. They are essentially very thin skin cancers that have not yet penetrated into deeper tissues. Large areas of skin thus exposed over years can result in what has recently been called a cancerization field defect. Continued exposure to ultraviolet light will likely induce invasive malignancies. Prevention and treatment of this condition which is most common in less-pigmented people is a significant part of medical skin care.

Skin Cancer: Actinic Cheilitis (Farmer's Lip)

Actinic cheilitis is simply actinic keratoses affecting the mucous membranes of the lips (vermillion border). This condition usually involves the lower lip simply because of the angle of incidence at which the overhead light waves hit the face. The forehead, cheeks, nose, and lower lip receive light waves perpendicularly and are not shaded by anatomical structures like the brows.

Skin Cancer: Cutaneous Horns

A cutaneous horn is a mass of dead skin cells. Essentially they have a lot in common with hair and nails since these are also composed of dead skin cells. The base which generates the horn can be an actinic keratosis, a squamous cell carcinoma, or a benign keratosis. The only way to differentiate between the three is by performing a surgical procedure called a biopsy and having it examined in a laboratory by a pathologist.

Identifying Cancerous Moles

The word "mole" is probably derived from a German word meaning spot. In the context of skin, a mole is a long-lasting skin spot that is a little darker than a freckle. Since there are a variety of benign and malignantskin growths which fulfill this description, more precision is necessary. The number of moles present on a particular person is most closely related to skin color and the extent of exposure to sunlight during childhood. The average number of moles is about 35 per person in Northern European populations.

Melanocytic Nevus

Moles that are melanocytic nevi (nevus singular) are local growths of melanocytes which can be present at birth or may develop after birth well into the third decade. They vary in color from black to flesh-colored. A melanocytic nevus can develop into melanoma, particularly if the nevus is large. The risk of a congenital melanocytic nevus developing into melanoma is greater for children under 10, which account for 70% of all cases.

Atypical Moles

When a physician examines a particular spot or mole it can appear either ordinary or peculiar. Most of these atypical nevi -- when examined under the microscope -- are not cancer; it seems to be the new lesions that develop in adulthood that are the ones that are most likely to be malignant melanomas.

The term dysplastic refers to changes noted in moles that can only be appreciated on microscopic examination. This term should only be used when describing the microscopic appearance of a nevus or other tissue. Most atypical nevi exhibit some degree of dysplasia under the microscope.

ABCDEs of Melanoma

In an attempt to systemize nevus description physicians use a variety of adjectives to describe visible alterations. To simplify things, benign lesions are almost always uniform in color, circular in shape, and exhibit bilateral symmetry about any axis drawn through its diameter. Malignant melanomas diverge from this appearance to a greater or lesser extent. To help one remember the criteria, they have been called the ABCDEs (mnemonic) of nevus description. Another valuable consideration is the so-called "ugly duckling" nevus which appears significantly different than all the other skin spots on the patient.

Melanoma Symptoms: 'A' Is for Asymmetry

Asymmetry refers to the degree of similarity when one compares the appearance of each of four quadrants produced by an imaginary cross through the middle of a melanocytic nevus.

Melanoma Symptoms: 'B' Is for Border

Border refers to degree of circular regularity of the edge of a pigmented lesion. Perfectly circular lesions are rarely malignant.

Melanoma Symptoms: 'C' Is for Color

Color: The degree of uniformity of color is a measure of atypicality. The more colors present the more likely the lesion is to be malignant.

Melanoma Symptoms: 'D' Is for Diameter

Diameter: Although malignant pigmented lesions tend to be larger than a pencil eraser this is one of the less reliable criteria for distinguishing melanomas.

Melanoma Symptoms: 'E' Is for Evolving

Evolving: Malignancies by their very nature tend to change over time -- mostly by increasing in size -- as opposed to benign lesions that are stable. Since cancers grow in an uncontrolled way they tend to produce asymmetrical lesions.

Screening for Cancerous Moles

If a mole looks or acts at all peculiarly it is best to have it evaluated by an expert. This frequently is a dermatologist. Most dermatologists can tell if the pigmented lesion is composed of melanocytes or is something quite different with no possibility of being a melanoma. Many dermatologists now use a hand-held magnifying device which produces polarized light to evaluate colored melanocytic tumors. The use of this instrument improves the doctor's ability to identify suspicious lesions.

Evaluating Potentially Cancerous Moles

The decision on which mole needs to be examined depends on the concern the doctor has that it may be cancerous. Since the procedure necessary to take off the suspicious bump is simple, requiring only local anesthesia and rarely is associated with complications, the threshold for this procedure is appropriately low. If the lesion is melanocytic in origin and it appears at all peculiar, exhibiting any of the features addressed in the ABCDE criteria and/or the patient complains that the bump bleeds or is irritated or itchy, that is often enough to trigger a biopsy.

Malignant Melanoma

Malignant melanoma is the most deadly form of skin cancer because it tends to spread at a very early stage to other parts of the body. The likelihood that it has spread is most directly related to the thickness of the melanoma as measured from its surface to its depth by a pathologist. This information is communicated to the doctor that submitted the nevus and subsequent treatment depends on this information.

Melanoma Symptoms

In addition to the ABCDEs of melanoma, there are other melanoma symptoms that may include:

• A sore that will not heal
• Pigment that spreads from the border of a spot into the surrounding skin
• Redness or swelling around a skin spot
• A spot that becomes itchy, tender, or painful
• Scaliness, bleeding, or oozing from the surface of a mole

How Melanoma Cancer Develops

Although it is possible for a previously benign mole to become malignant, most of the time a melanoma cancer begins as a single malignant cell in previously normal skin and then continues to grow in an uncontrolled manner.

Squamous Cell Carcinoma

Squamous cell carcinomas begin as malignancies of living epidermal cells which grow and invade into the deeper layers of the skin. They usually begin as an actinic keratosis and progress over many years. Although most actinic keratoses do not eventuate into squamous cell cancers, if one has a great many of them and they continue to receive sufficient ultraviolet irradiation producing sufficient mutational events, it is extremely likely that a squamous cell carcinoma will develop. They appear as thick, keratotic bumps on sun-exposed skin which continue to enlarge. They do not commonly spread to distant sites, but larger lesions can do this.

Bowen Disease: Is it Cancer?

So called "Bowen's disease" lesions are simply squamous cell carcinomas that have not as yet penetrated into the deeper layers of the skin. They involve the entire thickness of the most superficial living layer of the epidermis as opposed to actinic keratoses which involve the upper half of the epidermis. They seem to be a stage in the progression of an actinic keratosis to an invasive squamous cell carcinoma. As such it is cancer. Bowen disease is easily curable by cryotherapy, curettage with cautery and other methods.

Basal Cell Carcinoma

Basal cell carcinomas arise from the layer of skin cells present along the lowest layer of the epidermis and are the most common form of skin cancer. They are locally aggressive so they ought to be treated before they get so large that removal becomes difficult. The tumor has a shiny surface, is pearly white in color, and tends to bleed quite easily. It often ulcerates.

Who Is At Risk for Skin Cancer and Why?

Sunlight is by far the most common cause of skin cancer. Most of the exposure occurs during leisure time or sun tanning. The perceived benefits of exposure to sunlight seem to be confined mostly to the production of vitamin D in the skin and a belief that darker skin is more aesthetically appealing. Vitamin D requirements can be easily satisfied with dietary supplementation. Light-skinned individuals with blonde or red hair who live in regions near the equator are the most at risk to develop skin cancer.

Reduce Your Skin Cancer Risk

Beyond living a healthy lifestyle, it is important to avoid exposure to sunlight as much as is reasonably possible. Eating a balanced diet and staying physically active improves the body's ability to fight free radical damage and heal.

Protecting Your Skin

Any time there has been a darkening of the skin after sun exposure it is a sign that some damage has been sustained. Since the incubation period for skin cancers and photo-aging is quite long (5 to 15 years), it may be difficult to convince sun worshipers to head indoors.

Avoiding UV Damage

The use of clothing, searching for shade, and the application of effective, broad-spectrum sunscreens are all useful behaviors in limiting sun damage.

Seeking Shade to Avoid Skin Cancer

Shade is the first defense against skin damage. Between the hours of 10 a.m. and 4 p.m., when the sun's rays are at their most intense, find cover or wear a wide-brimmed hat. The Skin Cancer Foundation recommends hats with broad brims all around that are at least three inches wide.

Although shade is an important protection against skin cancer, it may still leave you vulnerable to UVB light, which can reach skin indirectly. UV radiation can bounce off of clouds, dry sand, concrete and other UV-reflective surfaces.

Choosing the Right Sunscreen

Sunscreens that are reasonably durable are currently available that block all the wavelengths of ultraviolet light with an SPF (Sun Protection Factor) of 50. It can help to look for the words “broad spectrum” or “multi spectrum” when choosing a sunscreen. This indicates that both UVA light and UVB light are being blocked by your sunscreen. Keep in mind that these phrases don't actually indicated how much of each ray is being blocked. Also, consider using an FDA approved “Water Resistant (40 or 80 min.)” sunscreen if you sweat or swim in sunlight.

Additional Information on Skin Cancer

For more information about Skin Cancer, please consider the following:

• The Skin Cancer Foundation
• American Cancer Society
• American Academy of Dermatology
• Melanoma Research Foundation

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Cancer

Breast Cancer Diagnosis and Treatment

By Melissa Conrad Stöppler, MD on 7/12/2016

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Breast Cancer Awareness

The outlook for women with breast cancer is improving constantly. Due to increased awareness, opportunities for early detection, and treatment advances, survival rates continue to climb. In the U.S., October is Breast Cancer Awareness Month and the campaign is designed to increase breast cancer awareness. There are many organizations that support Breast Cancer Awareness Month and provide assistance within early detection plans. Organizations also put together breast cancer fundraisers such as walks and events that support breast cancer research and help fund patients with socio-economic disadvantages.

Breast Cancer Symptoms

Breast cancer may or may not cause symptoms. Some women may discover the problem themselves, while others may have the abnormality first detected on a screening exam. Common breast cancer symptomsinclude the following:

• Non-painful lumps or masses
• Lumps or swelling under the arms
• Nipple skin changes or discharge
• Noticeable flattening or indentation of the breast
• Change in the nipple
• Unusual discharge from the nipple
• Changes in the feel, size, or shape of the breast tissue

Types of Breast Cancer

Inflammatory Breast Cancer

Inflammatory breast cancer is a rare type of cancer that often does not cause a breast lump or mass. As seen in this photo, it often causes thickening and pitting of the skin, like an orange peel. The affected breast may also be larger or firmer, tender, or itchy. A skin rash or reddening of the skin is common. These changes are caused by cancer cells blocking lymph vessels in the skin. Inflammatory cancer of the breast typically has a fast growth rate.

Invasive Ductal Carcinoma

Invasive (or infiltrating) ductal carcinoma (IDC) is the most common type of breast cancer. About 80% of all breast cancers are invasive ductal carcinomas. Invasive ductal carcinoma refers to cancer that has broken through the wall of the milk ducts and has invaded the breast tissues. Invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body.

Ductal Carcinoma in Situ (DCIS)

Ductal carcinoma in situ (DCIS) is considered to be a non-invasive or pre-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that starts in the skin or other tissue (including breast tissue) that line or cover the internal organs, and in situ means “in its original place.” The difference between DCIS and invasive cancer is that in DCIS, the cells have not spread through the walls of the milk ducts into the surrounding breast tissue.. DCIS is considered a ‘pre-cancer’, but some cases can transform into more invasive cancers.

Invasive Lobular Carcinoma

Invasive (or infiltrating) lobular carcinoma (ILC) is the second most common type of breast cancer after invasive ductal carcinoma. Lobular means that the cancer started in the milk-producing lobules, which empty out into the ducts that carry milk to the nipple. Invasive lobular carcinoma refers to cancer that has broken through the wall of the lobule and begun to invade the breast tissues. Invasive lobular carcinoma can spread to the lymph nodes and possibly to other areas of the body.

Mucinous Carcinoma

Mucinous (or colloid) carcinoma of the breast is a rare form of invasive ductal carcinoma. In this type of cancer, the tumor is composed of abnormal cells that “float” in pools of mucin, part of the slimy, slippery substance known as mucus. Mucus lines most of the inner surface of our bodies, such as our digestive tract, lungs, liver, and other vital organs. Breast cancer cells can produce some mucus. In mucinous carcinoma, mucin becomes part of the tumor and surrounds the breast cancer cells.

“Pure” mucinous carcinomas make up only 2-3% of invasive breast cancers. Approximately 5% of invasive breast cancer tumors have a mix of mucinous components in addition to other types of breast cancer cells.

Triple-Negative Breast Cancers

Testing negative for estrogen receptors (ER-), progesterone receptors (PR-), and HER2 (HER2-) on a pathology report means the cancer is “triple-negative”. These negative results indicate the growth of the cancer is not supported by the hormones estrogen and progesterone, nor by the presence of too many HER2 receptors. Therefore, triple-negative breast cancer does not respond to hormonal therapy (such as tamoxifen or aromatase inhibitors) or therapies that target HER2 receptors, such as Herceptin. However, other medicines can be used to treat triple-negative breast cancer.

Paget’s Disease of the Nipple

Paget's disease of the nipple is a rare form of breast cancer in which cancer cells collect in or around the nipple. The cancer usually affects the ducts of the nipple first then spreads to the nipple surface and the areola. A scaly, red, itchy, and irritated nipple and areola are signs of Paget’s disease of the nipple. One theory for the cause of Paget’s disease is that the cancer cells start growing inside the milk ducts within the breast and then break through to the nipple surface. Another possibility is that the cells of the nipple itself become cancerous.

Causes of Breast Cancer

Certain genes control the life cycle—the growth, function, division, and death—of a cell. When these genes are damaged, the balance between normal cell growth and death is lost. Normal breast cells become cancerous because of changes in DNA structure. Breast cancer is caused by cellular DNA damage that leads to out-of-control cell growth.

Causes of Breast Cancer: Genetics & Mutations

Inherited genes can increase the likelihood of breast cancer. For example, mutations of genes BRCA1 and BRCA2 (linked to an increased risk of breast and ovarian cancers) can inhibit the body’s ability to safe-guard and repair DNA. Copies of these mutated genes can be passed on genetically to future generations, leading to a genetically-inherited increased risk of cancer.

Causes of Breast Cancer: Environment

Breast cancer may be caused by environmental exposure. Sunlight can cause DNA damage that leads to breast cancer through ultraviolet radiation. So can air pollutants like soot, wood dust, asbestos, and arsenic, to name just a few.

Causes of Breast Cancer: Lifestyle

Lifestyle choices can lead to breast cancer as well. Eating a poor diet, inactivity, obesity, heavy alcohol use, tobacco use including smoking, and exposure to chemicals and toxins are all associated with a greater breast cancer risk.

Causes of Breast Cancer: Medical Treatment

Medical treatment with chemotherapy, radiation, or immunosuppressive drugs used to decrease the spread of cancer throughout the body can also cause damage to healthy cells. Some “second cancers”, completely separate from the initial cancer, have been known to occur following aggressive cancer treatments.

Mammograms and Breast Cancer Prevention

Early detection of breast cancer is the key to survival. Mammograms are X-rays of the breast that can detect tumors at a very early stage, before they would be felt or noticed otherwise. During a mammogram, your breasts are compressed between two firm surfaces to spread out the breast tissue. Then an X-ray captures black-and-white images of your breasts that are displayed on a computer screen and examined by a doctor who looks for signs of cancer. Women at average risk have are recommended to have a mammogram every year starting at age 45. Starting at age 54, women are recommended to have a screening mammogram every 2 years as long as they remain healthy.

3D mammograms, or breast tomosynthesis, is a breast imaging procedure that also uses X-rays to produce images of breast tissue in order to detect abnormalities.

Breast Cancer Prevention: Breast MRI and Ultrasound

Breast MRI

MRI (magnetic resonance imaging) is a technology that uses magnets and radio waves to create detailed, 3D images of the breast tissue. Before the test you may be injected through an intravenous line, in the arm, with a contrast solution (dye). The contrast solution will allow potential cancerous breast tissue to show more clearly. Radiologists are able to see areas that could be cancerous because the contrast tends to be more concentrated in areas of cancer growth.

During a breast MRI the breasts are exposed as the patient lies flat on a padded platform with cushioned openings for the breasts. A breast coil surrounds each opening and works with the MRI unit to create the images. MRI imaging is a painless diagnostic tool. The test takes between 30 and 45 minutes.

Ultrasound

Sometimes a breast ultrasound is ordered in addition to a mammogram. An ultrasound can demonstrate fluid-filled cysts that are not cancerous. Ultrasounds may also be recommended for routine screening tests in some women at a higher risk of developing breast cancer. During a breast ultrasound a small amount of water-soluble gel is applied to the skin over the area to be examined. Then, a probe is gently applied against the skin. You may be asked to hold your breath, briefly several times. The breast ultrasound takes about 10 minutes to complete.

Breast Cancer Prevention: Breast Self-Exams

Experts recommend that women be aware of their breasts and notice any changes, rather than performing checks on a regular schedule. Women who choose to do self-exams should be sure to discuss the technique with their doctor.

What is a Breast Self-Exam?

A breast self-exam is a way to check your breasts for changes such as lumps or thickenings. Early breast cancer detection can improve your chances of surviving the disease. Any unusual changes discovered during the breast self-exam should be reported to your doctor.

Lump in Breast: Could it be Cancer?

Remember that the majority (about 80%) of breast lumps are not due to cancer. Cysts, benign tumors, or changes in consistency due to the menstrual cycle can all cause benign breast lumps. Still, it's important to let your doctor know about any lumps or changes in your breast that you find.

Breast Cancer Biopsy

A biopsy is the most certain way to determine whether a breast lump is cancerous. Biopsies may be taken through a needle or through a minor surgical procedure. The results can also determine the type of breast cancer that is present in many cases (there are several different types of breast cancers). Treatments are tailored to the specific type of breast cancer that is present.

Needle Biopsies

A needle biopsy uses a hollow needle to remove tissue or cell samples from the breast. A pathologist studies the samples under a microscope to see if they contain cancer. There are two types of needle biopsies: core need biopsy and fine needle aspiration (fine needle biopsy).

1. Core Needle Biopsy
   If a lump can be felt in the breast (palpable mass), a core needle biopsy may be performed. The doctor will use a small amount of local anesthetic to numb the skin and the breast tissue around the area. The doctor will insert the needle and remove a small amount of tissue to be examined.
2. Ultrasound-Guided Core Needle Biopsy
   This is one type of biopsy for lumps or abnormalities that cannot be felt (nonpalpable mass). A core needle is placed into the breast tissue and ultrasound helps confirm the exact location of the potential cancer so the needle is placed correctly. Tissue samples are then taken through the needle. Ultrasound can see the difference between cysts and solid lesions.
3. MRI-Guided Core Needle Biopsy
   For this test, you will be given a contrast agent through an IV. Your breast will be numbed and compressed and several MRI images will be taken. The MRI images will guide the doctor to the suspicious area. A needle will be used in the biopsy device to remove tissue samples with a vacuum assisted probe.
4. Stereotactic Biopsy
   If the lump is nonpalpable you could be also given a stereotactic biopsy. Using a local anesthetic, the radiologist makes a small opening in the skin. A needle is placed into the breast tissue, and imaging studies help confirm the exact placement. Tissue samples are taken through the needle.

Surgical Biopsies

A surgeon makes a cut (incision) in the breast to remove tissue.

1. Open Excisional Biopsy
   This surgery removes an entire lump and the issue is examined under a microscope. If a section of normal breast tissue is taken all the way around a lump, it is called a lumpectomy. In this procedure, a wire is put through a needle into the area to be biopsied. The X-ray helps to make sure it is in the right location and a small hook at the end of the wire keeps it in position. The surgeon uses the wire as a guide to locate the suspicious tissue.
2. Incisional Biopsy
   An incisional biopsy is very similar to an excisional biopsy, but less tissue is removed. Local anesthetic will be used and you will also get IV sedation. An incisional biopsy removes part of the tumor, which means that more surgery may be needed to remove the remaining cancer.

Biopsy Results: Hormone-Sensitive Breast Cancer

A biopsy can tell whether the breast cancer has receptors for estrogen (ER-positive) and/or progesterone (PR-positive), indicating which hormone stimulates tumor growth. About two-thirds of breast cancers are hormone receptor-positive. Medications can be given that act to help prevent growth of the tumor from stimulation by these hormones.

ER-positive breast cancer is sensitive to estrogen, whereas PR-positive breast cancer is sensitive to progesterone. Both ER-positive and PR-positive breast cancers may respond to hormone therapy. Hormone receptor (HR) negative is a type of cancer that does not have hormone receptors and will not be affects by hormone blocking treatments.

Biopsy Results: HER2-Positive Breast Cancer

HER-2 (human epidermal growth factor receptor 2) is a protein that is expressed at a high level by about 20% of breast cancers. Having this receptor means the cancer tends to grow and spread faster than other forms of breast cancer. There are special targeted treatments available for this type of tumor.

Treatments specifically for HER2-positve breast cancer include:

• Herceptin (trastuzumab)
• Kadcyla (ado-trastuzumab emtansine)
• Perjeta (pertuzumab)
• Tykerb (lapatinib)

Breast Cancer Stages

Breast cancer stages are classified according to cancer tumor size, location, and extent of spread. Staging helps doctors determine the prognosis and treatment for cancer. The TNM staging system classifies breast cancers according to:

• Tumor (T): Primary tumor size and/or extent
• Nodes (N): Spread of cancer to lymph nodes in the regional area of the primary tumor
• Metastasis (M): Spread of cancer to distant sites away from the primary tumor

TNM Breast Cancer Classification

The TNM classification of a cancer usually correlates to one of the following five stages:

• Stage 0 Breast Cancer (Tis, N0, M0): This refers to cancer that is "in situ," meaning that cancerous cells are confined to the breast. This type of breast cancer has not spread and is not invading other tissues.


• Stage I Breast Cancer: Stage I invasive breast cancer is broken up into subcategories known as IA and IB.


• Stage IA breast cancer (T1, N0, M0) refers to the tumor measuring up to 2 centimeters and no cancer has spread outside the breast.


• Stage IB breast cancer (T0 or T1, N1mi, M0) includes no tumor in the breast, but small groups of cancer cells in the lymph nodes. Stage IB could also be a tumor in the breast that is no larger than 2 centimeters and small groups of cancer cells in the lymph nodes.

Stage II Breast Cancer

Stage II invasive breast cancer is broken up into two subcategories known as IIA and IIB.

• Stage IIA breast cancer (T0 or T1 or T2, N0 or N1, M0) includes no tumor in the breast, but cancer (larger than 2 millimeters) in 1 to 3 axillary lymph nodes or lymph nodes near the breast bone. Stage IIA can also include a tumor measuring 2 centimeters or smaller and cancer has spread to the axillary lymph nodes or a tumor 2-5 centimeters that has not spread to the axillary lymph nodes.


• Stage IIB breast cancer (T2 or T3, N0 or N1, M0) refers to a tumor 2-5 centimeters and small groups (0.2-2.0 millimeters) of breast cancer cells in the lymph nodes or a tumor 2-5 centimeters with cancer in 1 to 3 axillary lymph nodes or lymph nodes near the breastbone. Stage IIB breast cancer can also include a tumor larger than 5 centimeters with no affected lymph nodes.

Stage III Breast Cancer

Stage III invasive breast cancer is broken up into subcategories IIIA, IIIB, and IIIC.

• Stage IIIA (T0 to T3, N1 or N2, M0) refers to the tumor ranging from nonexistent to any size and cancer is found in 4 to 9 axillary lymph nodes or in lymph nodes near the breastbone. Stage IIIA can also include a tumor larger than 5 centimeters with small groups of breast cancer cells (0.2 to 2 millimeters) in the lymph nodes or a tumor larger than 5 centimeters with cancer in 1 to 3 axillary lymph nodes or lymph nodes near the breastbone.


• Stage IIIB (T4, N0 to N2, M0) refers to a tumor of any size and has spread to the chest wall and/or skin of the breast in addition to cancer that has spread to up to 9 axillary lymph nodes or lymph nodes near the breastbone.


• Stage IIIC (any T, N3, M0) refers to a tumor of any size and possible spreading to the chest wall and/or the skin of the breast as well as the cancer in 10 or more axillary lymph nodes or spread to lymph nodes above or below the collarbone or near the breastbone.


• Stage IV Breast Cancer (any T, any N, M1): Stage IV breast cancer refers to breast cancer that has spread to other organs such as the lungs, distant lymph nodes, skin, bones, liver, or brain.

Breast Cancer Survival Rates

Breast cancer survival depends upon a number of factors. Cancers that are found early are often localized to the breast. Statistics on the survival rate of breast cancer are often given as 5-year survival rates. The 5-year survival rate is the percentage of people who live at least 5 years after being diagnosed with breast cancer. According to the American Cancer Society, women with early stage (stage 1) breast cancer have a 5-year survival rate of 100%. Women with breast cancer that has spread to distant sites in the body (stage 4) have only a 20% chance of surviving 5 years; but this rate can improve as treatment advances are made.

Breast Cancer Treatments: Surgery

Breast-conserving surgery removes the cancer and some healthy tissue around it, but not the breast. Some lymph nodes under the arms may be removed for biopsy. If the cancer is near the chest wall, part of it may be removed. Breast-conserving surgery is also known as breast-sparing surgery, lumpectomy, partial mastectomy, quadrantectomy, and segmental mastectomy.

Mastectomy

Mastectomy is the removal of the entire breast and all the surrounding tissue and possibly nearby tissues. There are different mastectomy surgeries available, depending on how much additional tissue is removed. The following are different types of mastectomies:

• Simple mastectomy includes removal of the entire breast, but does not remove lymph nodes or muscle tissue.
• Double mastectomy is when both breasts are removed.
• Skin-sparing mastectomy includes keeping the skin over the breast intact. Breast reconstruction surgery is typically planned immediately after the mastectomy.
• Nipple-sparing mastectomy keeps the breast skin and nipple intact and breast reconstruction surgery immediately follows.
• Modified radical mastectomy combines a simple mastectomy with the removal of the lymph nodes under the arm
• Radical mastectomy includes the removal of the entire breast, lymph nodes, and the pectoral muscles under the breast.

Breast Cancer Treatments: Radiation Therapy

High-energy beams of localized radiation are used to kill targeted cancer cells. Radiation therapy can be used after breast cancer surgery, or it may be used in addition to chemotherapy for widespread cancer. This treatment does have side effects, which can include swelling of the area, tiredness, or a sunburn-like effect. There are two ways to administer radiation therapy.

External Beam Radiation

A beam of radiation is focused onto the affected area by an external machine. The treatment is usually given five days a week for five to six weeks.

Brachytherapy

This form of radiation involves radioactive seeds or pellets that are implanted into the breast next to the cancer.

Breast Cancer Treatments: Chemotherapy

Chemotherapy drugs are given to kill cancer cells that are located anywhere in the body. It can be administered by a slow IV infusion, by pill, or by a brief IV injection, depending upon the drug. Sometimes chemotherapy is given after surgery to help prevent the cancer from recurring (adjuvant therapy). Side effects of chemotherapy can include an increased risk of infection, nausea, fatigue, and hair loss.

Chemotherapy drugs are given to kill cancer cells that are located anywhere in the body. It can be administered by a slow IV infusion, by pill, or by a brief IV injection, depending upon the drug. Sometimes chemotherapy is given after surgery to help prevent the cancer from recurring. Usually, chemotherapy drugs are given in cycles with certain treatment intervals followed by a period of rest. The cycle length and rest intervals differ from drug to drug.

Adjuvant Chemotherapy

If all visible cancer has been removed, there is still the possibility that cancer cells have broken off or are left behind. Adjunct chemotherapy is given to assure that these small amounts of cells are killed. Since some women have a very low risk of recurrence even without chemotherapy, it is not given in all cases.

Neoadjuvant Chemotherapy

Neoadjuvant chemotherapy is given before surgery. There is no correlation between neoadjuvant chemotherapy and long-term survival, but there are advantages to see if the cancer responds to the chemotherapy before surgical removal. This can also reduce the size of the cancer and allow for a less extensive surgery in some patients.

Chemotherapy for Advanced Breast Cancer

Chemotherapy can be used if the cancer has metastasized to distant sites in the body. In this case, doctors will determine the most appropriate treatment.

Chemotherapy Side Effects

Different drugs cause different side effects. Certain types of chemotherapy have specific side effects, but each patient's experience is different. The following are common side effects of chemotherapy:

• Fatigue
• Pain (headaches, muscle pain, stomach pain, and pain from nerve damage)
• Mouth and throat sores
• Diarrhea
• Nausea and vomiting
• Constipation
• Blood disorders
• Changes in thinking and memory
• Sexual and reproductive issues
• Appetite loss
• Hair loss
• Permanent damage to the heart, lung, liver, kidneys, or reproductive system

Breast Cancer - Hormone Therapy

Some breast cancer cells are activated by female hormones estrogen and/or progesterone (ER- and PR-positive breast cancers). Hormone therapy can stop or slow the growth of hormone receptor-positive tumors by blocking the cancer cells from receiving the hormones they need to grow. Hormone therapy is usually given after surgery, but it can also be given to reduce the chance of developing breast cancer in women at high risk.

Targeted Drug Therapies for Breast Cancer

Targeted therapies are newer treatments for breast cancer patients. They utilize specific proteins within cancer cells, like the HER-2 protein. Targeted therapies can stop the HER-2 protein from stimulating tumor growth in cancer cells that have this protein. Targeted therapies have fewer side effects than traditional chemotherapy because they only target cancer cells. They are often used in combination with chemotherapy.

Breast Cancer Recovery

Breast cancer treatment can be both physically and emotionally exhausting. There are many changes taking place that may be difficult to cope with. “Chemobrain” is a term coined to describe the mental changes caused by chemotherapy treatment. Patients have experienced memory deficits and the inability to focus. Breast cancer treatments can also leave patients fatigued, which is normal.

It can be difficult to keep up with activities of daily life, and make patients feel isolated or overwhelmed. Friends and family can be invaluable sources of support and assistance during this time. Some people choose to join a local or an online support group to share their experiences and spread breast cancer awareness.

Breast Reconstructive Surgery

Many women opt to have reconstructive surgery after breast cancer surgery. Reconstructive procedures use implants or tissues obtained from other locations in the body. These procedures can be done at the time of mastectomy, or they may be performed months or even years later.

Implants

A tissue expander will be inserted un the skin, for a few weeks, to stretch the skin and allow a silicone-gel or saline implant to be inserted. Each week preceding the implant insertion, the tissue expander is filled to a desired volume until the patient is satisfied with their new breast size.

Tissue Flap Procedure

A women's own tissue is taken from the abdomen or back to create a mound to reconstruct the breast. The tissue is sometimes kept attached to its original blood supply or it is disconnected and reconnected to a blood supply near the new location. Some patients also have nipple reconstruction, which is created using tissue from the back or abdomen flap. The nipple is then tattooed in order to resemble the color of a nipple. A prosthetic nipple is also an option and can be created by making a copy of your natural nipple.

Alternative to Reconstructive Surgery: Prosthesis

A prosthesis, or breast form, is an alternative to reconstructive surgery. A prosthesis offers the appearance of breasts without surgery. This is a device that is worn inside a bra or bathing suit to permit a balanced appearance when clothed. Breast prostheses come in many shapes, sizes, and materials (silicone gel, foam, or fiberfill interior). Breast prosthetic devices are often covered by insurance plans.

Is Breast Cancer Genetic?

Breast cancer occurs in both men and women, but it is about 100 times more likely to affect women than men. Women over age 55 and those with a close relative who have had the condition are at greatest risk for developing breast cancer. Still, up to 80% of women who do get breast cancer do not have a relative with the disease. Certain inherited genetic mutations dramatically increase a women's risk of breast cancer. The most common of these are genes known as BRCA1 and BRCA2. Women who inherit mutations in these genes have up to an 80% chance of developing breast cancer.

The Breast Cancer (BRCA) Gene Test

Several tests are available to look for the Breast Cancer (BRCA) gene. A blood test can be given to analyze DNA mutations in BRCA1 and BRCA2. Women who have inherited mutations have a much higher risk of developing breast cancer. The BRCA test is typically only offered to people who may have inherited the mutation. You may be a candidate for the BRCA gene test if you have the following:

• Personal history of breast cancer
• Personal history of ovarian cancer
• Family history of breast cancer in parents, siblings, and/or children
• A male relative with breast cancer
• A family member with both breast and ovarian cancers
• A family member with bilateral breast cancer
• Two or more relatives with ovarian cancer
• A relative with known BRCA1 or BRCA2 mutation
• Ashkenazi Jewish ancestry with a close relative with breast or ovarian cancer
• Ashkenazi Jewish ancestry and a personal history of ovarian cancer

Breast Cancer Prevention

Factors that can raise the risk of getting breast cancer include not getting enough exercise, drinking more than one alcoholic drink per day, and being overweight. Breast cancer prevention also includes avoiding exposure to carcinogens, chemicals, and radiation from medical imaging. Some kinds of hormone therapy and birth control pills can also elevate risk, but the risk returns to normal after stopping these medications. Some studies have shown that regular physical activity may help lower the risk of recurrence in women who have survived breast cancer.

Preventative surgery (prophylactic mastectomy) may also prevent breast cancer. Bilateral prophylactic mastectomy is the removal of both breasts in order to prevent breast cancer. Women with a strong family history of BRCA1 or BRCA2 mutations may choose to have bilateral prophylactic mastectomy in order to lower their risk of developing breast cancer.

Breast Cancer Research

Doctors continue to search for more effective and tolerable treatments for breast cancer. The funding for this research comes from many sources, including advocacy groups throughout the country. Many of the 2.5 million breast cancer survivors and their families choose to participate in walk-a-thons and other fundraising events. This links each individual fight against cancer into a common effort for progress.

Additional Information on Breast Cancer

For more information about Breast Cancer, please consider the following:

• American Cancer Society
• National Breast Cancer Foundation, Inc.
• BreastCancer.org
• Susan G. Komen
• National Cancer Institute

WebMD does not provide medical advice, diagnosis or treatment. See additional information

© 2005-2018 WebMD, LLC. All rights reserved.

Cancer

Cervical Cancer and HPV

By Melissa Conrad Stöppler, MD on 8/15/2016

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What Is Cervical Cancer?

The cervix is the lower part of the uterus, where it extends into the vagina. Cancer of the uterine cervix affects over 12,000 women each year in the U.S. Most cases of cervical cancer are actually caused by an infectious agent, the human papillomavirus (HPV). It is highly curable when detected early enough.

Cervical Cancer Symptoms

At the very early stages of cervical cancer, there are usually no symptoms or signs. As the cancer grows, symptoms can include abnormal vaginal bleeding. Abnormal vaginal bleeding is bleeding that occurs between periods, during sex, or after menopause. Pain during sex and vaginal discharge are other possible symptoms.

HPV: Top Cause of Cervical Cancer

The Human Papilloma Viruses (HPVs) are a large group of viruses, about 40 of which can infect the human genital tract. Some HPVs are known to cause cervical cancers, while others cause genital warts.

HPV and Cervical Cancer Fast Facts

• Most genital HPV infections go away on their own.
• When they become chronic, genital HPV infections can cause precancerousand cancerous changes in the cells that line the uterine cervix.
• Over 90% of cervical cancers are caused by HPV infection.

HPV Symptoms

The types of HPVs that cause genital warts are different from those that cause cervical cancer. Genital warts are not precancerous lesions and will not develop into cervical cancer. The “high-risk” or potentially cancer causing types of HPV can stay in the body for years without causing symptoms. Most infections, however, go away on their own and do not cause cellular changes.

How Do You Get HPV?

HPV infection is extremely common. In fact, most men and women who have ever had sex will contract the infection at some point in life. In some people, the infection persists for years, even if they are not sexually active. Condoms may lower the risk of acquiring the infection, but they are not 100% effective.

Other Places Where HPV Causes Cancer

• Penis
• Anal area
• Vulva
• Vagina
• Oral cavity

How HPV Causes Cervical Cancer

High-risk HPVs lead to cancer because they produce changes in the cells of the cervix. These are initially precancerous changes that can be recognized with screening tests. With time, the precancerous cells can develop into cancer cells. After cancer has developed it spreads within the cervix and eventually to surrounding and finally to distant areas.

Other Risk Factors for Cervical Cancer

Women of Hispanic or African American ethnicity have a higher risk of cervical cancer than Caucasian women.

Factors That Increase Cervical Cancer Risk

• Smoking
• Long-term use of oral contraceptive pills
• Having many children
• Having HIV or a weakened immune system
• Having had multiple sexual partners

Pap Test for Finding Cervical Cancer Early

The Pap test has been a success in preventing many cases of cervical cancer because it is able to detect abnormal cells often before they turn into cancer cells. A swab is taken of the cervix that is then examined for abnormal cells.

Women should have a Pap test every 3 years starting at age 21. From age 30 to 65, women can go up to 5 years between Pap tests if they get both a Pap and HPV test. If you are at higher risk, you may need more frequent testing. Skipping tests increases the risk of cervical cancer. Even if you have received the HPV vaccine, you still need Pap tests, because the vaccine does not protect against all the types of HPV that can cause cancer.

What If Your Pap Test Results Are Abnormal?

If there are minor changes seen on the cells in a Pap smear, the doctor may order a repeat test. He or she may also suggest a colposcopy, an examination that looks at the cervix through a magnifying device, or a biopsy of the cervix. Abnormal cells can be destroyed before they turn into cancer cells, and this type of treatment is highly effective in preventing cervical cancer.

The Bethesda System and Squamous Cells

Pathologists who study Pap test cells use a set of terms known as the Bethesda System to classify the results of the test. Abnormal cells are typically divided into seven categories.

The Seven Cell Categories of the Bethesda System

1. Atypical Squamous Cells (ASC) -- This is the most common group of abnormal cells. ASCs don't appear normal, but whether they are precancerous or not is unknown. These are further divided into ASC-US and ASC-H, where ASC-H is considered more likely to be precancerous.


2. Low-Grade Squamous Intraepithelial Lesions (LSILs) -- These cells have mild abnormalities due to HPV infection.


3. High-Grade Squamous Intraepithelial Lesions (HSILs) -- HSILs are more likely than LSILs to progress to cancer if they remain untreated. Compared to LSILs, the sizes and shapes of HSILs are more dramatically altered from normal cells.


4. Squamous Cell Carcinoma -- This is cancer, meaning the abnormal cells have crept more deeply into the cervix. This type of finding during a Pap test is very unusual in a place with extensive cancer screenings such as the United States.


5. Atypical Glandular Cells (AGC) -- These are glandular cells of an uncertain type.


6. Endocervical Adenocarcinoma in Situ (AIS) -- These cells are considered severely abnormal, yet they have not spread past the cervix's gland tissue.


7. Adenocarcinoma -- this is cancer, and may refer to cervical cancer, but also cancers of the uterus, uterine lining, and elsewhere.

HPV DNA Test for Finding Cervical Cancer Early

Testing for the genetic material (DNA) of the HPV viruses is a diagnostic test that can be done in addition to the Pap test. This test identifies the high-risk forms of HPV that are associated with cancer. The test may also be used in women who have had abnormal Pap test results.

Biopsy for Cervical Cancer Diagnosis

A biopsy is the removal of a small piece of tissue for examination in the laboratory. The examination can identify the presence of precancerous changes or cancer cells. Most biopsies can be done in the doctor's office.

Cone Biopsy

A cone biopsy is a larger biopsy that removes the area around the cervical opening. It can also show the spread of abnormal cells beneath the surface of the cervix.

Cervical Cancer Stages

The stage of cervical cancer refers to the extent to which it has spread.

What Cervical Cancer Stages Mean

• Stage 0 -- Stage 0 means that the cancer cells are found on the surface of the cervix
• Stage I -- Stage I means the cancer is localized to the cervix.
• Stage II -- Spread to the upper part of the vagina signals a stage II cancer.
• Stage III -- Stage III tumors extent to the lower vagina
• Stage IV -- In stage IV, the tumor has spread to the bladder or rectum, or to distant sites in the body.

Cervical Cancer Treatment: Surgery

For cancers up to stage II, surgery is usually done to remove the areas of cancer. This generally means that the uterus is removed (hysterectomy) along with the surrounding tissue. The ovaries, Fallopian tubes, and lymph nodes in the area may also be removed.

Cervical Cancer Treatment: Radiation

External radiation therapy can be used to destroy cancer cells that may remain after surgery. Internal radiation (brachytherapy) involves placement of radioactive material inside the tumor itself to destroy cancer cells. Radiation therapy is often used together with chemotherapy to treat women with all but the earliest cases of cervical cancer.

Side Effects of Radiation Therapy

• Nausea
• Vomiting
• Tiredness
• Low blood cell counts

Cervical Cancer Treatment: Chemotherapy

Chemotherapy may be the main treatment if cervical cancer has spread to distant sites in the body. Chemotherapy is the use of toxic drugs to kill cancer cells.

Chemotherapy Side Effects

• Fatigue
• Hair loss
• Loss of appetite
• Nausea
• Vomiting
• Easy bruising

Coping With Cervical Cancer Treatments

Although cancer treatments can make you lose your appetite, it's important to maintain good nutrition and keep up a healthy weight. Being active is also helpful since exercise can increase your energy levels and reduce stress. Your doctor can help you decide what kind of activity is best for you.

Fertility After Cervical Cancer Surgery?

Since treatment for cervical cancer can involve removing the uterus and ovaries, future pregnancy may not be possible. However, if the cancer is caught early, there may be an option for future pregnancy with a treatment known as a radical trachelectomy. In this procedure, the cervix and part of the vagina are removed, but the majority of the uterus is left intact.

Cervical Cancer Survival Rates

Surviving cervical cancer depends upon the stage, or extent of spread, at the time it is found. Based upon women diagnosed between 2000 and 2002, 5-year survival rates ranged from 93% for cancers detected early to 15% for cancers that were widespread. But treatments and outlook are constantly improving, and these odds may be better today. And no statistics can predict exactly how one person will respond to treatment.

Cervical Cancer Vaccine

Vaccines are available to prevent infection with the types of HPV most likely to cause cancers.

Popular Cervical Cancer Vaccines

• Cervarix requires three shots over a six-month time period.
• Gardasil also requires three shots over a six-month time period. Gardasil also protects against the two types of HPV that most commonly cause genital warts.

Newer forms of these vaccines are in development.

Who Should Get the HPV Vaccine?

The vaccines do not treat existing HPV infection, but they may prevent it. For best results, they should be given before the individual becomes sexually active.

Girls and Young Women

The CDC recommends giving girls the three-vaccine series at age 11 or 12. Girls and women aged 13 to 26 can receive a catch-up vaccine.

Boys and Young Men

Recognizing that HPV infections are often sexually transmitted and likely cause more than half of the cancers of the throat, and other sites, boys between ages 11 and 21 are also advised to be vaccinated.

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