Skin Cancer Information

Information on Skin Cancer:

The types of skin cancer

There are three main types of skin cancer. These are:

  • Basal cell carcinoma,
  • Squamous cell carcinoma, and
  • Malignant melanoma – which is discussed in another section.

Over 75% of skin cancers in the UK are basal cell carcinomas – a cancer of the cells at the bottom of the skin’s outermost layer. The second most common type of skin cancer is called squamous cell carcinoma – a cancer of the outermost skin cells. Malignant melanoma is the rarest of the three types, but has been given its own section because of its differences.

Basal cell carcinomas almost never spread to other parts of the body due to their slow growth, but if they are undetected or left without treatment, they can become ulcerated (often referred to as a rodent ulcer).

Squamous cell carcinomas are more dangerous than basal cell carcinomas in that they are known to spread to other parts of the body. Fortunately, the majority of those that detect this type of cancer early have no re-occurrence of the condition after surgery.

The causes of skin cancer

 Risk factors for skin cancer:

  • Exposure to sunlight (especially for those with fair skin) – Ultraviolet light from the sun is the primary cause of skin cancer in the UK. Sun beds are also thought to increase your risk.
  • Radiotherapy – can cause skin cancers in later life.
  • Carcinogenic chemicals – if you are handling certain chemical substances at work, you should be sure to wear the appropriate protective clothing. Chemicals suspected to be related to skin cancer include petroleum and diesel derivatives, cutting oils, carbon compounds such as coal tar, soot and pitch, paraffin waxes, arsenic, asphalt, creosotes and hair dyes. This list is by no means exhaustive, so please exercise caution.  Visit the environmental risk factors section for other environmental factors.
  • Immunosupressants – drugs used to lower your immunity after organ transplant do increase your skin cancer risk.
  • Hereditary conditions – although considered rare, hereditary factors can also increase your risk.
  • As many as 92% of suntan lotions can also contain ingredients that may be detrimental to your skin, so take a look at our article entitled “Excessive sun exposure or excessive suntan lotion exposure?”

The symptoms of skin cancer

 Skin cancer can appear in different forms. Symptoms to look out for are:

  • A small lump on your skin that can be smooth or waxy in appearance. It may bleed sometimes or develop a crust.
  • A flat red spot which can become scaly or crusty.
  • A firm, red lump.
  • A hard, horny lump that is tender to the touch.

Malignant melanoma has slightly different symptoms. Click here to read about this type of skin cancer.

These symptoms can appear anywhere on your body but are generally found on skin that has been exposed to the sun, such as your face or neck, arms, hands and lower legs.

Although there are similar skin conditions that are not cancerous, you should consult with your doctor if you have any of the above symptoms – particularly if they do not disappear with 2-3 weeks.

Methods of diagnosis

The initial examination is normally carried out by your GP who simply examines the area of skin. If your doctor has any concerns, he or she will normally refer you to a dermatologist for further investigation.

Your dermatologist may advise you to undergo a biopsy to give a definitive diagnosis.

In the case of basal cell carcinoma, after surgical removal there will often be no need for further tests, because this type of cancer rarely spreads beyond the site of origin.

Squamous cell carcinomas, however, are more of a risk – so you are likely to be asked to undergo additional tests to make sure the disease hasn’t spread. These tests can include a physical examination – feeling your lymph glands, a chest x-ray, etc. Your doctor will discuss with you what tests may be necessary.

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Prostate Cancer Information

Information on Prostate Cancer:

Unlike most other types of cancer, prostate cancer is often present in small amounts within the prostate with no ill effects. The difference is that this type of cancer often remains dormant for some time before it develops into something more serious. Approximately 30% of men over 50 years old have cancerous cells within their prostate. These cancerous cells often grow so slowly that they never result in any physical symptoms, but on occasion the cancer can grow rapidly and travel to other parts of the body in the blood stream.

The causes of prostate cancer

 The cause of prostate cancer is not fully understood, but there are a number of risk factors that can influence how likely you are to develop this cancer:

  • Being over 50 years old – very few men under 50 develop this type of cancer,
  • Living on a diet with a high animal fat content,
  • Having relatives who currently have or have previously had prostate cancer,
  • Your ethnic origin may also play a part in your level of risk – for example, Afro-Caribbean men are more likely develop prostate cancer than Asian men.

The symptoms of prostate cancer

 Prostate cancer can present itself with any of the following symptoms:

  • Having difficulty urinating.
  • Needing to urinate more often than usual, especially at night.
  • On rare occasions, having blood in the urine.

The above symptoms are not restricted to prostate cancer, they can also occur in the case of benign prostatic enlargement. However, if you exhibit any of the above symptoms, please consult your doctor immediately. Early detection could save your life.

It is also important to realise that you will only have these detectable symptoms when prostate cancer has become advanced enough to put pressure on the urethra. On some occasions, the first symptoms of an aggressive prostate cancer are aching hips or back, caused by the cancer having spread to the bones.

As with any cancer, early detection is the key to successful treatment. Look out for any symptoms. You may also consider testing on an annual basis, as a measure to detect any abnormal cell growth early.

Methods of diagnosis

 Having reported your symptoms to your GP, the two initial tests for diagnosing prostate cancer are a PSA blood test and a rectal examination to feel for any abnormalities.

The PSA test detects and monitors your level of prostate specific antigen – a substance that is found in your blood, (having been released by your prostate), that increases in the presence of prostate cancer. Unfortunately, this test is not conclusive, because other conditions such as benign prostatic hypertrophy (BPH) can elevate your PSA level – but it is still a good indicator.

If either of these initial tests indicates a potential case of prostate cancer, further tests will have to be carried out at your local hospital. These can include any of the following:

  • Biopsy of the prostate.
  • Cystoscopy – where the doctor examines the urethra and bladder through a telescopic tube to detect any blockages.
  • CT scan or CAT scan.
  • Intravenous urogram.
  • Magnetic Resonance Imaging (MRI or NMR scan).
  • Trans-rectal ultrasound scan.
  • X-rays – to see if there has been any spread of the cancer to other parts of the body, especially the bones.
  • Isotope bone scan – a radioactive substance is injected into a vein and the whole body is scanned to highlight any areas of abnormal bone. Bone scans can detect cancer earlier than conventional X-rays.

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Laboratories That Conduct Cancer-Related Tests

To follow is a list of laboratories that offer a range of diagnostic screening tests to help with the detection and monitoring of various cancers, including :

  • Cancer antigen CA 15-3 – a sensitive blood test that gives an elevated result in the presence of breast cancer.
  • Cancer antigen CA 125 – a blood test that gives an elevated result in the presence of malignancies of the ovary.
  • Prostate specific antigen or PSA – a blood test to help detect prostate cancer.
  • Carcinoembryonic antigen or CEA – a blood test that detects a substance produced by malignant tumours.
  • Cancer antigen CA 19-9 – a blood test detecting a substance found in the serum of many patients with pancreatic, gastro-intestinal and hepatobiliary cancers.
  • Alpha fetoprotein or AFP – a blood test to detect a protein found in elevated levels in the presence of liver cancer, and sometimes in the presence of testicular, ovarian, stomach, or pancreatic cancer.
  • Placental alkaline phosphatase – a blood test to detect a substance that is present in 40-65% of patients with ovarian carcinoma and in up to 10% of other cancer patients.

This list is currently being updated – please contact us with your location to discover how to conduct tests in your country / area.

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Breast Cancer Information

Information on Breast Cancer:

The causes of breast cancer

It is now known that hereditary factors are responsible for a small percentage of the incidences of breast cancer. These are brought about by a faulty gene, which is passed on from one generation to the next. You should contact your doctor if you are concerned about this possibility.

The following factors have been known to indicate the possible presence of the inherited faulty gene, although this is not so in all cases:

Other factors that may slightly increase your risk of breast cancer include:

  • Taking hormone replacement therapy (HRT) for ten years or more,
  • Having no children or having children later in life,
  • Having started your periods at a very young age or going through menopause late,
  • Eating a diet with a high animal fat content.

The symptoms of breast cancer

The vast majority, (as much as 9 out of 10), of breast lumps are benign (non-cancerous) and can be easily treated. Quite often they are the result of cysts – which contain a build up of fluid in the breast tissue, or fibroadenomas – which are solid lumps or tumours made up of glandular and fibrous tissues.

In the vast majority of breast cancer cases, it is often discovered by the patient themselves as a lump in the breast – which just illustrates the value of breast self-examination.

However, in addition to palpable lumps in the breast, there are other signs to look out for:

  •  Breast: Change of shape or size, dimpling of the skin or exhibiting a lump or thickening.
  •  Nipple: Becoming inverted or turned in, exhibiting a lump or thickening, bloodstained discharge (very rare) or rash on nipple or surrounding area (also very rare).
  •  Arm: Swelling in armpit or axilla.

Breast cancer does not normally present itself as pain in your breast. In fact, some types of benign breast lumps can be uncomfortable and a lot of healthy women find their breasts feel lumpy and tender before a period.

Please consult your doctor immediately if you notice a lump in your breast. Even though most lumps are benign, anything unusual should always be examined to rule out the possibility of cancer. It is important to note that the sooner breast cancer is diagnosed, the greater the success rate of treatment.

Methods of diagnosis?

Currently, most breast tumours are initially detected by patients themselves. We cannot emphasise enough the value of breast self-examination and have even included instructions on how to conduct an examination as part of our cancer prevention section. Simply click here to go straight to the breast self-examination instructions.

Those lumps that are not picked up by the patients themselves are sometimes picked up by mammography.

Mammograms, or breast X-rays, can often detect cancer before it can be felt, and this is currently the most common method of screening. Mammograms are available every three years to all women aged 50 to 64 via the NHS, and to women over 64 years old upon request.

Although mammograms expose your breasts to ionising radiation, it is argued that the limited risk of these X-rays actually causing any harm is far outweighed by the benefits of detecting early breast cancer.  However, recent research is calling into question this assertion.

Alternative screening methods that do not involve radiation, such as thermography, (heat sensitive photography), can pick up breast cancer as early as (if not earlier than) mammography and may be a method you should consider.

Remember that mammograms are not 100% accurate, as a small number of breast cancers are not detected by this technique. So if, despite having a mammogram which showed no cancer, you find a lump in your breast, please have it checked by your doctor immediately.

Your doctor will examine you and may refer you to your local hospital where you may undergo additional tests:

  • The taking of your medical / family history,
  • Physical examination – an examination of your breasts, feeling for any enlarged lymph glands under your arms or at the base of your neck.
  • Mammography,
  • Magnetic resonance imaging (MRI or NMR scan),
  • Ultrasound, and
  • Colour doppler – a type of ultrasound that gives a colour picture, showing the blood supply to any detected lumps. This can often be used to distinguish between a malignant and a benign lump.

Further tests to determine the nature of a particular lump include:

  • Needle aspiration,
  • Needle biopsy and
  • Excision biopsy.

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Brain Cancer Information

Information on Brain Cancer:

Types of brain tumour

Brain tumours are categorised by the type of brain cell they developed from and their position within the brain. The symptoms of a particular type of tumour can vary greatly, depending upon which part of the brain it is growing in – as different parts of the brain have different functions.

The main types of malignant and benign brain tumours are discussed below:

Gliomas

Tumours that develop from the supporting cells of the brain (glial cells) are known as gliomas. These are the most common type of brain tumour and account for more than 50% of all primary brain tumours.

Upon diagnosis, gliomas are given a grade (1 to 4) that describes their level of activity and level of abnormality. Low grade tumours (grades 1 and 2 – or I & II) are the least aggressive and may only grow slowly, whereas high grade tumours (grades 3 and 4 – or III & IV) are more aggressive and grow more quickly. Your doctor will adjust your treatment to suit your grade of glioma.

Types of glioma are listed below:

  • Astrocytoma – Developing from cells called astrocytes, astrocytoma is the most common type of glioma. Anaplastic astrocytomas (grade 3 gliomas) and glioblastoma multiforme (grade 4 gliomas) are the most commonly occurring brain tumours in adults.
  • Oligodendroglioma – This type of tumour develops from the cells that produce the fatty covering of nerve cells (the myelin sheath). These tumours grow more slowly than astrocytomas.
  • Ependymoma – On rare occasions, the cells which line the blood vessels of the brain and the central canal of the spinal cord (called ependymal cells) can form tumours known as ependymomas.
  • Mixed glioma – If a tumour is made up of cells from two or more types of glioma they are referred to as a mixed glioma. The most common type of mixed glioma is oligo-astrocytoma.

Acoustic neuroma (schwannoma, neurilemmoma)

Acoustic neuromas develop from schwann cells in the auditory nerve (that transmits the signals necessary for hearing). Acoustic neuromas are benign tumours and are usually found only in adults. The genetic disease neurofibromatosis type II has been linked to this type of tumour.

Central nervous system (CNS) lymphoma

CNS lymphomas are cancers of the lymphatic system that can affect the brain. This type of brain tumour is quite rare.

Haemangioblastoma

Haemangioblastomas are a rare type of tumour that develops from the cells of the blood vessels in the brain. Often taking several years before they cause physical symptoms, these tumours are almost always benign.

Medulloblastoma (or PNET, primitive neuroectodermal tumour)

Medulloblastomas represent more than 25% of all childhood brain tumours. They develop at the back of the brain, in the cerebellum, but can spread to other areas within the brain. Medulloblastomas are much less common in adults.

Meningioma

Most meningiomas are benign, very slow growing and do not tend to spread to other parts of the brain. This type of tumour arises from the meninges, the protective membranes that surround the brain. Meningiomas can develop in virtually any part of the brain or spinal cord. Malignant meningiomas are very rare but meningiomas in general can account for about 15% of all brain tumours and about 25% of all primary spinal cord tumours.

Pineal region tumours

 Pineal tumours only account for about 1% of brain tumours, but account for between 3% and 8% of the intracranial tumours that occur in children. The pineal gland is a part of the brain that is situated below the central division of the two cerebral hemispheres. Types of pineal tumours include germinomas, pineoblastomas, pineocytomas and teratomas – the most common being germinomas.

Pituitary tumours

Pituitary adenomas account for about 10% of brain tumours. Adenomas are benign tumours in the pituitary gland that can result in disturbances of vision or hormone levels. The pituitary gland normally secretes hormones that control the other hormone-producing glands of the body, but when a tumour is present, this process can be disrupted.

Spinal tumours

Spinal tumours often present themselves as muscle weakness and pain in the back, neck and limbs. This can even escalate to loss of bladder or bowel control. This happens because the growing tumour presses on the spinal nerves, affecting their function.

Secondary brain tumours

Cancers that have developed in other parts of the body may spread via the bloodstream or lymphatic system to the brain. When this happens, these additional growths are called secondary brain tumours or metastases.

The causes of malignant brain tumours

Scientists are currently not sure what causes malignant brain tumours, but research is being carried out to help determine the causes.

The symptoms of brain tumours

Brain tumours can lead to a whole range of different symptoms, depending upon which area of the brain is affected. A list of general symptoms has been provided for your information:

  •  Headaches and nausea – These are usually caused by raised pressure within the brain as the tumour grows. This is likely to be worse when you cough, sneeze, bend down or do anything strenuous.
  • The onset of epilepsy – which can cause fits, muscle spasms or periods of unconsciousness.
  • Unsteadiness or an uncoordinated walk.
  • Difficulty in organising certain movements.
  • Numbness or weakness in one side of the body.
  • Neck stiffness.
  • Facial weakness, such as a one-sided smile or a drooping eyelid.
  • Flickering involuntary movements of the eyes.
  • Double vision or a loss of vision on one side.
  • Loss of sense of smell.
  • Difficulty in speaking or swallowing.
  • Difficulty in expressing or understanding words, and problems with reading or writing.
  • Changes in personality and intellect.
  • Experiencing strange sensations such as regular deja vu, strange smells, a feeling of fear, or even blackouts.

Some of the above symptoms can also be caused by other medical conditions. However, if you are experiencing any of the above it is important that you consult your doctor immediately.

Methods of diagnosis

Having taken your medical history and conducted a physical examination, your doctor may want you to undergo a series of tests to assess your nervous system. These tests may include:

  • Comparing the strength of your limbs,
  • An eye examination.
  • A facial muscle test
  • Hearing tests.
  • Mental exercises.
  • Checking your tongue movement, ability to swallow, etc.
  • Test of your reflexes.
  • Testing your ability to distinguish between hot and cold, to feel pin-pricks, etc.

If the doctor still feels that further tests are necessary to give a definitive diagnosis, the following techniques may be used:

  • Angiogram or arteriogram – An angiogram uses an injection of dye (which shows up on x-ray) to make the blood vessels of your brain visible on a series of x-rays. If there is a tumour present, this will help to determine its location and blood supply.
  • Biopsy.
  • Chest X-ray – to look for a possible primary tumour.
  • CT (CAT) Scan.
  • Electroencephalogram (EEG) – An EEG measures the electrical activity within the brain using wires that are placed against your head using small disks held on by a conductive gel. The resulting print-out of brain waves from the EEG machine can be examined for abnormal patterns.
  • Head X-ray.
  • Magnetic resonance imaging (MRI scan).
  • Positron emission tomography (PET) scan – This technique can help determine how active a tumour is and whether it is malignant or benign. Having received an injection of glucose (along with a small amount of radioactive marker) you will be scanned to provide a picture of brain activity. Tumours will show up as an abnormal area on the scan.

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Bowel Cancer / Colorectal Cancer Information

Information on Bowel Cancer and Cancer of the Colon and Rectum:

The cause of bowel cancer

It is thought that a high incidence of bowel cancer can be linked to our diet. A diet that is low in fibre and high in animal fat and protein is likely to increase the risk of developing bowel cancer quite considerably.

With diet being one of the largest preventable causes of cancer in the UK, we have included a number of hints and tips (and cancer-fighting dietary supplements) in our cancer prevention section.

After diet, hereditary factors can also be linked to an increased risk. A family history of bowel cancer is a major factor, but also rare conditions such as familial adenomatous polyposis, (where benign tumours called polyps are found in the lining of the colon), can increase your risk of developing bowel cancer.

Other conditions such as ulcerative colitis – a disease of the lining of the bowel, can also increase your risk, if persistent.

The symptoms of bowel cancer

The symptoms of cancer of the large bowel may include any of the following:

  • blood in the faeces (bowel motion) – sometimes seen as black stools,
  • persistent constipation or diarrhoea,
  • weight loss,
  • pain in the abdomen or back passage.

If the cancer is causing, or beginning to cause, a blockage in the bowel, you may experience:

  • sickness,
  • constipation,
  • pain and a bloated feeling in the abdomen.

These symptoms are also signs of other medical conditions, but nevertheless, it is still important that your doctor evaluate your condition as soon as possible.

Methods of diagnosis

Initial examination often involves a rectal examination to detect any abnormalities. This may also be accompanied by a faecal occult blood test – where you are asked to take a sample of your stool to the GP surgery or hospital so that it can be tested for the presence of blood.

Where further examination is required, the following tests are common:

  • Barium enema – This is where an X-ray of the bowel is taken with the aid of barium – a substance which shows up clearly on the x-ray.
  • Colonoscopy – A process that allows your doctor to visually examine the whole length of the large bowel using a flexible tube called a colonoscope. If there are any suspect areas, your doctor can take biopsies during the procedure.
  • Proctoscopy or Sigmoidoscopy – these tests are similar to the colonoscopy but use different tools to examine different areas. A proctoscope is a short tube which just goes into the rectum whilst a sigmoidoscope is a longer tube which can be passed further up into the large bowel. Again, a biopsy can be taken where necessary.

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Bladder Cancer Information

Information on Bladder Cancer:

Types of bladder cancer

The vast majority of bladder cancers begin in the lining of the bladder, or urothelium. Urothelial cell cancers come in many different forms, ranging from large growths in the wall of the bladder, which require major surgery, to small growths on the inside of the bladder, which can be successfully removed during a simple operation.

Many bladder cancers (known as superficial or papillary tumours) grow on the inside lining of the bladder. These have the appearance of small mushrooms, with the stalk attached to the lining of the bladder. If left untreated, they can spread into the wall of the bladder, making the condition harder to treat.

Those tumours that do spread into the wall of the bladder are known as invasive tumours.

The causes of bladder cancer

A number of factors are known to increase the risk of developing bladder cancer. In the UK, cigarette smoking is a primary factor. This is due to the fact that harmful chemicals (that are known to cause bladder cancer) are present in cigarette smoke.

Other factors include exposure to harmful chemicals at work, including those used in plastics and other chemical industries such as dye factories. These chemicals have been banned in the UK since the mid-seventies, but it can take up to 25 years for bladder cancers to develop as a result of such exposure. If you think that you were exposed to certain harmful chemicals through your workplace, discuss this with your doctor. You could be entitled to claim industrial disease benefit from the department of social security.

Infections or bladder stones that bring about repeated bouts of cystitis, are thought to be another factor leading to the development of bladder cancer.

Hereditary factors may also play a part on rare occasions. It is thought that this is due to an inherited faulty gene.

Bladder cancer occurs mainly in people over 50 years old and studies have shown that it is twice as common in men as it is in women.

The symptoms of bladder cancer

Bladder cancer often initially presents itself in the form of blood in the urine, which is known as haematuria. This generally is not painful and can come and go – although the underlying problem remains. On occasion, this can lead to painful muscle spasms in the bladder due to the formation of blood clots.

You should consult your doctor as a matter of priority if you do see any blood in your urine. Although this can often be attributable to other conditions such as kidney or bladder stones, it is important to let your doctor determine the cause so that you can receive treatment.

The need to pass urine regularly and a burning sensation are often found in many other conditions where the bladder is irritated – which of course is most commonly due to an infection rather than bladder cancer.

However, if these feelings do not go away having received antibiotics from your doctor, then additional diagnostic tests will be necessary.

Methods of diagnosis

The initial stages of diagnosis involve a physical examination and the provision of a urine sample, which is sent to the laboratory to be checked for cancer cells under a microscope.

The physical examination is likely to include a rectal examination for both men and women and an internal examination of the birth canal in women.

Your doctor may also refer you to your local hospital to undergo additional tests such as blood tests (to check your health, blood count and kidney function), and cytoscopy, (whereby a small fibre-optic telescope is used to visually examine the lining of the urethra and bladder).

If the cytoscopy reveals any abnormalities, you may be asked to undergo an intravenous urogram or IVU or even a biopsy.

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Early Detection

The National Cancer Intelligence Network (NCIN) recently announced that 24% of people who are diagnosed with cancer in the UK are only diagnosed as a result of a visit to accident and emergency wards.  In patients aged 70 or over, 31% of cancer diagnosis happen via emergency admission.

The research, published in the British Journal of Cancer, examined more than 730,000 cancer patients between 2006 and 2008.

This really illustrates the weaknesses we currently have in early detection.

Clearly, prevention is where our efforts can be most effectively focused, as 85% of cancers are preventable, but early diagnosis comes a very close second, when it comes to improving outcomes.

Numerous studies indicate that early detection dramatically improves the success rate of treatment.  So whilst the natural inclination is to “bury your head in the sand” and ignore the issue, this is not in your best interests.

Take a look at the early cancer detection articles below to learn more:

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